Belumosudil in patients with bronchiolitis obliterans syndrome phenotype of chronic lung allograft dysfunction: An exploratory single-center real-world retrospective study.

Authors

Xiaohua Wang, Lulin Wang, Jia Liu, Peihang Xu, Qiaoyan Lian, Xin Xu, Jianxing He, Chunrong Ju

Published in

Transplant immunology. Pages 102450. Aug 22, 2026. Epub Aug 22, 2026.

Abstract

Chronic lung allograft dysfunction (CLAD) is a major cause of post-lung transplant mortality, with limited medical treatment options. This exploratory single-center real-world retrospective study aimed to evaluate the clinical outcomes and safety of belumosudil in lung transplant recipients with the bronchiolitis obliterans syndrome (BOS) phenotype of CLAD.
An exploratory single-center real-world retrospective study was conducted of lung transplant recipients with CLAD-BOS who received belumosudil for at least 3 months between September 2024 and November 2025. Primary endpoint was treatment response to belumosudil as classified based on changes in forced expiratory volume in 1 s (FEV₁).
A total of 17 CLAD-BOS patients were included (9 CLAD stage 1-2 patients and 8 CLAD stage 3-4 patients). Treatment response to belumosudil was assessed at 3, 6, and 12 months after initiating belumosudil. At 3 months, 17.6% of patients achieved a response, 64.7% remained stable, and 17.6% were non-responders. At 6 and 12 months, most patients showed stabilization or improvement in FEV₁ (6 months: 68.8%, 11/16; 12 months: 70%, 7/10), while a minority exhibited a continued decline. All CLAD stage 1-2 patients achieved response or stabilization at 3 months, while no responses were observed in CLAD stage 3-4 patients. This stage-dependent pattern persisted at 6 and 12 months. Mixed-model analyses confirmed more favorable changes in FEV₁ and forced vital capacity (FVC) in early-stage patients. No significant adverse events were observed.
This exploratory single-center real-world study provides preliminary hypothesis-generating evidence that belumosudil may be associated with stabilization of pulmonary function in lung transplant recipients with CLAD-BOS, particularly when initiated during earlier disease stages. These findings require confirmation in larger prospective controlled studies.

PMID:
42632467
Bibliographic data and abstract were imported from PubMed on 23 Aug 2026.

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