Minimizing Immunosuppression in Old for Old Kidney Transplantation (ESP-CNI)
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
Purpose
Kidney transplantation in the elderly is a challenge since patient's co-morbidity and the decreased injury threshold of older grafts may limit the benefits of transplantation in these patients. To compare favourable effects between low dose tacrolimus (LD-Tac) and mycophenolate-mofetil (MMF) in this patient population the investigators conducted a one year prospective multicenter randomized controlled trial. 90 kidney transplant recipients > 65 years with cadaveric grafts (> 65 years) from 5 centers were enrolled and received baseline immunosuppression with daclizumab induction (1 mg/kg) at day one and day 14, LD-Tac (trough level 5-8 µg/ml), MMF (1-2 g/d) and steroids. After three months, patients were centrally randomized either to MMF (1-2 g/d) and steroids (23 patients) or to LD-Tac and steroids. Follow-up visits were performed every 4 weeks up to one year. Protocol biopsies were performed after one year. The investigators' primary hypothesis is that the biopsy proven rejection rate in the MMF group is not significantly different compared to the LD-Tac group after one year. The investigators' secondary hypothesis is that graft function in the MMF group (reflected by the glomerular filtration rate and protocol biopsy result) is superior to the graft function in the LD-Tac group.
| Condition | Intervention | Phase |
|---|---|---|
|
Kidney Transplantation |
Drug: MMF (Cellcept) and Steroids Drug: Tacrolimus (Prograf) |
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: | Prospective Randomized Controlled Trial to Compare a Calcineurin Inhibitor Free Immunosuppression With a Low Dose Tacrolimus Based Immunosuppression in "Old for Old" Kidney Transplantation. |
- Acute rejection rate [ Time Frame: One year ] [ Designated as safety issue: No ]
- Graft function [ Time Frame: One year ] [ Designated as safety issue: No ]
| Enrollment: | 90 |
| Study Start Date: | March 2002 |
| Study Completion Date: | October 2008 |
| Primary Completion Date: | July 2006 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: MMF and Steroid Group
Group of Patients randomized to MMF and Steroid maintenance immunosuppression after 3 months (Tacrolimus withdrawal)
|
Drug: MMF (Cellcept) and Steroids
Prograf was withdrawn completely after randomization, MMF and steroids were given.
Other Names:
|
|
Active Comparator: Low-Dose Tacrolimus Group
Patients randomized to withdrawal of MMF after 3 months and maintenance immunosuppression with low-dose tacrolimus and Steroids
|
Drug: Tacrolimus (Prograf)
After randomization CellCept was withdrawn completely, low-dose tacrolimus was given.
Other Name: Prograf
|
Eligibility| Ages Eligible for Study: | 65 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients receiving a cadaveric kidney transplant (first or re-transplant)
- Patients must met the criteria of the EUROTRANSPLANT program
- Organ allocation with the framework of EUROPEAN SENIOR PROGRAM (ESP) by EUROTRANSPLANT
- Written consent
Exclusion Criteria:
- Not fulfilled inclusion criteria
- Cadaveric kidney from "non heart beating donors"
- One or more than one steroid resistant acute rejections within the first 3 weeks after transplantation
- Two or more than two steroid sensitive rejections (more than 2 administered steroid boli) within the first 3 weeks after transplantation
- Tacrolimus trough level > 10ng/ml in three consecutive measurements
- Allergy against macrolide antibiotics or tacrolimus
- Systemic steroid therapy at study entry not related to transplantation
- History of Malignancy
- Clinical relevant uncontrolled infections, heavy diarrhea, vomiting or active ulcer disease
- Patients who are enrolled in other clinical studies or were enrolled in other clinical studies 28 days before transplantation
- Patients under medication not approved by the German Ministry of Health
Contacts and Locations| Germany | |
| Charite - Transplant Center - Virchow Clinic | |
| Berlin, Germany, 13353 | |
| Charite- Transplant Center - Campus Mitte | |
| Berlin, Germany, 10117 | |
| Transplant Center Cologne (Koeln-Mehrheim) | |
| Cologne, Germany, 51109 | |
| University of Essen - Transplant Center | |
| Essen, Germany | |
| University of Luebeck, Transplant Center | |
| Luebeck, Germany, 23562 | |
| Principal Investigator: | Lutz Fricke, MD, PhD | University of Luebeck |
More Information
Publications:
| Responsible Party: | Prof. Dr. Lutz Fricke, MD PhD, University of Luebeck Medical School, Medical Clinic I, Transplant Center |
| ClinicalTrials.gov Identifier: | NCT00912678 History of Changes |
| Other Study ID Numbers: | ESP-2004-1 |
| Study First Received: | June 1, 2009 |
| Last Updated: | June 2, 2009 |
| Health Authority: | Germany: Ethics Commission |
Keywords provided by University of Luebeck:
|
Kidney transplantation Old for old kidney transplantation European senior program Calcineurin inhibitor free immunosuppression |
Additional relevant MeSH terms:
|
Mycophenolic Acid Mycophenolate mofetil Tacrolimus Antibiotics, Antineoplastic Antineoplastic Agents Therapeutic Uses |
Pharmacologic Actions Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs |
ClinicalTrials.gov processed this record on June 18, 2013