Imlifidase is in clinical development for enabling kidney transplantation in highly sensitised patients with chronic kidney disease (CKD). CKD is a long-term irreversible condition where the kidneys do not work as well as they should. Kidney transplantation is considered to be treatment of choice for patients with end stage kidney disease. Many patients on the waiting list for organ transplantation carry antibodies to human leukocyte antigen (HLA), which is known as being ‘sensitised.’ Patients who are highly sensitised may find it difficult getting a donor and may not be able to receive a transplant due to increased risk of kidney rejection.
Imlifidase is made of an enzyme derived from the bacterium called Streptococcus pyogenes. It specifically cleaves all human subclasses of proteins called immunoglobulin IgG. This mechanism inhibits all IgG mediated immunity and prevents rejection of a transplanted kidney. If licensed, imlifidase will offer a treatment that enables kidney transplantation in highly sensitised patients with CKD.
Etrolizumab is a new monoclonal antibody (an immune protein) delivered by subcutaneous injection. The treatment works by targeting molecules called integrins to control the immune response and prevent the accumulation of immune molecules, which cause inflammation in individuals with a form of ulcerative colitis where inflammation is not mediated by a signalling protein called tumour necrosis factors (TNF) alpha (‘non-TNF-α’) and who are therefore intolerant to TNF blockers. This represents a new target group as current therapies focus mainly on anti-TNF inflammation. In one study, etrolizumab showed a greater reduction of intestinal lymphocyte infiltration in comparison to standard treatment.