Posts Tagged ‘transplant medication’

Emory Receives $20 Million Grant from NIH for Continued Transplant Research

Emory Transplant CenterIn the last few years, thanks to the development of anti-rejection drug therapies, outstanding breakthroughs in short-term outcomes have been achieved among organ transplant patients. We first introduced you to belatacept on our blog in September of 2010, while the medication was being studied by our team of doctors and researchers. Then in June of last year, we announced the FDA’s approval of belatacept and its confirmed ability to provide a less toxic alternative to the standard anti-rejection medications, including calcineurin inhibitors like cyclosporine.

Even with these developments, though, significant challenges remain for patients over the long term with organ rejection and drug toxicity that often leads to cardiovascular disease, infection or cancer.
To help overcome these challenges, a new $20 million grant has been bestowed upon Emory from the National Institute of Health to allow physician/researchers to develop better treatments for organ transplant recipients that help avoid both organ rejection and drug toxicity. The new grant builds upon more than 18 years of groundbreaking research by Emory scientists—such as the investigation into belatacept—that has already significantly advanced the transplant field.

Christian Larsen, Emory Transplant Center Director

Dr. Larsen

“Despite tremendous advances in immune drug therapy, the fact remains that organ recipients still must take immunosuppressant drugs over their lifetimes,” says Chris Larsen, MD, PhD, executive director of the Emory Transplant Center and principal investigator of the new grant. “Improvement in these transplant drugs is still a critical need for avoiding acute and late-stage rejection. Ultimately, we want to improve overall health while reducing cost through improved outcomes with fewer drugs.”

In addition to Dr. Larsen, project leaders from the Emory Transplant Center will include Allan D. Kirk, MD, PhD, scientific director of the Emory Transplant Center and a Georgia Research Alliance Eminent Scholar; Leslie Kean, MD, PhD, Emory associate professor of pediatrics and director of the Pediatric Bone Marrow Transplant Division of the Aflac Cancer and Blood Disorders Center of Children’s Healthcare of Atlanta, Stuart J. Knechtle, MD, surgical director of the liver transplant program at Emory Transplant Center and Children’s Healthcare of Atlanta, and Andrew Adams, MD, PhD, assistant professor of surgery.

“The most important feature of this award is its support for multiple investigators attacking the problems of immunosuppression from different but complementary angles,” says Kirk. “The team science approach is the best way to get results to our patients.”

Several projects funded by the new grant will aim to develop more effective transplant drugs and strategies to avoid immunosuppressant drugs altogether.

An additional project will develop strategies to overcome immune sensitization in patients who have had previous transplants, pregnancies or blood transfusions. These patients often are not candidates for transplant because of their increased risk of rejection.

For more information about the Emory Transplant Center, its research projects and clinical programs please  use the Related Resources links below.

Related Resources:

Hope for Kidney Transplant Patients Confirmed with FDA Approval of Drug Discovered at Emory

After decades of research and testing, the FDA approves belatacept, and a new class of transplant drugs first discovered by Emory doctors.

Back in September, Dr. Christian P. Larsen, Director of the Emory Transplant Center, shared a story with you here on our blog about belatacept, a new medication that was being studied to determine its ability to help block the immune system from graft rejection after kidney transplants. It’s been less than a year since we shared that story on belatacept with you, and since that time, the FDA has now approved belatacept for use for that exact purpose.

Christian Larsen, Emory Transplant Center Director

Dr. Christian Larsen, Director of Emory Transplant Center

Dr. Thomas Pearson

Dr. Thomas Pearson, Surgical Director, Kidney Transplant Program

Since the early 1990s, Emory surgeon-scientists Christian P. Larsen, MD, DPhil and Thomas C. Pearson, MD, DPhil have been searching for ways to promote immune tolerance of a transplanted organ. In collaboration with other Emory researchers and researchers at Bristol-Myers Squibb, they played a leading role in discovering belatacept and driving its development. The recent FDA approval of use of belatacept is the first time a new class of drugs has been developed for transplant since the 1990s.

So what led to this approval of a new class of drugs? From a research perspective, in the 1990s, Larsen and Pearson found that CTLA4-Ig, a fusion protein of which belatacept is a modified type, could control graft rejection in mice, but found that it didn’t work as well in non-human primates. Bristol-Myers Squibb researchers then developed a panel of hundreds of modified forms of CTLA4-Ig, and sifted through the mutated proteins to find two that could make CTLA4-Ig bind tighter to its target and work more effectively. Larsen and Pearson then showed that the enhanced version could prevent graft rejection in a non-human primate model for kidney transplant at Yerkes Research Center.

Once the determination was made that modified versions of the CTLA4-lg fusion proteins could work to prevent graft rejection on primates, belatacept was developed and tested. In two parallel studies with more than 1,200 participants over two years, patients taking belatacept had similar graft survival rates to those taking the calcineurin inhibitor cyclosporine, while maintaining higher kidney function and lower blood pressure and cholesterol. In addition, belatacept can be given every few weeks, in contrast to calcineurin inhibitors, which must be taken twice a day.

There is still room for improvement, though. Compared with cyclosporine-treated patients, belatacept-treated patients had a higher rate of early acute rejection – a temporary flare-up of the immune system against the donated kidney. However, in most cases the acute rejection was successfully treated with drugs and did not lead to graft failure. The Emory Transplant Center team is researching approaches to reduce this risk.

“Our goal is to achieve a normal life span for kidney transplant patients, and have them survive dialysis-free,” Larsen, Director of the Emory Transplant Center, says. “We believe belatacept can help us move toward that goal.”

Clinical trials are now also being conducted to determine if belatacept will have similar positive outcomes on liver transplant and pancreatic islet transplant patients.

For more information on belatacept, you can check out the video below. If you have additional questions, leave them in the comments for Dr. Larsen or Dr. Pearson and we’ll make sure they see them and give you a response!

For more information on the FDA’s approval of belatacept, visit: http://shared.web.emory.edu/whsc/news/releases/2011/06/fda-approves-transplant-drug-that-preserves-kidneys,-avoids-toxicity.html