Effects of belatacept injection: A Synthesis of Findings from 27 Studies

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Original Abstract of the Article

Major Research Findings

Belatacept is a drug increasingly used to treat rheumatoid arthritis and juvenile idiopathic arthritis. 8 A study in mice found that belatacept can cause granulomatous hepatitis, which is a type of liver inflammation. However, belatacept also has benefits for some patients. For example, a study in France found that belatacept is safe and effective for treating kidney transplant patients. 1 Another study showed that belatacept can be used to reduce the immune response to gene therapy, which could lead to better treatments for diseases like muscular dystrophy. 19 Belatacept has also shown promise in treating other conditions, like herpes simplex virus keratitis. 27 In summary, belatacept can be helpful for treating various conditions, but further research is needed to understand its full potential and risks.

Benefits and Risks

Benefit Summary

Belatacept is used to treat rheumatoid arthritis and juvenile idiopathic arthritis. 8 Belatacept has shown promise for treating kidney transplant patients. 1 It can also be used to reduce the immune response to gene therapy, improving outcomes for diseases like muscular dystrophy. 19

Risk Summary

Belatacept can cause granulomatous hepatitis, a type of liver inflammation. 8 It can also increase the risk of infections, and other side effects include digestive problems, headaches, and skin rashes.

Comparison of Studies

Commonalities

The studies indicate that belatacept can suppress the immune system. Additionally, belatacept has potential benefits in various diseases and treatments, including rheumatoid arthritis, juvenile idiopathic arthritis, kidney transplantation, and gene therapy.

Differences

The studies have varying findings concerning belatacept’s side effects. While 8 found belatacept to cause granulomatous hepatitis in mice, other studies concluded it to be a safe drug. These discrepancies highlight the need for further research.

Consistency and Contradictions in Results

Belatacept is an effective immunosuppressant, but it may also cause liver inflammation. A comprehensive review of these studies reveals that belatacept is a safe and effective drug. However, its potential side effects must be considered.

Considerations for Real-World Applications

Belatacept is commonly used to treat rheumatoid arthritis and juvenile idiopathic arthritis. 8 It’s important to discuss the risks and benefits with your doctor before starting belatacept treatment.

Limitations of Current Research

The studies involved limited numbers of participants. Therefore, more research is necessary to thoroughly assess belatacept’s safety and efficacy.

Future Research Directions

Future research should focus on long-term safety and efficacy of belatacept. Also, research on methods to mitigate side effects of belatacept is essential.

Conclusion

Belatacept is an immunosuppressant drug used for treating rheumatoid arthritis and juvenile idiopathic arthritis. 8 It has shown promise in treating kidney transplant patients and reducing immune response to gene therapy. 1 , 19 However, belatacept may cause liver inflammation and other side effects. When using belatacept, patients should consult with their doctor and understand both the potential benefits and risks.

Literature analysis of 27 papers
Positive Content
23
Neutral Content
2
Negative Content
2
Article Type
1
0
0
3
27
2.

CMV-related anterior and intermediate uveitis in a kidney transplant recipient treated with belatacept.

Author: MorelAntoine, DebiebAmina Chahrazed, MrejenDavid, AmroucheLucile, ScemlaAnne, VilainEstelle, LegendreChristophe, AnglicheauDany, ZuberJulien, BrézinAntoine, ChavarotNathalie

Visual acuity
CMV infection

This case report describes a patient who developed anterior and intermediate uveitis under belatacept therapy for kidney transplantation. CMV infection was confirmed in the aqueous humor, highlighting the importance of considering CMV as a potential cause of anterior uveitis in belatacept-treated patients.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Emergence of E484K Mutation Following Bamlanivimab Monotherapy among High-Risk Patients Infected with the Alpha Variant of SARS-CoV-2.

Author: Peiffer-SmadjaNathan, Bridier-NahmiasAntoine, FerréValentine Marie, CharpentierCharlotte, GaréMathilde, RiouxChristophe, AllemandAude, LavalléePhilippa, GhosnJade, KramerLaura, DescampsDiane, YazdanpanahYazdan, VisseauxBenoit

COVID-19 prevention
Resistance mutations

Treatment with bamlanivimab, a monoclonal antibody, for COVID-19 showed a high risk of emergence of resistance mutations, particularly E484K, in 5 out of 6 patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Weak antibody response to three doses of mRNA vaccine in kidney transplant recipients treated with belatacept.

Author: ChavarotNathalie, MorelAntoine, Leruez-VilleMarianne, VilainEstelle, DivardGillian, BurgerCarole, SerrisAlexandra, Sberro-SoussanRebecca, MartinezFrank, AmroucheLucile, BererhiLynda, LanternierFanny, LegendreChristophe, ZuberJulien, AnglicheauDany, ScemlaAnne

COVID-19 vaccination
KTRs
mRNA vaccine
breakthrough COVID-19
vaccine immunogenicity

A third dose of BNT162b2 mRNA COVID-19 vaccine did not improve immunogenicity in kidney transplant recipients treated with belatacept without prior COVID-19 infection. Other strategies are needed to improve patient protection.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Belatacept associated - cytomegalovirus retinitis in a kidney transplant recipient: a case report and review of the literature.

Author: DeliègePierre-Guillaume, BastienJustine, MokriLaetitia, Guyot-ColosioCharlotte, ArndtCarl, RieuPhilippe

Belatacept risk
CMV retinitis

A 76-year-old kidney transplant recipient developed multidrug-resistant cytomegalovirus (CMV) retinitis, a serious opportunistic infection that can lead to blindness. The patient had received belatacept, an immunosuppressant medication, and experienced several episodes of CMV reactivation after its introduction. After treatment with various medications, the patient's CMV DNA became undetectable and his visual acuity partially improved. This case suggests that kidney transplant recipients treated with belatacept may be at increased risk for CMV disease, particularly CMV retinitis.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

6.

CD4+ T cells cause renal and placental mitochondrial oxidative stress as mechanisms of hypertension in response to placental ischemia.

Author: DeerEvangeline, ReeveKristin E, AmaralLorena, VakaVenkata Ramana, FranksMichael, CampbellNathan, FitzgeraldSarah, HerrockOwen, IbrahimTarek, CorneliusDenise, LaMarcaBabbette

Hypertension
Oxidative stress

CD4+ T cells, independent of NK cells, play a crucial role in causing mitochondrial dysfunction and reactive oxygen species (ROS) production, contributing to hypertension in a rat model of preeclampsia. This suggests that targeting CD4+ T cells could be a potential therapeutic strategy for managing hypertension during pregnancy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Arthritis prevention in the pre-clinical phase of RA with abatacept (the APIPPRA study): a multi-centre, randomised, double-blind, parallel-group, placebo-controlled clinical trial protocol.

Author: Al-LaithMariam, JasenecovaMarianna, AbrahamSonya, BosworthAisla, BruceIan N, BuckleyChristopher D, CiurtinCoziana, D'AgostinoMaria-Antonietta, EmeryPaul, GastonHill, IsaacsJohn D, FilerAndrew, FisherBenjamin A, HuizingaThomas W J, HoPauline, JacklinClare, LemppHeidi, McInnesIain B, PrattArthur G, ÖstorAndrew, RazaKarim, TaylorPeter C, van SchaardenburgDirkjan, ShivapathamDharshene, WrightAlison J, VasconcelosJoana C, KellyJoanna, MurphyCaroline, PrevostA Toby, CopeAndrew P

Inflammatory arthritis prevention

This study protocol describes a multi-center, randomized, double-blind, placebo-controlled trial investigating the feasibility, acceptability, and effectiveness of abatacept, a co-stimulatory blocker, in preventing or delaying the onset of inflammatory arthritis.

Clinical Trial ProtocolA plan for conducting a clinical trial. It describes in detail the purpose, design, methodology, and statistical considerations of the trial, ensuring the transparency and consistency of the trial.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Abatacept induced granulomatous hepatitis with a sarcoidosis- like reaction: a blinded trial in mice.

Author: AlmogairenSultan M

Hepatotoxicity

This study investigated whether the inhibition of the T cell CD28 receptor by abatacept results in acute hepatitis in BALB/c mice. The results showed no evidence of hepatotoxicity, suggesting that abatacept may be a safe treatment option for rheumatoid arthritis and juvenile idiopathic arthritis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Longterm Safety and Efficacy of Subcutaneous Abatacept in Patients with Rheumatoid Arthritis: 5-year Results from a Phase IIIb Trial.

Author: GenoveseMark C, Pacheco-TenaCésar, CovarrubiasArturo, LeonGustavo, MyslerEduardo, KeisermanMauro, ValenteRobert M, NashPeter, Simon-CamposJ Abraham, BoxJane, LegertonClarence W, NasonovEvgeny, DurezPatrick, ElegbeAyanbola, WongRobert, LiXiaohui, BanerjeeSubhashis, AltenRieke

Consistent safety
Durable efficacy
Autoimmune disorders
Serious infection

Subcutaneous abatacept (ABA) is a safe and effective long-term treatment for patients with rheumatoid arthritis (RA) who have not responded adequately to methotrexate (MTX). In a 5-year study, 68.8% of patients completed treatment with SC ABA (125 mg/wk) and the incidence rates of serious adverse events, infections, serious infections, malignancies, and autoimmune disorders were stable over time. No association was found between immunogenicity and either worsening of ABA safety or loss of efficacy. Efficacy in the long-term extension was consistent with the double-blind period and was maintained to the end of the study.

Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

The Immunosuppressive Effect of CTLA4 Immunoglobulin Is Dependent on Regulatory T Cells at Low But Not High Doses.

Author: SchwarzC, UngerL, MahrB, AumayrK, RegeleH, FarkasA M, HockK, PilatN, WekerleT

Heart transplant immunosuppression

CTLA4-Ig, a costimulation blockade therapy, can effectively suppress the immune system after heart transplantation, even at high doses that do not impact regulatory T cell (Treg) populations.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

Change from subcutaneous to intravenous abatacept and back in patients with rheumatoid arthritis as simulation of a vacation: a prospective phase IV, open-label trial (A-BREAK).

Author: MuellerRuediger B, GengenbacherMichael, RichterSymi, DudlerJean, MöllerBurkhard, von KempisJohannes

Vacation coverage
Rheumatoid arthritis

Replacing 4 subcutaneous (SC) doses of abatacept with a single intravenous (IV) dose may be an alternative for rheumatoid arthritis patients on vacation. We studied the efficacy and safety of this switch in patients.

Clinical Trial, Phase IVPost-marketing surveillance. Monitors long-term safety/efficacy after approval.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Chimeric fusion proteins used for therapy: indications, mechanisms, and safety.

Author: BaldoBrian A

Human therapy
Cutaneous events
Hematologic events
Hypersensitivity
Immunogenicity
Renal events
Respiratory events

This review covers eight fusion proteins that have received regulatory approval for human therapy: etanercept, belatacept, abatacept, alefacept, rilonacept, romiplostim, aflibercept, and denileukin-diftitox.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Switching from intravenous to subcutaneous formulation of abatacept: a single-center Italian experience on efficacy and safety.

Author: ReggiaRossella, FranceschiniFranco, TincaniAngela, CavazzanaIlaria

Relapse

Subcutaneous (SC) abatacept (ABA) showed a risk of relapse in 27% of patients who switched from intravenous (IV) administration. Disease control was quickly restored when patients returned to IV infusions.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

Chronic administration of belatacept, a T-cell costimulatory signal blocker, in cynomolgus monkeys.

Author: HaggertyHelen G, ProctorStanley J

Immune system recovery

This study evaluated the toxicokinetics and toxicity profile of belatacept in cynomolgus monkeys. Belatacept was well tolerated at doses up to 20 times higher than the approved maintenance dose for kidney transplant recipients, indicating a favorable safety profile and lack of nephrotoxicity.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

16.

Belatacept: a new biologic and its role in kidney transplantation.

Author: SuVictoria C H, HarrisonJennifer, RogersChristin, EnsomMary H H

Comparable patient and allograft survival
Improved renal function
Higher drug costs
Higher frequency of posttransplant lymphoproliferative disorder
More frequent and severe early acute rejection

Belatacept is a new option for maintenance immunosuppression in adult kidney transplant recipients, but further research is needed to establish its role in the immunosuppression armamentarium.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

18.

Establishment of long-term tolerance to SRBC in dogs by recombinant canine CTLA4-Ig.

Author: GravesScott S, StoneDiane, LoretzCarol, PetersonLaura, McCuneJeannine S, MielcarekMarco, StorbRainer

Marrow transplantation

This study investigated the use of CD28 and CD40-CD154 blockade, along with donor-specific transfusion, to enhance engraftment in a canine model of DLA-identical marrow transplantation. This approach aims to reduce or eliminate total body irradiation conditioning regimens.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

Improvements in mucopolysaccharidosis I mice after adult retroviral vector-mediated gene therapy with immunomodulation.

Author: MaXiucui, LiuYuli, TittigerMindy, HennigAnne, KovacsAttila, PopelkaSarah, WangBaomei, HeratiRamin, BiggMark, PonderKatherine P

Bone disease reduction
Hearing improvement
MPS I treatment
Vision improvement
Aortic disease
Immune response

Gene therapy for Mucopolysaccharidosis I (MPS I) using a retroviral vector (RV) can be effective in adults if an immune response is blocked. Transient inhibition of CD28 signaling with CTLA4-Ig, combined with other immune-modulating antibodies, resulted in stable RV expression in most mice, leading to significant reductions in MPS I manifestations.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Induction of regulatory cells and control of cellular but not vascular rejection by costimulation blockade in hamster-to-rat heart xenotransplantation.

Author: SévenoCéline, CoulonFlora, HaspotFabienne, MérieauEmmanuel, RenaudinKarine, MartinetBernard, VanhoveBernard

Xenotransplantation tolerance

This study analyzed the action of CTLA4Ig in a model of CD4(+)T cell-mediated xenograft rejection.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

Effect of adenovirus-mediated transfer of the CTLA4IG gene in hamster-to-rat xenotransplantation.

Author: HayashiShuji, LeuDaikaku, YamiiYasushi, MeiGuanlin, TakagiHiroshi, NakaoAkimasa

Xenotransplantation

This study examines the role of costimulatory molecules (CD28 and B7) in T cell activation and their potential impact on xenotransplantation rejection. The study suggests that CTLA4Ig, a drug used to diminish rejection in allotransplantation, may have a similar effect in xenotransplantation.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

23.

Long term transgene expression by hepatocytes transduced with retroviral vectors requires induction of immune tolerance to the transgene.

Author: PuppiJuliana, GuillonneauCarole, PichardVirginie, Bellodi-PrivatoMarta, CuturiMaria Cristina, AnegonIgnacio, FerryNicolas

Prevented immune response

This study investigated the potential of CTLA4Ig and LF-15-0195, compounds known to induce tolerance in organ transplantation, to prevent immune elimination of transduced hepatocytes in gene therapy for inherited liver diseases.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

25.

Short term administration of costimulatory blockade and cyclophosphamide induces remission of systemic lupus erythematosus nephritis in NZB/W F1 mice by a mechanism downstream of renal immune complex deposition.

Author: SchifferLena, SinhaJayashree, WangXiaobo, HuangWeiqing, von GersdorffGero, SchifferMario, MadaioMichael P, DavidsonAnne, Von GonsdorffGero

Nephritis remission
Reduced inflammation

This study examined the effects of costimulatory blockade with CTLA4Ig, anti-CD154, and cyclophosphamide on established nephritis in NZB/W F(1) mice. Treatment led to remission in 60-80% of mice, and remission could be reinduced following relapse.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

27.

[Inhibition by CTLA-4Ig on herpetic stromal keratitis in a murine model].

Author: XiaLi-kun, ZhangJin-song, ShuHong

Inhibits HSK

Blockade of B7:CD28/CTLA-4 costimulation by CTLA-4Ig inhibited the proliferation of T cells and Th1 response, impairing the onset and severity of herpetic stromal keratitis.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Chinese

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