Belatacept in renal transplantation in comparison to tacrolimus and molecular understanding of resistance pattern: Meta-analysis and systematic review.
Adverse events
Belatacept
Calcineurin inhibitors
Graft failure
Kidney transplantation
Tacrolimus
Journal
World journal of transplantation
ISSN: 2220-3230
Titre abrégé: World J Transplant
Pays: United States
ID NLM: 101608356
Informations de publication
Date de publication:
18 Mar 2021
18 Mar 2021
Historique:
received:
23
11
2020
revised:
23
12
2020
accepted:
12
02
2021
entrez:
5
4
2021
pubmed:
6
4
2021
medline:
6
4
2021
Statut:
ppublish
Résumé
The T-cell costimulation blocking agent belatacept has been identified as a possible substitute for calcineurin inhibitors, however, no consensus has been established against its use over the standard care agent Tacrolimus. To evaluate the effectiveness of belatacept based maintenance immuno-suppressive regimens in comparison to tacrolimus in renal transplantion. We did extensive search of all the available literature comparing the role of belatacept to tacrolimus in renal transplant recipients by searching the PubMed, Embase, Cochrane, Crossref, Scopus, clinical trials registry on October 5, 2020. The literature search identified four randomized controlled trials ( The evidence reviewed in this meta-analysis suggested that belatacept-based maintenance immunosuppression regimens were associated with an increased risk allograft loss in renal transplant recipients with equivalent renal functioning against standard tacrolimus; however, observed significantly reduced new onset diabetes mellitus after transplantation incidence and lower serum low density lipid profile levels in belatacept group. In addition, the adaptation of belatacept in renal transplantation has been forestalled by increased rates of rejection and resistance owing to development of various effector memory T cells through, parallel differentiation and immunological plasticity.
Sections du résumé
BACKGROUND
BACKGROUND
The T-cell costimulation blocking agent belatacept has been identified as a possible substitute for calcineurin inhibitors, however, no consensus has been established against its use over the standard care agent Tacrolimus.
AIM
OBJECTIVE
To evaluate the effectiveness of belatacept based maintenance immuno-suppressive regimens in comparison to tacrolimus in renal transplantion.
METHODS
METHODS
We did extensive search of all the available literature comparing the role of belatacept to tacrolimus in renal transplant recipients by searching the PubMed, Embase, Cochrane, Crossref, Scopus, clinical trials registry on October 5, 2020.
RESULTS
RESULTS
The literature search identified four randomized controlled trials (
CONCLUSION
CONCLUSIONS
The evidence reviewed in this meta-analysis suggested that belatacept-based maintenance immunosuppression regimens were associated with an increased risk allograft loss in renal transplant recipients with equivalent renal functioning against standard tacrolimus; however, observed significantly reduced new onset diabetes mellitus after transplantation incidence and lower serum low density lipid profile levels in belatacept group. In addition, the adaptation of belatacept in renal transplantation has been forestalled by increased rates of rejection and resistance owing to development of various effector memory T cells through, parallel differentiation and immunological plasticity.
Identifiants
pubmed: 33816147
doi: 10.5500/wjt.v11.i3.70
pmc: PMC8009058
doi:
Types de publication
Journal Article
Langues
eng
Pagination
70-86Informations de copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflict-of-interest statement: None of the contributing authors have any conflict of interest, including specific financial interests or relationships and affiliations relevant to the subject matter or materials discussed in the manuscript.
Références
N Engl J Med. 2007 Dec 20;357(25):2562-75
pubmed: 18094377
Transpl Int. 2012 Feb;25(2):139-50
pubmed: 22151353
Transplant Rev (Orlando). 2012 Jan;26(1):27-9
pubmed: 22137729
Am J Transplant. 2011 Jan;11(1):66-76
pubmed: 21114656
Nat Immunol. 2003 Dec;4(12):1191-8
pubmed: 14625547
Int J Pharm. 2013 Aug 16;452(1-2):14-35
pubmed: 23711732
J Immunol. 1995 Dec 1;155(11):5167-74
pubmed: 7594526
Immunity. 1997 Oct;7(4):549-57
pubmed: 9354475
Transplantation. 2008 Jan 27;85(2):209-16
pubmed: 18212625
Am J Transplant. 2017 Sep;17(9):2285-2299
pubmed: 28502128
Med Res Rev. 2002 Mar;22(2):146-67
pubmed: 11857637
Nat Rev Drug Discov. 2011 Aug 31;10(9):655-6
pubmed: 21878974
Nephrol Dial Transplant. 2005 May;20 Suppl 2:ii3-10, ii62
pubmed: 15814547
Transplantation. 2007 Apr 15;83(7):883-92
pubmed: 17460558
J Exp Med. 1999 Jan 18;189(2):435-40
pubmed: 9892625
Nat Med. 2009 Jul;15(7):746-9
pubmed: 19584865
N Engl J Med. 2005 Aug 25;353(8):770-81
pubmed: 16120857
Stat Med. 2014 Dec 30;33(30):5399-412
pubmed: 25316006
Am J Transplant. 2016 Apr;16(4):1102-12
pubmed: 26603381
J Surg Res. 2015 Jun 15;196(2):241-6
pubmed: 25801976
Am J Transplant. 2010 Mar;10(3):547-57
pubmed: 20415898
Transplantation. 2003 May 27;75(10):1677-82
pubmed: 12777855
Am J Transplant. 2011 Jan;11(1):22-33
pubmed: 21070604
J Transplant. 2018 May 2;2018:1968029
pubmed: 29854421
J Immunol. 1998 Jan 15;160(2):615-23
pubmed: 9551895
J Am Soc Nephrol. 2006 Jul;17(7):2006-16
pubmed: 16762986
Peptides. 2003 Mar;24(3):487-501
pubmed: 12732350
Expert Opin Drug Saf. 2013 Jan;12(1):111-22
pubmed: 23206310
Clin Exp Immunol. 2007 Dec;150(3):487-93
pubmed: 17924973
Am J Transplant. 2005 Aug;5(8):1986-91
pubmed: 15996249
Transplantation. 2003 Apr 27;75(8):1291-5
pubmed: 12717218
Eur J Immunol. 1997 Mar;27(3):598-608
pubmed: 9079798
Transplantation. 2009 Apr 27;87(8 Suppl):S1-6
pubmed: 19384179
Lancet. 2002 Mar 2;359(9308):741-6
pubmed: 11888584
Nat Rev Nephrol. 2014 Jan;10(1):14-24
pubmed: 24100403
J Exp Med. 2005 May 16;201(10):1531-41
pubmed: 15897272
Semin Immunol. 2004 Oct;16(5):323-33
pubmed: 15528077
Stat Med. 2011 May 20;30(11):1183-98
pubmed: 21538449
Cochrane Database Syst Rev. 2014 Nov 24;(11):CD010699
pubmed: 25416857
BioDrugs. 2012 Dec 1;26(6):413-24
pubmed: 22928660
Nature. 1987 Mar 26-Apr 1;326(6111):400-3
pubmed: 2951597
Curr Med Res Opin. 2016 Jun;32(6):1065-72
pubmed: 26907083
Lancet. 1982 Dec 11;2(8311):1309-11
pubmed: 6128601
World J Transplant. 2013 Jun 24;3(2):7-25
pubmed: 24175203
Expert Opin Biol Ther. 2010 Oct;10(10):1501-8
pubmed: 20726688
Transpl Int. 2005 Jan;18(1):22-8
pubmed: 15612979
Am J Transplant. 2017 Oct;17(10):2712-2719
pubmed: 28556519
Am J Transplant. 2005 Oct;5(10):2531-8
pubmed: 16162204
Transpl Int. 2015 Nov;28(11):1251-64
pubmed: 25965549
Exp Clin Transplant. 2017 Jun;15(3):241-252
pubmed: 27915965
Int J Organ Transplant Med. 2017;8(2):68-76
pubmed: 28828166
Curr Opin Nephrol Hypertens. 2005 May;14(3):229-34
pubmed: 15821415
Transplantation. 2006 Sep 15;82(5):603-11
pubmed: 16969281
Nat Immunol. 2014 Dec;15(12):1104-15
pubmed: 25396352
Am J Transplant. 2005 Mar;5(3):443-53
pubmed: 15707398
BMJ. 2005 Oct 8;331(7520):810
pubmed: 16157605
PLoS One. 2016 Feb 26;11(2):e0148604
pubmed: 26919152
Am J Transplant. 2017 Dec;17(12):3219-3227
pubmed: 28758341
J Am Soc Nephrol. 2018 Mar;29(3):1049-1062
pubmed: 29321143
Am J Transplant. 2014 Feb;14(2):319-32
pubmed: 24472192
Nat Rev Nephrol. 2009 Sep;5(9):513-9
pubmed: 19636333
Science. 1999 Jul 9;285(5425):221-7
pubmed: 10398592
Curr Opin Organ Transplant. 2012 Aug;17(4):393-400
pubmed: 22790074
Transplantation. 2017 Oct;101(10):2571-2581
pubmed: 28403127
Transplantation. 2011 May 15;91(9):976-83
pubmed: 21372756
Transpl Int. 2016 Mar;29(3):307-14
pubmed: 26565071