Belatacept rescue therapy of CNI-induced nephrotoxicity, meta-analysis

Transplant Rev (Orlando). 2021 Dec;35(4):100653. doi: 10.1016/j.trre.2021.100653. Epub 2021 Sep 21.

Abstract

There is growing evidence about the potential favorable effects that can be obtained from converting the administration of calcineurin inhibitors (CNIs) to Belatacept in kidney transplantation recipients. We conducted a meta-analysis to formulate strong evidence from the current literature about this effect on kidney functions, as measured by the estimated glomerular filtration rate (eGFR). Our search was conducted on the following databases: PubMed, Web of Science, Scopus, Embase, Google Scholar, Cochrane library, the clinical trials, and the International Standard Randomized Controlled Trial Number registries to obtain all studies that investigated the effect of post-transplantation CNIs conversion to Belatacept on kidney functions. Thirteen studies were finally included in the current study. The results showed a significant improvement in the eGFR following the conversion as compared to its value prior to it (MD = 10.41; 95% CI = 6.93, 13.90; P-value < 0.001). Although, there was no risk of bias among the pooled studies (P-value = 0.391), there was a significant heterogenity (I 2 = 80%; P value < 0.001). Serum creatinine levels showed no significant change following the conversion as compared to its value prior to it (MD = -1.22; 95% CI = -2.61, 0.16; P-value = 0.083). Nevertheless, a significant heterogeneity among the included studies was observed (I 2 = 87%; P-value = 0.005). Belatacept can be a good alternative to the CNI-based regimens following the kidney transplantation. The conversion to Belatacept resulted in an improvement in eGFR.

Keywords: Belatacept; Calcineurin inhibitors; Conversion; Kidney functions; Kidney transplantation.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Abatacept / therapeutic use
  • Calcineurin Inhibitors
  • Graft Rejection* / drug therapy
  • Graft Rejection* / prevention & control
  • Graft Survival
  • Humans
  • Immunosuppressive Agents* / adverse effects
  • Randomized Controlled Trials as Topic

Substances

  • Calcineurin Inhibitors
  • Immunosuppressive Agents
  • Abatacept