Belatacept

Products

Belatacept was approved in many countries in 2011 as a powder for the preparation of an infusion solution concentrate (Nulojix).

Structure and properties

Belatacept is a soluble fusion protein consisting of a modified extracellular domain of human cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and a fragment of the Fc domain of a human IgG1 antibody. In the binding region of CTLA-4, two amino acids have been exchanged for others. Belatacept is produced by biotechnological methods. It is closely related to abatacept.

Effects

Belatacept (ATC L04AA28) has immunosuppressive properties. The effects are due to binding to CD80 and CD86 of antigen-presenting cells. Belatacept blocks CD28-mediated costimulation of T cells (T lymphocytes) and inhibits their activation and proliferation. The interaction of CD28 and CD80/CD86 is a condition for costimulation. By selective immunosuppression, Belatacept counteracts graft rejection.

Indications

To prevent graft rejection in patients undergoing renal transplantation with initiation therapy with an interleukin-2 receptor antagonist in combination with mycophenolic acid and glucocorticoids.

Dosage

According to the SmPC. The drug is administered as an intravenous infusion.

Contraindications

  • Hypersensitivity
  • EBV-seronegative transplant recipients or recipients with unknown serostatus.

For complete precautions, see the drug label.

Interactions

Belatacept does not interact with CYP450 isoenzymes or UDP-glucuronosyltransferases (UGT) .

Adverse effects

The most common possible adverse effects include: