Tegoprubart preserves kidney function better than tacrolimus in first-time transplant patients, trial suggests

The phase 2 BESTOW clinical trial showed that tegoprubart (a novel anti-CD40L antibody therapy) was better at preserving kidney function than tacrolimus (the current standard of care) in immunosuppressive regimens in adults receiving their first kidney transplant. Kidney graft function stabilized after the first month of treatment and remained higher in tegoprubart-treated patients than in tacrolimus-treated patients at each reported time point, with a statistically significant kidney function benefit at 18 months. A recent analysis of BESTOW data found that tegoprubart also caused greater improvements in patient-reported health-related quality of life compared with tacrolimus in study participants. The findings will be presented at ASN Kidney Week 2026, Oct. 22–25.

Of 127 treated patients, 107 (51 taking tegoprubart and 56 taking tacrolimus) completed study treatment to week 52. Health-related quality of life improvements from baseline were observed at week 52 across all five subscales with tegoprubart, and four of five subscales with tacrolimus. Improvements were greater with tegoprubart than tacrolimus on a mental component summary, and patients on tegoprubart also had a numerically greater reduction in total symptom score from baseline.

“Treatment today with tacrolimus helps prevent organ rejection but at a high cost to patients, with side effects such as kidney toxicity, hypertension, diabetes, tremors and brain fog. Tegoprubart, which works by targeting the CD40L pathway that is central to how immune cells communicate, has the potential to replace tacrolimus and become the new standard of care immunosuppression therapy across all transplant types, not just kidney transplantation,” said corresponding author Andrew Adams, M.D., Ph.D., of the University of Minnesota Medical School.

“These latest BESTOW trial results are encouraging that we may soon have a new medication that can prevent rejection without the side effects of tacrolimus and transform the broader transplant immunosuppression treatment landscape.”

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