Eledon reports 12-month Phase 2 BESTOW results showing improved quality of life and reduced symptom burden with tegoprubart versus tacrolimus after kidney transplantation.
Written By: Khushi Patel, PharmD
Reviewed By: Pharmacally Editorial Team
Eledon Pharmaceuticals reported sustained improvements in symptom burden and health-related quality of life with tegoprubart versus tacrolimus in kidney transplant recipients in the Phase 2 BESTOW trial. The 12-month patient-reported outcomes, presented at the American Society of Nephrology (ASN) Kidney Week 2026, showed statistically significant improvement on a key kidney disease quality-of-life measure and lower symptom occurrence with tegoprubart.
Tegoprubart Shows Sustained Symptom Reduction
Tegoprubart is an investigational anti-CD40L antibody that blocks CD40 ligand, a protein involved in adaptive and innate immune cell activation. Eledon is developing the therapy as an alternative immunosuppressive approach for kidney transplantation, where tacrolimus remains a standard treatment to prevent graft rejection.
Investigators assessed patient-reported outcomes using the Modified Transplant Symptom Occurrence and Symptom Distress Scale (MTSOSD-59R) and the Kidney Disease Quality of Life Short Form (KDQOL-SF).
On the MTSOSD-59R, tegoprubart-treated patients reported continued reductions in symptom occurrence at months 6 and 12 compared with baseline. Symptoms initially declined in the tacrolimus group through month 6 but returned to slightly above baseline by month 12.
At month 12, the mean total MTSOSD-59R symptom occurrence score was 18.6 in the tegoprubart group versus 25.7 with tacrolimus. Lower scores indicate fewer symptoms. The reported unadjusted between-group difference was −7.1 points (95% confidence interval [CI], −12.2 to −1.0), while the baseline-adjusted difference was −6.9 points (95% CI, −12.7 to −1.1).
The advantage extended across individual symptom domains. Tegoprubart showed greater improvement than tacrolimus in 22 of the 23 domains where differential improvement was observed. Tacrolimus showed greater symptom worsening in all 22 domains where differential worsening was observed. These domains included neurological, gastrointestinal, metabolic and physical symptoms.
Quality-of-Life Scores Improve with Tegoprubart
The KDQOL-SF results reinforced the symptom findings. Patients receiving tegoprubart improved from baseline across all five subscales through month 12.
On the Symptoms and Problems subscale, the mean change from baseline was 9.0 points with tegoprubart versus 3.3 points with tacrolimus, a statistically significant between-group difference (p<0.05). The announcement cites a 3–5-point change as potentially clinically significant, placing the 9.0-point improvement within a range consistent with a meaningful patient-reported benefit.
The SF-12 mental component summary score also favoured tegoprubart. It increased by 1.5 points in the tegoprubart group, compared with a decline of 1.6 points with tacrolimus, resulting in a 3.1-point between-group difference.
Development Outlook
Andrew Adams, MD, PhD, of the University of Minnesota, presented the results at ASN Kidney Week 2026, held October 21–25 in Denver. The oral presentation was titled Patient-Reported Outcomes in the Phase 2 BESTOW Trial Comparing Tegoprubart to Tacrolimus in Kidney Transplant Recipients (abstract FR-OR084).
Eledon is also investigating tegoprubart in other transplantation settings, including liver, islet-cell and xenotransplantation, as well as amyotrophic lateral sclerosis. For kidney transplantation, subsequent development will need to establish the consistency of the patient-reported benefits alongside clinical efficacy and safety. Tegoprubart remains investigational, and the Phase 2 findings do not establish regulatory approval or a change in standard care.
Clinical Interpretation
The numerical findings suggest that tegoprubart’s potential advantages may extend beyond immunosuppression to patients’ symptoms and perceived quality of life during the first year after kidney transplantation. The MTSOSD-59R results indicate lower symptom occurrence, while the KDQOL-SF findings provide a statistically significant and potentially clinically meaningful improvement in the Symptoms and Problems subscale.
However, these patient-reported outcomes do not independently establish superior graft survival, rejection prevention or overall safety. The announcement refers to previously reported BESTOW efficacy, kidney function and safety findings but does not provide detailed comparative adverse-event data alongside the current results. The reported symptom-domain counts also describe domains with differential changes, not the proportion of patients who benefited.
Further clinical evaluation will need to determine whether these differences persist beyond 12 months and accompany durable graft outcomes and an acceptable safety profile.
Reference
Eledon Pharmaceuticals Presents Phase 2 BESTOW Trial Data Showing Sustained Improvements in Quality of Life and Symptom Burden with Tegoprubart Compared to Tacrolimus at American Society of Nephrology Kidney Week 2026 Annual Meeting, Eledon Pharmaceuticals, 26 October 2026
Safety and Efficacy of Tegoprubart in Patients Undergoing Kidney Transplantation, ClinicalTrials.gov ID NCT05983770
About the Writer
Khushi Patel is a Pharm.D (Linkedin) professional with a strong foundation in clinical pharmacy, patient-centered care, regulatory affairs, and pharmacovigilance, with published work on Brugada syndrome.
Her interests include regulatory affairs, pharmacovigilance, guideline integration, multimodal therapy, pharmacogenomics, and antibiogram utilization, with a focus on evidence-based clinical decision-making and medication safety.
As a Pharmacally healthcare writer, she translates clinical and scientific evidence into clear, accurate, and clinically relevant healthcare content, while continuously developing her expertise in evolving pharmacy practice.