Department of Medicine, University of California San Francisco, San Francisco, California, USA.
Division of Transplant Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Am J Transplant. 2024 Sep;24(9):1644-1651. doi: 10.1016/j.ajt.2024.02.014. Epub 2024 Feb 20.
In kidney transplant recipients, delayed graft function increases the risk of graft failure and mortality. In a phase 3, randomized, double-blind, placebo-controlled trial, we investigated the hepatocyte growth factor mimetic, ANG-3777 (once daily for 3 consecutive days, starting ≤30 hours posttransplant), in 248 patients receiving a first kidney transplant from a deceased donor. At day 360, estimated glomerular filtration rate (primary endpoint) was not significantly different between the ANG-3777 and placebo groups. There were no significant between-group differences in the duration of dialysis through day 30 or in the percentage of patients with an estimated glomerular filtration rate of >30 mL/min/1.73 m at day 360. The incidence of both delayed graft function and acute rejection was similar between ANG-3777 and placebo groups (68.5% vs 69.4% and 8.1% vs 6.5%, respectively). ANG-3777 was well tolerated, and there was a numerically lower incidence of graft failure versus placebo (3.2% vs 8.1%). Although there is insufficient evidence to support an indication of ANG-3777 for patients at risk of renal dysfunction after deceased-donor kidney transplantation, these findings indicate potential biological activity that may warrant further investigation.
在接受肾移植的患者中,延迟移植物功能会增加移植物失功和死亡的风险。在一项 3 期、随机、双盲、安慰剂对照试验中,我们研究了肝细胞生长因子类似物 ANG-3777(在移植后≤30 小时内连续 3 天每天 1 次)在 248 例接受已故供体肾移植的患者中的应用。在第 360 天,ANG-3777 组和安慰剂组的肾小球滤过率估计值(主要终点)无显著差异。在第 30 天之前进行透析的持续时间或在第 360 天肾小球滤过率估计值>30 mL/min/1.73 m 的患者比例方面,两组间均无显著差异。ANG-3777 组和安慰剂组的延迟移植物功能和急性排斥反应的发生率相似(分别为 68.5%比 69.4%和 8.1%比 6.5%)。ANG-3777 耐受性良好,与安慰剂相比,移植物失功的发生率较低(3.2%比 8.1%)。尽管尚无充分证据支持 ANG-3777 用于有肾功能障碍风险的已故供体肾移植患者,但这些发现表明其具有潜在的生物学活性,可能需要进一步研究。