Effect of Treatment With Tabalumab, a B Cell-Activating Factor Inhibitor, on Highly Sensitized Patients With End-Stage Renal Disease Awaiting Transplantation

M. A. Mujtaba, W. J. Komocsar, E. Nantz, M. D. Samaniego, S. L. Henson, J. A. Hague, A. L. Lobashevsky, N. G. Higgins, Magdalena Czader, B. K. Book, Melissa Anderson, M. D. Pescovitz, Tim Taber

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16 Scopus citations

Abstract

B cell-activation factor (BAFF) is critical for B cell maturation. Inhibition of BAFF represents an appealing target for desensitization of sensitized end-stage renal disease (ESRD) patients. We conducted a Phase 2a, single-arm, open-label exploratory study investigating the effect of tabalumab (BAFF inhibitor) in patients with ESRD and calculated panel reactive antibodies (cPRAs) >50%. The treatment period duration was 24 weeks. Eighteen patients received tabalumab, at doses of 240-mg subcutaneous (SC) at Week 0 followed by 120-mg SC monthly for 5 additional months. Patients were followed for an additional 52 weeks. Immunopharmacologic effects were characterized through analysis of blood for HLA antibodies, BAFF concentrations, immunoglobulins, T and B cell subsets, as well as pre- and posttreatment tonsil and bone marrow biopsies. Significant reductions in cPRAs were observed at Weeks 16 (p=0.043) and 36 (p=0.004); however, absolute reductions were small (

Original languageEnglish (US)
JournalAmerican Journal of Transplantation
DOIs
StateAccepted/In press - 2016

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Keywords

  • Alloantibody
  • B cell biology
  • Basic (laboratory) research/science
  • Clinical research/practice
  • Desensitization
  • Fusion proteins and monoclonal antibodies: B cell specific
  • Immunobiology
  • Immunosuppressant
  • Kidney transplantation/nephrology

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)

Cite this

Mujtaba, M. A., Komocsar, W. J., Nantz, E., Samaniego, M. D., Henson, S. L., Hague, J. A., Lobashevsky, A. L., Higgins, N. G., Czader, M., Book, B. K., Anderson, M., Pescovitz, M. D., & Taber, T. (Accepted/In press). Effect of Treatment With Tabalumab, a B Cell-Activating Factor Inhibitor, on Highly Sensitized Patients With End-Stage Renal Disease Awaiting Transplantation. American Journal of Transplantation. https://doi.org/10.1111/ajt.13557