Consensus Definitions of BK Polyomavirus Nephropathy in Renal Transplant Recipients for Clinical Trials

Author:

Imlay Hannah1,Baum Paul2,Brennan Daniel C3,Hanson Kimberly E1,Hodges Michael R4,Hodowanec Aimee C5,Komatsu Takashi E5,Ljungman Per6,Miller Veronica7,Natori Yoichiro8ORCID,Nickeleit Volker9,O’Rear Jules5,Pikis Andreas5,Randhawa Parmjeet S10,Sawinski Deirdre11,Singh Harsharan K9,Westman Gabriel12,Limaye Ajit P13

Affiliation:

1. Department of Internal Medicine, University of Utah , Salt Lake City, Utah , USA

2. Roche Molecular Diagnostics , San Francisco, California , USA

3. Johns Hopkins Comprehensive Medical Center , Baltimore, Maryland , USA

4. RNA Medicines , San Diego, California , USA

5. US Food and Drug Administration , Silver Spring, Maryland , USA

6. Karolinska University Hospital and Karolinska Institutet , Stockholm , Sweden

7. The Forum for Collaborative Research , Washington DC , USA

8. Department of Medicine, University of Miami Miller School of Medicine/Miami Transplant Institute , Miami, Florida , USA

9. Department of Pathology & Laboratory Medicine, University of North Carolina School of Medicine , Chapel Hill, North Carolina , USA

10. Department of Pathology, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania , USA

11. Department of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA

12. Swedish Medical Products Agency, Uppsala University , Uppsala , Sweden

13. Department of Medicine, University of Washington , Seattle, Washington , USA

Abstract

Abstract Background BK polyomavirus (BKPyV) infection and BK polyomavirus nephropathy (BKPyVAN) are important causes of allograft dysfunction and premature allograft loss in renal transplant recipients. Results and Discussion Controlled clinical trials to evaluate new agents for prevention and treatment are needed but are hampered by the lack of outcome measures that accurately assess the effect of the intervention, are clinically relevant, and are acceptable from a regulatory perspective. Methods To facilitate consistent end points in clinical trials and to support clinical research and drug development, definitions of BKPyV infection and disease have been developed by the BK Disease Definitions Working Group of the Transplantation Associated Virus Infection Forum with the Forum for Collaborative Research, which consists of scientists, clinicians, regulators, and industry representatives. Conclusions These definitions refine established principles of “proven” BKPyV disease and introduce a “probable” disease category that could be used in clinical trials to prevent or treat BKPyVAN in renal transplant recipients.

Funder

National Institutes of Health

National Heart, Lung, and Blood Institute

National Institute of Allergy and Infectious Diseases

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

Reference40 articles.

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3. BK virus nephropathy: histological evolution by sequential pathology.;Nankivell;Am J Transplant,2017

4. BK polyomavirus in solid organ transplantation;Hirsch;Clin Transplant,2019

5. BK virus nephropathy.;Sawinski;Clin J Am Soc Nephrol,2018

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