How many times is Basiliximab (Simulect) used after kidney transplantation?

From the Guidelines

Basiliximab is typically administered as a two-dose regimen for kidney transplant recipients, with the first dose given within 2 hours before transplantation surgery and the second dose administered 4 days after the transplant. This medication is an interleukin-2 receptor antagonist that works by blocking the activation of T-lymphocytes, which play a key role in organ rejection. The two-dose regimen provides sufficient immunosuppression during the critical early post-transplant period when the risk of acute rejection is highest.

Key Points

• Basiliximab is used as part of an immunosuppressive regimen that typically includes calcineurin inhibitors (like tacrolimus or cyclosporine) and corticosteroids 1.
• It's essential to note that basiliximab is only used for induction therapy and is not continued as maintenance immunosuppression.
• The medication is administered as an intravenous infusion over 20-30 minutes and should be given under medical supervision.
• According to the provided evidence, there is no direct information on the use of basiliximab in kidney transplantation in the study from 2024 1, but the study from 2016 1 provides information on the use of basiliximab in liver transplantation, which can be applied to kidney transplantation.

Administration and Dosage

• The first dose of basiliximab (20 mg) is given within 2 hours before transplantation surgery.
• The second dose (20 mg) is administered 4 days after the transplant.
• The two-dose regimen is sufficient for induction therapy, and basiliximab is not continued as maintenance immunosuppression.

Importance of Medical Supervision

• Basiliximab should be administered under medical supervision due to the potential risks and side effects associated with the medication.
• Medical supervision ensures that the patient receives the correct dosage and that any potential side effects are promptly addressed.

From the FDA Drug Label

Adults In adult patients, the recommended regimen is two doses of 20 mg each. The first 20-mg dose should be given within 2 hours prior to transplantation surgery. The recommended second 20-mg dose should be given 4 days after transplantation

• Basiliximab (Simulect) is used twice after kidney transplantation, with the first dose given within 2 hours prior to transplantation surgery and the second dose given 4 days after transplantation 2.
• The dosage may vary for pediatric patients, but for adults, the standard regimen consists of two 20-mg doses.
• It is essential to note that the second dose should be withheld if complications, such as severe hypersensitivity reactions to Simulect or graft loss, occur.

From the Research

Basiliximab (Simulect) Usage After Kidney Transplantation

• Basiliximab (Simulect) is typically used in two doses after kidney transplantation, with the first dose administered 2 hours before transplantation and the second dose on day 4 posttransplant 3, 4, 5, 6, 7.
• The two-dose regimen provides suppression of the interleukin-2 receptor for up to 45 days, reducing the rate of acute rejection in kidney transplantation 3.
• Some studies suggest that a single dose of Simulect may be equally effective as the recommended two doses, with significant cost reduction 3.
• The standard dosage of basiliximab is 20 mg intravenously per dose, given at the time of transplantation and 4 days later 6.

Administration and Efficacy

• Basiliximab induction therapy is given at days 0 and 4 after transplantation, and appears to be safe and cost-effective for immunoprophylaxis in solid organ transplant recipients 5.
• Randomized controlled trials have shown that basiliximab can significantly reduce the incidence of acute rejection without increasing the risk of adverse events 6.
• Basiliximab has been used effectively in high-risk recipients, steroid-sparing and steroid-minimization protocols, and in post-transplant patients with renal dysfunction 5.

Safety and Tolerability

• Basiliximab has a tolerability profile similar to that reported with placebo, and better than that reported with rabbit-derived antithymocyte globulin (RATG) 4.
• No serious safety problems related to basiliximab have been reported, and it has not demonstrated increased incidence of malignancy, infections, or death 5, 6.