A Clinical Trial to Assess the Efficacy and Safety of the Conversion to Everolimus
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Purpose
The study hypotheses to be tested in this study are:
- Conversion to everolimus at 3 months post-transplantation is safe and effective;
- Accurate noninvasive molecular diagnostic tests can replace biopsy at 3 months pre-conversion (for the diagnosis of subclinical cellular and/or humoral rejection, tissue fibrosis and calcineurin inhibitor-induced nephrotoxicity) in kidney transplant recipients;
- Follow-up biopsy at 12 months post-conversion (for the diagnosis of tissue fibrosis) can be replaced with accurate noninvasive molecular diagnostic tests in kidney transplant recipients.
| Condition | Intervention | Phase |
|---|---|---|
|
Kidney Transplant Recipients |
Drug: Tacrolimus Drug: Everolimus |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | An Open-label Randomized Controlled Clinical Trial to Assess the Efficacy and Safety of the Conversion to Everolimus 3 Months After Kidney Transplantation. |
- Evaluate cumulative patient and graft survival at 12 months post conversion [ Time Frame: one year ] [ Designated as safety issue: No ]Patient and graft survival will be evaluated one year after randomization by Kaplan-Meier analysis
- Evaluation of estimated glomerular filtration rate 12 months post-conversion [ Time Frame: one year ] [ Designated as safety issue: No ]- To assess the efficacy of conversion from tacrolimus to everolimus 12 months post-conversion by measuring the estimated glomerular filtration rate using the Modification of Diet in Renal Disease (MDRD) equation
| Estimated Enrollment: | 120 |
| Study Start Date: | February 2012 |
| Estimated Study Completion Date: | July 2014 |
| Estimated Primary Completion Date: | July 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Tacrolimus
The subjects included in the study will be clinically followed up for at least 12 months. The patients will be selected at 3 months post-transplant according to inclusion and exclusion criteria and randomized in a 1:1 ratio for conversion to everolimus or maintenance of tacrolimus therapy. Intervention arm: Tacrolimus |
Drug: Tacrolimus
TACROLIMUS (C0 = 5-10 ng/mL) + MPS 1440 mg + Pred
|
|
Active Comparator: Everolimus
The subjects included in the study will be clinically followed up for at least 12 months. The patients will be selected at 3 months post-transplant according to inclusion and exclusion criteria and randomized in a 1:1 ratio for conversion to everolimus or maintenance of tacrolimus therapy. Intervention arm: Everolimus |
Drug: Everolimus
Everolimus (C0 = 6-10 ng/mL) + MPS 1440 mg + Pred
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients undergoing their first living- or deceased-donor kidney transplant who maintain a functioning graft 3 months post-transplant;
- Older than 18 years;
- Panel-reactive antibodies lower than 20%;
- Baseline immunosuppression with tacrolimus, mycophenolate sodium (MPS) and prednisone at randomization at 3 months.
Exclusion Criteria:
- eGFR < 35 mL/min at randomization;
- Urine protein-to-creatinine ratio > 0.8 at randomization;
- Episode of acute rejection with Banff histological classification > 1A in the first 3 months post-transplant;
- Cholesterol > 350 mg/dL or triglycerides > 400 mg/dL with therapy at randomization;
- Active infection at randomization;
- Chronic liver disease;
- Refusal to participate in the study;
- Contraindications to kidney biopsy;
- Biopsy findings at 3 months post-transplant including borderline rejection, cellular rejection or antibody-mediated rejection.
Contacts and Locations| Contact: Luiz Felipe S. Gonçalves, MD | lfgoncalves@hcpa.ufrgs.br | |
| Contact: Nisséia Jahn, RN | nisseia@yahoo.com.br |
| Brazil | |
| Hospital de Clínicas de Porto Alegre | Recruiting |
| Porto Alegre, RS, Brazil, 90035-903 | |
| Principal Investigator: | Luiz Felipe S. Gonçalves, MD | HCPA |
More Information
No publications provided
| Responsible Party: | Hospital de Clinicas de Porto Alegre |
| ClinicalTrials.gov Identifier: | NCT01608412 History of Changes |
| Other Study ID Numbers: | CRAD001ABR19T |
| Study First Received: | May 8, 2012 |
| Last Updated: | May 30, 2012 |
| Health Authority: | Brazil: National Health Surveillance Agency |
Keywords provided by Hospital de Clinicas de Porto Alegre:
|
renal transplantation everolimus tacrolimus molecular evaluation |
Additional relevant MeSH terms:
|
Everolimus Sirolimus Tacrolimus Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions |
Antibiotics, Antineoplastic Antineoplastic Agents Therapeutic Uses Antifungal Agents Anti-Infective Agents Anti-Bacterial Agents |
ClinicalTrials.gov processed this record on May 19, 2013