European Trial of Immunosuppression in SPK Tx
Recruitment status was Active, not recruiting
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Purpose
- To determine and compare the efficacy of Tacrolimus/Rapa versus Tacrolimus/MMF-based immunosuppression (in conjunction with initial short-term steroids and polyclonal antibody administration) in Type 1-diabetic patients undergoing simultaneous pancreas/kidney allograft transplantation.
- To evaluate the safety of Tacrolimus/Rapa versus Tacrolimus/MMF in terms of drug-related complications and overimmunosuppression-associated complications, particularly under monitoring of the pharmacokinetic profile of all drugs administered.
| Condition | Intervention | Phase |
|---|---|---|
|
Diabetes Mellitus, Type 1 Diabetic Nephropathy |
Drug: sirolimus versus mycophenolate mofetil |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A European Multicenter Open-Label Randomised Trial to Evaluate the Efficacy and Safety of Sirolimus and Tacrolimus Compared to MMF and Tacrolimus With Short-Course Induction Therapy, Short-Term Steroids Application in De Novo SPK Transplanted Diabetic Patients |
- At 1 year:Incidence of biopsy-proven (kidney) rejection episodes.
- SECONDARY ENDPOINTS: At 6 months and 1 year
- * Kidney/Pancreas function (at 6 months and 1 year):
- - Kidney function will be measured by:
- - S- creatinine
- - Creatinine clearance
- - Pancreas function will be measured by:
- - Fasting Glucose level (< 123 mg/dl)
- - HbA1C
- - Need for insulin therapy
- - Need for oral drugs
- * At 6 months and 1 year:
- - Patient and graft survival
- - Lipid profile
- - Infections
- - Side effects
- - Blood Pressure
- - Treatment failure for any reason, such as permanent discontinuation of a drug, graft loss or death.
- * % of steroid free patients: at 6 months and 1 year.
| Estimated Enrollment: | 228 |
| Study Start Date: | February 2002 |
| Estimated Study Completion Date: | April 2008 |
This will be a controlled, randomised study, to be performed in 15-20 pancreas transplantation centers throughout Europe. Patients will be randomised into one of two treatment groups. Group 1 will receive Tacrolimus and Mycophenolate Mofetil (= best group in EuroSPK001 trial). Group 2 will receive Tacrolimus and Sirolimus. Both groups will receive in association short-term corticosteroids and polyclonal antibody preparation. Patients will be randomly assigned to one of the 2 treatment groups in a 1:1 ratio before transplantation. The study will last 3 years, with a first interim analysis of the data at 6 months and a complete analysis at 1 year.
Eligibility| Ages Eligible for Study: | 18 Years to 55 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Male or female patients, of 18 to 55 years of age, with end-stage, C-peptide-negative, Type 1-diabetic nephropathy.
- Female patients of childbearing age must have a negative pregnancy test and must agree to maintain effective birth control practice throughout the study period (3 years).
- Patient must have signed the Patient Informed Consent Form.
- Patient must receive a primary simultaneous pancreas/kidney (SPK) cadaveric transplant, with either intestinal or bladder and either portal or systemic venous drainages.
Exclusion Criteria:
- Patient is pregnant or breastfeeding.
- Patient is allergic or intolerant to Mycophenolate Mofetil, Sirolimus, Tacrolimus or other macrolides, or any compounds structurally related to these compounds.
- Patient has a positive T-cell crossmatch on the most recent serum specimen.
- Patient is known for active liver disease or has significant liver disease, defined by ASAT and ALAT serum levels greater than 3 times the upper limit of normal.
- Patient has malignancy or history of malignancy, with the exception of adequately treated localised squamous cell or basal cell carcinoma, without recurrence.
- Patient has been included in another clinical trial protocol for any investigational drug within 4 weeks prior to randomisation.
- Patient has any form of substance abuse, psychiatric disorder or condition, which, in the opinion of the investigator, may invalidate communication.
- Patient receives a SPK transplant from a living donor, or receives segmental pancreatic transplant, or a previous kidney transplant alone.
- Pancreatic duct occlusion technique .
Donor is older than 55 years of age.
-
Contacts and Locations| Austria | |
| Universitätsklinik | |
| Innsbruck, Austria, 6020 | |
| Belgium | |
| Cliniques Universitaires Saint Luc | |
| Brussels, Belgium, 1200 | |
| UZ Gent | |
| Gent, Belgium, 9000 | |
| UZ Gasthuisberg | |
| Leuven, Belgium, 3000 | |
| Czech Republic | |
| Institute for clinical and experimental medicine-IKEM | |
| Prague, Czech Republic, 14021 | |
| Germany | |
| Charite Campus Virchow Klinikum | |
| Berlin, Germany, 13353 | |
| Knappschaftskrankenhaus | |
| Bochum-Langendreer, Germany, 44892 | |
| Goethe University | |
| Frankfurt am Main, Germany, 60590 | |
| Chirurgische Universitätsklinik | |
| Freiburg, Germany, 79111 | |
| Klinikum Innenstadt der Universität München | |
| Munich, Germany, 90336 | |
| Klinikum Grosshadern-University of Munich | |
| Munich, Germany, 81366 | |
| Israel | |
| Tel Aviv Sourasky Medical Center | |
| Tel Aviv, Israel, 64239 | |
| Spain | |
| Hospital Clinico | |
| Barcelona, Spain, 08036 | |
| Switzerland | |
| Hôpital Cantonal de Geneve | |
| Geneva, Switzerland, 1211 | |
| Study Chair: | Jean-Paul Squifflet, MD,PhD | SPEAKER FOR THE EUROSPK STUDY GROUP |
More Information
No publications provided
| ClinicalTrials.gov Identifier: | NCT00140543 History of Changes |
| Other Study ID Numbers: | EUROSPK002 |
| Study First Received: | August 31, 2005 |
| Last Updated: | November 17, 2005 |
| Health Authority: | Belgium: Directorate general for the protection of Public health: Medicines |
Keywords provided by EUROSPK Study Group:
|
simultaneous pancreas/kidney transplantation Immunosuppression |
Additional relevant MeSH terms:
|
Diabetes Mellitus Diabetes Mellitus, Type 1 Diabetic Nephropathies Kidney Diseases Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases Autoimmune Diseases Immune System Diseases Urologic Diseases Diabetes Complications Mycophenolate mofetil Sirolimus Everolimus |
Mycophenolic Acid Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions Antibiotics, Antineoplastic Antineoplastic Agents Therapeutic Uses Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Antifungal Agents Anti-Infective Agents Anti-Bacterial Agents |
ClinicalTrials.gov processed this record on May 19, 2013