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In addition, belatacept was associated with superior renal function and reduced CAN, despite a higher rate of early AR [100]. The prevalence of CAN in protocol biopsies was 18%, 24% and 32% in the MI, LI and CsA groups, respectively (P?=?0.001) in the BENEFIT study, and 45%, 46% and 52% in the corresponding groups, respectively (P?=?0.22) in the BENEFIT-EXT. The differences between the two studies concerning the prevalence of CAN probably reflect the higher incidence http://www.selleckchem.com/products/Y-27632.html of pre-existing lesions in kidneys from extended criteria donors in the BENEFIT-EXT study. The renal function in belatacept-treated patients evaluated by estimated GFR showed a positive slope through year 3 in contrast with a negative slope in patients receiving CsA in the BENEFIT study. In the BENEFIT-EXT, the three therapeutic arms displayed a negative slope through year http://www.selleck.cn/products/BKM-120.html 3, but attenuated in belatacept patients in comparison with those under CsA. The better preservation of renal function and parenchyma might have a positive impact on long-term graft survival, which should be assessed in extended follow-up. Whether the renal benefits of belatacept observed in these pivotal trials are as a result of its immunomodulatory properties or the mere avoidance of CNI-related nephrotoxicity is a question that remains open. Another potential benefit of avoiding the use of CNI immunosuppressants in maintenance immunosuppression with belatacept might be the amelioration of cardiovascular risk profile of renal transplant recipients. In a pooled analysis of BENEFIT http://www.selleckchem.com/products/chir-99021-ct99021-hcl.html and BENEFIT-EXT studies including 1209 patients, cardiovascular and metabolic endpoints were assessed at 12?months after transplantation [105]. Across both studies, fewer patients in the belatacept regimens used three or more antihypertensive medications. In BENEFIT, 29% (MI), 26% (LI), and 35% (CsA) of patients used three or more antihypertensive medications. Both the belatacept MI and LI regimens were associated with a 30% reduction in the odds for requiring a higher number of antihypertensive medications at month 12 (P?=?0.02 LI versus CsA). In BENEFIT-EXT, 43% (MI), 39% (LI), and 52% (CsA) of patients used three or more antihypertensive medications. The belatacept regimens were associated with a 30% (MI) and 40% (LI) reduction in the odds for requiring a higher number of antihypertensive medications at month 12 (P?=?0.011; LI versus CsA) and mean systolic blood pressure was 6�C9?mmHg lower and mean diastolic blood pressure was 3�C4?mmHg lower in the MI and LI groups versus CsA (P?��?0.002). The lipidic profile was also better under belatacept. Non-HDL cholesterol was lower in the belatacept groups versus CsA (P?