Outcomes at 7 years post-transplant in black vs nonblack kidney transplant recipients administered belatacept or cyclosporine in BENEFIT and BENEFIT-EXT

Sander Florman, Flavio Vincenti, Antoine Durrbach, Marwan Abouljoud, Barbara Bresnahan, Valter Duro Garcia, Laura L Mulloy, Kim Rice, Lionel Rostaing, Carlos F Zayas Montalvo, Kellie Calderon, Ulf Meier-Kriesche, Martin Polinsky, Lingfeng Yang, Jose Medina Pestana, Christian P. Larsen

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Clinical outcomes are generally worse for black vs nonblack renal allograft recipients. In BENEFIT and BENEFIT-EXT, recipients were randomized to belatacept more intense-based, belatacept less intense-based, or cyclosporine-based immunosuppression. At year 7, belatacept was associated with superior graft survival vs cyclosporine in BENEFIT (recipients of living or standard criteria deceased donor kidneys); belatacept was associated with similar graft survival vs cyclosporine in BENEFIT-EXT (recipients of extended criteria donor kidneys). In both studies, renal function was superior for belatacept-treated vs cyclosporine-treated patients. Seven-year outcomes were examined by race post hoc in each study. The effect of race and treatment on time to death or graft loss was compared using Cox regression. The interaction between treatment and race was also considered. Glomerular filtration rate (GFR) was estimated from months 1 to 84 using a repeated-measures model. In total, 8.3% (55/666) and 13.1% (71/543) of patients in BENEFIT and BENEFIT-EXT, respectively, were black. Time to death or graft loss was similar in blacks and nonblacks. For both subgroups, estimated mean GFR increased over 7 years for belatacept, but declined for cyclosporine. Outcomes were similar in belatacept-treated black and nonblack patients. Due to the small number of black patients, these results must be interpreted with caution.

Original languageEnglish (US)
Article numbere13225
JournalClinical Transplantation
Volume32
Issue number4
DOIs
StatePublished - Apr 1 2018

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Cyclosporine
Transplants
Kidney
Graft Survival
Glomerular Filtration Rate
Tissue Donors
Abatacept
Transplant Recipients
Immunosuppression
Allografts
Therapeutics

Keywords

  • acute rejection
  • cadaver organ transplantation
  • clinical trial
  • kidney
  • kidney transplantation
  • renal function

ASJC Scopus subject areas

  • Transplantation

Cite this

Outcomes at 7 years post-transplant in black vs nonblack kidney transplant recipients administered belatacept or cyclosporine in BENEFIT and BENEFIT-EXT. / Florman, Sander; Vincenti, Flavio; Durrbach, Antoine; Abouljoud, Marwan; Bresnahan, Barbara; Garcia, Valter Duro; Mulloy, Laura L; Rice, Kim; Rostaing, Lionel; Zayas Montalvo, Carlos F; Calderon, Kellie; Meier-Kriesche, Ulf; Polinsky, Martin; Yang, Lingfeng; Medina Pestana, Jose; Larsen, Christian P.

In: Clinical Transplantation, Vol. 32, No. 4, e13225, 01.04.2018.

Research output: Contribution to journalArticle

Florman, S, Vincenti, F, Durrbach, A, Abouljoud, M, Bresnahan, B, Garcia, VD, Mulloy, LL, Rice, K, Rostaing, L, Zayas Montalvo, CF, Calderon, K, Meier-Kriesche, U, Polinsky, M, Yang, L, Medina Pestana, J & Larsen, CP 2018, 'Outcomes at 7 years post-transplant in black vs nonblack kidney transplant recipients administered belatacept or cyclosporine in BENEFIT and BENEFIT-EXT', Clinical Transplantation, vol. 32, no. 4, e13225. https://doi.org/10.1111/ctr.13225
Florman, Sander ; Vincenti, Flavio ; Durrbach, Antoine ; Abouljoud, Marwan ; Bresnahan, Barbara ; Garcia, Valter Duro ; Mulloy, Laura L ; Rice, Kim ; Rostaing, Lionel ; Zayas Montalvo, Carlos F ; Calderon, Kellie ; Meier-Kriesche, Ulf ; Polinsky, Martin ; Yang, Lingfeng ; Medina Pestana, Jose ; Larsen, Christian P. / Outcomes at 7 years post-transplant in black vs nonblack kidney transplant recipients administered belatacept or cyclosporine in BENEFIT and BENEFIT-EXT. In: Clinical Transplantation. 2018 ; Vol. 32, No. 4.
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abstract = "Clinical outcomes are generally worse for black vs nonblack renal allograft recipients. In BENEFIT and BENEFIT-EXT, recipients were randomized to belatacept more intense-based, belatacept less intense-based, or cyclosporine-based immunosuppression. At year 7, belatacept was associated with superior graft survival vs cyclosporine in BENEFIT (recipients of living or standard criteria deceased donor kidneys); belatacept was associated with similar graft survival vs cyclosporine in BENEFIT-EXT (recipients of extended criteria donor kidneys). In both studies, renal function was superior for belatacept-treated vs cyclosporine-treated patients. Seven-year outcomes were examined by race post hoc in each study. The effect of race and treatment on time to death or graft loss was compared using Cox regression. The interaction between treatment and race was also considered. Glomerular filtration rate (GFR) was estimated from months 1 to 84 using a repeated-measures model. In total, 8.3{\%} (55/666) and 13.1{\%} (71/543) of patients in BENEFIT and BENEFIT-EXT, respectively, were black. Time to death or graft loss was similar in blacks and nonblacks. For both subgroups, estimated mean GFR increased over 7 years for belatacept, but declined for cyclosporine. Outcomes were similar in belatacept-treated black and nonblack patients. Due to the small number of black patients, these results must be interpreted with caution.",
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AU - Vincenti, Flavio

AU - Durrbach, Antoine

AU - Abouljoud, Marwan

AU - Bresnahan, Barbara

AU - Garcia, Valter Duro

AU - Mulloy, Laura L

AU - Rice, Kim

AU - Rostaing, Lionel

AU - Zayas Montalvo, Carlos F

AU - Calderon, Kellie

AU - Meier-Kriesche, Ulf

AU - Polinsky, Martin

AU - Yang, Lingfeng

AU - Medina Pestana, Jose

AU - Larsen, Christian P.

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