Several patient series have suggested positive effects of bortezomib within multimodal treatment regimens with an acceptable safety profile. Furthermore, no specific treatment approaches have been approved by the US Food and Drug Administration.
Roche’s product Rituximab, a chimeric monoclonal IgG antibody directed against the CD20 antigen expressed on the surface of pre‐B and mature B cells, causes B cell lysis via both complement‐dependent cytotoxicity and antibody‐dependent cell‐mediated cytotoxicity. It is approved for use in several B cell lymphomas and leukemias as well as in rheumatoid arthritis. Rituximab appears to be ineffective for the treatment of AMR.
Belatacept is a fusion protein designed to be a selective T cell co-stimulation blocker that binds to a specific site on certain cells of the immune system (i.e., antigen presenting cells) to block the second signal necessary to activate T cells, which are the predominate immune mediators of allograft rejection. While removal of antibody remains the cornerstone of AMR therapy, improved understanding of the pathophysiological mechanisms of antibody production and antibody mediated injury have yielded several adjunctive treatment.
AMR is a fascinating field with ample opportunities for research and progress in the future. Despite the use of advanced techniques for the detection of human leukocyte antigen (HLA) or non-HLA donor-specific antibodies, alloimmune response remains an important barrier for successful long-term allograft function. Treatment of AMR with currently available therapies has produced a variety of results, some of them suboptimal, precluding the development of standardized protocols. New therapies are promising, but randomized controlled trials are needed to find surrogate markers and improve the efficacy of therapy.
Given the scope and severity of the problem, it is unfortunate that there are no commonly accepted guidelines for treatment. To date, clinical trials of AMR have been small or inconclusive, and there are no Federal Drug Administration (FDA)-approved therapies for the prevention and treatment of the condition. The lack of an accepted common standard for the treatment of AMR has been an impediment to the development of new therapies because it is difficult for industry to initiate phase II and III clinical trials for novel treatments or prevention of AMR. These factors indicate the need for development of novel treatment regimes which in turn will contribute towards the market growth during the forecast period (2020-2030).
Read More- Antibody-Mediated Rejection Market Insights
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