belatacept at a glance
Medicine class
Selective immunosuppressant and T-cell costimulation blocker
Usual role
Prevention of rejection after an adult kidney transplant
Administration
Intravenous infusion prepared and given by a healthcare professional
Specialist care
Prescribed and supervised by a kidney-transplant specialist
What is belatacept used for?
Belatacept is licensed with corticosteroids and mycophenolic acid to prevent graft rejection in adult kidney-transplant recipients.
A specialist may use it following transplantation or when converting an eligible adult from calcineurin-inhibitor-based maintenance treatment.
It is not recommended for liver transplantation. Safety and effectiveness have not been established in people under 18.
How does belatacept work?
Belatacept binds CD80 and CD86 on antigen-presenting cells, blocking a signal needed for T-cell activation. This weakens the immune response that can attack a transplanted kidney.
belatacept preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 250 mg
How to take belatacept
Belatacept is not taken by mouth. A healthcare professional prepares the powder and gives it through a vein. Keep every infusion appointment and do not stop belatacept or alter other anti-rejection treatments without agreement from the transplant team.
No food restrictions are specified because it is given intravenously.
Tell staff immediately if you feel unwell during an infusion.
Tell the transplant team before receiving any vaccination.
belatacept side effects
Common or expected effects
- Urinary, respiratory or cytomegalovirus infections
- Fever, cough or shortness of breath
- Diarrhoea, constipation, nausea, vomiting or abdominal pain
- Headache, insomnia or anxiety
- High or low blood pressure
- Swelling of the hands or feet
- Joint, back or limb pain
- Changes in blood counts, glucose, electrolytes or kidney-test results
Get urgent medical advice
- Severe or opportunistic infection, including sepsis, tuberculosis or pneumonia
- Anaphylaxis or another serious infusion reaction
- New neurological, cognitive, visual or behavioural symptoms that could indicate PML or another neurological disorder
- Swollen glands, unexplained weight loss or neurological symptoms that could indicate post-transplant lymphoproliferative disorder
- Reduced urine, blood in the urine or pain over the transplant, which may indicate rejection, infection or graft thrombosis
- A new or changing mole, skin lesion or lump
belatacept in pregnancy
Human data are insufficient to establish safety in pregnancy, although a small number of case reports have been published. Product information says belatacept should be used during pregnancy only when clearly necessary. Contact the transplant and obstetric specialists when planning pregnancy or after becoming pregnant.
belatacept while breastfeeding
It is unknown whether belatacept enters human milk. Product information advises against breastfeeding during a belatacept-based treatment regimen; discuss feeding options with the transplant and maternity teams.
belatacept interactions
Belatacept has few expected metabolic interactions, but clinically important immune-system interactions remain.
Live vaccines
Avoid during treatment because immunosuppression may cause an unsafe response; other vaccines may also be less effective.
Mycophenolate mofetil or mycophenolic acid
Mycophenolic-acid exposure may be higher with belatacept than with ciclosporin, so adverse effects and overall immunosuppression require specialist review.
Other immunosuppressants, including lymphocyte-depleting therapies
Combined immunosuppression increases the risk of serious infection and malignancy. Treatment must be coordinated by the transplant team.
Common questions about belatacept
Answers are fully visible for fast scanning and source review.
Is belatacept a tablet?
No. It is prepared from a powder and given into a vein by a healthcare professional.
Why is an Epstein-Barr virus test needed?
People without previous EBV exposure have a higher risk of post-transplant lymphoproliferative disorder. Belatacept must not be given when EBV testing is negative or the status is unknown.
Does belatacept increase infection risk?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.