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Cardiovascular side effects after renal allograft rejection therapy with Orthoclone: prevention with nitrendipine
C Spieker1, W Zidek, M Barenbrock
1Medizinische Poliklinik, Westfälischen Wilhelms-Universität, Münster, F.R.G.
Abstract:
Orthoclone (OKT-3), a monoclonal antibody, is an effective immunosuppressant in organ graft recipients. One of the reported side effects is serious pulmonary edema, heart failure, hyperdynamia, and elevation of blood pressure. It should be assessed whether patients treated with OKT-3 benefit from antihypertensive therapy with a calcium channel blocker before and during the allograft rejection therapy to prevent from cardiovascular side effects. To assess a preventive cardiovascular effect of therapy with nitrendipine before and during the OKT-3 rejection therapy, the patients studied (n = 28) were randomly allocated to two study groups. Group a without nitrendipine comprised 15 patients, and group b with 2 x 10 mg of nitrendipine daily comprised 13 patients. In study group a (without nitrendipine therapy), in 8 of 15 patients, there was a short-lasting increase in blood pressure during 3 h after the first injection of OKT-3 by 20.0 +/- 12.8 (systolic)/10.1 +/- 6.7 (diastolic) mm Hg. Whereas this initial rise of blood pressure on the first day was accompanied by an increase in heart rate by 24.1 +/- 10.8 beats/min, the longer-lasting increase in blood pressure at day 2 was not associated with significant changes in heart rate. In group b (patients receiving 2 x 10 mg of nitrendipine before OKT-3 therapy was started and during the whole treatment course), in 3 of 13 patients, a short increase in blood pressure (13.7 +/- 2.9/7.8 +/- 5.1 mm Hg) was recorded 5 h after the first dose of OKT-3.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
Orthoclone (OKT-3) can cause cardiovascular side effects like increased blood pressure. Nitrendipine may help prevent these side effects in organ transplant recipients receiving OKT-3 therapy.
Area of Science:
- Nephrology
- Immunology
- Cardiology
Background:
- Orthoclone (OKT-3) is a monoclonal antibody used as an immunosuppressant in organ graft recipients.
- Cardiovascular side effects, including hypertension, are associated with OKT-3 therapy.
Purpose of the Study:
- To evaluate the preventive cardiovascular effect of nitrendipine, a calcium channel blocker, in patients treated with OKT-3.
- To assess if antihypertensive therapy with nitrendipine can mitigate cardiovascular side effects during allograft rejection therapy.
Main Methods:
- A randomized study involving 28 patients undergoing OKT-3 therapy.
- Patients were divided into two groups: one receiving nitrendipine (20 mg daily) before and during OKT-3 treatment, and a control group without nitrendipine.
- Blood pressure and heart rate were monitored after OKT-3 administration.
Main Results:
- In the group without nitrendipine, 8 of 15 patients experienced a significant increase in blood pressure and heart rate after the first OKT-3 injection.
- In the group receiving nitrendipine, only 3 of 13 patients showed a minor increase in blood pressure after OKT-3.
- The initial rise in blood pressure in the control group was accompanied by increased heart rate, which was not observed in the nitrendipine group.
Conclusions:
- Nitrendipine therapy appears to reduce the incidence and severity of acute blood pressure elevation associated with OKT-3 administration.
- Calcium channel blockers like nitrendipine may be beneficial in preventing cardiovascular side effects in organ transplant recipients treated with OKT-3.