Belatacept Compared to Tacrolimus for Kidney Transplantation: A Propensity Score Matched Cohort Study.

Background: While tacrolimus is the basis of most maintenance immunosuppression regimens for kidney transplantation, concerns about toxicity have made alternative agents, such as belatacept, attractive to clinicians. However, limited data exists to directly compare outcomes with belatacept-based regimens to tacrolimus. Methods: We performed a propensity score matched cohort study of adult kidney transplant recipients transplanted between May 1, 2001 and December 31, 2015 using national transplant registry data to compare patient and allograft survival in patients discharged from their index hospitalization on belatacept versus tacrolimus-based regimens. Results: In the primary analysis, we found that belatacept was not associated with a statistically significant difference in risk of patient death (HR 0.84, 95% CI 0.61-1.15, p=0.28) or allograft loss (HR 0.83, 95% CI 0.62-1.11, p=0.20) despite an increased risk of acute rejection in the first year posttransplant (OR 3.12, 95% CI 2.13-4.57, p

http://ift.tt/2gVasKz