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Title: Belatacept-Based Regimens Are Associated With Improved Cardiovascular and Metabolic Risk Factors Compared With Cyclosporine in Kidney Transplant Recipients (BENEFIT and BENEFIT-EXT Studies)
Authors: Vanrenterghem, Yves
Bresnahan, Barbara
Campistol, Josep
Durrbach, Antoine
Grinyo, Josep
Neumayer, Hans-Hellmut
Lang, Philippe
Larsen, Christian P.
Mancilla-Urrea, Eduardo
Pestana, Jose Medina [UNIFESP]
Block, Alan
Duan, Tao
Glicklich, Alan
Gujrathi, Sheila
Vincenti, Flavio
Univ Hosp Leuven
Med Coll Wisconsin
Univ Barcelona
Univ Paris 11
Univ Hosp Bellvitge
Univ Med
Hosp Henri Mondor
Emory Univ
Inst Nacl Cardiol Dr Ignacio Chavez
Universidade Federal de São Paulo (UNIFESP)
Bristol Myers Squibb Co
Univ Calif San Francisco
Keywords: Belatacept
Cyclosporine A
Issue Date: 15-May-2011
Publisher: Lippincott Williams & Wilkins
Citation: Transplantation. Philadelphia: Lippincott Williams & Wilkins, v. 91, n. 9, p. 976-983, 2011.
Abstract: Background. Cardiovascular disease, the most common cause of death with a functioning graft among kidney transplant recipients, can be exacerbated by immunosuppressive drugs, particularly the calcineurin inhibitors. Belatacept, a selective co-stimulation blocker, may provide a better cardiovascular/metabolic risk profile than current immunosuppressants.Methods. Cardiovascular and metabolic endpoints from two Phase III studies (BENEFIT and BENEFIT-EXT) of belatacept-based regimens in kidney transplant recipients were assessed at month 12. Each study assessed belatacept in more intensive (MI) and less intensive (LI) regimens versus cyclosporine A (CsA). These secondary endpoints included changes in blood pressure, changes in serum lipids, and the incidence of new-onset diabetes after transplant (NODAT).Results. A total of 1209 patients were randomized and transplanted across the two studies. Mean systolic blood pressure was 6 to 9 mm Hg lower and mean diastolic blood pressure was 3 to 4 mm Hg lower in the MI and LI groups versus CsA (P <= 0.002) across both studies at month 12. Non-HDL cholesterol was lower in the belatacept groups versus CsA (P<0.01 MI or LI vs. CsA in each study). Serum triglycerides were lower in the belatacept groups versus CsA (P<0.02 MI or LI vs. CsA in each study). NODAT occurred less often in the belatacept groups versus CsA in a prespecified pooled analysis (P<0.05 MI or LI vs. CsA).Conclusions. At month 12, belatacept regimens were associated with better cardiovascular and metabolic risk profiles, with lower blood pressure and serum lipids and less NODAT versus CsA. the overall profile of belatacept will continue to be assessed over the 3-year trials.
ISSN: 0041-1337
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