PRETREATMENT WITH DIVIDED DOSES OF STEROIDS STRONGLY DECREASES SIDE-EFFECTS OF OKT3

The aim of this study was to attenuate side effects of OKT3 by variati on of the time interval between administration of corticosteroids and OKT3 in renal allograft recipients. In view of a maximal lymphocytopen ia at six hours following MPNS, we postulated a greater preventive act ion on side effects from administration of methylprednisolone (MPNS) a t six hours preceding the first dose of OKT3 compared to administratio n immediately before. Two groups of renal transplant patients treated for acute rejection with 5 mg OKT3 were studied. Ten patients received 500 mg MPNS six hours and ten patients one hour before administration of OKT3. We measured clinical side effects, body temperature, TNF and IL-6. There were no differences between the two groups regarding clin ical side effects and peak body temperatures. However, MPNS administer ed six hours before administration of OKT3 diminished TNF release; MPN S one hour before decreased IL-6 release. We studied an additional gro up of six patients receiving 250 mg MPNS six hours before, followed by 250 mg one hour before OKT3. This group experienced significantly les s side effects and lower body temperature. In addition, IL-6 levels we re significantly decreased. We conclude that two times 250 mg MPNS adm inistered six hours and one hour before the first administration of OK T3 effectively attenuates adverse reactions following administration o f OKT3.