For which kind of rejection is Besudil Mesylate Tablets useful?

Belumosudil mesylate tablets (Belumosudil) has been approved overseas for the treatment of chronic graft-versus-host disease (chronic GVHD) that has failed to respond to previous treatments. It is not suitable for acute GVHD, but has a more significant effect on chronic phase rejection. Chronic GVHD is a common long-term complication after hematopoietic stem cell transplantation. It can affect multiple systems such as the skin, oral cavity, liver, lungs, eyes, etc., and its manifestations are complex and changeable. Traditional treatments mainly rely on glucocorticoids or calcineurin inhibitors, but some patients will enter a hormone-refractory or dependent state. At this time, besudil can be used as a later-line treatment option.

The mechanism of Besudil is to regulate the activity of T cells and B cells in the immune system by inhibiting the ROCK2 pathway, thereby reducing tissue fibrosis and immune attack. This targeted immunomodulatory effect makes it particularly suitable for controlling tissue sclerosis, skin inflammation, joint restriction and other manifestations in chronic rejection, especially in cGVHD patients with skin and oral involvement. Its therapeutic effect has been stable in multiple studies. Different from the broad-spectrum suppression mechanism of systemic immunosuppressants, Besudil is more inclined to restore immune balance and reduce over-activated inflammatory cell populations while retaining basic immune function. Therefore, it is well tolerated and suitable for long-term use.

From the current medical consensus, besudil has been included in the multi-national chronicGVHD treatment guidelines and serves as an important supplement after standard treatment fails. Its use needs to be evaluated and decided by doctors specialized in hematology or transplantation, especially when the patient has a history of multiple lines of treatment. Besudil provides a treatment path with a unique mechanism and clear targeting, changing the previous "irreversible" treatment limitations for chronic GVHD.

Reference: https://www.drugs.com/pro/rezurock.html