On 2016 Dec 08, NephJC - Nephrology Journal Club commented:

This trial on early steroid tapering was discussed on November 29th and 30th 2016 in the open online nephrology journal club, #NephJC, on twitter. Introductory comments written by Hector Madariaga and Kevin Fowler are available at the NephJC website here and here.

The discussion was quite detailed, with over 60 participants, including general and transplant nephrologists, fellows and patients. The highlights of the tweetchat were:

• The authors should be commended for designing and conducting this important trial, with funding received from the industry.

• The trial results generated a lot of discussion, though it was thought to be underpowered for the outcome of biopsy proven acute rejection, given the small difference observed (9.9% in ATG versus 10.6 to 11.2% in basiliximab arms) relative to the generous sample size assumptions (6.7and 17% respectively). The high rate of new onset diabetes observed overall (compared to lower rates in other trials such as SYMPHONY) were explained on the basis of explicit evaluation on the basis of glucose tolerance tests.

• Overall, the trial did not change any opinions amongst the discussants: practitioners favoring steroid-free regimens were comforted with these results, but others would like to see stronger data with long term graft outcomes before embracing steroid-free regimens.

Transcripts of the tweetchats, and curated versions as storify are available from the NephJC website.

Interested individuals can track and join in the conversation by following @NephJC or #NephJC on twitter, liking @NephJC on facebook, signing up for the mailing list, or just visit the webpage at NephJC.com.

On 2016 Dec 08, NephJC - Nephrology Journal Club commented:

This trial on early steroid tapering was discussed on November 29th and 30th 2016 in the open online nephrology journal club, #NephJC, on twitter. Introductory comments written by Hector Madariaga and Kevin Fowler are available at the NephJC website here and here.

The discussion was quite detailed, with over 60 participants, including general and transplant nephrologists, fellows and patients. The highlights of the tweetchat were:

• The authors should be commended for designing and conducting this important trial, with funding received from the industry.

• The trial results generated a lot of discussion, though it was thought to be underpowered for the outcome of biopsy proven acute rejection, given the small difference observed (9.9% in ATG versus 10.6 to 11.2% in basiliximab arms) relative to the generous sample size assumptions (6.7and 17% respectively). The high rate of new onset diabetes observed overall (compared to lower rates in other trials such as SYMPHONY) were explained on the basis of explicit evaluation on the basis of glucose tolerance tests.

• Overall, the trial did not change any opinions amongst the discussants: practitioners favoring steroid-free regimens were comforted with these results, but others would like to see stronger data with long term graft outcomes before embracing steroid-free regimens.

Transcripts of the tweetchats, and curated versions as storify are available from the NephJC website.

Interested individuals can track and join in the conversation by following @NephJC or #NephJC on twitter, liking @NephJC on facebook, signing up for the mailing list, or just visit the webpage at NephJC.com.