Literature DB >> 22368435

Authors' reply.

George Melvin1, Selvarajan Sandhiya, Kumaresan Subraja.   

Abstract

Entities:  

Year:  2012        PMID: 22368435      PMCID: PMC3284056          DOI: 10.4103/0976-500x.92511

Source DB:  PubMed          Journal:  J Pharmacol Pharmacother        ISSN: 0976-500X


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We thank Parameswaran et al for their interest and cogent comments[1] on our article on belatacept. We have already mentioned in our paper[2] that a major limitation of belatacept is its intravenous route of administration. In developing countries like India patients invariably end up making frequent visits to the hospital to receive medication. A once monthly injection of belatacept should rather reduce the frequency of his/her hospital visits and ensure better compliance. We do agree with him that tacrolimus would have been a better comparator in the trial as it is the first-line drug for maintenance immunosuppression in postrenal transplant patients. However considering the fact that tacrolimus was not approved for coadministration with mycophenolate mofetil at the time of commencement of the BENEFIT trial in 2008 by the US FDA,[3] cyclosporine was preferred instead. Tacrolimus being a CYP3A4 substrate is known to have drug interactions with several drugs. The incidence of nephrotoxicity matches with that of cyclosporine, and there is an increased frequency of insulin-dependent diabetes mellitus.[45] These disadvantages of tacrolimus may be circumvented to a certain extent with belatacept. A study is now underway that compares belatacept over tacrolimus or cyclosporine.[6] The results of this study would be able to answer the question of belatacept's superiority over tacrolimus.
  3 in total

Review 1.  Tacrolimus versus cyclosporin as primary immunosuppression for kidney transplant recipients.

Authors:  A Webster; R C Woodroffe; R S Taylor; J R Chapman; J C Craig
Journal:  Cochrane Database Syst Rev       Date:  2005-10-19

2.  Belatacept: A worthy alternative to cyclosporine?

Authors:  George Melvin; Selvarajan Sandhiya; Kumaresan Subraja
Journal:  J Pharmacol Pharmacother       Date:  2012-01

3.  Belatacept: Good, but not good enough?

Authors:  Sreejith Parameswaran; R P Swaminathan
Journal:  J Pharmacol Pharmacother       Date:  2012-01
  3 in total

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