Table 2.

Randomized trials of rATG (Thymoglobulin^®) induction therapy in kidney transplant patients using contemporary dosing regimens (cumulative dose (≤7.5 mg/kg)

Study (year)	N	Immunological risk status	rATG regimen	Comparator group/s	Maintenance immunosuppression	Follow-up	Treatment group	Patient survival (%)	Graft survival (%)	Acute rejection (%)a
rATG vs. IL-2RA induction
Brennan et al. (2006) [24]	278	High	Total dose 7.5 mg/kg/day (days 0–4)	Basiliximab	CsA by day 4 MMF Steroids	12 months	rATG	95.7	90.8	15.6
							IL-2RA	95.6	89.8	25.5
							p-Value	0.90	0.68	0.02 b
Ciancio et al. (2005) [92]	60	Low	Total dose 7.0 mg/kg/day (days 0–7)	Daclizumab	Tacrolimus MMF Steroids	Median 15 months	rATG	92	88	16.6
							IL-2RA	88	88	16.6
							p-Value	NS	NS	0.99
Abou-Ayache et al. (2008) [93]	109	Low	1.0–1.5 mg/kg 4–9 infusions	Daclizumab	Delayed CsA MMF Steroids	12 months	rATG	98	95	14.5
							IL-2RA	98	94	16.7
							p-Value	NS	NS	NS
Mourad et al. (2004) [72]	105	Low	1.0 mg/kg Mean 5.4 infusions	Basiliximab	Delayed CsA MMF Steroids	12 months	rATG	98.1	96.2	9.4
							IL-2RA	98.1	94.2	9.6
							p-Value	NS	NS	NS
Steroid-sparing vs. standard steroid regimen				Steroid regimen
Woodle et al. (2009) [94]	151	Low	Total dose 5–6 mg/kg	Steroid withdrawal by day 8	Tacrolimus MMF	12 months	Withdrawal	98.9	98.9	13.9
							Standard	100	100	19.4
							p-Value	NS	NS	NS
CNI-free vs. standard CNI regimens				CNI regimen
Glotz et al. (2010) [48]	141	Standard	1.25–1.5 mg/kg 4 dosesc	CNI free	Sirolimus MMF Steroids	12 months	CNI free	95.8	85.9	16.9
				Tacrolimus	MMF Steroids		CNI	97.1	95.7	12.9
							p-Value	NS	0.044	NS
Büchler et al. (2007) [49]	145	Standard	Total dose 7.5 mg/kg/day (days 0–4)	CNI free	MMF Steroids (to month 6)	12 months	CNI free	97	90	14.3
				CsA	MMF Steroids (to month 6)		CNI	97	93	8.6
							p-Value	NS	NS	0.30
Larson et al. (2006) [50]	165	Standard	Total dose 7.5 mg/kg/day (days 0–4)	Sirolimus	Sirolimus MMF Steroids	12 months	CNI free	98	94	19
				Tacrolimus	MMF Steroids		CNI	96	92	14
							p-Value	NS	NS	NS
Lo et al. (2004) [51]	70	High	Total dose 4.5–10.5 mg/kg	CNI free	Sirolimus MMF Steroids	12 months	CNI free	100	89	7
				Low CNI	Sirolimus Reduced tacrolimus Steroids		Low CNI	98	80	10
							p-Value	NS	NS	NS

Significant p-values are shown in bold

CNI calcineurin inhibitor, CsA cyclosporine, DGF delayed graft function, IL-2RA interleukin-2 receptor antagonist, MMF mycophenolate mofetil, NS not significant, rATG rabbit antithymocyte globulin

^aOr biopsy-proven acute rejection

^bSteroid-resistant acute rejection: 1.4 % with Thymoglobulin^®, 8.0 % with IL-2RA induction (p = 0.005)

^cOnly given to tacrolimus-treated patients in the event of DGF