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肝细胞生长因子类似物 ANG-3777 治疗移植肾功能延迟恢复患者的随机 3 期临床试验结果。

The hepatocyte growth factor mimetic, ANG-3777, in kidney transplant recipients with delayed graft function: Results from a randomized phase 3 trial.

机构信息

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.

出版信息

Am J Transplant. 2024 Sep;24(9):1644-1651. doi: 10.1016/j.ajt.2024.02.014. Epub 2024 Feb 20.

Abstract

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.

摘要

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。

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