Has Anyone been treated with Zenapax?

[willieandwinnie]

I'm always asking you guys questions, aren't I?

My husbands coordinator just called and moved this weeks appointment to next week and said she wanted to give him another IV dose of Zenapax. This scares the crap out of me because back in October when he had it, I was only home about 2 hours when I had to call 911. He was doubled over in pain and vomiting. Has anybody here had this and had any side effects? The coordinator said she doesn't think it was the drug. DUH!  I can read. Maybe because he already has so many internal problems this drug just magnifies it? Does that make sense? I'm getting frustrated. Thanks for your help again.

[okarol]

Was this something you agreed to pre-transplant?

From what I read Zenapax is still in clinical trials - so I am not clear why they would give it to your hubby since he's had other complications.

Just my opinion, of course, but unless there's a reason to believe he isn't doing well on his existing immunosuppressants, why are they giving him this?

You may want to read here http://www.rxlist.com/cgi/generic/zenapax_ad.htm - or maybe you already have.

It's confusing to me.

[okarol]

I also found this information - http://health.yahoo.com/alternativemed-overview/daclizumab/healthwise--d04262a1.html - hope it helps.

[willieandwinnie]

Len had Zenapax given at time of transplant and then again at 6 weeks post transplant and they want to give it again at 12 weeks. I'm going to call the coordinator tomorrow and have her ask the transplant surgeon about it. Len is only taking 1 mg of prograf twice a day. Maybe that's why they want to give it again. This is one of the bad things about having transplant at a teaching hospital.

okarol, thanks for the yahoo site. I had not read that one.

[Roxy]

You may want to talk to the transplant surgeon directly. I have had a few experiences even with the transplant coordinators i like and trust, that information sometimes gets twisted in the mix of relaying it to patients. 

[pelagia]

Thanks to willieandwinnie for sending me to this thread for more information on Zenapax.  (I had mentioned Zenapax in another thread and had indicated that I didn't know much about it.)  I previously posted a bit of text from the site below and I'm posting the link here in case someone comes across this thread and is looking for additional information.

http://en.wikipedia.org/wiki/Daclizumab

Despite all the warnings of possible side effects (which I think is true for many of the drugs transplant patients take), my husband didn't have any side effects after receiving his transfusions on day 0, 6 and approx. 3 weeks.  He's just about 5 weeks post transplant and all is well so far.  He is also taking prograf, cellcept and prednisone.

[pelagia]

Here's an interesting article from the Mercury News (CA) about the use of daclizumab (Zenapax) to reduce or eliminate steroids after transplants in kids:

http://www.mercurynews.com/valley/ci_9511480

Here are a few excerpts:

"The decade-long study, based at Lucile Packard Children's Hospital, represents the largest and longest study of this treatment in pediatric transplant patients. Funded by the National Institutes of Health, it received additional support from the companies that make the drugs used in both steroid and non-steroid treatments.

The NIH is now conducting an $8 million trial of the steroid-free treatment in children at 12 centers nationwide.

Sarwal and Stanford biostatistician Dr. Li Li compared 123 children with kidney transplants who did not receive steroids with 111 age-matched, transplanted peers who received the standard steroid-based treatment. Following each child for up to eight years, they found that those undergoing the steroid-free treatment were significantly less likely than their peers to undergo acute rejection.

Their physical development also improved. Many of the steroid-free patients caught up and surpassed their peers in height within a few years. Steroid-free children were also less likely to have high blood pressure or weight gain.

Sarwal was inspired by data showing success in adults. But because young people can experience stronger rejection episodes, her team was apprehensive about testing daclizumab, a monoclonal antibody, in children."

[willieandwinnie]

Great article pelagia  . Our transplant coordinator told me she has an article on Zenapax to give me Wednesday. I wonder if this is the one, our transplant hospital is only a couple of miles from the National Institute of Health and our transplant hospital is also a teaching hospital and they have all kinds of studies going on. There are big boards in the waiting rooms that list some of them and ask for people to sign up to participate. Len had to sign papers at the time of transplant to be part of the Zenapax study. Thanks for the information.

[spacezombie]

My aftercare info sheet given to me by the hospital lists Zenapax on it but they have not yet scheduled the infusion. I'll ask them about it on Tuesday at my clinic visit. Hopefully, I will not have a bad reaction to it. I had a little trouble with my blood pressure after IVIG.  I'd be more inclined to argue against getting this medication, but since I had a slight problem with rejection after transplant I feel like I need all the help I can get.

[pelagia]

From what I've been reading, if they use this treatment they typically start it on day 0.

[spacezombie]

It is confirmed: I'm getting some Zenapax at 11am tomorrow. I'll let you know how it goes!

[pelagia]

I've been trying to dig a little deeper on the web about Zenapax, but I'm not really getting anywhere.  Zenapax has been around for awhile.  There are a bunch of articles from the late 1990s.  There are also a bunch of articles from the last few years, but those are mostly locked.  As far as I can tell most of the trials relate to reducing the use of drugs that are more nephrotoxic (calcineurin inhibitors, such as tacrolimus - Prograf) by combining them with daclizumab (Zenapax).  If I am reading the abstracts correctly, this is resulting in lower rates of acute rejection, but I think the jury is still out on longer term graft survival.

[spacezombie]

 The Zenapax infusion today was quick and pretty much free of side effects. It took about 15 minutes to infuse the tiny bag of medication. On the way home I noticed that my legs were itchy but that could have been something else. Regardless, I took some Benadryl just in case.

[pelagia]

Happy to hear that it went well.

[pelagia]

Happened across this today - Zenapax being used in a clinical trial at UCLA

http://www.uclaurology.com/trials/Kidne47.cfm