[The new drugs in development for kidney transplantation]

Several drugs currently under development may have uses in transplantation, whether they are developed directly in this domain or in others such as clinical immunology. The transplantation community has greatest hope in three new organic compounds currently in phase II trials. ISA247, a cyclosporine analog, has the advantage of inducing less posttransplantation diabetes and CP-690550, a specific inhibitor of the JAK3 protein kinase, has an effect comparable to tacrolimus on the acute rejection rate and kidney function. As for AEB071, a protein kinase C inhibitor, it should find its place in association with everolimus in the minimization of anticalcineurin doses. Two biological agents in phase II/III of development are also expected: belatacept, a CTLA4-Ig fusion protein that has already demonstrated efficacy comparable to cyclosporine while maintaining better renal function, and alefacept, an LFA3-IgG1 fusion protein whose efficacy and tolerance assessment are currently underway. Other drugs such as the B anti-lymphocytes, currently being developed in other indications, could be tested in transplantation, given the involvement of humoral immunity.