{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:39:34Z","timestamp":1792795174387,"version":"4.5.0"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T00:00:00Z","timestamp":1699488000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>Chronic active antibody-mediated rejection (caAMR) is arguably the most important cause of late kidney allograft failure. However, there are no US Food and Drug Administration (FDA)-approved treatments for acute or chronic AMR and there is no consensus on effective treatment. Many trials in transplantation have failed because of slow and\/or inadequate enrollment, and no new agent has been approved by the FDA for transplantation in over a decade. Several lines of evidence suggest that interleukin-6 is an important driver of AMR, and clazakizumab, a humanized monoclonal antibody that neutralizes interleukin-6, has shown promising results in phase 2 studies. The IMAGINE trial (Interleukin-6 Blockade Modifying Antibody-mediated Graft Injury and Estimated Glomerular Filtration Rate Decline) (NCT03744910) is the first to be considered by the FDA using a reasonably likely surrogate endpoint (slope of estimated glomerular filtration rate decline &gt;1 y) for accelerated approval and is the only ongoing clinical trial for the treatment of chronic rejection. This trial offers us the opportunity to advance the care for our patients in need, and this article is a call to action for all transplant providers caring for patients with caAMR.<\/jats:p>","DOI":"10.1097\/tp.0000000000004822","type":"journal-article","created":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T00:00:32Z","timestamp":1699488032000},"page":"1109-1114","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":22,"title":["Chronic Active Antibody-mediated Rejection: Opportunity to Determine the Role of Interleukin-6 Blockade"],"prefix":"10.1097","volume":"108","author":[{"given":"Mel","family":"Berger","sequence":"first","affiliation":[{"name":"Departments of Pediatrics and Pathology, Case Western Reserve University, Cleveland, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Baliker","sequence":"additional","affiliation":[{"name":"Patient Advocate, Middle Town, WI."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teun","family":"Van Gelder","sequence":"additional","affiliation":[{"name":"Department Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg A.","family":"B\u00f6hmig","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Vienna, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roslyn B.","family":"Mannon","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepali","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Transplant Infectious Disease, Ajmera Transplant Centre, Toronto, ON, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Chadban","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, NSW, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Nickerson","sequence":"additional","affiliation":[{"name":"Department of Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie A.","family":"Lee","sequence":"additional","affiliation":[{"name":"Research and Development, Transplant Therapeutic Area, CSL Behring, King of Prussia, Pennsylvania, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjang","family":"Djamali","sequence":"additional","affiliation":[{"name":"Department of Medicine, Maine Medical Center, Portland, 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