A safety evaluation of belatacept for the treatment of kidney transplant.
BACKGROUND
Improving long-term survival in kidney transplantation is one of the main goals in modern immunosuppressive research. Current standard immunosuppression based in a combination of calcineurin inhibitors (CNI) and antiproliferatives, with or without steroids, has improved short-term graft survival. In the last decade, belatacept has been evaluated as a CNI free option regimen addressing better kidney transplant outcomes.


METHODS
This paper reviewed the indications, mechanisms of action, pharmacology and published trials using belatacept in different clinical situations. The main objective was to evaluate the safety of this immunosuppressive drug.


CONCLUSIONS
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.
a Head of Renal and Pancreas Transplant Department , Santa Casa de Misericórdia de Porto Alegre (ISCMPA) , Porto Alegre , Brazil.
Valter Duro
VD
Garcia
b Post-Graduation Program in Pathology , Universidade Federal de Ciências da Saúde de Porto Alegre (UFSCPA) , Porto Alegre , Brazil.|c Renal and Pancreas Transplant Department , ISCMPA , Porto Alegre , Brazil.
Gisele
G
Meinerz
b Post-Graduation Program in Pathology , Universidade Federal de Ciências da Saúde de Porto Alegre (UFSCPA) , Porto Alegre , Brazil.|c Renal and Pancreas Transplant Department , ISCMPA , Porto Alegre , Brazil.
Elizete
E
Keitel
D000069594:Abatacept / Q000009:adverse effects / Q000627:therapeutic use*; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000379:methods*; D011788:Quality of Life; D015996:Survival Rate; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D000069594:Abatacept
Belatacept; LEA29Y; drug safety; kidney transplant