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Bestow Clinical Trial-Hope for New Antirejection Medication with Fewer Side Effects

February 5, 2024

By Dr. Manpreet Singh, MD, Nephrologist

There are over 90,000 people waiting for a kidney transplant in the United States. Diabetes and hypertension are the most common causes of kidney disease. Patients with kidney disease are at an increased risk of long-term complications including heart disease and stroke. Kidney transplantation has several benefits including better quality of life and increased longevity for most of the patients as compared to dialysis.

Patients need to take immunosuppressant medications post-transplant to alleviate the risk of rejection. These medications have several side effects including high blood pressure, high sugars, and high cholesterol. Over time, these medications could also cause damage to the transplanted kidney. To lessen the side effects of current antirejection medications, pharmaceutical companies are working on developing new medications with fewer side effects. These medications will have less impact on heart disease and increase the average life span of kidney transplants, currently 8-12 years. Tegoprubart is an antibody developed by Eledon Pharmaceuticals that may be able to handle the challenges with the side effects of current antirejection medications. There is hope that Tegoprubart will be an effective immunosuppressant that will increase the lifespan of the transplanted kidneys, reduce the need for a repeat kidney transplant, decrease the duration of dialysis and waiting times for a kidney alone, and improve the quality of life for patients.

Bestow is a multicenter clinical trial evaluating the safety and efficacy of Tegoprubart in patients receiving a kidney transplant for the first time in comparison to standard of care (Tacrolimus, Cellcept, and Prednisone). It is an intravenous medication infused over 1 hour every 3 weeks after the initial loading phase for the life of the transplanted kidney. The most commonly reported side effects were headaches and mild drowsiness. This trial will assess kidney function in the participants along with the risk of rejection and risk of new-onset diabetes at 1-year post-transplant. UPMC Harrisburg Transplant is one of the centers currently enrolling patients under this trial. We are hopeful this trial of the new novel agent will prevent rejection in kidney transplant patients.