在转换为基于贝拉塔塞普的免疫抑制剂后,脏移植接受者的长期结果
Gillian Divard1,2, Olivier Aubert1,3, Charlotte Debiais-Deschamp1,3
1INSERM U970 PARCC, Pa`ris Institute for Transplantation and Organ Regeneration, Université Paris Cité, Paris, France.
Clinical journal of the American Society of Nephrology : CJASN
|January 24, 2024
概括
将移植接受者转换为贝拉塔塞普 (一种氨酸抑制剂回避策略) 改善了长期的全移植存活率. 这项研究发现,与卡尔西纽林抑制剂相比,贝拉塔塞普提供了可接受的安全结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 免疫学 免疫学 免疫学
- 移植医学 移植医学
背景情况:
- 氨酸抑制剂 (CNI) 免疫抑制是移植后的标准.
- 贝拉塔塞普特为不耐受CNI的患者提供了一个替代方案.
- 关于贝拉塔塞普转换疗效和安全性的长期数据有限.
研究的目的:
- 为了评估从CNIs转换为belatacept的移植接受者的长期 (7年) 结果.
- 为了比较belatacept和CNI组之间的全移植存活率,患者存活率和安全性概况.
主要方法:
- 对311名移植接受者进行前性研究,后者转换为belatacept.
- 最佳匹配用于将转换的患者与CNI患者进行比较.
- 主要终点:死亡审查的7年全移植存活率.
- 二级终点:患者存活率,eGFR和安全结果 (感染,排斥,心血管事件,癌症).
主要成果:
- 贝拉塔塞普特组 (78%) 与CNI组 (63%) 的7年死亡审查的全移植存活率显著更高.
- 患者存活率,排斥率,心血管事件和癌症发病率在各组之间相似.
- 在贝拉cept组中观察到新发蛋白尿的发病率更高.
结论:
- 转换为贝拉塔塞普与移植患者的长期移植存活率的改善有关.
- 与长期的CNI维持相比,贝拉塔塞普显示了可接受的安全结果.
- 贝拉塔塞普特是一种可行的替代方案,可以在移植中避免CNI.
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