Safety Outcomes of Lower Immunosuppression Versus Traditional Immunosuppression in Heart Transplant Recipients

NCT ID: NCT00299221

Last Updated: 2015-05-28

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-04-30

Study Completion Date

2009-12-31

Brief Summary

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This was a study to compare less intense immunosuppression with a more traditional approach. The hypothesis was that less immunosuppression will provide similar protection against rejection than typical 2-3 drug therapy.

Detailed Description

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This was a prospective, randomized, controlled (open-label) trial of 2 different strategies of immunosuppression in de novo post-heart transplant patients. The hypothesis was that immunosuppression with tacrolimus and mycophenolate mofetil, coupled with rapid steroid weaning would provide similar anti-rejection efficacy as tacrolimus with only a 2 week course of mycophenolate mofetil but including the same rapid steroid wean.

The primary endpoint was the mean International Society for Heart and Lung Transplantation (ISHLT) biopsy score over the first 6 months post-transplant. Secondary endpoints included the incidence of adverse events over the first year post-transplant, as well as all-cause mortality, 12 month ISHLT biopsy score (mean), along with the incidence of proven cytomegalovirus disease. In addition, the incidence of allograft vasculopathy as assessed by angiography or intravascular ultrasound was compared between groups.

Conditions

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Immunosuppression

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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Monotherapy

Tacrolimus alone

Group Type ACTIVE_COMPARATOR

Tacrolimus

Intervention Type DRUG

tacrolimus

Combination therapy

tacrolimus with mycophenolate mofetil

Group Type ACTIVE_COMPARATOR

Tacrolimus

Intervention Type DRUG

tacrolimus

combination therapy

Intervention Type DRUG

MMF

Interventions

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Tacrolimus

tacrolimus

Intervention Type DRUG

combination therapy

MMF

Intervention Type DRUG

Other Intervention Names

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Prograf mycophenolate mofetil / CellCept

Eligibility Criteria

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Inclusion Criteria

* Adult (at least 18 years old)
* Undergoing a first heart transplant (no heart/kidney transplants), who receive their transplant at one of the study sites
* Specifically INCLUDED are patients on ventricular assist devices, and allosensitized recipients

Exclusion Criteria

* Age less than 18
* Inability to provide proper informed consent
* Combined organ transplantation
* Re-Transplantation
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Astellas Pharma Inc

INDUSTRY

Sponsor Role collaborator

Newark Beth Israel Medical Center

OTHER

Sponsor Role lead

Responsible Party

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David A. Baran, MD

Director, Heart Failure and Transplant Research

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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David A Baran, MD

Role: PRINCIPAL_INVESTIGATOR

Newark Beth Israel Medical Center

Locations

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Newark Beth Israel Medical Center

Newark, New Jersey, United States

Site Status

Mt. Sinai Cardiovascular Institute

New York, New York, United States

Site Status

Countries

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United States

References

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Baran DA, Zucker MJ, Arroyo LH, Alwarshetty MM, Ramirez MR, Prendergast TW, Goldstein DJ, Camacho M, Gass AL, Carr C, Cohen M. Randomized trial of tacrolimus monotherapy: tacrolimus in combination, tacrolimus alone compared (the TICTAC trial). J Heart Lung Transplant. 2007 Oct;26(10):992-7. doi: 10.1016/j.healun.2007.07.022.

Reference Type RESULT
PMID: 17919618 (View on PubMed)

Baran DA, Zucker MJ, Arroyo LH, Camacho M, Goldschmidt ME, Nicholls SJ, Prevost-Fernandez J, Carr C, Adams L, Pardi S, Hou V, Binetti M, McCahill J, Chichetti J, Viloria V, Sanagustin MG, Ebuenga-Smith J, Mele L, Martin A, Blicharz D, Wolski K, Olesnicky L, Qian F, Gass AL, Cohen M. A prospective, randomized trial of single-drug versus dual-drug immunosuppression in heart transplantation: the tacrolimus in combination, tacrolimus alone compared (TICTAC) trial. Circ Heart Fail. 2011 Mar;4(2):129-37. doi: 10.1161/CIRCHEARTFAILURE.110.958520. Epub 2011 Jan 7.

Reference Type RESULT
PMID: 21216835 (View on PubMed)

Other Identifiers

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TICTAC

Identifier Type: -

Identifier Source: org_study_id

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