Nowadays kidney failure causes one of every 55 to 75 deaths of Americans or Europeans. Kidney transplantation is the treatment of choice for patients with end stage renal failure, because it has by large demonstrated to improve patients QoL and to decrease treatment costs.
However, these patients have a persistent risk of graft rejection due to immune-mediated kidney injury. To limit this risk, transplanted kidney patients require long term treatment with different immunosuppressive (IMSs) drugs and doses.
Currently, the IMSs prescribed regimens are mainly empirical, based on standard clinical guidelines, drug levels on blood, and the appearance of adverse events related with the treatment. There is a lack of biomarkers to help health professionals to establish a personalized therapeutic immunosuppression plan for each patient. Consequently, patients with inadequate drug regimens of IMSs may have over medication and under medication. Under-immunosuppression can lead to graft rejection and over-immunosuppression exposes the patient to a variety of adverse events like opportunistic infections and increased risk of cancer.
Here are some figures that illustrate the current situation:
- Circa 50% of all renal transplants fail within 10 years (deceased-donor kidney transplant, unadjusted). 1
- Rejection is the most important cause of graft failure (64%) and it is closely related with the immunosuppressive treatment patients receive. 2
- Around 60% of transplant recipients could be resistant to their current medication
- 33% of the mortality in renal transplant patients is due to infections and malignancies
“The aim of immunosuppression optimization is to develop an immunosuppression protocol for the individual recipient, which provides maximum protection for both patient and graft from immune-mediated damage, with the minimum immunosuppressive burden” 3
A new approach is needed, based on the principles of precision medicine, to facilitate doctors the opportunity to prescribe their patients those drugs with the best response at the appropriate dose.
There is a clear medical need for technological advances in renal transplantation to develop new tools capable of measuring the patient’s pharmacodynamic immune response to each IMS.
At Biohope, with the objective to fulfill this unmet medical need, we have developed the Immunobiogram®. It is a simple, proven, and unique blood-based in vitro diagnostic tool that offers physicians information of the patient´s response to individual immunosuppressive drugs. This information eases them to personalize immunosuppressant therapy by selecting the optimal combination of drugs and dosage.
Immunobiogram®-Renal Transplant combines a biotechnological KIT and a software for data interpretation; as a pharmacodynamic test, it provides the sensitivity profile of kidney transplant patients circulating PBMCs to a panel of immunosuppressants.
Because medication is mostly the only actionable driver in clinical management, the personalization of therapies and the improvement of the patients´ response to medication should contribute to a better clinical prognosis. The results from the Immunobiogram®-Renal Transplant, with other relevant clinical information, can support clinicians to take informed decisions to adequate the immunosuppressive treatment in patients with RT.
The Immunobiogram®-Renal Transplant could benefit patients, physicians, and healthcare providers. In kidney transplant patients, a personalized immunosuppression treatment could substantially contribute to reduce graft rejection rates and prevent adverse events such as metabolic disorders, opportunistic infections, and malignancies.
In summary, what are the main benefits of the Immunobiogram®-Renal Transplant?
- It provides a predictable individualized patient response pattern to immunosuppressive medication
- A sensitivity profile can be determined in each patient for each of the drugs
- It can help to identify patients with bad prognosis due to low sensitivity to specific immunosuppressants.
- It can help to avoid over medication and the effects derived from an excess of drugs in transplant patients
- Its use may have the potential to reduce the risk of renal graft failure and adverse events associated with IMSs, with considerable savings for the NHS.
The Immunobiogram® platform was developed with the aim of improving the clinical management of autoimmune diseases, being Immunobiogram®-Renal Transplant the first application.
If you want to know more, please contact us
* Immunobiogram® is a Biohope trademark
1 United States Renal Data System. 2017 USRDS annual data report. vol 2 Table 6.4 Trends in 1-, 5-, & 10-year deceased-donor kidney transplant outcomes. https://www.usrds.org/2017/view/Default.aspx
2 Sellares et al. American Journal of Transplantation 2012; 12: 388–399
3 Neuberger J et al.Transplantation 2017;101: S1–S56