Renal Function Optimization With Mycophenolate Mofetil (MMF) Immunosuppressor Regimes (ALHAMBRA)

The recruitment status of this study is unknown because the information has not been verified recently.
Verified February 2006 by Sociedad Andaluza de Trasplantes de Organos y Tejidos.
Recruitment status was  Not yet recruiting
Sponsor:
Information provided by:
Sociedad Andaluza de Trasplantes de Organos y Tejidos
ClinicalTrials.gov Identifier:
NCT00290069
First received: February 9, 2006
Last updated: May 14, 2007
Last verified: February 2006
  Purpose

The main aim of this study is to compare the renal function (serum creatinine at 6 months) in the later introduction of tacrolimus or rapamycin based in immunosuppressor regimes with daclizumab, mycophenolate mofetil, and steroids in patients older than 50 years of age who are the recipients of a graft from donors aged 55 years and older.


Condition Intervention Phase
Kidney Diseases
Graft Rejection
Drug: Tacrolimus
Drug: Rapamycin
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Comparative Study of Tacrolimus and Rapamycin to Evaluate the Renal Function in Patients Older Than 50 Years, Receptors of a Kidney From a Donor Older Than 55 Years in a Mycophenolate Mofetil and Daclizumab Immunosuppressor Regime

Resource links provided by NLM:


Further study details as provided by Sociedad Andaluza de Trasplantes de Organos y Tejidos:

Primary Outcome Measures:
  • Serum creatinine at 6 months

Secondary Outcome Measures:
  • Calculated creatinine clearance (Cockroft Gault)
  • Acute rejection rate at 6 months and time until first rejection
  • Patient and graft survival at 6 months
  • Rate and length of the delay in the graft function defined as dialysis in the first week post-transplant
  • Treatment failure at 6 months

Estimated Enrollment: 94
Detailed Description:

The study population characteristics raise the need to establish a treatment regime that assures suitable intensity immunosuppression to avoid the appearance of rejection episodes, but minimizes the doses to prevent over-immunosuppression in a population with a theoretic minor immune response.

On the other hand, the delay in the introduction of calcineurin inhibitors will prevent increasing the risk of early graft dysfunction allowing the highest post-transplant renal recovery in organs with less operative mass and greater sensibility to the nephrotoxic effect of these drugs.

The results of several studies confirm the goodness of regimes that include low doses of calcineurin inhibitors, delay their introduction or avoid them.

Nevertheless, although it is standard practice to evaluate the effectiveness of the regimes for a time to assure, with certainty, the response to the treatments, these follow-ups are still relatively short to assure the efficacy for a long-term study and to detect the problems. The studies with a high number of patients and long follow-up periods are difficult, so several authors have proposed different alternatives of control in a short-term study that could be useful as surrogate markers or predictive efficacy variables for the long term.

If the drug or study regime is efficient, the observed change after the transplantation surgery will have to be fast and objective. The increase of serum creatinine between 6 and 12 months post-transplant is a reliable marker of graft failure risk, and the magnitude of the serum creatinine change in these months is a marker of the relationship with long-term survival. For that reason, renal function (serum creatinine) is included as a main efficacy variable.

  Eligibility

Ages Eligible for Study:   50 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Both male and female patients older than 50 years who are primary recipients of a renal allograft from a donor older than 55 years.
  • Patients who have given their consent previously to their participation in the study.

Exclusion Criteria:

  • Recipients of a multi-organ transplant.
  • Recipients of a transplant from a cadaveric donor with a cold ischemic time > 30 hours.
  • Patients with a plasma renin activity (PRA) > 20% in 6 months previous to the inclusion.
  • Breast-feeding, pregnant, or fertile women who do not use a reliable anticonceptive method before starting therapy with the study drug, during the therapy, and during the 4 months after the last dose of the drugs administered in the study.
  • Patients with leukocyte count < 2.5 x 10^9/L, platelet count < 100 x 10^9/L, or haemoglobin < 6 g/dL in the inclusion time
  • Patients with active hepatic illness evidence.
  • Patients with active peptic ulcer.
  • Patients with serious diarrhoea or any intestinal upset that may interfere in the absorption capability of oral medication, including diabetic patients with previously diagnosticated diabetic gastroenteropathy.
  • Patients with evidence of active systemic infection that require the continued use of antibiotics or evidence of HIV infection or hepatitis B presence (positive HBs-Ag) or active chronic hepatitis C.
  • Patients with malignancy history (except satisfactorily treated non- melanocytic localized skin cancer and cervix "in situ" carcinoma).
  • Patients with history of psychologic disease that may interfere in the patients capability to understand the study requirements.
  • Patients who the investigator thinks need a treatment with any medication listed below:

    • Azathioprine,
    • Methotrexate,
    • Cyclofosfamide,
    • Polyclonal or monoclonal anti-lymphocitaries antibodies (OKT3, ATG), used for the induction in patients with high immunologic risk,
    • Basiliximab, and
    • Other research drugs
  • Known hypersensibility or complete contraindication of any of the drugs administered in the study context or any other substance present in the study drugs.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00290069

Locations
Spain
Complejo Hospitalario Universitario de Santiago Not yet recruiting
Santiago de Compostela, La Coruña, Spain, 15706
Contact: Rafael Romero, MD         
Principal Investigator: Rafael Romero, MD         
Hospital Universitario Ramón y Cajal Not yet recruiting
Madrid, Spain, 28034
Contact: Roberto Marcén, MD         
Principal Investigator: Roberto Marcén, MD         
Hospital Universitario 12 de Octubre Not yet recruiting
Madrid, Spain, 28041
Contact: José L Morales, MD         
Principal Investigator: José L Morales, MD         
Hospital General Universitario Gregorio Marañón Not yet recruiting
Madrid, Spain, 28007
Contact: Fernando Anaya, MD         
Principal Investigator: Fernando Anaya, MD         
Hospital Universitario de Canarias Not yet recruiting
Santa Cruz de Tenerife, Spain, 38320
Contact: Domingo Hernández, MD         
Principal Investigator: Domingo Hernández, MD         
Hospital Universitario Marqués de Valdecilla Not yet recruiting
Santander, Spain, 39008
Contact: Juan C Ruiz San Millán, MD         
Principal Investigator: Juan C Ruiz San Millán, MD         
Hospital Universitario La Fe Not yet recruiting
Valencia, Spain, 46009
Contact: Jaime Sánchez Plumed, MD         
Principal Investigator: Jaime Sánchez Plumed, MD         
Sponsors and Collaborators
Sociedad Andaluza de Trasplantes de Organos y Tejidos
Investigators
Principal Investigator: Miguel A Gonzalez Molina, MD Sociedad Andaluza de Trasplantes de Organos y Tejidos
  More Information

No publications provided

ClinicalTrials.gov Identifier: NCT00290069     History of Changes
Other Study ID Numbers: SATOT42005, EudraCT number: 2005-001854-25, ALHAMBRA
Study First Received: February 9, 2006
Last Updated: May 14, 2007
Health Authority: Spain: Spanish Agency of Medicines

Keywords provided by Sociedad Andaluza de Trasplantes de Organos y Tejidos:
Renal function
Serum creatinine
Immunosuppression
Rejection

Additional relevant MeSH terms:
Kidney Diseases
Urologic Diseases
Tacrolimus
Mycophenolate mofetil
Mycophenolic Acid
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Pharmacologic Actions
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Antibiotics, Antineoplastic
Antineoplastic Agents
Therapeutic Uses

ClinicalTrials.gov processed this record on September 22, 2014