Alternative to IVIG Reduces Antibodies in Kidney Patients

A novel preoperative drug therapy may increase a patient’s candidacy for kidney transplantation and decrease the likelihood of organ rejection, according to a recent study.

The traditional method for reducing antibody levels in transplant patients is intravenous immunoglobulin (IVIG), though prior studies have indicated that a majority of patients are unresponsive to the therapy. For the new study, which appears in the January 2015 edition of the American Journal of Transplantation, 50 kidney transplant candidates with high antibody levels received treatment with the novel regimen.

“This study is important because it has the potential to change the way we approach kidney transplantation,” said lead investigator E. Steve Woodle, MD, in a press release. “This also may benefit 10% to 20% of heart and pancreas transplant candidates who often have such high levels of antibodies that transplantation is nearly impossible.”

The researchers sought to develop therapies that target plasma cells that make antibodies using bortezomib, which is an FDA-approved proteasome inhibitor for the treatment of multiple myeloma.

“The rejection rates were low and the chances of the patient developing a new antibody against their kidney were very low,” Dr. Woodle noted. “In addition, in some patients, antibodies remained suppressed for several months—something that has not previously been described with other approaches.”

The researchers plan to next evaluate 4 new regimens described as second-generation plasma cell—targeted therapies.