Prospective randomized trial comparing two doses of rabbit anti‐thymocyte globulin in patients with severe aplastic anaemia
Open Access
- 17 June 2019
- journal article
- research article
- Published by Wiley in British Journal of Haematology
- Vol. 187 (2) , 227-237
Abstract
Summary: The treatment of choice for patients with severe aplastic anaemia (SAA) includes immunosuppressive therapy (IST) with anti‐thymocyte globulin (ATG) and ciclosporin A. However, the optimal dose for rabbit ATG has yet to be established. We herein report the first prospective, randomized, multicentre study comparing two doses of rabbit ATG in patients with SAA. Patients with SAA who required initial IST in Japan (n = 89), China (n = 85) and Korea (n = 48) were enrolled between May 2012 and October 2017. A 1:1 block randomization was employed for two doses of rabbit ATG. In total, 222 patients were randomized, with 112 patients receiving 2·5 mg/kg and 110 receiving 3·5 mg/kg of rabbit ATG for 5 days. The primary endpoint was the haematological response at day 180. After 6 months, no significant difference in response rates was observed between the 2·5 and 3·5 mg/kg groups (49% vs. 48%, P = 0·894). Overall survival at 3 years was similar between the two groups [85% (95% confidence interval [CI], 76%−91%) vs. 91% (95% CI, 82%−96%); P = 0·107]. The current study revealed no significant differences in the efficacy and safety between the 2·5 and 3·5 mg/kg doses of rabbit ATG in patients with SAA.Trial registration: UMIN000011134.Keywords
Funding Information
- Sanofi
This publication has 30 references indexed in Scilit:
- Rabbit antithymocyte globulin dose does not affect response or survival as first-line therapy for acquired aplastic anemia: a multicenter retrospective studyAnnals of Hematology, 2018
- First line treatment of aplastic anemia with thymoglobuline in Europe and Asia: Outcome of 955 patients treated 2001‐2012American Journal of Hematology, 2018
- Horse versus rabbit antithymocyte globulin in immunosuppressive therapy of treatment-naïve aplastic anemia: a systematic review and meta-analysisAnnals of Hematology, 2017
- Predictors of early mortality after rabbit antithymocyte globulin as first-line treatment in severe aplastic anemiaAnnals of Hematology, 2017
- Rabbit antithymocyte globulin versus horse antithymocyte globulin for treatment of acquired aplastic anemia: a retrospective analysisAnnals of Hematology, 2015
- Effectiveness and safety of rabbit anti-thymocyte globulin in Japanese patients with aplastic anemiaInternational Journal of Hematology, 2013
- The efficacy of rabbit antithymocyte globulin with cyclosporine in comparison to horse antithymocyte globulin as a first-line treatment in adult patients with severe aplastic anemia: a single-center retrospective studyAnnals of Hematology, 2013
- Rabbit-antithymocyte globulin combined with cyclosporin A as a first-line therapy: improved, effective, and safe for children with acquired severe aplastic anemiaJournal of Cancer Research and Clinical Oncology, 2012
- The Third Consensus Conference on the treatment of aplastic anemiaInternational Journal of Hematology, 2011
- Comparison between horse and rabbit antithymocyte globulin as first-line treatment for patients with severe aplastic anemia: a single-center retrospective studyAnnals of Hematology, 2010