Back to Browse Journals » Biologics: Targets and Therapy » Volume 6

Belatacept for prevention of acute rejection in adult patients who have had a kidney transplant: an update

Authors Wojciechowski D, Vincenti F

Published Date November 2012 Volume 2012:6 Pages 385—393


Received 13 April 2012, Accepted 5 June 2012, Published 2 November 2012

David Wojciechowski, Flavio Vincenti

Kidney Transplant Service, University of California, San Francisco, CA, USA

Abstract: In June 2011, the US Food and Drug Administration approved belatacept for the prophylaxis of organ rejection in adult kidney transplant recipients. This review discusses the use of belatacept for the prevention of acute rejection as part of a maintenance immunosuppression regimen. Belatacept is a selective costimulation blocker designed to provide effective immunosuppression while avoiding the toxicities associated with calcineurin inhibitors. Phase III 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. However, the rate of acute rejection was higher in belatacept-treated patients compared with cyclosporine. Specifically, there was a higher incidence of Banff type II rejections in patients treated with belatacept. Despite the higher Banff grade, rejections on belatacept were not associated with other factors associated with poor outcomes, such as the development of donor-specific antibodies or reduced estimated glomerular filtration rate. One safety issue that must be considered when using belatacept is the potential for increased risk of post-transplant lymphoproliferative disease. There were more cases of post-transplant lymphoproliferative disease in belatacept-treated patients, especially in recipients seronegative for Epstein–Barr virus or patients treated with lymphocyte-depleting agents. Therefore, belatacept can be recommended for use in Epstein–Barr virus antibody-positive recipients.

Keywords: belatacept, kidney transplant, acute rejection

Download Article [PDF] View Full Text [HTML] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at:

Readers of this article also read:

Duration of remission after halving of the etanercept dose in patients with ankylosing spondylitis: a randomized, prospective, long-term, follow-up study

Cantini F, Niccoli L, Cassara E, Kaloudi O, Nannini C

Biologics: Targets and Therapy 2013, 7:1-6

Published Date: 4 January 2013

Anti-tumor necrosis factor (TNF) drugs for the treatment of psoriatic arthritis: an indirect comparison meta-analysis

Thorlund K, Druyts E, Aviña-Zubieta JA, Mills EJ

Biologics: Targets and Therapy 2012, 6:417-427

Published Date: 3 December 2012

Potential role of 124I-girentuximab in the presurgical diagnosis of clear-cell renal cell cancer

Smaldone MC, Chen DY, Yu JQ, Plimack ER

Biologics: Targets and Therapy 2012, 6:395-407

Published Date: 19 November 2012

Efficacy of ipamorelin, a ghrelin mimetic, on gastric dysmotility in a rodent model of postoperative ileus

Greenwood-Van Meerveld B, Tyler K, Mohammadi E, Pietra C

Journal of Experimental Pharmacology 2012, 4:149-155

Published Date: 23 October 2012

Introduction to the use of belatacept: a fusion protein for the prevention of posttransplant kidney rejection

Ippoliti G, D'Armini AM, Lucioni M, Marjieh M, Viganò M

Biologics: Targets and Therapy 2012, 6:355-362

Published Date: 4 October 2012

Critical appraisal of belatacept for prophylaxis of rejection in kidney transplant patients

Martin ST, Tsapepas D, Gabardi S, Chandraker A

Transplant Research and Risk Management 2011, 3:65-75

Published Date: 12 April 2011