What is Belatacept and is it going to change the face of transplantation? Its a fusion protein composed of components of TLA-4, extracellular domain of IgG1. The drug can selectively block the T cell activation by inhibiting this costimulatory molecule CTLA-4. From the researchers mainly at UCSF, a landmark paper was published few years ago in NEJM.
They assigned renal tranplant patients to receive an intensive or less intensive of belatacept or cyclosporine. All patients were induced with the same agent of basiliximab. All received steroids and MMF. At six months, they evaluated that the incidence of acute rejection was no different in two groups. CAN, and decrease in GFR was less common in the belatacept arm.
This drug might show promise. Lets see once more widespread use of it is noted. It might allow us to spare cyclosporine or tacrolimus use in many of our patients. This is important as one of the most common causes of graft loss these days is not rejection but chronic calcineurin toxicity or chronic changes due to medications. The effect on the pancreas by these drugs is also not benign and the most common glomerular disease post transplant still remains to be diabetes.
Lets await and see.
- ► 2019 (42)
- ► 2018 (57)
- ► 2017 (52)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- ► 2013 (133)
- ► 2012 (201)
- ► 2011 (370)
- CLINICAL CASE 9
- The Online Transplant Center: Post transplant MPGN
- Post transplant MPGN
- TOPIC DISCUSSION: PCO2, which one is better?
- Image Quiz- Answers
- CONSULT ROUNDS: METHANOL and the EYE?
- CONSULT ROUNDS: ACID BASE
- JOURNAL CLUB: Kidney allograft nephrectomy can imp...
- TOPIC DISCUSSION: Nutrition
- TOPIC DISCUSSION: Drugs and Cyclosporine
- IN THE NEWS- NSF and Kidney Transplantation
- Bowel Transplantations, not enough!
- Horseshoe Kidney
- The Online Transplant Center: New Agents for renal...
- CLINICAL CASE 8
- History of Nephrology: The first randomised contro...
- Common Sense vs. Evidence-based Medicine
- TOPIC DISCUSSION: DIFFERENT TYPES OF PROTEINURIA
- New Agents for renal transplantation
- TOPIC DISCUSSION: Renal Artery Stenosis
- TOPIC DISCUSSION: THE WWW and the NEPHROLOGIST
- IN THE NEWS- Hyperkalemia treatment in trouble
- IN THE NEWS ---> ACUTE KIDNEY INJURY
- CONSULT ROUNDS: SIADH and Escitalopram ( lexapro)
- CONSULT ROUNDS: Clinical dilemma in Nephrogenic Di...
- CONSULT ROUNDS: Metformin toxicity, Lactic Acidosi...
- CLINICAL CASE 7
- IN THE NEWS- HgA1C for Diabetes Diagnosis. How abo...
- KIDNEY DONORS have Good Long term survival
- TOPIC DISCUSSION: VEGF Nephropathology
- TOPIC DISCUSSION: Post Transplant Collapsing FSGS,...
- Post Transplant Collapsing FSGS: Is it really all ...
- CLINICAL CASE 6
- Topic Discussion: OUCH!! Should Anesthesia Hurt??
- TOPIC DISCUSSION: Alcohol Poisonings, gaps and osm...
- Belatacept approved by FDA
- Protocol Biopsies in Renal Allograft Recipients
- ▼ March (37)