July 6, 2009

A Randomized, Doubleblind, Placebo-Controlled, Study of Single-Dose Rituximab as Induction in Renal Transplantation


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This  is the first RCT assessing the effect of rituximab compared to no induction therapy in patients receiving tacrolimus, mycophenolate mofetil and steroids. Rituximab durably depleted B cells. There was no increase in the incidence of infections with rituximab but also did not reduce the incidence of acute rejection or lead to improved graft function.

Renal Transplantation

  • http://HeadOfNephrology,KingfahdSpecialistHospitalDammam,SaudiArabia Imran Zahid M.D Consultant Nephrologist

    The study is well done though does not introduce any new induction treatment. The primary end point did not show any increase in rejection or in other words did not show non inferiority of Riruximab to other existing agents. There was no evidence for increase in incidence of infection after induction. The transplantation area has been lacking new medicine which can address the induction of tolerance. Most immunosuppressive only target early phases of T cells activation, preventing them from producing cytokines required for their proliferation. It remains to be seen where monoclonal antibodies used for induction can promote tolerance rather destroying the regulatory mechanism important for the tolerance.