RituxiMab INDuction in Renal Transplantation

NCT ID: NCT01095172

Last Updated: 2020-07-22

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

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-11-30

Study Completion Date

2022-10-31

Brief Summary

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Hypothesis:

* That B cell depletion, rather than reducing acute rejection, will allow minimisation of immunosuppression, which may lead to better graft survival.

Aim:

* To assess whether the addition of rituximab to a low-dose tacrolimus immunosuppression regime allows a reduction in steroid administration.

Objectives:

* To assess whether B cell depletion affects graft function, acute rejection and complication rates
* To assess whether the T cell response to allotransplantation is impaired by B cell depletion.

Detailed Description

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Conditions

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Function of Renal 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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Rituximab

Rituximab 375mg/m2

Low dose tacrolimus with mycophenylate mofetil, hydrocortisone and 1 week prednisolone

Group Type EXPERIMENTAL

Rituximab

Intervention Type DRUG

375mg/m\^2, single dose given 2-4 weeks prior to transplantation

Tacrolimus

Intervention Type DRUG

dose calculated to give levels of 3-7ng/ml

Mycophenylate mofetil

Intervention Type DRUG

Mycophenylate mofetil 2g/day in divided doses

Hydrocortisone

Intervention Type DRUG

100mg hydrocortisone on the evening of the day of surgery and 2 further doses of hydrocortisone on day 1 post transplant.

Prednisolone

Intervention Type DRUG

Prednisolone 0.3mg/kg on day 2, 0.25mg/kg on day 3, 0.2mg/kg on day 4 and 0.16mg/kg on day 5. On day 6 they will receive 5mg prednisolone, and on day 7 none.

Control group

Low dose tacrolimus with mycophenylate mofetil and continued prednisolone

Group Type ACTIVE_COMPARATOR

Tacrolimus

Intervention Type DRUG

dose calculated to give levels of 3-7ng/ml

Mycophenylate mofetil

Intervention Type DRUG

Mycophenylate mofetil 2g/day in divided doses

Hydrocortisone

Intervention Type DRUG

100mg hydrocortisone on the evening of the day of surgery and 2 further doses of hydrocortisone on day 1 post transplant.

Prednisolone

Intervention Type DRUG

Reducing dose of prednisolone over at least 6 months. Subsequent steroid maintenance or withdrawal will be at the discretion of the patient's clinician.

Interventions

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Rituximab

375mg/m\^2, single dose given 2-4 weeks prior to transplantation

Intervention Type DRUG

Tacrolimus

dose calculated to give levels of 3-7ng/ml

Intervention Type DRUG

Mycophenylate mofetil

Mycophenylate mofetil 2g/day in divided doses

Intervention Type DRUG

Hydrocortisone

100mg hydrocortisone on the evening of the day of surgery and 2 further doses of hydrocortisone on day 1 post transplant.

Intervention Type DRUG

Prednisolone

Prednisolone 0.3mg/kg on day 2, 0.25mg/kg on day 3, 0.2mg/kg on day 4 and 0.16mg/kg on day 5. On day 6 they will receive 5mg prednisolone, and on day 7 none.

Intervention Type DRUG

Prednisolone

Reducing dose of prednisolone over at least 6 months. Subsequent steroid maintenance or withdrawal will be at the discretion of the patient's clinician.

Intervention Type DRUG

Other Intervention Names

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Mabthera Advagraf, Adoport, Prograf MMF, Cellcept

Eligibility Criteria

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Inclusion Criteria

* Adult patients over 18 years receiving their first living donor renal transplant, or their second if the first was not lost from acute rejection
* Patients who have given written informed consent
* Women of child bearing potential taking adequate contraception.

Exclusion Criteria

* Previous other organ transplants lost through acute rejection
* Patients undergoing antibody incompatible transplantation
* Patients with other organ transplants
* Patients previously treated with cyclophosphamide, ATG, OKT3 or rituximab
* Patients with white cell count below 4.0x10\^9/L.
* Patients with platelet count below 100x10\^9/L
* Patients who are treated with drugs that are strong inhibitors or inducers of cytochrome P450, or treated with terfenadine, astemizole, cisapride or lovastatin
* Patients who have been involved in any other investigational trial or non protocol immunosuppressive regimen in the previous 90 days prior to transplant
* Pregnant or breastfeeding women
* Patients with a documented history of malignancy and its origins and treatment in the last five years. (Localised basal cell carcinoma of the skin is permitted)
* Patients known to be HIV, Hepatitis B surface antigen or Hepatitis C antibody positive
* Patients who in the opinion of the Investigator would not be a suitable candidate for study participation
* Women of child bearing potential not willing to take adequate contraception
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Astellas Pharma Europe Ltd.

INDUSTRY

Sponsor Role collaborator

Guy's and St Thomas' NHS Foundation Trust

OTHER

Sponsor Role lead

Responsible Party

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Nizam Mamode

Consultant Surgeon and Reader in Transplant Surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Nizam Mamode, MD FRCS(Gen)

Role: PRINCIPAL_INVESTIGATOR

Guy's and St Thomas' NHS Foundation Trust

Locations

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South West Transplant Centre

Plymouth, Devon, United Kingdom

Site Status

East Kent Hospitals NHS Foundation Trust

Canterbury, Kent, United Kingdom

Site Status

Glasgow Renal and Transplant Unit

Glasgow, , United Kingdom

Site Status

Guy's and St Thomas' NHS Foundation Trust

London, , United Kingdom

Site Status

Central Manchester University Hospitals NHS Foundation Trust

Manchester, , United Kingdom

Site Status

Sheffield Kidney Institute

Sheffield, , United Kingdom

Site Status

Countries

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United Kingdom

Other Identifiers

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2009-017066-23

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

95769119

Identifier Type: REGISTRY

Identifier Source: secondary_id

9154

Identifier Type: REGISTRY

Identifier Source: secondary_id

RituxiRT

Identifier Type: -

Identifier Source: org_study_id

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