Current evidence and insights on single vs. double dose of basiliximab in adult solid organ transplant recipients: A systematic review.

Abstract

Aim: The aim of this systematic review was to assess all available clinical data regarding the use of a single dose of basiliximab in solid organ transplantation compared to the standard double dosage, with particular interest in efficacy, safety and cost-savings.

Methodology: A systematic review was performed following PRISMA guidelines by searching PubMed, Web of Science, Ovid MEDLINE and Google Scholar for studies from 2000 to 2024 evaluating single-dose basiliximab in adult transplant recipients. Screening was based on PICOS criteria and MeSH terms. After removing duplicates and applying filters (English, full text, adults, clinical trials and observational studies), three eligible studies were included. Risk of bias was assessed using the ROBINS-I-V2 tool.

Results: All three included studies demonstrated comparable outcomes between single and double-dose basiliximab regimens. Acute cellular rejection ranged from 4.3% to 12.3%, and graft loss occurred in 0% to 2.9% of patients. Patient survival remained elevated across studies, ranging from 95.6% to 100%. Concerning safety, no major differences were reported in overall infection rates or hospital readmissions. Cost-savings favoured the single-dose regimen across all studies. Reported per-patient savings ranged from approximately US$2100 to US$4400, with institutional savings up to US$697864.

Conclusion: A single dose of basiliximab can be a reasonable and cost-saving option, with comparable efficacy and safety, reducing drug expenses. This change in the maintenance regimen suggests that the initial induction therapy can be slightly reduced without affecting efficacy, as supported by the reviewed studies, which is promising for future research.