A safety evaluation of belatacept for the treatment of kidney transplant

Abstract

Kidney transplant patients receiving belatacept demonstrated improvement in renal function, less chronic allograft nephropathy, a more favorable metabolic profile and lower donor-specific antibody formation compared with cyclosporine. Based on the published data and on our personal experience, we have good expectations on belatacept use in the future. If these characteristics will translate in sustained better renal function, less chronic kidney disease-related complications and lower cardiovascular risk, improving patient and graft survival and quality of life, is still to be assessed with longer term follow-up and a larger number of exposed patients.

Impact of belatacept and tacrolimus on cytomegalovirus viral load control and relapse in moderate and high‐risk cytomegalovirus serostatus kidney transplant recipients

“…In contrast, there is much less information about the behavior of CMV, patterns of viremia, and response to treatment for recipients treated with newer costimulation blockade‐based regimens such as belatacept. In phase III studies, belatacept demonstrated improved renal function and lower death and graft loss at 7 years among renal transplant recipients; however, there is limited information about CMV as an assessment of viremia was neither specified nor captured in these studies 12–14 . Recent analyses indicate that the clinical manifestations and consequences of CMV in belatacept‐based and standard CNI regiments may differ 15 .…”

“…In phase III studies, belatacept demonstrated improved renal function and lower death and graft loss at 7 years among renal transplant recipients; however, there is limited information about CMV as an assessment of viremia was neither specified nor captured in these studies. 12 , 13 , 14 Recent analyses indicate that the clinical manifestations and consequences of CMV in belatacept‐based and standard CNI regiments may differ. 15 When considering CMV serostatus, we previously reported that high‐risk belatacept‐treated recipients (donor/recipient serostatus pair: D+/R−) showed a higher cumulative incidence of CMV viremia, higher area under the viral load curves (AUC), and a trend of high risk of graft loss than tacrolimus‐treated recipients.…”