Document Detail

Belatacept in kidney transplantation.
MedLine Citation:
PMID:  23044530     Owner:  NLM     Status:  MEDLINE    
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.
David Wojciechowski; Flavio Vincenti
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current opinion in organ transplantation     Volume:  17     ISSN:  1531-7013     ISO Abbreviation:  Curr Opin Organ Transplant     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-13     Completed Date:  2013-04-15     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  9717388     Medline TA:  Curr Opin Organ Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  640-7     Citation Subset:  IM    
Kidney Transplant Service, University of California, San Francisco, California 94143-0780, USA.
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MeSH Terms
Acute Disease
Antigens, CD28 / immunology,  metabolism
Clinical Trials as Topic
Graft Rejection / immunology,  prevention & control*
Graft Survival / drug effects*,  immunology
Immunoconjugates / administration & dosage*,  pharmacology
Immunosuppressive Agents / administration & dosage*,  pharmacology
Kidney / immunology
Kidney Transplantation / adverse effects,  immunology*
Lymphoproliferative Disorders / chemically induced
Signal Transduction / drug effects,  immunology
T-Lymphocytes, Regulatory / drug effects,  immunology
Transplantation, Homologous
Treatment Outcome
Reg. No./Substance:
0/Antigens, CD28; 0/Immunoconjugates; 0/Immunosuppressive Agents; 7D0YB67S97/abatacept

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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