Evaluate Effects and Safety of Pre-load Myfortic® in Transplant Patients
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Purpose
This study is specifically designed to determine whether the initiation of Myfortic 2 weeks prior to transplantation will enhance the therapeutic efficacy of Simulect induction therapy in low to moderate risk patients. Specifically, the addition of Myfortic pretransplant to Simulect induction will be compared to standard Myfortic therapy with Thymoglobulin induction starting at the time of transplant in kidney transplant recipients.
| Condition | Intervention | Phase |
|---|---|---|
|
Kidney Transplant Recipients |
Drug: mycophenolic acid |
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: | A 12-month, Prospective, Randomized, Dual Center, Open Label Pilot Study to Evaluate the Safety and Efficacy of Myfortic® (Mycophenolic Acid) Loading Regimens in Combination With Thymoglobulin® [Anti-thymocyte Globulin (Rabbit)] or Simulect® (Basiliximab) Induction and Prograf® (Tacrolimus) in Early Corticosteroid Withdrawal |
- Incidence of biopsy-confirmed acute rejection by Banff '97 Criteria (updated 2007) at 6 months [ Time Frame: 6 months ] [ Designated as safety issue: No ]Incidence of biopsy-confirmed acute rejection by Banff '97 Criteria (updated 2007) at 6 months.
- Severity of acute rejection by Banff '97 Criteria [ Time Frame: 6 months ] [ Designated as safety issue: No ]
Severity of acute rejection by Banff '97 Criteria. Acute cellular rejection Acute antibody mediated (humoral) rejection Proportion of patients requiring anti-lymphocyte therapy for acute rejection Incidence of chronic alloantibody rejection or chronic allograft arteriopathy by Banff '97 Criteria Change in creatinine clearance Urinary protein Incidence of denovo donor specific antibodies (DSA) Incidence of death, graft loss, delayed graft function (DGF), infection, and post-transplant malignancies.
Patient and allograft survival
| Estimated Enrollment: | 75 |
| Study Start Date: | September 2010 |
| Estimated Study Completion Date: | May 2014 |
| Estimated Primary Completion Date: | March 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Myfortic preload
Initiation of Myfortic 2 weeks prior to transplantation (with Simulect induction at time of transplant)
|
Drug: mycophenolic acid
Comparing mycophenolic acid 720mg orally twice daily starting 2 weeks prior to transplant to mycophenolic acid 720mg orally twice daily starting day of transplant
|
|
Active Comparator: Myfortic standard
Myfortic at time of transplant with Thymoglobulin induction
|
Drug: mycophenolic acid
Comparing mycophenolic acid 720mg orally twice daily starting 2 weeks prior to transplant to mycophenolic acid 720mg orally twice daily starting day of transplant
|
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients capable of understanding the purposes and risks of the study.
- Patients who can give written informed consent, and who are willing and able to participate in the full course of the study.
- Women of childbearing potential must have a negative serum pregnancy test within the last 48 hours prior to receiving study medication.
- Women of childbearing potential must use two reliable forms of contraception simultaneously, unless they are status post bilateral tubal ligation, bilateral oophorectomy, or hysterectomy. Effective contraception must be used before beginning study drug therapy, for the duration of the study and for 6 weeks following completion of the study.
Exclusion Criteria:
- Patients who are recipients of a multiple organ transplant or if the patient previously received and organ transplant.
- Patients who are recipients of A-B-O incompatible transplants, all complement-dependent cytotoxicity (CDC) crossmatch positive transplants.
- Sensitized patients [most recent anti-Human Leukocyte Antigens (HLA) Class I panel reactive antibody (PRA) ≥ 25% by a CDC-based assay].
- Recipient or donor is known to be seropositive for hepatitis C virus (HCV) or B virus (HBV) except for hepatitis B surface antibody positive.
- Recipient or donor is known to be seropositive for human immunodeficiency virus (HIV).
- Patient has uncontrolled concomitant infection or any other unstable medical condition that could interfere with the study objectives.
- Patients with thrombocytopenia (<75,000/mm3 ), with an absolute neutrophil count of < 1,500/mm3); and/or leucopoenia (< 2,500/mm3), or anemia (hemoglobin < 6 g/dL) prior to study inclusion.
- Patient is taking or has been taking an investigational drug in the 30 days prior to transplant.
- Patient has a known hypersensitivity to tacrolimus, mycophenolate mofetil, enteric-coated mycophenolic acid, rabbit anti-thymocyte globulin, or corticosteroids.
- Patients with severe diarrhea or other gastrointestinal disorders that might interfere with their ability to absorb oral medication; diabetic patients with previously diagnosed diabetic gastroenteropathy, or patients with active peptic ulcer disease.
- Patient is receiving chronic steroid therapy at the time of transplant.
- Patients with a history of malignancy within the last five years, except for successfully excised squamous or basal cell carcinoma of the skin.
- Patient is pregnant or lactating, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by positive human Chorionic Gonadotropin (hCG) laboratory test.
- Patient has any form of substance abuse, psychiatric disorder or a condition that, in the opinion of the investigator, may invalidate communication with the investigator.
- Inability to cooperate or communicate with the investigator.
Contacts and Locations| Contact: Adele Shields, Pharm.D. | 513-558-0046 | rikea@uc.edu |
| Contact: Lacey Thieken | 513-558-0736 | lacey.thieken@uc.edu |
| United States, Ohio | |
| University of Cincinnati Medical Center | Recruiting |
| Cincinnati, Ohio, United States, 45267 | |
| Contact: Adele Shields, Pharm.D 513-558-0046 rikea@uc.edu | |
| Principal Investigator: | Adele Shields, Pharm.D. | University of Cincinnati |
More Information
No publications provided
| Responsible Party: | E. Steve Woodle, MD, FACS, University of Cincinnati |
| ClinicalTrials.gov Identifier: | NCT01336296 History of Changes |
| Other Study ID Numbers: | Myfortic Preload |
| Study First Received: | October 28, 2010 |
| Last Updated: | January 18, 2013 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Antilymphocyte Serum Mycophenolate mofetil 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 |
ClinicalTrials.gov processed this record on May 19, 2013