Mycophenolate Mofetil and Rapamycin as Secondary Intervention vs. Continuation of Calcineurin Inhibitors in Patients at Risk for Chronic Renal Allograft Failure

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2000-06-30

Study Completion Date

2009-10-31

Brief Summary

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A study to determine the effect on renal function in renal transplant patients with biopsy proven Chronic allograft nephropathy (CAN) nephropathy who are switched from a Calcinerin inhibitor (CI) triple drug regimen to a Rapamycin based triple drug regimen or maintained on their CI protocol

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Detailed Description

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Conditions

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Kidney Transplant

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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1

pt will switch from calcineurin inhibitor (CYA, prograf) to Rapamycin

Group Type ACTIVE_COMPARATOR

Rapamycin

Intervention Type DRUG

Rapamycin will start within 24 hours of last calcineurin inhibitors (Cya, Prograf). Initial dose of Rapamune 10mg will be given for 3 days and then dose will be adjusted to attain a target whole blood trough of 5-15

2

Patient will remain on calcineruin inhibitor

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Rapamycin

Rapamycin will start within 24 hours of last calcineurin inhibitors (Cya, Prograf). Initial dose of Rapamune 10mg will be given for 3 days and then dose will be adjusted to attain a target whole blood trough of 5-15

Intervention Type DRUG

Other Intervention Names

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Sirolimus

Eligibility Criteria

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Inclusion Criteria

1. Patient is the recipient of a cadaveric or living donor renal transplant.
2. Patient was \> 12 years of age at the time of transplant.
3. Patient is at least 3 months post-transplant.
4. Patient has been on a calcineurin inhibitor based immunosuppression since the transplant.
5. Patient has one of the following risk factors for chronic renal allograft failure:

I. Serum creatinine \> 2.0 mg/dL 3 months or later post-transplant in males patients.

II. Serum creatinine \> 1.7 mg/dL 3 months or later post-transplant in female patients.

III. Serum \> 30% increased over post discharge nadir.
6. Patients had a renal biopsy that shows chronic allograft nephropathy.
7. Patient or legal guardian had signed and dated an Institutional Review Board (IRB) approved informed consent document and is willing and able to follow study procedures.
8. If female and of child bearing potential, patient has a negative pregnancy test and agrees to practice effective birth control while receiving mycophenolate mofetil (MMF), Rapamycin and other immunosuppressants.

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Exclusion Criteria

1. Patient is the recipient of a solid organ transplant other than the kidney.
2. Patient is dialysis dependent.
3. Patient has recurrence of primary renal disease, or de novo renal disease.
4. Patient has an estimated creatinine clearance \<25ml/min calculated using the Cockcroft/Gault formula.
5. Patient has changed maintenance immunosuppressant therapy (e.g., azathioprine to MMF) within three months of randomization.
6. Baseline biopsy shows acute rejection Banff Grade \> Class 2 (IIB).
7. Patient required anti-lymphocyte therapy to treat rejection found on baseline biopsy.
8. Patient has received an investigational immunosuppressant within three months.
9. Patient is pregnant or lactating.
10. Patient is a known carrier of any of the HIV viruses.
11. Patient has known hypersensitivity to Rapamycin, or any of the excipients of the drug.

Minimum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No