Calcineurin Inhibitor Sparing After Kidney Transplantation

NCT ID: NCT01062555

Last Updated: 2020-12-14

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1/PHASE2

Total Enrollment

527 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-10-01

Study Completion Date

2014-04-03

Brief Summary

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Reducing drug side effects is a key issue in transplantation. One class of drugs commonly used, calcineurin inhibitors (CNIs), is associated with negative side effects, namely, toxicity to the transplanted kidney. In some patients, this toxicity is thought to be associated with loss of transplant function in those who have had their transplants for many years. The introduction of new immunosuppression medications however, has provided the opportunity to minimize or avoid CNIs, which may reduce the occurrence of toxicity to the kidney.

Detailed Description

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It is clear that minimizing the use of CNIs may be beneficial to some or all kidney transplant recipients. The purpose of this study is to determine whether minimization of these CNI drugs will improve patient survival rates and long-term kidney function.

If the subject agrees to participate in this research project, they will be randomly assigned to one of two different immunosuppression drug combinations. All of the drugs used in this study are standard FDA Approved immunosuppressive drugs currently in use by transplant patients. It is unclear however, which combination provides a better long-term outcome.

If after six months of being on the study the subject has not experienced a rejection episode that excludes them from participating in the second phase of this study, they will asked whether or not they would like to continue the study. If they decide to participate in Phase II, there will be another randomization to one of two different immunosuppression drug combinations. This will involve either being assigned to a group that will have their CNI dose lowered or a group that will have their CNI drug stopped and replaced with a non-CNI drug called Sirolimus. Phase II begins at 6 months post-transplant and a second consent will be obtained for those who participate in Phase II.

Conditions

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CNI Side Effects

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Phase I Arm 1

CSA and MMF

Group Type ACTIVE_COMPARATOR

Cyclosporine & Cellcept

Intervention Type DRUG

Dose and frequency determined as usual by transplant physicians. The drugs are not experimental drugs. The study is looking at reducing negative side effects of some of the drugs.

Phase I Arm 2

FK and MMF

Group Type ACTIVE_COMPARATOR

Prograf & Cellcept

Intervention Type DRUG

Dose and frequency determined as usual by transplant physicians. The drugs are not experimental drugs. The study is looking at reducing negative side effects of some of the drugs.

Phase II Arm 1

Low CNI and MMF

Group Type ACTIVE_COMPARATOR

Low Dose CNI (Cyclosporine or FK) and Cellcept

Intervention Type DRUG

Dose and frequency determined as usual by transplant physicians. The drugs are not experimental drugs. The study is looking at reducing negative side effects of some of the drugs.

Phase II Arm 2

Rapa and MMF

Group Type ACTIVE_COMPARATOR

Rapamune and Cellcept

Intervention Type DRUG

Dose and frequency determined as usual by transplant physicians. The drugs are not experimental drugs. The study is looking at reducing negative side effects of some of the drugs.

Interventions

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Cyclosporine & Cellcept

Dose and frequency determined as usual by transplant physicians. The drugs are not experimental drugs. The study is looking at reducing negative side effects of some of the drugs.

Intervention Type DRUG

Prograf & Cellcept

Dose and frequency determined as usual by transplant physicians. The drugs are not experimental drugs. The study is looking at reducing negative side effects of some of the drugs.

Intervention Type DRUG

Low Dose CNI (Cyclosporine or FK) and Cellcept

Dose and frequency determined as usual by transplant physicians. The drugs are not experimental drugs. The study is looking at reducing negative side effects of some of the drugs.

Intervention Type DRUG

Rapamune and Cellcept

Dose and frequency determined as usual by transplant physicians. The drugs are not experimental drugs. The study is looking at reducing negative side effects of some of the drugs.

Intervention Type DRUG

Other Intervention Names

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CSA, Gengraf, Neoral, Sandimmune, MMF, Mycophenolate Mofetil FK, Tacrolimus, MMF, Mycophenolate Mofetil Gengraf, Neoral, Sandimmune, Tacrolimus, Prograf, MMF Sirolimus, MMF, Mycophenolate Mofetil

Eligibility Criteria

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Inclusion Criteria

* Kidney Transplant Recipients \> 18 years old
* First or Second Kidney Transplant only

Exclusion Criteria

* Kidney Transplant Recipients \< 18 years old
* Kidney Transplant Recipients who have a history of \> 2 kidney transplants
* Kidney Transplant Recipients with an already functioning non-renal transplant
* Kidney Transplant Recipients who receive another organ simultaneously at the same time of their kidney transplant (example: Kidney/pancreas, kidney/liver)
* Non-skin malignancy with 2 years previous to enrollment
* Donor Specific Antibodies to kidney donor
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Roche Pharma AG

INDUSTRY

Sponsor Role collaborator

Wyeth is now a wholly owned subsidiary of Pfizer

INDUSTRY

Sponsor Role collaborator

Genzyme, a Sanofi Company

INDUSTRY

Sponsor Role collaborator

University of Minnesota

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Arthur Matas, MD

Role: PRINCIPAL_INVESTIGATOR

University of Minnesota

Locations

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University of Minnesota

Minneapolis, Minnesota, United States

Site Status

Countries

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United States

Other Identifiers

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0604M85327

Identifier Type: -

Identifier Source: org_study_id