Efficacy and safety of interleukin-1 blockers in kidney transplant recipients with familial Mediterranean fever: a propensity score–matched cohort study
ABSTRACT Background Data on use of interleukin (IL)-1 blockers in kidney transplant recipients (KTRs) with familial Mediterranean fever (FMF) are very limited. We aimed to evaluate the efficacy and safety of anakinra and canakinumab in the transplantation setting. Methods In this retrospective cohor...
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| Veröffentlicht in: | Nephrology, dialysis, transplantation dialysis, transplantation, 2023-05, Vol.38 (5), p.1327-1336 |
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| creator | Mirioglu, Safak Dirim, Ahmet Burak Bektas, Murat Demir, Erol Tor, Yavuz Burak Ozluk, Yasemin Kilicaslan, Isin Oto, Ozgur Akin Yalcinkaya, Yasemin Caliskan, Yasar Artim-Esen, Bahar Yazici, Halil Inanc, Murat Turkmen, Aydin Gul, Ahmet Sever, Mehmet Sukru |
| description | ABSTRACT
Background
Data on use of interleukin (IL)-1 blockers in kidney transplant recipients (KTRs) with familial Mediterranean fever (FMF) are very limited. We aimed to evaluate the efficacy and safety of anakinra and canakinumab in the transplantation setting.
Methods
In this retrospective cohort study, we included KTRs who suffered from AA amyloidosis caused by FMF and treated with anakinra or canakinumab (study group, n = 36). Using propensity score matching, we selected 36 patients without FMF or amyloidosis from our database of 696 KTRs as the control group. Primary outcomes were patient and graft survival. Biopsy-confirmed graft rejection, changes in estimated glomerular filtration rate (eGFR), high-sensitivity CRP (hsCRP), erythrocyte sedimentation rate (ESR), proteinuria and number of monthly attacks were secondary outcomes.
Results
All KTRs with FMF began IL-1 blocker therapy with anakinra and nine (25%) were switched to canakinumab. Overall death was more frequent in the study group (19.4% vs 0%) (P = .005); however, overall graft loss was comparable between study (27.8%) and control groups (36.1%) (P = .448). Five- and 10-year graft survival rates were significantly higher in the study group (94.4% and 83.3%, respectively) than in the control group (77.8% and 63.9%, respectively) (P = .014 and P |
| doi_str_mv | 10.1093/ndt/gfac335 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2756670049</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ndt/gfac335</oup_id><sourcerecordid>2756670049</sourcerecordid><originalsourceid>FETCH-LOGICAL-c320t-d41511a15026f8e187552e3db9d9722ea8154c876c4e309cab2fc0d09fb92ab23</originalsourceid><addsrcrecordid>eNp9kctu1TAQhi0EoqeFFfvKK1SpCvUlTmJ2VVVapCI2sI4ce8wxJ7FT22mVHe_AjsfjSXB1DixZjWbm0z-XH6E3lLyjRPILb_LFN6s05-IZ2tC6IRXjnXiONqVLKyKIPELHKX0nhEjWti_REW9EzepWbNCva2udVnrFyhuclIW84mCx8xniCMvO-YriYQx6BzGVMt4542HFOSqf5lH5jCNoNzvwOeFHl7fYqsmNTo34ExhXZAoJymMLDxDfY4XnGGbwyZVJSYcIv3_8nFTWWzBYh22IGae8mPUVemHVmOD1IZ6grx-uv1zdVnefbz5eXd5VmjOSK1NTQamigrDGdkC7VggG3AzSyJYxUB0Vte7aRtfAidRqYFYTQ6QdJCsJP0Fne92y1_0CKfeTSxrGchuEJfWsFU3TElLLgp7vUR1DShFsP0c3qbj2lPRPZvTFjP5gRqFPD8LLMIH5x_79fgHe7oGwzP9V-gPG-pfg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2756670049</pqid></control><display><type>article</type><title>Efficacy and safety of interleukin-1 blockers in kidney transplant recipients with familial Mediterranean fever: a propensity score–matched cohort study</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Mirioglu, Safak ; Dirim, Ahmet Burak ; Bektas, Murat ; Demir, Erol ; Tor, Yavuz Burak ; Ozluk, Yasemin ; Kilicaslan, Isin ; Oto, Ozgur Akin ; Yalcinkaya, Yasemin ; Caliskan, Yasar ; Artim-Esen, Bahar ; Yazici, Halil ; Inanc, Murat ; Turkmen, Aydin ; Gul, Ahmet ; Sever, Mehmet Sukru</creator><creatorcontrib>Mirioglu, Safak ; Dirim, Ahmet Burak ; Bektas, Murat ; Demir, Erol ; Tor, Yavuz Burak ; Ozluk, Yasemin ; Kilicaslan, Isin ; Oto, Ozgur Akin ; Yalcinkaya, Yasemin ; Caliskan, Yasar ; Artim-Esen, Bahar ; Yazici, Halil ; Inanc, Murat ; Turkmen, Aydin ; Gul, Ahmet ; Sever, Mehmet Sukru</creatorcontrib><description>ABSTRACT
Background
Data on use of interleukin (IL)-1 blockers in kidney transplant recipients (KTRs) with familial Mediterranean fever (FMF) are very limited. We aimed to evaluate the efficacy and safety of anakinra and canakinumab in the transplantation setting.
Methods
In this retrospective cohort study, we included KTRs who suffered from AA amyloidosis caused by FMF and treated with anakinra or canakinumab (study group, n = 36). Using propensity score matching, we selected 36 patients without FMF or amyloidosis from our database of 696 KTRs as the control group. Primary outcomes were patient and graft survival. Biopsy-confirmed graft rejection, changes in estimated glomerular filtration rate (eGFR), high-sensitivity CRP (hsCRP), erythrocyte sedimentation rate (ESR), proteinuria and number of monthly attacks were secondary outcomes.
Results
All KTRs with FMF began IL-1 blocker therapy with anakinra and nine (25%) were switched to canakinumab. Overall death was more frequent in the study group (19.4% vs 0%) (P = .005); however, overall graft loss was comparable between study (27.8%) and control groups (36.1%) (P = .448). Five- and 10-year graft survival rates were significantly higher in the study group (94.4% and 83.3%, respectively) than in the control group (77.8% and 63.9%, respectively) (P = .014 and P < .001, respectively). Rejections were numerically lower in study group (8.3% vs 25%), but it did not reach to statistical significance (P = .058). When compared with the pre-treatment period, with IL-1 blockers, the number of attacks per month (P < .001), and eGFR (P = .004), hsCRP (P < .001) and ESR (P = .026) levels were lower throughout the follow-up, whereas proteinuria levels were not.
Conclusions
Anakinra and canakinumab are effective in KTRs suffering from FMF; however, the mortality rate may be of concern.
Graphical Abstract
Graphical Abstract</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfac335</identifier><identifier>PMID: 36542475</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>C-Reactive Protein ; Cohort Studies ; Colchicine ; Familial Mediterranean Fever - complications ; Familial Mediterranean Fever - drug therapy ; Humans ; Interleukin 1 Receptor Antagonist Protein - therapeutic use ; Interleukin-1 ; Kidney Transplantation - adverse effects ; Propensity Score ; Proteinuria - complications ; Retrospective Studies</subject><ispartof>Nephrology, dialysis, transplantation, 2023-05, Vol.38 (5), p.1327-1336</ispartof><rights>The Author(s) 2022. Published by Oxford University Press on behalf of the ERA. 2022</rights><rights>The Author(s) 2022. Published by Oxford University Press on behalf of the ERA.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c320t-d41511a15026f8e187552e3db9d9722ea8154c876c4e309cab2fc0d09fb92ab23</citedby><cites>FETCH-LOGICAL-c320t-d41511a15026f8e187552e3db9d9722ea8154c876c4e309cab2fc0d09fb92ab23</cites><orcidid>0000-0003-0362-8154</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36542475$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mirioglu, Safak</creatorcontrib><creatorcontrib>Dirim, Ahmet Burak</creatorcontrib><creatorcontrib>Bektas, Murat</creatorcontrib><creatorcontrib>Demir, Erol</creatorcontrib><creatorcontrib>Tor, Yavuz Burak</creatorcontrib><creatorcontrib>Ozluk, Yasemin</creatorcontrib><creatorcontrib>Kilicaslan, Isin</creatorcontrib><creatorcontrib>Oto, Ozgur Akin</creatorcontrib><creatorcontrib>Yalcinkaya, Yasemin</creatorcontrib><creatorcontrib>Caliskan, Yasar</creatorcontrib><creatorcontrib>Artim-Esen, Bahar</creatorcontrib><creatorcontrib>Yazici, Halil</creatorcontrib><creatorcontrib>Inanc, Murat</creatorcontrib><creatorcontrib>Turkmen, Aydin</creatorcontrib><creatorcontrib>Gul, Ahmet</creatorcontrib><creatorcontrib>Sever, Mehmet Sukru</creatorcontrib><title>Efficacy and safety of interleukin-1 blockers in kidney transplant recipients with familial Mediterranean fever: a propensity score–matched cohort study</title><title>Nephrology, dialysis, transplantation</title><addtitle>Nephrol Dial Transplant</addtitle><description>ABSTRACT
Background
Data on use of interleukin (IL)-1 blockers in kidney transplant recipients (KTRs) with familial Mediterranean fever (FMF) are very limited. We aimed to evaluate the efficacy and safety of anakinra and canakinumab in the transplantation setting.
Methods
In this retrospective cohort study, we included KTRs who suffered from AA amyloidosis caused by FMF and treated with anakinra or canakinumab (study group, n = 36). Using propensity score matching, we selected 36 patients without FMF or amyloidosis from our database of 696 KTRs as the control group. Primary outcomes were patient and graft survival. Biopsy-confirmed graft rejection, changes in estimated glomerular filtration rate (eGFR), high-sensitivity CRP (hsCRP), erythrocyte sedimentation rate (ESR), proteinuria and number of monthly attacks were secondary outcomes.
Results
All KTRs with FMF began IL-1 blocker therapy with anakinra and nine (25%) were switched to canakinumab. Overall death was more frequent in the study group (19.4% vs 0%) (P = .005); however, overall graft loss was comparable between study (27.8%) and control groups (36.1%) (P = .448). Five- and 10-year graft survival rates were significantly higher in the study group (94.4% and 83.3%, respectively) than in the control group (77.8% and 63.9%, respectively) (P = .014 and P < .001, respectively). Rejections were numerically lower in study group (8.3% vs 25%), but it did not reach to statistical significance (P = .058). When compared with the pre-treatment period, with IL-1 blockers, the number of attacks per month (P < .001), and eGFR (P = .004), hsCRP (P < .001) and ESR (P = .026) levels were lower throughout the follow-up, whereas proteinuria levels were not.
Conclusions
Anakinra and canakinumab are effective in KTRs suffering from FMF; however, the mortality rate may be of concern.
Graphical Abstract
Graphical Abstract</description><subject>C-Reactive Protein</subject><subject>Cohort Studies</subject><subject>Colchicine</subject><subject>Familial Mediterranean Fever - complications</subject><subject>Familial Mediterranean Fever - drug therapy</subject><subject>Humans</subject><subject>Interleukin 1 Receptor Antagonist Protein - therapeutic use</subject><subject>Interleukin-1</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Propensity Score</subject><subject>Proteinuria - complications</subject><subject>Retrospective Studies</subject><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctu1TAQhi0EoqeFFfvKK1SpCvUlTmJ2VVVapCI2sI4ce8wxJ7FT22mVHe_AjsfjSXB1DixZjWbm0z-XH6E3lLyjRPILb_LFN6s05-IZ2tC6IRXjnXiONqVLKyKIPELHKX0nhEjWti_REW9EzepWbNCva2udVnrFyhuclIW84mCx8xniCMvO-YriYQx6BzGVMt4542HFOSqf5lH5jCNoNzvwOeFHl7fYqsmNTo34ExhXZAoJymMLDxDfY4XnGGbwyZVJSYcIv3_8nFTWWzBYh22IGae8mPUVemHVmOD1IZ6grx-uv1zdVnefbz5eXd5VmjOSK1NTQamigrDGdkC7VggG3AzSyJYxUB0Vte7aRtfAidRqYFYTQ6QdJCsJP0Fne92y1_0CKfeTSxrGchuEJfWsFU3TElLLgp7vUR1DShFsP0c3qbj2lPRPZvTFjP5gRqFPD8LLMIH5x_79fgHe7oGwzP9V-gPG-pfg</recordid><startdate>20230504</startdate><enddate>20230504</enddate><creator>Mirioglu, Safak</creator><creator>Dirim, Ahmet Burak</creator><creator>Bektas, Murat</creator><creator>Demir, Erol</creator><creator>Tor, Yavuz Burak</creator><creator>Ozluk, Yasemin</creator><creator>Kilicaslan, Isin</creator><creator>Oto, Ozgur Akin</creator><creator>Yalcinkaya, Yasemin</creator><creator>Caliskan, Yasar</creator><creator>Artim-Esen, Bahar</creator><creator>Yazici, Halil</creator><creator>Inanc, Murat</creator><creator>Turkmen, Aydin</creator><creator>Gul, Ahmet</creator><creator>Sever, Mehmet Sukru</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0362-8154</orcidid></search><sort><creationdate>20230504</creationdate><title>Efficacy and safety of interleukin-1 blockers in kidney transplant recipients with familial Mediterranean fever: a propensity score–matched cohort study</title><author>Mirioglu, Safak ; Dirim, Ahmet Burak ; Bektas, Murat ; Demir, Erol ; Tor, Yavuz Burak ; Ozluk, Yasemin ; Kilicaslan, Isin ; Oto, Ozgur Akin ; Yalcinkaya, Yasemin ; Caliskan, Yasar ; Artim-Esen, Bahar ; Yazici, Halil ; Inanc, Murat ; Turkmen, Aydin ; Gul, Ahmet ; Sever, Mehmet Sukru</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c320t-d41511a15026f8e187552e3db9d9722ea8154c876c4e309cab2fc0d09fb92ab23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>C-Reactive Protein</topic><topic>Cohort Studies</topic><topic>Colchicine</topic><topic>Familial Mediterranean Fever - complications</topic><topic>Familial Mediterranean Fever - drug therapy</topic><topic>Humans</topic><topic>Interleukin 1 Receptor Antagonist Protein - therapeutic use</topic><topic>Interleukin-1</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Propensity Score</topic><topic>Proteinuria - complications</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mirioglu, Safak</creatorcontrib><creatorcontrib>Dirim, Ahmet Burak</creatorcontrib><creatorcontrib>Bektas, Murat</creatorcontrib><creatorcontrib>Demir, Erol</creatorcontrib><creatorcontrib>Tor, Yavuz Burak</creatorcontrib><creatorcontrib>Ozluk, Yasemin</creatorcontrib><creatorcontrib>Kilicaslan, Isin</creatorcontrib><creatorcontrib>Oto, Ozgur Akin</creatorcontrib><creatorcontrib>Yalcinkaya, Yasemin</creatorcontrib><creatorcontrib>Caliskan, Yasar</creatorcontrib><creatorcontrib>Artim-Esen, Bahar</creatorcontrib><creatorcontrib>Yazici, Halil</creatorcontrib><creatorcontrib>Inanc, Murat</creatorcontrib><creatorcontrib>Turkmen, Aydin</creatorcontrib><creatorcontrib>Gul, Ahmet</creatorcontrib><creatorcontrib>Sever, Mehmet Sukru</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mirioglu, Safak</au><au>Dirim, Ahmet Burak</au><au>Bektas, Murat</au><au>Demir, Erol</au><au>Tor, Yavuz Burak</au><au>Ozluk, Yasemin</au><au>Kilicaslan, Isin</au><au>Oto, Ozgur Akin</au><au>Yalcinkaya, Yasemin</au><au>Caliskan, Yasar</au><au>Artim-Esen, Bahar</au><au>Yazici, Halil</au><au>Inanc, Murat</au><au>Turkmen, Aydin</au><au>Gul, Ahmet</au><au>Sever, Mehmet Sukru</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy and safety of interleukin-1 blockers in kidney transplant recipients with familial Mediterranean fever: a propensity score–matched cohort study</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><addtitle>Nephrol Dial Transplant</addtitle><date>2023-05-04</date><risdate>2023</risdate><volume>38</volume><issue>5</issue><spage>1327</spage><epage>1336</epage><pages>1327-1336</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><abstract>ABSTRACT
Background
Data on use of interleukin (IL)-1 blockers in kidney transplant recipients (KTRs) with familial Mediterranean fever (FMF) are very limited. We aimed to evaluate the efficacy and safety of anakinra and canakinumab in the transplantation setting.
Methods
In this retrospective cohort study, we included KTRs who suffered from AA amyloidosis caused by FMF and treated with anakinra or canakinumab (study group, n = 36). Using propensity score matching, we selected 36 patients without FMF or amyloidosis from our database of 696 KTRs as the control group. Primary outcomes were patient and graft survival. Biopsy-confirmed graft rejection, changes in estimated glomerular filtration rate (eGFR), high-sensitivity CRP (hsCRP), erythrocyte sedimentation rate (ESR), proteinuria and number of monthly attacks were secondary outcomes.
Results
All KTRs with FMF began IL-1 blocker therapy with anakinra and nine (25%) were switched to canakinumab. Overall death was more frequent in the study group (19.4% vs 0%) (P = .005); however, overall graft loss was comparable between study (27.8%) and control groups (36.1%) (P = .448). Five- and 10-year graft survival rates were significantly higher in the study group (94.4% and 83.3%, respectively) than in the control group (77.8% and 63.9%, respectively) (P = .014 and P < .001, respectively). Rejections were numerically lower in study group (8.3% vs 25%), but it did not reach to statistical significance (P = .058). When compared with the pre-treatment period, with IL-1 blockers, the number of attacks per month (P < .001), and eGFR (P = .004), hsCRP (P < .001) and ESR (P = .026) levels were lower throughout the follow-up, whereas proteinuria levels were not.
Conclusions
Anakinra and canakinumab are effective in KTRs suffering from FMF; however, the mortality rate may be of concern.
Graphical Abstract
Graphical Abstract</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>36542475</pmid><doi>10.1093/ndt/gfac335</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-0362-8154</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0931-0509 |
| ispartof | Nephrology, dialysis, transplantation, 2023-05, Vol.38 (5), p.1327-1336 |
| issn | 0931-0509 1460-2385 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2756670049 |
| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | C-Reactive Protein Cohort Studies Colchicine Familial Mediterranean Fever - complications Familial Mediterranean Fever - drug therapy Humans Interleukin 1 Receptor Antagonist Protein - therapeutic use Interleukin-1 Kidney Transplantation - adverse effects Propensity Score Proteinuria - complications Retrospective Studies |
| title | Efficacy and safety of interleukin-1 blockers in kidney transplant recipients with familial Mediterranean fever: a propensity score–matched cohort study |
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