Evidence map›Paper›PMID 36593877›Full record

ArticleKidney medicine2023

Cardiovascular Risk Following Conversion to Belatacept From a Calcineurin Inhibitor in Kidney Transplant Recipients: A Randomized Clinical Trial.

Obbo W Bredewold, Joe Chan, My Svensson, Annette Bruchfeld, Johan W de Fijter, Hans Furuland, Josep M Grinyo, Anders Hartmann, Hallvard Holdaas, Olof Hellberg and 8 more

Open access · goldAbstract read
In one paragraph

Article in Kidney medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.7field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 9 citations in OpenAlex.

  1. New kidneys, old risks: cardiovascular challenges after transplantation.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026
    Review
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 13 institutions in 6 countries.

Obbo W BredewoldDepartment of Nephrology, Leiden University Medical Center, Leiden, The Netherlands.
Joe ChanDepartment of Renal Medicine, Akershus University Hospital, Lørenskog, Norway.
My SvenssonDepartment of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark.
Annette BruchfeldDepartment of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Johan W de FijterDepartment of Nephrology, Leiden University Medical Center, Leiden, The Netherlands.
Hans FurulandDepartment of Medical Science, Renal Unit, University Hospital, Uppsala, Sweden.
Josep M GrinyoDepartment of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
Anders HartmannDepartment of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.
Hallvard HoldaasDepartment of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.
Olof HellbergDepartment of Internal Medicine, School of Medical Sciences, Örebro University, Örebro, Sweden.
Alan JardineDepartment of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Lars MjörnstedtDivision of Transplantation, Department of Surgery, Sahlgrenska University Hospital, Göteborg, Sweden.
Karin SkovDepartment of Renal Medicine, Aarhus University Hospital, Denmark.
Knut T SmerudSmerud Medical Research International AS, Oslo, Norway.
Inga SoveriDepartment of Medical Science, Renal Unit, University Hospital, Uppsala, Sweden.
Søren S SørensenDepartment of Nephrology, Copenhagen University Hospital, Copenhagen, Denmark.
Anton-Jan van ZonneveldDepartment of Nephrology, Leiden University Medical Center, Leiden, The Netherlands.
Bengt FellströmDepartment of Medical Science, Renal Unit, University Hospital, Uppsala, Sweden.
Leiden University Medical Center · NLUppsala University Hospital · SEOslo University Hospital · NOAalborg University Hospital · DKAarhus University Hospital · DKAkershus University Hospital · NOCopenhagen University Hospital · DKLinköping University · SEÖrebro University · SESahlgrenska University Hospital · SESmerud Medical Research (Norway) · NOUniversitat de Barcelona · ESUniversity of Glasgow · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Rationale & Objective: In kidney transplant recipients (KTRs), a belatacept-based immunosuppressive regimen is associated with beneficial effects on cardiovascular (CV) risk factors compared with calcineurin inhibitor (CNI)-based regimens. Our objective was to compare the calculated CV risk between belatacept and CNI (predominantly tacrolimus) treatments using a validated model developed for KTRs. Study Design: Prospective, randomized, open-label, parallel-group, investigator-initiated, international multicenter trial. Setting & Participants: KTRs aged 18-80 years with a stable graft function (estimated glomerular filtration rate > 20 mL/min/1.73 m Intervention: Continuation with a CNI-based regimen or switch to belatacept for 12 months. Outcomes: Comparison of the change in the estimated 7-year risk of major adverse CV events and all-cause mortality, changes in traditional markers of CV health, as well as measures of arterial stiffness. Results: Among the 105 KTRs randomized, we found no differences between the treatment groups in the predicted risk for major adverse CV events or mortality. Diastolic blood pressure, measured both centrally by using a SphygmoCor device and peripherally, was lower after the belatacept treatment than after the CNI treatment. The mean changes in traditional cardiovascular (CV) risk factors, including kidney transplant function, were otherwise similar in both the treatment groups. The belatacept group had 4 acute rejection episodes; 2 were severe rejections, of which 1 led to graft loss. Limitations: The heterogeneous baseline estimated glomerular filtration rate and time from transplantation to trial enrollment in the participants. A limited study duration of 1 year. Conclusions: We found no effects on the calculated CV risk by switching to the belatacept treatment. Participants in the belatacept group had not only lower central and peripheral diastolic blood pressure but also a higher rejection rate. Funding: The trial has received a financial grant from Bristol-Myers Squibb. Trial Registration: EudraCT no. 2013-001178-20.

Indexed as

arterial stiffnessbelataceptblood pressurecalcineurin inhibitorscardiovascular diseaseKidney transplantationmortalitypulse wave velocityrandomized clinical trialtacrolimus

Identifiers

PMID36593877
PMCPMC9803830
OpenAlexW4309472574

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.