One-year outcomes in simultaneous kidney–pancreas transplant recipients receiving an alternative dosing regimen of daclizumab

Abstract

The purpose of this study was to compare the safety and efficacy of two dosing regimen of daclizumab with no-antibody induction in simultaneous kidney–pancreas transplant (SKPT) recipients receiving tacrolimus, mycophenolate mofetil, and steroids. Methods A total of 297 SKPT patients were enrolled into this prospective, multicenter, randomized, open-label study. The patients were randomized into three groups: daclizumab 1 mg/kg/dose every 14 days for five doses (group I, n = 107), daclizumab 2 mg/kg/dose every 14 days for two doses (group II, n = 112), and no-antibody induction (group III, n = 78). Results There were no differences in baseline characteristics among the three groups, except for a higher proportion of African-Americans in group II. The incidence of composite events (acute rejection, graft loss, or death) at 1 year was 36.4%, 32.7%, and 48.7% for groups I, II, and III, respectively ( P < .05, group II vs group III). The incidence of acute rejection was highest in group III (34.6%) compared to groups I and II (22.4% and 22.1%, respectively, P < .05). The mean time to acute rejection was delayed in group II (96 days) compared to 23 days in group I and 20 days in group III ( P < .05). The adverse-event profiles were comparable among the three groups, except for a higher incidence of infection and readmissions in group III. Conclusions Daclizumab was safe and effective in reducing the incidence of acute rejection when compared to no induction. The alternative two-dose regimen of daclizumab was as effective as the conventional five-dose regimen and is logistically more desirable.