Belatacept in kidney transplantation.

Abstract:

PURPOSE OF REVIEW:In June 2011 the US Food and Drug Administration approved belatacept (Nulojix; Bristol-Myers Squibb, Princeton, New Jersey, USA) for the prophylaxis of organ rejection in adult kidney transplant recipients. This review will discuss the use of belatacept for the prevention of acute rejection as part of a maintenance immunosuppression regimen. RECENT FINDINGS:Belatacept is a selective costimulation blocker designed to provide effective immunosuppression while avoiding the toxicities associated with calcineurin inhibitors. Phase 3 trial data have demonstrated that belatacept is noninferior to cyclosporine in 1-year patient and allograft survival. Three-year data demonstrate an ongoing improvement in mean measured glomerular filtration rate in belatacept-treated versus cyclosporine-treated patients. Overall, there seemed to be an improvement in cardiometabolic parameters in patients treated with belatacept compared with cyclosporine. There was a trend toward higher rates of early rejection episodes in patients treated with belatacept. One safety issue that must be considered when using belatacept is the potential for increased risk of posttransplant lymphoproliferative disease, especially in Epstein-Barr virus-seronegative recipients or patients treated with lymphocyte-depleting agents. SUMMARY:Belatacept is the first new agent available in kidney transplant that may achieve the goal of improved long-term renal function.

authors

Wojciechowski D,Vincenti F

doi

10.1097/MOT.0b013e32835a4c0d

subject

Has Abstract

pub_date

2012-12-01 00:00:00

pages

640-7

issue

6

eissn

1087-2418

issn

1531-7013

journal_volume

17

pub_type

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