Thymoglobulin in Calcineurin Inhibitor and Steroid Minimization Protocol

NCT ID: NCT00706680

Last Updated: 2008-06-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-02-29

Study Completion Date

2009-06-30

Brief Summary

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This study has been designed to test whether using Thymoglobulin with low dose Cyclosporine and early steroid dosage reduction will minimize both kidney rejection and the development of new onset diabetes mellitus after renal transplant.

Detailed Description

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All patients will receive methyl prednisone intravenously pre-operatively, as per institutional practice. Thymoglobulin will be initiated prior to completion of the anastomosis, or if not possible, within 24 hours of transplantation in all patients and a total dose of 6-7.5mg/kg will be given over 3-5 doses. Steroids will be initiated post-operatively at 1mg/kg/day for 2 days, then 0.5mg/kg/day for 2 days, then 0.25mg/kg/day for 2 days and then patients will be placed on 5mg daily for the remainder of the study. All patients will receive Mycophenolic acid at a dose of 2gm/day (Cellcept) or 1440mg/day (Myfortic) post-transplantation with dose adjustment as needed. Cyclosporine micro-emulsion will be initiated when renal function is established or no later than day 10 in a dose of 3mg/kg twice daily with adjustment to achieve a C2 target of 600-800 nanograms/ml.

Conditions

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Diabetes Graft Rejection

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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1

All subjects meeting the entry criteria will be treated with the study immunosuppressive protocol.

Group Type EXPERIMENTAL

Thymoglobulin

Intervention Type DRUG

methyl prednisone intravenously pre-operatively, as per institutional practice. Thymoglobulin, initiated prior to completion of the anastomosis, or if not possible, within 24 hours of transplantation for a total dose of 6-7.5mg/kg given over 3-5 doses. Steroids initiated post-operatively at 1mg/kg/day for 2 days, then 0.5mg/kg/day for 2 days, then 0.25mg/kg/day for 2 days. Patients will be placed on 5mg daily for the remainder of the study. All patients will receive Mycophenolic acid at a dose of 2gm/day (Cellcept) or 1440mg/day (Myfortic) post-transplantation with dose adjustment as needed. Cyclosporine micro-emulsion will be initiated when renal function is established or no later than day 10 in a dose of 3mg/kg twice daily with adjustment to achieve a C2 target of 600-800 nanograms/ml.

Interventions

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Thymoglobulin

methyl prednisone intravenously pre-operatively, as per institutional practice. Thymoglobulin, initiated prior to completion of the anastomosis, or if not possible, within 24 hours of transplantation for a total dose of 6-7.5mg/kg given over 3-5 doses. Steroids initiated post-operatively at 1mg/kg/day for 2 days, then 0.5mg/kg/day for 2 days, then 0.25mg/kg/day for 2 days. Patients will be placed on 5mg daily for the remainder of the study. All patients will receive Mycophenolic acid at a dose of 2gm/day (Cellcept) or 1440mg/day (Myfortic) post-transplantation with dose adjustment as needed. Cyclosporine micro-emulsion will be initiated when renal function is established or no later than day 10 in a dose of 3mg/kg twice daily with adjustment to achieve a C2 target of 600-800 nanograms/ml.

Intervention Type DRUG

Other Intervention Names

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Thymo Polyclonal ATG Methyl Prednisone SoluMedrol Steroid Prednisone MMF Cell Cept Mycophenolate Mofetil Mycopnlolic Acid Myfortic Cyclosporine Neoral

Eligibility Criteria

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Inclusion Criteria

* De Novo, single Kidney recipient
* At least 1 HLA mismatch

Exclusion Criteria

* Recipient of multiple organs
* prior transplant recipient
* Subjects who have Diabetes prior to transplant, as indicated by pre-transplant OGTT
* PRA \>10%
* Hepatitis B surface antigen positive
* Hepatitis C antibody positive
* HIV positive
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Genzyme, a Sanofi Company

INDUSTRY

Sponsor Role collaborator

Unity Health Toronto

OTHER

Sponsor Role collaborator

St. Paul's Hospital, Canada

OTHER

Sponsor Role collaborator

University Health Network, Toronto

OTHER

Sponsor Role lead

Responsible Party

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University Health Network

Principal Investigators

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Edward Cole

Role: STUDY_DIRECTOR

University Health Network, Toronto

John Gill

Role: PRINCIPAL_INVESTIGATOR

St. Paul's Hospital

Ramesh Prasad

Role: PRINCIPAL_INVESTIGATOR

Unity Health Toronto

Locations

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St Paul's Hospital

Vancouver, British Columbia, Canada

Site Status NOT_YET_RECRUITING

St Michael's Hospital

Toronto, Ontario, Canada

Site Status NOT_YET_RECRUITING

University health Network

Toronto, Ontario, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Edward Cole

Role: CONTACT

Phone: 416-340-4800

Email: [email protected]

Bricio Rodriguez

Role: CONTACT

Phone: 416-340-4800

Email: [email protected]

Facility Contacts

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John Gill

Role: primary

Ramesh Prasad

Role: primary

Bricio Rodriguez

Role: primary

References

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Cole EH, Prasad GV, Cardella CJ, Kim JS, Tinckam KJ, Cattran DC, Schiff JR, Landsberg DN, Zaltzman JS, Gill JS. A pilot study of reduced dose cyclosporine and corticosteroids to reduce new onset diabetes mellitus and acute rejection in kidney transplant recipients. Transplant Res. 2013 Jan 12;2(1):1. doi: 10.1186/2047-1440-2-1.

Reference Type DERIVED
PMID: 23369458 (View on PubMed)

Other Identifiers

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07-0619-A

Identifier Type: -

Identifier Source: org_study_id