Abatacept Rescue Therapy in Kidney Transplant Recipients: A Case Series of Five Patients
Charlotte Uro-Coste, Alba Atenza, Anne-Élisabeth Heng, Paul-Olivier Rouzaire, Cyril Garrouste
Abstract
Abatacept, a cytotoxic T-lymphocyte-associated antigen 4 immunoglobulin (CTLA4-Ig), is a subcutaneously administered immunosuppressive drug that selectively inhibits T-cell activation by blocking the CD28-CD80/86 costimulatory pathway. Abatacept is widely used in rheumatology, especially in the treatment of rheumatoid arthritis (1). More recently, intravenously administered belatacept, another CTLA4-Ig, has shown better renal transplant (RT) survival results, improvement in long-term renal function, and less de novo donor-specific antibody (DSA) formation than a calcineurin inhibitor (CNI) regimen, either in induction therapy or after conversion from CNIs (2-4). However, to date, abatacept has been reported only exceptionally as maintenance treatment in patients who have undergone renal transplantation (5).