{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:01:19Z","timestamp":1790143279442,"version":"4.0.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009647","name":"Ministry of Health","doi-asserted-by":"publisher","award":["PHRC 2012; AOM0045"],"award-info":[{"award-number":["PHRC 2012; AOM0045"]}],"id":[{"id":"10.13039\/100009647","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008008","name":"Fondation Centaure","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008008","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontierspartnerships.org"],"crossmark-restriction":true},"short-container-title":["Transpl. Int."],"abstract":"<jats:p>\n                    Bortezomib has been proposed as a treatment for antibody-mediated rejection (AMR) after kidney transplantation; however, its efficacy remains uncertain. We conducted a multicenter, randomized, open-label trial in France between February 2015 and July 2019 in adult kidney transplant recipients with late active AMR associated with\n                    <jats:italic>de novo<\/jats:italic>\n                    donor-specific antibodies (dnDSA). Sixty of the planned 100 patients were randomized 1:1 to receive standard-of-care consisting of corticosteroids, plasmapheresis, and intravenous immunoglobulin, either alone or with bortezomib administered as two cycles of four infusions. The primary endpoint was a composite of a &amp;gt;50% reduction in immunodominant DSA mean fluorescence intensity and stabilization or improvement of microvascular inflammation and transplant glomerulopathy on graft biopsy at 12 months. This endpoint was achieved in 40.0% of patients receiving bortezomib and 33.3% receiving standard-of-care alone in the intention-to-treat analysis (RR = 1.20, 95% CI 0.61\u20132.34; p = 0.59), and in 50.0% and 42.1%, respectively, in the per-protocol analysis (RR = 1.19, 95% CI 0.60\u20132.36; p = 0.62). Neither component differed between groups. Serious adverse events occurred in 23 patients (76.7%) receiving bortezomib and 14 patients (46.7%) receiving standard-of-care alone (p = 0.017). Adding bortezomib did not demonstrate a significant efficacy benefit and was associated with a higher incidence of serious adverse events (\n                    <jats:ext-link>ClinicalTrials.gov<\/jats:ext-link>\n                    number: NCT02201576).\n                  <\/jats:p>","DOI":"10.3389\/ti.2026.16702","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:10:09Z","timestamp":1790140209000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Bortezomib in combination with standard-of-care for late active antibody-mediated rejection with de novo donor-specific antibodies after kidney transplantation: a multicenter randomized trial"],"prefix":"10.3389","volume":"39","author":[{"given":"Renaud","family":"Snanoudj","sequence":"first","affiliation":[{"name":"Nephrology Dialysis and Transplantation Department, Hopital Bicetre","place":["Le Kremlin-Bic\u00eatre, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabienne","family":"Marquant","sequence":"additional","affiliation":[{"name":"Unit of Clinical Research, Hopital Universitaire Necker-Enfants Malades","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karine","family":"Renaudin","sequence":"additional","affiliation":[{"name":"Pathology Department, Centre Hospitalier Universitaire de Nantes","place":["Nantes, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Dubois","sequence":"additional","affiliation":[{"name":"Histocompatibility Department, Etablissement Francais du Sang Auvergne-Rhone-Alpes","place":["D\u00e9cines-Charpieu, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Koenig","sequence":"additional","affiliation":[{"name":"Transplantation Department, Hospices Civils de Lyon","place":["Lyon, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Arzouk","sequence":"additional","affiliation":[{"name":"Transplantation Department, Hopital Universitaire Pitie-Salpetriere","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Caillard","sequence":"additional","affiliation":[{"name":"Nephrology Dialysis and Transplantation Department, Hopital Civil","place":["Strasbourg, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magali","family":"Giral","sequence":"additional","affiliation":[{"name":"Nephrology Dialysis and Transplantation Department, Hotel Dieu","place":["Nantes, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arwa","family":"Jalal Eddine","sequence":"additional","affiliation":[{"name":"Nephrology Department, Hopital Foch","place":["Suresnes, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakim","family":"Mazouz","sequence":"additional","affiliation":[{"name":"Nephrology and Transplantation Department, Centre Hospitalier Universitaire Amiens-Picardie","place":["Amiens, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nassim","family":"Kamar","sequence":"additional","affiliation":[{"name":"Nephrology and Organ Transplantation Department, Hopital de Rangueil","place":["Toulouse, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Pernin","sequence":"additional","affiliation":[{"name":"Nephrology and Organ Transplantation Department, Hopital Lapeyronie","place":["Montpellier, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Matignon","sequence":"additional","affiliation":[{"name":"Nephrology and Organ Transplantation Department, Hopitaux Universitaires Henri Mondor","place":["Cr\u00e9teil, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nacera","family":"Ouali","sequence":"additional","affiliation":[{"name":"Nephrology and Organ Transplantation Department, Hopital Tenon","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dany","family":"Anglicheau","sequence":"additional","affiliation":[{"name":"Department of Kidney and Metabolic Diseases, Transplantation and Clinical Immunology, AP-HP, Necker Hospital, Universit\u00e9 Paris Cit\u00e9","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Elie","sequence":"additional","affiliation":[{"name":"Unit of Clinical Research, Hopital Universitaire Necker-Enfants Malades","place":["Paris, France"]},{"name":"Pharmacologie et \u00c9valuations des Th\u00e9rapeutiques Chez l\u2019Enfant et la Femme Enceinte, Inserm, Universite Paris Cite","place":["Paris, 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