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Improvement of Humoral Immune Response With Hemodialysis on BK-F Membrane: Correlation to Soluble CD40 Clearing (HEPADIAL)

This study is ongoing, but not recruiting participants.
Sponsor:
Information provided by (Responsible Party):
University Hospital, Bordeaux
ClinicalTrials.gov Identifier:
NCT01066559
First received: February 9, 2010
Last updated: July 2, 2014
Last verified: July 2014
  Purpose

The aim of this study is to improve the humoral immune response efficiency of hemodialyzed patient by the use of PMMA membrane (BK-F) able to clear the soluble form of CD40 in a model of anti-HBV vaccination


Condition Intervention
Chronic Renal Failure
Humoral Immune Alterations
Procedure: High flux polymethylmetacrylate membrane
Procedure: Polysulfone membrane
Biological: Hepatitis B serological control
Biological: Seric sCD40 level

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Multicentric Randomized Clinical Trial of the Impact of Hemodialysis With Polymethylmetacrylate Membrane on the Improvement of Humoral Immune Response in the Hemodialyzed Patients : Application to Hepatitis B Vaccination and Correlation to sCD40 Clearing

Resource links provided by NLM:


Further study details as provided by University Hospital, Bordeaux:

Primary Outcome Measures:
  • Percentage of patients who will respond to vaccination [ Time Frame: Week 40 ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Percentage and the level of anti-HBs antibodies [ Time Frame: at week 16, week 20, week 24 and week 40 ] [ Designated as safety issue: No ]
  • Correlation between the sCD40 levels and the response to HBV vaccination [ Time Frame: At week 12 and week 40 ] [ Designated as safety issue: No ]
  • Correlation between albuminemia, C-Reactive Protein, lymphocytes, parathyroid hormone, chronic immunosuppressive treatment or corticoid taking and vaccinal response. [ Time Frame: at week 12, week 24, and week 36 ] [ Designated as safety issue: No ]

Estimated Enrollment: 98
Study Start Date: April 2010
Estimated Study Completion Date: April 2015
Primary Completion Date: March 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: High flux polymethylmetacrylate membrane Procedure: High flux polymethylmetacrylate membrane
Patients will be hemodialysed with high flux polymethylmetacrylate membranes
Biological: Hepatitis B serological control
It will be assessed at week 16, week 20 and week 40
Biological: Seric sCD40 level
Ir will be measured at inclusion and week 12 by ELISA test according to the manufacturer instructions.
Active Comparator: Polysulfone membranes Procedure: Polysulfone membrane
Patients be hemodialysed with polysulfone membranes
Biological: Hepatitis B serological control
It will be assessed at week 16, week 20 and week 40
Biological: Seric sCD40 level
Ir will be measured at inclusion and week 12 by ELISA test according to the manufacturer instructions.

Detailed Description:

Chronic renal failure is associated with humoral immune alterations characterized by a diminished vaccine response notably against hepatitis B virus (HBV). Defects in cellular contact between immunological cells have been hypothesized to explain this observation but the precise mechanism leading to this "immunocompromised" status is not clear. The soluble form of CD40 (sCD40) is dramatically increased in the serum of uremic patients, particularly in the hemodialyzed patients. This molecule acts like an inhibitor of the CD40/CD154 contact, which is pivotal in the establishment of a proper humoral immune response. It has been shown that the most elevated sCD40 levels are associated with a lack of response to HBV vaccination in the hemodialyzed patients. The majority of the hemodialysis membranes, including high flux polysulfone membranes are unable to clear sCD40 from the sera. However, we found that the high flux polymethylmetacrylate (PMMA) membrane (BK-F Toray Medical Company, Japan) allows for sCD40 clearing.

The aim of this study is to assess the effect of dialysis on PMMA membrane on the improvement of humoral immune response through the efficiency of HBV vaccination in hemodialysed patients who were non responders to one ore more previous vaccination and its link to sCD40 clearing.

  Eligibility

Ages Eligible for Study:   18 Years to 85 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age 18 to 80 years, male or female
  • Patient not immunized against hepatitis B despite complete well done anterior vaccination according to recommendations
  • Hemodialyzed patients with hemodialysed sessions performed three times a week
  • Patient able to give informed consent and affiliated to the medical insurance

Exclusion Criteria:

  • Pregnant woman
  • Patient never vaccinated against HBV
  • Previous known hepatitis B even without anti HBs antibody (anti HBc antibody or HBs antigenemia positive)
  • Active neoplasia or plasma cell dyscrasia
  • VIH infection
  • Known allergy to vaccine or to PMMA membrane
  • Patient dialysed with PMMA membrane within three months before screening
  • Necessity of acetate free biofiltration or hemodiafiltration as the technique of extrarenal epuration
  • Vascular access problem with necessity of unipuncture for more than 30% of dialysis sessions.
  • Patient under judicial protection
  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: NCT01066559

Locations
France
CH Annonay
Annonay, France
CH de la côte Basque
Bayonne, France, 64100
CHU de Besançon
Besançon, France, 25000
Pellegrin Hospital, Nephrology Unit
Bordeaux, France, 33076
Saint-Augustin Clinic, Dialyze Unit
Bordeaux, France, 33000
Larrey Hospital, Dialyze Unit
Toulouse, France, 31059
Sponsors and Collaborators
University Hospital, Bordeaux
Investigators
Principal Investigator: Valérie de PRECIGOUT, MD University Hospital, Bordeaux, France
Principal Investigator: Pierre BORIES, MD University Hospital, Toulouse, France
Principal Investigator: Michel RINCE, MD University Hospital, Limoges, France
Principal Investigator: Caroline DELCLAUX, MD Hospital, Libourne, France
Principal Investigator: Antoine POMMEREAU, MD Clinic Saint-Augustin, Bordeaux, France
Principal Investigator: Benjamin DEROURE, MD Clinic Delay, Bayonne, France
Principal Investigator: Hervé BONAREK, MD Hospital, Saintes, France
Study Chair: Antoine BENARD, MD University Hospital, Bordeaux, France
  More Information

No publications provided

Responsible Party: University Hospital, Bordeaux
ClinicalTrials.gov Identifier: NCT01066559     History of Changes
Other Study ID Numbers: CHUBX 2009/11
Study First Received: February 9, 2010
Last Updated: July 2, 2014
Health Authority: France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis)

Additional relevant MeSH terms:
Kidney Failure, Chronic
Renal Insufficiency
Kidney Diseases
Renal Insufficiency, Chronic
Urologic Diseases
Polymethyl Methacrylate
Antimutagenic Agents
Cardiovascular Agents
Pharmacologic Actions
Physiological Effects of Drugs
Protective Agents
Therapeutic Uses
Vasodilator Agents

ClinicalTrials.gov processed this record on November 20, 2014