Rapamycin Versus Mycophenolate Mofetil in Kidney-Pancreas Recipients

NCT ID: NCT00533442

Last Updated: 2017-07-12

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

170 participants

Study Classification

INTERVENTIONAL

Study Start Date

2000-09-30

Study Completion Date

2016-05-31

Brief Summary

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This study was designed to determine which maintenance immunosuppressive agent, rapamycin or mycophenalate mofetil, resulted in better outcome in patients with type 1 diabetes and renal failure, who presented for a kidney-pancreas transplant.

Detailed Description

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This is a randomized, prospective single center study evaluating the two maintenance drugs above.

Conditions

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Type 1 Diabetes

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Tacrolimus plus MMF plus Steroids

Patients randomized to this arm were scheduled to receive maintenance therapy consisting of Tacrolimus, Mycophenolate Mofetil (MMF), and Steroids. Patients in both treatment arms received dual induction therapy consisting of Rabbit Anti-thymocyte Globulin (Thymoglobulin) plus Daclizumab.

Group Type ACTIVE_COMPARATOR

Mycophenolate Mofetil

Intervention Type DRUG

MMF 1 gm BID beginning 1st day postoperative day

Tacrolimus

Intervention Type DRUG

Part of standard maintenance.

Steroids

Intervention Type DRUG

Part of standard maintenance

Tacrolimus plus Rapamycin plus Steroids

Patients randomized to this arm were scheduled to receive maintenance therapy consisting of Tacrolimus, Rapamycin (Sirolimus), and Steroids. Patients in both treatment arms received dual induction therapy consisting of Rabbit Anti-thymocyte Globulin (Thymoglobulin) plus Daclizumab.

Group Type EXPERIMENTAL

Rapamycin

Intervention Type DRUG

Rapamycin was initiated on day 1 postoperatively, 4mg/day;levels were maintained 5-8ng/ml. Those patients randomized to receive mycophenolate mofetil were given 1gm twice/day starting on the first post-operative day.

Tacrolimus

Intervention Type DRUG

Part of standard maintenance.

Steroids

Intervention Type DRUG

Part of standard maintenance

Interventions

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Rapamycin

Rapamycin was initiated on day 1 postoperatively, 4mg/day;levels were maintained 5-8ng/ml. Those patients randomized to receive mycophenolate mofetil were given 1gm twice/day starting on the first post-operative day.

Intervention Type DRUG

Mycophenolate Mofetil

MMF 1 gm BID beginning 1st day postoperative day

Intervention Type DRUG

Tacrolimus

Part of standard maintenance.

Intervention Type DRUG

Steroids

Part of standard maintenance

Intervention Type DRUG

Other Intervention Names

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Rapamune® (sirolimus) Cellcept MMF TAC Corticosteroids

Eligibility Criteria

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Inclusion Criteria

* Patient with Type 1 diabetes and end stage renal disease.
* Women of childbearing potential must have had a negative pregnancy test (serum or urine).
* Patient agrees to participate in the study and sign an informed consent.
* Patient has no known contraindication to the administration of rapamycin or mycophenolate mofetil.
* Patient has no history of hypersensitivity to rapamycin or mycophenolate mofetil.

Exclusion Criteria

* Patient has history of a malignancy within two years, with the exception of adequately treated localized squamous or basal cell carcinoma of the skin without evidence of recurrence.
* Patient is currently abusing drugs or alcohol.
* Patient is known or suspected to have an active infection or be seropositive for hepatitis B surface antigen (HBsAg), hepatitis C (HCV) or human immunodeficiency virus (HIV).
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Astellas Pharma Inc

INDUSTRY

Sponsor Role collaborator

University of Miami

OTHER

Sponsor Role lead

Responsible Party

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George W. Burke

Professor of Surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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George W Burke, MD

Role: PRINCIPAL_INVESTIGATOR

University of Miami

Locations

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University of Miami, Miller School of Medicine

Miami, Florida, United States

Site Status

Countries

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United States

References

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Burke GW 3rd, Ciancio G, Figueiro J, Olson L, Gomez C, Rosen A, Suzart K, Miller J. Steroid-resistant acute rejection following SPK: importance of maintaining therapeutic dosing in a triple-drug regimen. Transplant Proc. 2002 Aug;34(5):1918-9. doi: 10.1016/s0041-1345(02)03122-6. No abstract available.

Reference Type RESULT
PMID: 12176628 (View on PubMed)

Burke G 3rd, Ciancio G, Figueiro J, Olson L, Gomez C, Rosen A, Suzart K, Miller J. Can acute rejection be prevented in SPK transplantation? Transplant Proc. 2002 Aug;34(5):1913-4. doi: 10.1016/s0041-1345(02)03149-4. No abstract available.

Reference Type RESULT
PMID: 12176626 (View on PubMed)

Burke GW 3rd, Ciancio G, Figueiro J, Buigas R, Olson L, Roth D, Kupin W, Miller J. Hypercoagulable state associated with kidney-pancreas transplantation. Thromboelastogram-directed anti-coagulation and implications for future therapy. Clin Transplant. 2004 Aug;18(4):423-8. doi: 10.1111/j.1399-0012.2004.00183.x.

Reference Type RESULT
PMID: 15233820 (View on PubMed)

Ciancio G, Sageshima J, Chen L, Gaynor JJ, Hanson L, Tueros L, Montenora-Velarde E, Gomez C, Kupin W, Guerra G, Mattiazzi A, Fornoni A, Pugliese A, Roth D, Wolf M, Burke GW 3rd. Advantage of rapamycin over mycophenolate mofetil when used with tacrolimus for simultaneous pancreas kidney transplants: randomized, single-center trial at 10 years. Am J Transplant. 2012 Dec;12(12):3363-76. doi: 10.1111/j.1600-6143.2012.04235.x. Epub 2012 Sep 4.

Reference Type RESULT
PMID: 22946986 (View on PubMed)

Other Identifiers

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20000176

Identifier Type: -

Identifier Source: org_study_id

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