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CellCept® Dose Adjustment Versus Fixed Dose (Standard Care) in Renal Transplant Recipients (MMF)

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ClinicalTrials.gov Identifier: NCT00737659
Recruitment Status : Unknown
Verified December 2008 by Rabin Medical Center.
Recruitment status was:  Recruiting
First Posted : August 19, 2008
Last Update Posted : March 26, 2010
Sponsor:
Information provided by:
Rabin Medical Center

Study Description
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Brief Summary:

In order to avoid renal transplant rejection, the immune system should be suppressed. After the renal transplant subjects are treated with a combination of two to four different types of immunosuppressive drugs. Theses drugs are very efficient in the prevention of the renal transplant rejection. Still, they can cause side effect.

Research in renal transplant tries to find the best treatment in order to avoid renal rejection on one hand and to reduce as much as possible the undesired adverse and toxicity effects on the other hand.

Therapeutic efficacy and the onset of adverse effects are influenced by levels of mycophenolic acid (MPA, the active metabolite of MMF, CellCept®).

The primary objective of this study is to assess the treatment superiority of CellCept® Dose Adjustment treatment, based on individual MPA concentration value monitored periodically, against treatment with CellCept® Fixed Dose (standard care).


Condition or disease Intervention/treatment Phase
Renal Transplant Drug: Mycophenolate mofetil (CellCept® ) Phase 4

Detailed Description:
Patient will be randomized into two treatment groups on a 1:1 ratio. Both groups will be treated with the same drugs which is the usual treatment for avoiding renal transplant rejection. In one group the CellCept® dose will be adjusted based on MPA concentration value which will be monitored periodically; and the second group will be treated with CellCept® Fixed Dose (based on the clinical judgment of the treating physician).

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 138 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Phase IV, Open-Label, Multicenter, Randomized Study Comparing Mycophenolate Mofetil (MMF) Dose Adjustment Based on Blood MPA Concentration to Standard Care Treatment With MMF in Renal Transplant Recipients Receiving Tacrolimus
Study Start Date : August 2008
Estimated Primary Completion Date : August 2011
Estimated Study Completion Date : August 2013

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Arms and Interventions
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Arm Intervention/treatment
Experimental: 1
Concentration Controlled (CC)group will receive an individually adjusted MMF dosing regimen based on the plasma concentrations of mycophenolic acid (MPA,the active metabolite of mycophenolate mofetil).
 Drug: Mycophenolate mofetil (CellCept® )
Concentration Control group: MMF dosage will be adjusted (by addition or subtraction of least 250 mg of MMF twice a day) based on MPA levels (MPA AUC target of 40 mg*h\L) measured on Days 7,14,Months 1,3,6 and 12.
Other Names:
  • CellCept®
  • MMF
Active Comparator: 2
Fixed dose (FD) group will receive an a priori set dose of 2mg\day MMF, the recommended dose, with a possible secondary adaptation by the clinician based on criteria of clinical efficacy, toxicity or interactions with other medications.
 Drug: Mycophenolate mofetil (CellCept® )
Fixed Dose group, MMF dosage will be adjusted based on standard care


Outcome Measures
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Primary Outcome Measures :
  1. Primary Endpoint Treatment failure defined as a biopsy proven acute rejection, graft loss, death, MMF discontinuation or lost to follow-up. [ Time Frame: During the first 12 months following randomization. ]

Eligibility Criteria
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Ages Eligible for Study:   18 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Male or female subjects, between 18 to 70 years of age at the time of enrollment.
  • Patient who received first or second renal transplant.
  • Patients who are 0-14 days post transplant.
  • Patients capable of understanding the purposes and risks of the study who signed a written informed consent to participate and to comply with the requirements of the study.

Exclusion Criteria:

  • Women lactating, pregnant or of childbearing potential not using a reliable contraceptive method before beginning study drug therapy, during therapy and for 4 months following their last dose of the study drug therapy.
  • Patients with severe diarrhea or other gastrointestinal disorders that might interfere with their ability to absorb oral medication, including diabetic patients with previously diagnosed diabetic gastroenteropathy.
  • Patients with a history of a psychological illness or condition such as to interfere with the patient's ability to understand the requirements of the study.
  • Patients with evidence of an active systemic infection requiring the continued use of antibiotics or evidence of an HIV infection, or the presence of a chronic active hepatitis B (HBs-Ag positive) or C.
  • Current or historic Panel Reactive Antibody (PRA) >50%
  • Positive crossmatch (irrespective of method).
  • Cold ischemia time of the graft of more than 30 hours.
  • Patients who had received an investigational new drug within the last three months at the time of enrollment.
  • Multi-organ recipients (e.g. kidney and pancreas) or previous transplant with any organ other than kidney.
  • Patients with any known hypersensitivity to MPA, EC-MPS or other components of the formulation (e.g. lactose).
  • Patients with thrombocytopenia (< 75,000/mm3), with an absolute neutrophil count of <1,500/mm3, and/or leukocytopenia (< 2,500/mm3), and/or hemoglobin < 6 g/dL at Screening or Baseline.
  • Patients with a history of malignancy within the last five years, except excised squamous or basal cell carcinoma of the skin.
  • Previous exposure to EC-MPS.
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00737659


Contacts
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Contact: Eytan Mor, Prof. +972-39376452
Contact: Alexander Yussim, Dr. +972-39376528

Locations
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Israel
Rabin Medical Center Recruiting
Petach Tikvah, Israel
Contact: Eytan Mor, Prof.    +972-39376528      
Contact: Alexander Yussim, Dr.    +972-39376452      
Principal Investigator: Eitan Mor, Prof.         
Tel Aviv sourasky Medical Center Recruiting
Tel Aviv, Israel
Contact: Richard Nakache, MD    972-3-6974408      
Contact: Ravit Tvito, RC    972-508356663      
Principal Investigator: Richard Nakache, Prof.         
Sponsors and Collaborators
Rabin Medical Center
Investigators
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Principal Investigator: Eytan Mor, Prof. Rabin Medical Center
Principal Investigator: Richard Nakache, Prof. Sorasky Medical Center
More Information
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Responsible Party: Eytan Mor Prof., Rabin MC
ClinicalTrials.gov Identifier: NCT00737659     History of Changes
Other Study ID Numbers: ML21706
First Posted: August 19, 2008    Key Record Dates
Last Update Posted: March 26, 2010
Last Verified: December 2008
Keywords provided by Rabin Medical Center:
Renal Transplant
Renal
Transplant
 MMF
MPA
Recipients
Additional relevant MeSH terms:
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Mycophenolic Acid
Antibiotics, Antineoplastic
Antineoplastic Agents
Antibiotics, Antitubercular
Antitubercular Agents
 Anti-Bacterial Agents
Anti-Infective Agents
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action