The use of anti-interleukin-1 agents and tumor necrosis factor‐alpha inhibitors in renal transplant recipients
Veli Yazısız1, Vural Taner Yılmaz2, İsmail Uçar1, Özgür Dandin3, Bengisu Aslan1, Funda Erbasan1, Hüseyin Koçak2, Mustafa Ender Terzioğlu1
1Department of Internal Medicine, Division of Rheumatology, Akdeniz University School of Medicine, Antalya, Turkey
2Department of Nephrology, Akdeniz University School of Medicine, Antalya, Turkey
3Department of General Surgery, Akdeniz University School of Medicine, Antalya, Turkey
Keywords: Amyloidosis, anti-interleukin-1, familial Mediterranean fever, inhibitors, kidney, transplantation, tumor necrosis factor-alpha
Objectives: The aim of this study was to investigate the efficacy and safety of anti-interleukin-1 (anti-IL-1) agents and tumor necrosis factor‐alpha (TNF-α) inhibitors in renal transplant patients.
Patients and methods: Between February 2014 and February 2020, data of 12 renal transplant recipients (9 males, 3 females; median age: 51 years; range, 19 to 70 years) who received anti-IL-1 agents or TNF-α inhibitors for inflammatory diseases in the post-transplant time period and were followed in a single transplant center (n=12) were retrospectively analyzed. A total of 46 cases were reported in the literature, before the data were collected. The overall outcomes of all cases were analyzed in this study.
Results: Thirty-seven patients received anti-IL-1 agents in the post-transplant period. The main indications for anti-IL-1 agents were familial Mediterranean fever (FMF) and amyloidosis (75.7%). The continuation rate of colchicine treatment in patients with FMF was 85.7%. Anti-IL-1 agents prevented attacks completely in 89.3% of FMF patients. The number of cases used TNF-α inhibitors among renal transplant patients was lower (n=21). The TNF-α inhibitors were used mainly for inflammatory bowel diseases (57.1%) and ankylosing spondylitis (33.3%) and suppressed the disease activity in most of the patients with inflammatory diseases (72.7%). Death (n=3) and malignancies (n=3) were reported in patients who received TNF-α inhibitors, but not in patients who received anti-IL-1. The renal outcomes and graft survival rates were satisfactory in patients who received both anti-IL-1 agents and TNF-α inhibitors.
Conclusion: Our results support that anti-IL-1 agents can be used effectively and safely in renal transplant patients.