Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Kidney transplant drug halves the early risk of rejection and allows less toxic treatment

28.07.2014

Oxford University scientists have shown that a powerful drug given at the time of a kidney transplant operation not only halves the early risk of rejection, but that it also allows a less toxic regimen of anti-rejection drugs to be used after the operation.

The key results are reported in The Lancet and presented at the World Transplant Congress in San Francisco today. They will help doctors faced with a difficult transplant conundrum: the powerful combinations of treatments used to prevent early kidney rejection may cause kidney damage later and may subsequently be a cause of transplant failure.

One of the main culprits is a class of drugs known as calcineurin inhibitors. These drugs are very effective at preventing rejection in the first weeks and months after a transplant, but their lasting effects can have serious consequences for the kidney later on.

Kidney transplantation is still the best treatment for patients with kidney failure, but much more subtle approaches are needed if success rates are to be improved.

Around 15,000 people undergo transplant in the USA every year and 2,000 in the UK. Patients need to take drugs to suppress their immune system in order to reduce the chances that it will 'reject' the new kidney. It is a risky procedure since disabling the immune system in this way can lead to an increased number of infections and cancer.

The 3C study (Campath, Calcineurin inhibitor reduction and Chronic allograft nephropathy) tested whether alemtuzumab (Campath; an anti-rejection treatment) partnered with low dose tacrolimus (a calcineurin inhibitor) could reduce transplant rejection when compared with existing treatment.

The study recruited 852 patients who underwent kidney transplantation in the UK between 2010 and 2013.

'Our primary aim was to find out whether alemtuzumab-based induction therapy would produce worthwhile reductions in acute rejection,' explained Chief Investigator Professor Peter Friend, from Oxford University's Nuffield Department of Surgical Sciences, 'but we also wanted to see whether we could use it with a lower dose of tacrolimus, because there is some evidence that tacrolimus contributes to long-term transplant failure.'

Among those allocated alemtuzumab-based induction therapy, 7.3% experienced acute rejection compared to 16.0% of those allocated basiliximab-based induction therapy – a halving in the risk of early rejection.

'These are important findings which we hope will guide treatments in the future,' said Professor Friend.

Although alemtuzumab has been available for many years, its use has been limited by concerns about possible side effects, in particular infections.

But no overall excess in serious side effects – such as infections and cancer – was found in patients on the treatment, the scientists report.

Medical Research Council-funded researcher, Dr Richard Haynes of the Clinical Trial Service Unit at Oxford University, said: 'The safety data from the 3C Study are reassuring. There was no overall excess risk of infections or other known complications of immunosuppression.'

Medical Research Council scientist Professor Colin Baigent, one of the other lead investigators, said: 'These results from the first 6 months of the 3C Study demonstrate the importance of large randomized trials in transplantation. The planned long-term follow-up of the 3C Study will provide a unique opportunity to investigate whether these differences in short-term outcomes translate into improvements in the long-term which will be of great interest to patients and their doctors.'

Dr Richard Haynes expressed his gratitude to all of the participants in the study: 'Without their help we would not have been able to make this progress towards improving the care of people who receive kidney transplants,' he said.

Prof James Neuberger, Associate Medical Director at NHS Blood and Transplant, said: 'NHS Blood and Transplant is delighted to be supporting this multi-centre UK study into the immunosuppression treatment of patients who have received a kidney transplant. We would like to congratulate the investigators on the good outcomes they are reporting and we hope these results will be sustained in the long term. Improving outcomes for patients and their families, will help us to achieve our aim to make every donation count and enable even more patients receive the transplants they need.'

###

Alemtuzumab-based induction treatment versus basiliximab-based induction treatment in kidney transplantation (the 3C Study): a randomised trial, published in The Lancet online, July 28, 2014 http://dx.doi.org/10.1016/S0140-6736(14)61095-3

Alemtuzumab is a lymphocyte-depleting agent (ie, it removes one type of white cell which is central to 'rejection' of transplanted organs – called lymphocytes – from the patient) unlike more commonly used treatments like basiliximab which block lymphocyte activation.

The 3C Study was funded by a research grant from the National Health Service Blood and Transplant (UK) and by grants from Novartis Pharmaceuticals UK and Pfizer. The study was designed, conducted, analysed and interpreted independently by the investigators at Oxford University and by the independent members of the study Steering Committee. The study was coordinated by the Oxford University Clinical Trial Service Unit (CTSU) which is funded by the Medical Research Council, British Heart Foundation and Cancer Research UK.

Andrew Trehearne | Eurek Alert!
Further information:
http://www.ox.ac.uk

Further reports about: drugs failure infections investigators rejection tacrolimus therapy toxic transplant treatments

More articles from Health and Medicine:

nachricht Finnish research group discovers a new immune system regulator
23.02.2018 | University of Turku

nachricht Minimising risks of transplants
22.02.2018 | Friedrich-Alexander-Universität Erlangen-Nürnberg

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Attoseconds break into atomic interior

A newly developed laser technology has enabled physicists in the Laboratory for Attosecond Physics (jointly run by LMU Munich and the Max Planck Institute of Quantum Optics) to generate attosecond bursts of high-energy photons of unprecedented intensity. This has made it possible to observe the interaction of multiple photons in a single such pulse with electrons in the inner orbital shell of an atom.

In order to observe the ultrafast electron motion in the inner shells of atoms with short light pulses, the pulses must not only be ultrashort, but very...

Im Focus: Good vibrations feel the force

A group of researchers led by Andrea Cavalleri at the Max Planck Institute for Structure and Dynamics of Matter (MPSD) in Hamburg has demonstrated a new method enabling precise measurements of the interatomic forces that hold crystalline solids together. The paper Probing the Interatomic Potential of Solids by Strong-Field Nonlinear Phononics, published online in Nature, explains how a terahertz-frequency laser pulse can drive very large deformations of the crystal.

By measuring the highly unusual atomic trajectories under extreme electromagnetic transients, the MPSD group could reconstruct how rigid the atomic bonds are...

Im Focus: Developing reliable quantum computers

International research team makes important step on the path to solving certification problems

Quantum computers may one day solve algorithmic problems which even the biggest supercomputers today can’t manage. But how do you test a quantum computer to...

Im Focus: In best circles: First integrated circuit from self-assembled polymer

For the first time, a team of researchers at the Max-Planck Institute (MPI) for Polymer Research in Mainz, Germany, has succeeded in making an integrated circuit (IC) from just a monolayer of a semiconducting polymer via a bottom-up, self-assembly approach.

In the self-assembly process, the semiconducting polymer arranges itself into an ordered monolayer in a transistor. The transistors are binary switches used...

Im Focus: Demonstration of a single molecule piezoelectric effect

Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale

Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

2nd International Conference on High Temperature Shape Memory Alloys (HTSMAs)

15.02.2018 | Event News

Aachen DC Grid Summit 2018

13.02.2018 | Event News

How Global Climate Policy Can Learn from the Energy Transition

12.02.2018 | Event News

 
Latest News

Basque researchers turn light upside down

23.02.2018 | Physics and Astronomy

Finnish research group discovers a new immune system regulator

23.02.2018 | Health and Medicine

Attoseconds break into atomic interior

23.02.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>