Abstract: TH-PO1269
Early Experience of Sibeprenlimab in Kidney Transplant Recipients with Disease Recurrence and Antibody Mediated Rejection
Session Information
- Late-Breaking Research Posters
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Author
- Qazi, Yasir A., Providence St Joseph Heritage Medical Group, Orange, California, United States
Background
Sibeprenlimab (SIBE) was approved in the US recently but no published clinical trial data or case reports of SIBE in kidney transplant recipients (KTR's) is currently available in medical literature. KTR's who develop antibody-mediated rejection (AMR) or recurrent glomerular disease (e.g IgA nephropathy) represent disease states where B-cell directed therapies using APRIL inhibition have treatment potential.to address an unmet need. We present an observational study of SIBE added to standard immunosuppression in KTR's
Methods
We retrospectively studied 9 KTR's started on SIBE ( off label) following an indication biopsy - triggered predominantly by rising donor-derived cell-free DNA (dd-cfDNA; AlloSure/Prospera) -that showed AMR and/or immune-complex glomerular disease (including IgA-dominant deposits). Pre-therapy creatinine, eGFR, and UPCR's, WBC count were defined as the mean of the last ≤6 results immediately preceding SIBE initiation . dd-cfDNA were compared pre and post SIBE. Post-therapy values were compared to pre-therapy values using the Wilcoxon signed-rank test. BK and CMV PCR positivity before versus after therapy initiation were also assessed.
Results
dd-cfDNA decreased in 6 of 7 evaluable patients (mean 2.25% to 1.63%, p=0.11). Renal function remained stable, with no significant change in creatinine (1.65 to 1.70 mg/dL, p=0.82), eGFR (58.2 to 57.4 mL/min/1.73msq, p=0.57), or UPCR (0.35 to 0.37 mg/mg, p=0.57). No patient developed newly positive BK or CMV PCR after starting therapy; all post-therapy positive results occurred in patients with pre-existing viremia, with no signal for increased viral reactivation (Figure 1).
Conclusion
Our outcomes study is amongst the first to describe the use of SIBE in KTR's and demonstrates that SIBE was associated with a reduction in dd-cfDNA and stable renal function, without evidence of increased BK or CMV reactivation and infection in KTR's treated for AMR or recurrent glomerular disease.These findings support further investigation of SIBE as a therapeutic option addressing an unmet need in this population. Data is being collected prospectively and a multicenter registry being created.