Tocilizumab for antibody-mediated rejection treatment in lung transplantation

Spenser E. January; Keith A. Fester; Laura P. Halverson; Chad A. Witt; Derek E. Byers; Rodrigo Vazquez-Guillamet; Jennifer Alexander-Brett; Laneshia K. Tague; Daniel Kreisel; Andrew Gelman; Varun Puri; Ruben Nava Bahena; Tsuyoshi Takahashi; Ramsey R. Hachem; Hrishikesh S. Kulkarni

doi:10.1016/j.healun.2023.05.012

Tocilizumab for antibody-mediated rejection treatment in lung transplantation

Spenser E. January, Keith A. Fester, Laura P. Halverson, Chad A. Witt, Derek E. Byers, Rodrigo Vazquez-Guillamet, Jennifer Alexander-Brett, Laneshia K. Tague, Daniel Kreisel, Andrew Gelman, Varun Puri, Ruben Nava Bahena, Tsuyoshi Takahashi, Ramsey R. Hachem, Hrishikesh S. Kulkarni

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6 Scopus citations

Abstract

Tocilizumab (TCZ), an IL-6 inhibitor, has shown promise in the treatment of donor-specific antibodies (DSA) and chronic antibody-mediated rejection (AMR) in renal transplant recipients. However, its use in lung transplantation has not been described. This retrospective case–control study compared AMR treatments containing TCZ in 9 bilateral lung transplant recipients to 18 patients treated for AMR without TCZ. Treatment with TCZ resulted in more clearance of DSA, lower recurrence of DSA, lower incidence of new DSA, and lower rates of graft failure when compared to those treated for AMR without TCZ. The incidence of infusion reactions, elevation in transaminases, and infections were similar between the 2 groups. These data support a role for TCZ in pulmonary AMR and establish preliminary evidence to design a randomized controlled trial of IL-6 inhibition for the management of AMR.

Original language	English
Pages (from-to)	1353-1357
Number of pages	5
Journal	Journal of Heart and Lung Transplantation
Volume	42
Issue number	10
DOIs	https://doi.org/10.1016/j.healun.2023.05.012
State	Published - Oct 2023

Keywords

antibody-mediated rejection
donor-specific antibodies
interleukin-6 inhibition
lung transplantation
tocilizumab

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10.1016/j.healun.2023.05.012

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January, S. E., Fester, K. A., Halverson, L. P., Witt, C. A., Byers, D. E., Vazquez-Guillamet, R., Alexander-Brett, J., Tague, L. K., Kreisel, D., Gelman, A., Puri, V., Bahena, R. N., Takahashi, T., Hachem, R. R., & Kulkarni, H. S. (2023). Tocilizumab for antibody-mediated rejection treatment in lung transplantation. Journal of Heart and Lung Transplantation, 42(10), 1353-1357. https://doi.org/10.1016/j.healun.2023.05.012

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title = "Tocilizumab for antibody-mediated rejection treatment in lung transplantation",

abstract = "Tocilizumab (TCZ), an IL-6 inhibitor, has shown promise in the treatment of donor-specific antibodies (DSA) and chronic antibody-mediated rejection (AMR) in renal transplant recipients. However, its use in lung transplantation has not been described. This retrospective case–control study compared AMR treatments containing TCZ in 9 bilateral lung transplant recipients to 18 patients treated for AMR without TCZ. Treatment with TCZ resulted in more clearance of DSA, lower recurrence of DSA, lower incidence of new DSA, and lower rates of graft failure when compared to those treated for AMR without TCZ. The incidence of infusion reactions, elevation in transaminases, and infections were similar between the 2 groups. These data support a role for TCZ in pulmonary AMR and establish preliminary evidence to design a randomized controlled trial of IL-6 inhibition for the management of AMR.",

keywords = "antibody-mediated rejection, donor-specific antibodies, interleukin-6 inhibition, lung transplantation, tocilizumab",

author = "January, {Spenser E.} and Fester, {Keith A.} and Halverson, {Laura P.} and Witt, {Chad A.} and Byers, {Derek E.} and Rodrigo Vazquez-Guillamet and Jennifer Alexander-Brett and Tague, {Laneshia K.} and Daniel Kreisel and Andrew Gelman and Varun Puri and Bahena, {Ruben Nava} and Tsuyoshi Takahashi and Hachem, {Ramsey R.} and Kulkarni, {Hrishikesh S.}",

note = "Publisher Copyright: {\textcopyright} 2023 International Society for the Heart and Lung Transplantation",

year = "2023",

month = oct,

doi = "10.1016/j.healun.2023.05.012",

language = "English",

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pages = "1353--1357",

journal = "Journal of Heart and Lung Transplantation",

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January, SE, Fester, KA, Halverson, LP , Witt, CA , Byers, DE , Vazquez-Guillamet, R , Alexander-Brett, J , Tague, LK , Kreisel, D , Gelman, A , Puri, V, Bahena, RN, Takahashi, T, Hachem, RR & Kulkarni, HS 2023, 'Tocilizumab for antibody-mediated rejection treatment in lung transplantation', Journal of Heart and Lung Transplantation, vol. 42, no. 10, pp. 1353-1357. https://doi.org/10.1016/j.healun.2023.05.012

TY - JOUR

T1 - Tocilizumab for antibody-mediated rejection treatment in lung transplantation

AU - January, Spenser E.

AU - Fester, Keith A.

AU - Halverson, Laura P.

AU - Witt, Chad A.

AU - Byers, Derek E.

AU - Vazquez-Guillamet, Rodrigo

AU - Alexander-Brett, Jennifer

AU - Tague, Laneshia K.

AU - Kreisel, Daniel

AU - Gelman, Andrew

AU - Puri, Varun

AU - Bahena, Ruben Nava

AU - Takahashi, Tsuyoshi

AU - Hachem, Ramsey R.

AU - Kulkarni, Hrishikesh S.

PY - 2023/10

Y1 - 2023/10

N2 - Tocilizumab (TCZ), an IL-6 inhibitor, has shown promise in the treatment of donor-specific antibodies (DSA) and chronic antibody-mediated rejection (AMR) in renal transplant recipients. However, its use in lung transplantation has not been described. This retrospective case–control study compared AMR treatments containing TCZ in 9 bilateral lung transplant recipients to 18 patients treated for AMR without TCZ. Treatment with TCZ resulted in more clearance of DSA, lower recurrence of DSA, lower incidence of new DSA, and lower rates of graft failure when compared to those treated for AMR without TCZ. The incidence of infusion reactions, elevation in transaminases, and infections were similar between the 2 groups. These data support a role for TCZ in pulmonary AMR and establish preliminary evidence to design a randomized controlled trial of IL-6 inhibition for the management of AMR.

AB - Tocilizumab (TCZ), an IL-6 inhibitor, has shown promise in the treatment of donor-specific antibodies (DSA) and chronic antibody-mediated rejection (AMR) in renal transplant recipients. However, its use in lung transplantation has not been described. This retrospective case–control study compared AMR treatments containing TCZ in 9 bilateral lung transplant recipients to 18 patients treated for AMR without TCZ. Treatment with TCZ resulted in more clearance of DSA, lower recurrence of DSA, lower incidence of new DSA, and lower rates of graft failure when compared to those treated for AMR without TCZ. The incidence of infusion reactions, elevation in transaminases, and infections were similar between the 2 groups. These data support a role for TCZ in pulmonary AMR and establish preliminary evidence to design a randomized controlled trial of IL-6 inhibition for the management of AMR.

KW - antibody-mediated rejection

KW - donor-specific antibodies

KW - interleukin-6 inhibition

KW - lung transplantation

KW - tocilizumab

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U2 - 10.1016/j.healun.2023.05.012

DO - 10.1016/j.healun.2023.05.012

M3 - Article

C2 - 37268051

AN - SCOPUS:85163876839

SN - 1053-2498

VL - 42

SP - 1353

EP - 1357

JO - Journal of Heart and Lung Transplantation

JF - Journal of Heart and Lung Transplantation

IS - 10

ER -

Tocilizumab for antibody-mediated rejection treatment in lung transplantation

Abstract

Keywords

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