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Belatacept in kidney transplantation.
Curr Opin Organ Transplant. 2012 Dec; 17(6):640-7.CO

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+Show Affiliations

Kidney Transplant Service, University of California, San Francisco, California 94143-0780, USA.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

23044530

Citation

Wojciechowski, David, and Flavio Vincenti. "Belatacept in Kidney Transplantation." Current Opinion in Organ Transplantation, vol. 17, no. 6, 2012, pp. 640-7.
Wojciechowski D, Vincenti F. Belatacept in kidney transplantation. Curr Opin Organ Transplant. 2012;17(6):640-7.
Wojciechowski, D., & Vincenti, F. (2012). Belatacept in kidney transplantation. Current Opinion in Organ Transplantation, 17(6), 640-7. https://doi.org/10.1097/MOT.0b013e32835a4c0d
Wojciechowski D, Vincenti F. Belatacept in Kidney Transplantation. Curr Opin Organ Transplant. 2012;17(6):640-7. PubMed PMID: 23044530.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Belatacept in kidney transplantation. AU - Wojciechowski,David, AU - Vincenti,Flavio, PY - 2012/10/10/entrez PY - 2012/10/10/pubmed PY - 2013/4/16/medline SP - 640 EP - 7 JF - Current opinion in organ transplantation JO - Curr Opin Organ Transplant VL - 17 IS - 6 N2 - 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. SN - 1531-7013 UR - https://www.unboundmedicine.com/medline/citation/23044530/Belatacept_in_kidney_transplantation_ L2 - http://dx.doi.org/10.1097/MOT.0b013e32835a4c0d DB - PRIME DP - Unbound Medicine ER -