Background: Belatacept was approved for prevention of acute rejection\nin adult kidney transplantation in 2011 based on two randomized,\ncontrolled, multicenter phase 3 studies. Long-term experience\nover 10 years with belatacept-based immunosuppression\nafter kidney transplantation has not been reported before.\nPatients and Methods: Analyzed were 20 patients who had been\nincluded into a randomized multicenter phase 2 study by our institution\nbetween March 2001 and November 2002. For 10-year follow-\nup, three different groups could be analyzed: 1) patients with\nprimary calcineurin inhibitor-based (CNI-based) immunosuppression\n(n = 5), 2) patients with early switch from a belatacept-based\nto a CNI-based regimen within the first 14 months (n = 8) and 3)\npatients with completely CNI-free belatacept immunosuppression\n(n = 7).\nResults: Fifteen patients received primary belatacept-based immunosuppression\nand five patients primary cyclosporine A (CyA).\nFive patients are still on belatacept. Kidney function measured by\nserum creatinine levels worsened in the CNI group and the belatacept\nto CNI switch group during long-term follow-up whereas all\npatients receiving belatacept throughout follow-up showed stable\ncreatinine values. Acute rejections occurred predominantly in the\nfirst 12 months after transplantation and were responsible for four\nof seven switches from belatacept- to CNI-based immunosuppression\nwithin the first 14 months. Five of the 20 patients died.\nConclusions: Belatacept is effective and safe in renal transplant\npatients and was not associated with graft loss due to chronic allograft\nnephropathy. Belatacept was well tolerated in all patients\nand caused less nephrotoxic side effects and was well accepted in\nmost patients.
Loading....