A recent study suggests that kidney transplant recipients may soon have the option of monthly immunotherapy treatments instead of taking daily pills. This new approach could also lower side effects and extend the lifespan of transplanted kidneys.
Currently, people who receive a kidney transplant must take daily immunosuppressant medications for life to prevent their immune system from rejecting the organ. However, these drugs can harm kidney function over time and become less effective. They are also linked to health issues such as diabetes, high blood pressure, and high cholesterol. Many patients experience side effects like fatigue, muscle weakness, sexual dysfunction, hair loss, and trouble sleeping. These complications often lead patients to skip doses, according to Flavio Vincenti, MD, professor of medicine and surgery in the Division of Nephrology at UC San Francisco.
The phase 2 pilot study involved 23 patients who were given infusions of belatacept and dazodalibep—proteins designed to stop the immune system from attacking the new kidney without affecting other cells in the body as standard treatments do.
All patients who completed the study showed improved kidney function. Even those who experienced organ rejection saw similar levels of improvement after treatment. No patient had organ rejection caused by antibodies produced by their immune system—a common reason for transplant failure. The results were published on February 3 in the American Journal of Transplantation.
Initially, participants received traditional immunosuppressants but switched to monthly infusions by day 28 for the remainder of the 48-week trial period.
Two out of three initial participants experienced organ rejection; however, both cases were treated successfully with reversal achieved. Following this outcome, researchers adjusted dosing schedules for subsequent participants. Thirteen completed the study while seven withdrew due to acute rejection episodes, side effects or other unspecified reasons.
The next phase will involve testing whether these early findings hold true with a larger group of patients. Senior author Allan D. Kirk, MD, PhD—professor of surgery at Duke University School of Medicine—said: "We hope that most patients can be spared the toxic effects of immunosuppressants, which would be reserved for those with certain high-risk factors."
