Trial Outcomes & Findings for Pharmacodynamics, Efficacy and Safety of Basiliximab 40 or 80 mg in Combination With Ciclosporine Microemulsion or Everolimus, in Adult Low Risk de Novo Renal Transplant Recipients (IDEALE Study) (NCT NCT01596062)

NCT ID: NCT01596062

Last Updated: 2014-07-25

Results Overview

CD25 saturation is the percentage of T cells expressing CD25. Mean AUC of CD25 was calculated only for patients who received two Simulect® injections.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

16 participants

Primary outcome timeframe

Day 84 (Week 12) after transplantation

Results posted on

2014-07-25

Participant Flow

With premature end of recruitment only 16 patients were included. Descriptive analysis was done \& statistical method fitted the small number of patients. One final analysis was performed at M6 post-transplantation \& comprised assessment of criteria planned at M3 and M6. Some analysis pertaining to the secondary objectives were not performed.

Participant milestones

Participant milestones
Measure
Simulect 40mg + Neoral + Myfortic + Steroids
A cumulative dose of 40 mg of Simulect® (20mg at Day 0 (D0) and 20mg at Day 4 (D4)+ Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Neoral + Myfortic + Steroids
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Certican + Myfortic + Steroids
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Certican® + Myfortic® + corticosteroids
Overall Study
STARTED
3
6
7
Overall Study
COMPLETED
2
6
4
Overall Study
NOT COMPLETED
1
0
3

Reasons for withdrawal

Reasons for withdrawal
Measure
Simulect 40mg + Neoral + Myfortic + Steroids
A cumulative dose of 40 mg of Simulect® (20mg at Day 0 (D0) and 20mg at Day 4 (D4)+ Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Neoral + Myfortic + Steroids
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Certican + Myfortic + Steroids
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Certican® + Myfortic® + corticosteroids
Overall Study
Adverse Event
1
0
2
Overall Study
Lack of Efficacy
0
0
1

Baseline Characteristics

Pharmacodynamics, Efficacy and Safety of Basiliximab 40 or 80 mg in Combination With Ciclosporine Microemulsion or Everolimus, in Adult Low Risk de Novo Renal Transplant Recipients (IDEALE Study)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Simulect 40mg + Neoral + Myfortic + Steroids
n=3 Participants
A cumulative dose of 40 mg of Simulect® (20mg at Day 0 (D0) and 20mg at Day 4 (D4)+ Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Neoral + Myfortic + Steroids
n=6 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Certican + Myfortic + Steroids
n=7 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Certican® + Myfortic® + corticosteroids
Total
n=16 Participants
Total of all reporting groups
Age, Continuous
53.7 years
STANDARD_DEVIATION 8.7 • n=5 Participants
45.0 years
STANDARD_DEVIATION 11.4 • n=7 Participants
39.7 years
STANDARD_DEVIATION 12.2 • n=5 Participants
44.3 years
STANDARD_DEVIATION 11.9 • n=4 Participants
Sex: Female, Male
Female
0 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
4 Participants
n=4 Participants
Sex: Female, Male
Male
3 Participants
n=5 Participants
4 Participants
n=7 Participants
5 Participants
n=5 Participants
12 Participants
n=4 Participants

PRIMARY outcome

Timeframe: Day 84 (Week 12) after transplantation

Population: PK/PD population: Patients included in the ITT population for whom at least one blood sample for PK/PD analyses was collected. This population is the reference population for the PK and PD analyses.

CD25 saturation is the percentage of T cells expressing CD25. Mean AUC of CD25 was calculated only for patients who received two Simulect® injections.

Outcome measures

Outcome measures
Measure
Simulect 40mg + Neoral + Myfortic + Steroids
n=3 Participants
A cumulative dose of 40 mg of Simulect® (20mg at Day 0 (D0) and 20mg at Day 4 (D4)+ Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Neoral + Myfortic + Steroids
n=6 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Certican + Myfortic + Steroids
n=6 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Certican® + Myfortic® + corticosteroids
Area Under the Curve (AUC) of CD25 Saturation by Basiliximab From Day 0 to Day 84
8.4 Weeks * Percentage of saturated CD25
Standard Deviation 1.61
11.1 Weeks * Percentage of saturated CD25
Standard Deviation 1.12
9.7 Weeks * Percentage of saturated CD25
Standard Deviation 0.70

PRIMARY outcome

Timeframe: Day 0, Day 1, Day 4, Day 6, Day 14, Day 21, Day 28, Day 42, Day 56 and Day 84 (Week 12) post-transplantation

Population: PK/PD population: Patients included in the ITT population for whom at least one blood sample for PK/PD analyses was collected. This population is the reference population for the PK and PD analyses.

CD25 saturation is the percentage of T cells expressing CD25

Outcome measures

Outcome measures
Measure
Simulect 40mg + Neoral + Myfortic + Steroids
n=3 Participants
A cumulative dose of 40 mg of Simulect® (20mg at Day 0 (D0) and 20mg at Day 4 (D4)+ Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Neoral + Myfortic + Steroids
n=6 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Certican + Myfortic + Steroids
n=7 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Certican® + Myfortic® + corticosteroids
Saturation Rate of CD25 Antigen Saturation by Basiliximab
Day 0 (before injection)
0.0 percentage of T cells
Standard Deviation 0.00
0.0 percentage of T cells
Standard Deviation 0.00
0.0 percentage of T cells
Standard Deviation 0.00
Saturation Rate of CD25 Antigen Saturation by Basiliximab
Day 0 (2 hours after injection)
93.7 percentage of T cells
Standard Deviation 10.97
96.7 percentage of T cells
Standard Deviation 8.16
94.7 percentage of T cells
Standard Deviation 5.19
Saturation Rate of CD25 Antigen Saturation by Basiliximab
Day 1
95.7 percentage of T cells
Standard Deviation 7.51
97.7 percentage of T cells
Standard Deviation 5.24
99.0 percentage of T cells
Standard Deviation 2.65
Saturation Rate of CD25 Antigen Saturation by Basiliximab
Day 4 (before injection); (n= 3, 6, 6)
100.0 percentage of T cells
Standard Deviation 0.00
96.2 percentage of T cells
Standard Deviation 6.88
93.7 percentage of T cells
Standard Deviation 9.89
Saturation Rate of CD25 Antigen Saturation by Basiliximab
Day 4 (2 hours after injection): (n= 3, 6, 5)
96.7 percentage of T cells
Standard Deviation 5.77
96.3 percentage of T cells
Standard Deviation 6.83
84.8 percentage of T cells
Standard Deviation 19.25
Saturation Rate of CD25 Antigen Saturation by Basiliximab
Day 6: (n= 3, 6, 6)
98.7 percentage of T cells
Standard Deviation 2.31
100.0 percentage of T cells
Standard Deviation 0.00
94.0 percentage of T cells
Standard Deviation 14.70
Saturation Rate of CD25 Antigen Saturation by Basiliximab
Day 14: (n= 3, 6, 6)
98.3 percentage of T cells
Standard Deviation 2.89
96.7 percentage of T cells
Standard Deviation 7.23
97.3 percentage of T cells
Standard Deviation 6.53
Saturation Rate of CD25 Antigen Saturation by Basiliximab
Day 21: (n= 3, 6, 6)
100.0 percentage of T cells
Standard Deviation 0.00
94.5 percentage of T cells
Standard Deviation 10.80
92.5 percentage of T cells
Standard Deviation 11.83
Saturation Rate of CD25 Antigen Saturation by Basiliximab
Day 28: (n= 3, 6, 6)
95.3 percentage of T cells
Standard Deviation 4.16
100.0 percentage of T cells
Standard Deviation 0.00
92.7 percentage of T cells
Standard Deviation 9.33
Saturation Rate of CD25 Antigen Saturation by Basiliximab
Day 42: (n= 3, 6, 5)
78.3 percentage of T cells
Standard Deviation 9.07
100.0 percentage of T cells
Standard Deviation 0.00
99.2 percentage of T cells
Standard Deviation 1.79
Saturation Rate of CD25 Antigen Saturation by Basiliximab
Day 56: (n= 3, 6, 5)
65.0 percentage of T cells
Standard Deviation 56.35
93.3 percentage of T cells
Standard Deviation 13.20
94.2 percentage of T cells
Standard Deviation 12.97
Saturation Rate of CD25 Antigen Saturation by Basiliximab
Day 84 (Week 12): (n= 3, 6, 5)
0.0 percentage of T cells
Standard Deviation 0.00
67.5 percentage of T cells
Standard Deviation 48.55
14.2 percentage of T cells
Standard Deviation 20.86

SECONDARY outcome

Timeframe: Day 84 (Week 12) post-transplantation

Population: PK/PD population: Patients included in the ITT population for whom at least one blood sample for PK/PD analyses was collected. This population is the reference population for the PK and PD analyses.

Mean AUC was calculated only for patients who received two Simulect injections.

Outcome measures

Outcome measures
Measure
Simulect 40mg + Neoral + Myfortic + Steroids
n=3 Participants
A cumulative dose of 40 mg of Simulect® (20mg at Day 0 (D0) and 20mg at Day 4 (D4)+ Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Neoral + Myfortic + Steroids
n=6 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Certican + Myfortic + Steroids
n=6 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Certican® + Myfortic® + corticosteroids
AUC of Basiliximab Binding to CD25 Receptors From Day 0 to Day 84
7.0 Weeks * Percentage of T cells
Standard Deviation 1.80
9.9 Weeks * Percentage of T cells
Standard Deviation 2.22
8.4 Weeks * Percentage of T cells
Standard Deviation 0.75

SECONDARY outcome

Timeframe: Day 0, Day 1, Day 4, Day 6, Day 14, Day 21, Day 28, Day 42, Day 56 and Day 84 (Week 12) post-transplantation

Population: PK/PD population: Patients included in the ITT population for whom at least one blood sample for PK/PD analyses was collected. This population is the reference population for the PK and PD analyses.

This is the percentage of T cells binding basiliximab at all timepoints.

Outcome measures

Outcome measures
Measure
Simulect 40mg + Neoral + Myfortic + Steroids
n=3 Participants
A cumulative dose of 40 mg of Simulect® (20mg at Day 0 (D0) and 20mg at Day 4 (D4)+ Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Neoral + Myfortic + Steroids
n=6 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Certican + Myfortic + Steroids
n=7 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Certican® + Myfortic® + corticosteroids
Percentage of T-cells That Bind Basiliximab to CD25 Receptors
Day 0 (before injection)
0.0 Percentage of T cells
Standard Deviation 0.00
0.0 Percentage of T cells
Standard Deviation 0.00
4.7 Percentage of T cells
Standard Deviation 12.47
Percentage of T-cells That Bind Basiliximab to CD25 Receptors
Day 0 (2 hours after injection)
95.3 Percentage of T cells
Standard Deviation 8.08
96.2 Percentage of T cells
Standard Deviation 9.39
81.6 Percentage of T cells
Standard Deviation 28.30
Percentage of T-cells That Bind Basiliximab to CD25 Receptors
Day 1 (n= 3, 5, 7)
70.0 Percentage of T cells
Standard Deviation 28.58
64.8 Percentage of T cells
Standard Deviation 35.15
91.4 Percentage of T cells
Standard Deviation 11.65
Percentage of T-cells That Bind Basiliximab to CD25 Receptors
Day 4 (before injection): (n= 3, 6, 6)
100.0 Percentage of T cells
Standard Deviation 0.00
59.0 Percentage of T cells
Standard Deviation 45.98
53.0 Percentage of T cells
Standard Deviation 33.33
Percentage of T-cells That Bind Basiliximab to CD25 Receptors
Day 4 (2 hours after injection): (n= 3, 5, 5)
100.0 Percentage of T cells
Standard Deviation 0.00
83.4 Percentage of T cells
Standard Deviation 20.14
81.2 Percentage of T cells
Standard Deviation 16.02
Percentage of T-cells That Bind Basiliximab to CD25 Receptors
Day 6: (n= 3, 6, 6)
91.7 Percentage of T cells
Standard Deviation 14.43
99.0 Percentage of T cells
Standard Deviation 2.45
98.3 Percentage of T cells
Standard Deviation 4.08
Percentage of T-cells That Bind Basiliximab to CD25 Receptors
Day 14: (n= 3, 6, 6)
100.0 Percentage of T cells
Standard Deviation 0.00
89.0 Percentage of T cells
Standard Deviation 22.00
93.8 Percentage of T cells
Standard Deviation 15.11
Percentage of T-cells That Bind Basiliximab to CD25 Receptors
Day 21: (n= 3, 6, 6)
89.0 Percentage of T cells
Standard Deviation 19.05
87.7 Percentage of T cells
Standard Deviation 26.93
85.8 Percentage of T cells
Standard Deviation 32.31
Percentage of T-cells That Bind Basiliximab to CD25 Receptors
Day 28: (n= 3, 6, 6)
76.3 Percentage of T cells
Standard Deviation 17.62
91.0 Percentage of T cells
Standard Deviation 14.00
82.7 Percentage of T cells
Standard Deviation 26.29
Percentage of T-cells That Bind Basiliximab to CD25 Receptors
Day 42: (n= 3, 6, 5)
47.3 Percentage of T cells
Standard Deviation 28.22
84.0 Percentage of T cells
Standard Deviation 19.75
78.8 Percentage of T cells
Standard Deviation 30.11
Percentage of T-cells That Bind Basiliximab to CD25 Receptors
Day 56: (n= 3, 6, 5)
53.0 Percentage of T cells
Standard Deviation 41.80
88.8 Percentage of T cells
Standard Deviation 27.35
75.2 Percentage of T cells
Standard Deviation 15.29
Percentage of T-cells That Bind Basiliximab to CD25 Receptors
Day 84 (Week 12): (n= 3, 6, 5)
6.7 Percentage of T cells
Standard Deviation 6.11
57.7 Percentage of T cells
Standard Deviation 43.83
15.8 Percentage of T cells
Standard Deviation 9.73

SECONDARY outcome

Timeframe: Day 0, Day 6, Day 42, Day 84 (Week 12)

Population: PK/PD population: Patients included in the ITT population for whom at least one blood sample for PK/PD analyses was collected. This population is the reference population for the PK and PD analyses.

Cell counts of various subpopulations of T, B and NK lymphocytes (CD3, CD4, CD8, CD19 and CD56) (flow cytometry).

Outcome measures

Outcome measures
Measure
Simulect 40mg + Neoral + Myfortic + Steroids
n=3 Participants
A cumulative dose of 40 mg of Simulect® (20mg at Day 0 (D0) and 20mg at Day 4 (D4)+ Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Neoral + Myfortic + Steroids
n=6 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Certican + Myfortic + Steroids
n=7 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Certican® + Myfortic® + corticosteroids
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD3 cells count at Day 42: (n= 3, 6, 5)
0.5 10^9 cells/L
Standard Deviation 0.09
1.2 10^9 cells/L
Standard Deviation 0.96
1.1 10^9 cells/L
Standard Deviation 1.18
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD3 cells count at Day 0 (before injection)
0.5 10^9 cells/L
Standard Deviation 0.25
0.9 10^9 cells/L
Standard Deviation 0.28
0.7 10^9 cells/L
Standard Deviation 0.28
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD3 cells count at Day 6: (n= 3, 6, 6)
0.6 10^9 cells/L
Standard Deviation 0.39
1.1 10^9 cells/L
Standard Deviation 0.50
0.9 10^9 cells/L
Standard Deviation 0.75
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD3 cells count at Day 84 (Week 12): (n= 3, 6, 6)
0.8 10^9 cells/L
Standard Deviation 0.58
1.2 10^9 cells/L
Standard Deviation 0.72
1.1 10^9 cells/L
Standard Deviation 1.22
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD4 cells count at Day 0 (before injection)
0.4 10^9 cells/L
Standard Deviation 0.19
0.6 10^9 cells/L
Standard Deviation 0.20
0.5 10^9 cells/L
Standard Deviation 0.22
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD4 cells count at Day 6: (n= 3, 6, 6)
0.5 10^9 cells/L
Standard Deviation 0.30
0.7 10^9 cells/L
Standard Deviation 0.28
0.6 10^9 cells/L
Standard Deviation 0.59
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD4 cells count at Day 42: (n= 3, 6, 5)
0.3 10^9 cells/L
Standard Deviation 0.08
0.8 10^9 cells/L
Standard Deviation 0.53
0.8 10^9 cells/L
Standard Deviation 0.82
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD4 cells count at Day 84 (Week 12): (n= 3, 6, 6)
0.6 10^9 cells/L
Standard Deviation 0.36
0.8 10^9 cells/L
Standard Deviation 0.42
0.7 10^9 cells/L
Standard Deviation 0.86
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD8 cells count at Day 0 (before injection)
0.1 10^9 cells/L
Standard Deviation 0.05
0.3 10^9 cells/L
Standard Deviation 0.13
0.2 10^9 cells/L
Standard Deviation 0.15
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD8 cells count at Day 6: (n= 3, 6, 6)
0.2 10^9 cells/L
Standard Deviation 0.08
0.3 10^9 cells/L
Standard Deviation 0.25
0.2 10^9 cells/L
Standard Deviation 0.24
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD8 cells count at Day 42: (n= 3, 6, 5)
0.1 10^9 cells/L
Standard Deviation 0.05
0.3 10^9 cells/L
Standard Deviation 0.44
0.4 10^9 cells/L
Standard Deviation 0.37
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD8 cells count at Day 84 (Week 12): (n= 3, 6, 6)
0.2 10^9 cells/L
Standard Deviation 0.24
0.3 10^9 cells/L
Standard Deviation 0.32
0.3 10^9 cells/L
Standard Deviation 0.37
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD19 cells count at Day 0 (before injection)
0.1 10^9 cells/L
Standard Deviation 0.08
0.1 10^9 cells/L
Standard Deviation 0.10
0.1 10^9 cells/L
Standard Deviation 0.05
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD19 cells count at Day 6: (n=3, 6, 6)
0.1 10^9 cells/L
Standard Deviation 0.07
0.2 10^9 cells/L
Standard Deviation 0.27
0.2 10^9 cells/L
Standard Deviation 0.17
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD19 cells count at Day 42: (n= 3, 6, 5)
0.1 10^9 cells/L
Standard Deviation 0.09
0.2 10^9 cells/L
Standard Deviation 0.21
0.2 10^9 cells/L
Standard Deviation 0.18
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD19 cells count at Day 84 (Week 12): (n= 3, 6, 6)
0.2 10^9 cells/L
Standard Deviation 0.20
0.1 10^9 cells/L
Standard Deviation 0.11
0.1 10^9 cells/L
Standard Deviation 0.15
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD56 cells count at Day 0 (before injection)
0.1 10^9 cells/L
Standard Deviation 0.20
0.2 10^9 cells/L
Standard Deviation 0.14
0.2 10^9 cells/L
Standard Deviation 0.31
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD56 cells count at Day 6: (n= 3, 6, 6)
0.1 10^9 cells/L
Standard Deviation 0.00
0.1 10^9 cells/L
Standard Deviation 0.06
0.2 10^9 cells/L
Standard Deviation 0.25
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD56 cells count at Day 42: (n= 3, 6, 5)
0.1 10^9 cells/L
Standard Deviation 0.05
0.2 10^9 cells/L
Standard Deviation 0.10
0.2 10^9 cells/L
Standard Deviation 0.13
Proportion of CD3+, CD4+, CD8+, CD19+ and CD56+ T Cells
CD56 cells count at Day 84 (Week 12): (n= 3, 6, 6)
0.1 10^9 cells/L
Standard Deviation 0.05
0.1 10^9 cells/L
Standard Deviation 0.03
0.1 10^9 cells/L
Standard Deviation 0.15

SECONDARY outcome

Timeframe: Day 84 (Week 12), Week 24 post-transplantation

Population: Intent to treat (ITT) population: All randomized patients having received at least one Simulect® injection and who had been transplanted. This population is the reference population for the efficacy analyses.

BPAR is one of the components of treatment failure. One assessment of efficacy was BPAR. Renal graft biopsies were performed and the renal tissue was examined to determine if there was acute rejection of the renal transplant.

Outcome measures

Outcome measures
Measure
Simulect 40mg + Neoral + Myfortic + Steroids
n=3 Participants
A cumulative dose of 40 mg of Simulect® (20mg at Day 0 (D0) and 20mg at Day 4 (D4)+ Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Neoral + Myfortic + Steroids
n=6 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Certican + Myfortic + Steroids
n=7 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Certican® + Myfortic® + corticosteroids
Percentage of Participants With of Biopsy Proven Acute Rejection (BPAR)
Day 84 (Week 12): No
66.7 Percentage of participants
83.3 Percentage of participants
42.9 Percentage of participants
Percentage of Participants With of Biopsy Proven Acute Rejection (BPAR)
Day 84 (Week 12):Yes
33.3 Percentage of participants
16.7 Percentage of participants
57.1 Percentage of participants
Percentage of Participants With of Biopsy Proven Acute Rejection (BPAR)
Week 24: No
66.7 Percentage of participants
83.3 Percentage of participants
42.9 Percentage of participants
Percentage of Participants With of Biopsy Proven Acute Rejection (BPAR)
Week 24:Yes
33.3 Percentage of participants
16.7 Percentage of participants
57.1 Percentage of participants

SECONDARY outcome

Timeframe: Day 84 (Week 12), Week 24 post-transplantation

Population: Intent to treat (ITT) population: All randomized patients having received at least one Simulect® injection and who had been transplanted. This population is the reference population for the efficacy analyses.

Antibody mediated acute rejection: C4d deposition, presence of circulating antidonor antibody, morphologic evidence of acute tissue injury such as acute tubular necrosis-like minimal inflammation or capillary and/or glomerular inflammation and/or thromboses or arterial inflammation. Cellular acute rejection: acute T-cell mediated rejection Type IA: Significant interstitial infiltration (\> 25% of parenchyma) and foci of moderate tubulitis (\> 4 mononuclear cells/tubular cross section or group of 10 tubular cells) Type IB: Significant interstitial infiltration (\> 25% of parenchyma) and foci of severe tubulitis (\> 10 mononuclear cells/tubular cross section or group of 10 tubular cells) Type IIA: Mild to moderate intimal arteritis. Type IIB: Severe intimal arteritis comprising \> 25% of the lumenal area. Type III: Transmural (full vessel wall thickness) arteritis and/or arterial fibrinoid change and necrosis of medial smooth muscle cells (with accompanying lymphocytic inflammation).

Outcome measures

Outcome measures
Measure
Simulect 40mg + Neoral + Myfortic + Steroids
n=3 Participants
A cumulative dose of 40 mg of Simulect® (20mg at Day 0 (D0) and 20mg at Day 4 (D4)+ Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Neoral + Myfortic + Steroids
n=6 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Certican + Myfortic + Steroids
n=7 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Certican® + Myfortic® + corticosteroids
Percentage of Participants With Biopsy Proven Acute Rejection (BPAR) According to Type and Severity
Day 84 (Week 12): Antibody mediated AR - No
66.7 Percentage of participants
100.0 Percentage of participants
85.7 Percentage of participants
Percentage of Participants With Biopsy Proven Acute Rejection (BPAR) According to Type and Severity
Day 84 (Week 12): Banff type lll (C AR)
0.0 Percentage of participants
0.0 Percentage of participants
0.0 Percentage of participants
Percentage of Participants With Biopsy Proven Acute Rejection (BPAR) According to Type and Severity
Week 24: Banff type llA
0.0 Percentage of participants
0.0 Percentage of participants
0.0 Percentage of participants
Percentage of Participants With Biopsy Proven Acute Rejection (BPAR) According to Type and Severity
Day 84 (Week 12): Antibody mediated AR - Yes
33.3 Percentage of participants
0.0 Percentage of participants
14.3 Percentage of participants
Percentage of Participants With Biopsy Proven Acute Rejection (BPAR) According to Type and Severity
Day 84 (Week 12): Cellular AR - No
100.0 Percentage of participants
83.3 Percentage of participants
57.1 Percentage of participants
Percentage of Participants With Biopsy Proven Acute Rejection (BPAR) According to Type and Severity
Day 84 (Week 12): Cellular AR - Yes
0.0 Percentage of participants
16.7 Percentage of participants
42.9 Percentage of participants
Percentage of Participants With Biopsy Proven Acute Rejection (BPAR) According to Type and Severity
Day 84 (Week 12): Banff type lA
0.0 Percentage of participants
0.0 Percentage of participants
14.3 Percentage of participants
Percentage of Participants With Biopsy Proven Acute Rejection (BPAR) According to Type and Severity
Day 84 (Week 12): Banff type lB
0.0 Percentage of participants
16.7 Percentage of participants
14.3 Percentage of participants
Percentage of Participants With Biopsy Proven Acute Rejection (BPAR) According to Type and Severity
Day 84 (Week 12): Banff type llA
0.0 Percentage of participants
0.0 Percentage of participants
0.0 Percentage of participants
Percentage of Participants With Biopsy Proven Acute Rejection (BPAR) According to Type and Severity
Day 84 (Week 12): Banff type llB
0.0 Percentage of participants
0.0 Percentage of participants
14.3 Percentage of participants
Percentage of Participants With Biopsy Proven Acute Rejection (BPAR) According to Type and Severity
Week 24: Antibody mediated AR - No
66.7 Percentage of participants
100.0 Percentage of participants
85.7 Percentage of participants
Percentage of Participants With Biopsy Proven Acute Rejection (BPAR) According to Type and Severity
Week 24: Antibody mediated AR - Yes
33.3 Percentage of participants
0.0 Percentage of participants
14.3 Percentage of participants
Percentage of Participants With Biopsy Proven Acute Rejection (BPAR) According to Type and Severity
Week 24: Cellular AR - No
100.0 Percentage of participants
83.3 Percentage of participants
57.1 Percentage of participants
Percentage of Participants With Biopsy Proven Acute Rejection (BPAR) According to Type and Severity
Week 24: Cellular AR - Yes
0.0 Percentage of participants
16.7 Percentage of participants
42.9 Percentage of participants
Percentage of Participants With Biopsy Proven Acute Rejection (BPAR) According to Type and Severity
Week 24: Banff type lA
0.0 Percentage of participants
0.0 Percentage of participants
0.0 Percentage of participants
Percentage of Participants With Biopsy Proven Acute Rejection (BPAR) According to Type and Severity
Week 24: Banff type lB
0.0 Percentage of participants
16.7 Percentage of participants
28.6 Percentage of participants
Percentage of Participants With Biopsy Proven Acute Rejection (BPAR) According to Type and Severity
Week 24: Banff type llB
0.0 Percentage of participants
0.0 Percentage of participants
14.3 Percentage of participants
Percentage of Participants With Biopsy Proven Acute Rejection (BPAR) According to Type and Severity
Week 24: Banff type lll
0.0 Percentage of participants
0.0 Percentage of participants
0.0 Percentage of participants

SECONDARY outcome

Timeframe: Day 84 (Week 12), Week 24

Population: Intent to treat (ITT) population: All randomized patients having received at least one Simulect® injection and who had been transplanted. This population is the reference population for the efficacy analyses.

Treatment failure was defined either as a BPAR, a graft loss, a death or a loss to follow-up. An extended treatment failure was also defined including treated borderline lesions, BPAR, graft loss, death or loss to follow-up. Treated borderline lesions were considered as acute rejection by investigators and DMC experts.

Outcome measures

Outcome measures
Measure
Simulect 40mg + Neoral + Myfortic + Steroids
n=3 Participants
A cumulative dose of 40 mg of Simulect® (20mg at Day 0 (D0) and 20mg at Day 4 (D4)+ Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Neoral + Myfortic + Steroids
n=6 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Certican + Myfortic + Steroids
n=7 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Certican® + Myfortic® + corticosteroids
Percentage of Participants With of Treatment Failures
Day 84 (Week 12): Death - No
100.0 Percentage of participants
100.0 Percentage of participants
100.0 Percentage of participants
Percentage of Participants With of Treatment Failures
Week 24: Graft loss - No
66.7 Percentage of participants
100.0 Percentage of participants
100.0 Percentage of participants
Percentage of Participants With of Treatment Failures
Day84 (Week 12): BPAR and/or borderline lesions-No
66.7 Percentage of participants
66.7 Percentage of participants
14.3 Percentage of participants
Percentage of Participants With of Treatment Failures
Day84 (Week 12):BPAR and/or borderline lesions-Yes
33.3 Percentage of participants
33.3 Percentage of participants
85.7 Percentage of participants
Percentage of Participants With of Treatment Failures
Day 84 (Week 12): Graft loss - No
66.7 Percentage of participants
100.0 Percentage of participants
100.0 Percentage of participants
Percentage of Participants With of Treatment Failures
Day 84 (Week 12): Graft loss - Yes
33.3 Percentage of participants
0.0 Percentage of participants
0.0 Percentage of participants
Percentage of Participants With of Treatment Failures
Day 84 (Week 12): Death - Yes
0.0 Percentage of participants
0.0 Percentage of participants
0.0 Percentage of participants
Percentage of Participants With of Treatment Failures
Day 84 (Week 12): Loss to follow-up - No
100.0 Percentage of participants
100.0 Percentage of participants
100.0 Percentage of participants
Percentage of Participants With of Treatment Failures
Day 84 (Week 12): Loss to follow-up - Yes
0.0 Percentage of participants
0.0 Percentage of participants
0.0 Percentage of participants
Percentage of Participants With of Treatment Failures
Week 24: BPAR or borderline lesions - No
66.7 Percentage of participants
66.7 Percentage of participants
14.3 Percentage of participants
Percentage of Participants With of Treatment Failures
Week 24: Death - No
100.0 Percentage of participants
100.0 Percentage of participants
100.0 Percentage of participants
Percentage of Participants With of Treatment Failures
Week 24: Loss to follow-up - No
100.0 Percentage of participants
100.0 Percentage of participants
100.0 Percentage of participants
Percentage of Participants With of Treatment Failures
Week 24: Loss to follow-up - Yes
0.0 Percentage of participants
0.0 Percentage of participants
0.0 Percentage of participants
Percentage of Participants With of Treatment Failures
Week 24: BPAR or borderline lesions - Yes
33.3 Percentage of participants
33.3 Percentage of participants
85.7 Percentage of participants
Percentage of Participants With of Treatment Failures
Week 24: Graft loss - Yes
33.3 Percentage of participants
0.0 Percentage of participants
0.0 Percentage of participants
Percentage of Participants With of Treatment Failures
Week 24: Death - Yes
0.0 Percentage of participants
0.0 Percentage of participants
0.0 Percentage of participants

SECONDARY outcome

Timeframe: Day 8, Week 24

Population: Intent to treat (ITT) population: All randomized patients having received at least one Simulect® injection and who had been transplanted. This population is the reference population for the efficacy analyses.

(MDRDa formula) with imputation by last observation carried forward (LOCF)

Outcome measures

Outcome measures
Measure
Simulect 40mg + Neoral + Myfortic + Steroids
n=3 Participants
A cumulative dose of 40 mg of Simulect® (20mg at Day 0 (D0) and 20mg at Day 4 (D4)+ Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Neoral + Myfortic + Steroids
n=6 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Certican + Myfortic + Steroids
n=7 Participants
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Certican® + Myfortic® + corticosteroids
Estimated Glomerular Filtration Rate (eGFR) at Day 8 and Week 24
Week 24 (n= 3, 6, 6)
31.9 mL/min/1.73m^2
Standard Deviation 27.93
55.7 mL/min/1.73m^2
Standard Deviation 15.68
54.4 mL/min/1.73m^2
Standard Deviation 10.48
Estimated Glomerular Filtration Rate (eGFR) at Day 8 and Week 24
Day 8
35.0 mL/min/1.73m^2
Standard Deviation 13.20
53.8 mL/min/1.73m^2
Standard Deviation 23.79
49.9 mL/min/1.73m^2
Standard Deviation 18.45

Adverse Events

Simulect 40mg + Neoral + Myfortic + Steroids

Serious events: 2 serious events
Other events: 3 other events
Deaths: 0 deaths

Simulect 80mg + Neoral + Myfortic + Steroids

Serious events: 2 serious events
Other events: 6 other events
Deaths: 0 deaths

Simulect 80mg + Certican + Myfortic + Steroids

Serious events: 5 serious events
Other events: 6 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Simulect 40mg + Neoral + Myfortic + Steroids
n=3 participants at risk
A cumulative dose of 40 mg of Simulect® (20mg at Day 0 (D0) and 20mg at Day 4 (D4)+ Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Neoral + Myfortic + Steroids
n=6 participants at risk
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Certican + Myfortic + Steroids
n=7 participants at risk
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Certican® + Myfortic® + corticosteroids
Gastrointestinal disorders
Gastritis
0.00%
0/3
16.7%
1/6
0.00%
0/7
Gastrointestinal disorders
Peritoneal haemorrhage
0.00%
0/3
0.00%
0/6
14.3%
1/7
Immune system disorders
Kidney transplant rejection
0.00%
0/3
0.00%
0/6
14.3%
1/7
Immune system disorders
Transplant rejection
33.3%
1/3
0.00%
0/6
14.3%
1/7
Infections and infestations
Pyelonephritis
0.00%
0/3
0.00%
0/6
14.3%
1/7
Injury, poisoning and procedural complications
Femur fracture
33.3%
1/3
0.00%
0/6
0.00%
0/7
Injury, poisoning and procedural complications
Graft loss
33.3%
1/3
0.00%
0/6
0.00%
0/7
Injury, poisoning and procedural complications
Post procedural haematuria
33.3%
1/3
0.00%
0/6
0.00%
0/7
Investigations
Blood creatinine increased
0.00%
0/3
16.7%
1/6
14.3%
1/7
Metabolism and nutrition disorders
Diabetes mellitus
0.00%
0/3
16.7%
1/6
0.00%
0/7
Renal and urinary disorders
Renal failure acute
0.00%
0/3
0.00%
0/6
28.6%
2/7
Reproductive system and breast disorders
Epididymitis
0.00%
0/3
0.00%
0/6
14.3%
1/7
Respiratory, thoracic and mediastinal disorders
Cough
0.00%
0/3
16.7%
1/6
0.00%
0/7
Vascular disorders
Lymphocele
0.00%
0/3
0.00%
0/6
14.3%
1/7

Other adverse events

Other adverse events
Measure
Simulect 40mg + Neoral + Myfortic + Steroids
n=3 participants at risk
A cumulative dose of 40 mg of Simulect® (20mg at Day 0 (D0) and 20mg at Day 4 (D4)+ Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Neoral + Myfortic + Steroids
n=6 participants at risk
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Certican + Myfortic + Steroids
n=7 participants at risk
A cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Certican® + Myfortic® + corticosteroids
Blood and lymphatic system disorders
Anaemia
33.3%
1/3
33.3%
2/6
28.6%
2/7
Blood and lymphatic system disorders
Leukopenia
0.00%
0/3
0.00%
0/6
14.3%
1/7
Blood and lymphatic system disorders
Neutropenia
0.00%
0/3
33.3%
2/6
0.00%
0/7
Blood and lymphatic system disorders
Thrombocytopenia
33.3%
1/3
0.00%
0/6
0.00%
0/7
Gastrointestinal disorders
Abdominal pain
0.00%
0/3
0.00%
0/6
14.3%
1/7
Gastrointestinal disorders
Aphthous stomatitis
0.00%
0/3
0.00%
0/6
28.6%
2/7
Gastrointestinal disorders
Ascites
33.3%
1/3
0.00%
0/6
0.00%
0/7
Gastrointestinal disorders
Diarrhoea
0.00%
0/3
16.7%
1/6
14.3%
1/7
Gastrointestinal disorders
Gastrointestinal disorder
0.00%
0/3
16.7%
1/6
0.00%
0/7
Gastrointestinal disorders
Gastrooesophageal reflux disease
0.00%
0/3
16.7%
1/6
0.00%
0/7
Gastrointestinal disorders
Gingival hypertrophy
33.3%
1/3
16.7%
1/6
0.00%
0/7
Gastrointestinal disorders
Lip pruritus
0.00%
0/3
16.7%
1/6
0.00%
0/7
Gastrointestinal disorders
Peritoneal haemorrhage
0.00%
0/3
0.00%
0/6
14.3%
1/7
General disorders
Asthenia
0.00%
0/3
0.00%
0/6
14.3%
1/7
General disorders
Oedema
0.00%
0/3
0.00%
0/6
14.3%
1/7
General disorders
Oedema peripheral
100.0%
3/3
16.7%
1/6
14.3%
1/7
Hepatobiliary disorders
Cholestasis
33.3%
1/3
0.00%
0/6
0.00%
0/7
Hepatobiliary disorders
Cytolytic hepatitis
33.3%
1/3
50.0%
3/6
0.00%
0/7
Infections and infestations
BK virus infection
0.00%
0/3
0.00%
0/6
14.3%
1/7
Infections and infestations
Gingival infection
0.00%
0/3
0.00%
0/6
14.3%
1/7
Infections and infestations
Herpes simplex
0.00%
0/3
0.00%
0/6
14.3%
1/7
Infections and infestations
Oral herpes
0.00%
0/3
16.7%
1/6
0.00%
0/7
Infections and infestations
Otitis media
0.00%
0/3
0.00%
0/6
14.3%
1/7
Infections and infestations
Rhinitis
0.00%
0/3
16.7%
1/6
0.00%
0/7
Infections and infestations
Sinusitis
0.00%
0/3
16.7%
1/6
14.3%
1/7
Infections and infestations
Urinary tract infection
0.00%
0/3
16.7%
1/6
14.3%
1/7
Injury, poisoning and procedural complications
Arteriovenous fistula thrombosis
0.00%
0/3
0.00%
0/6
14.3%
1/7
Injury, poisoning and procedural complications
Complications of transplanted kidney
33.3%
1/3
0.00%
0/6
14.3%
1/7
Injury, poisoning and procedural complications
Incision site pain
0.00%
0/3
0.00%
0/6
14.3%
1/7
Investigations
Blood creatinine increased
0.00%
0/3
16.7%
1/6
14.3%
1/7
Investigations
Weight increased
33.3%
1/3
0.00%
0/6
0.00%
0/7
Metabolism and nutrition disorders
Acidosis
33.3%
1/3
0.00%
0/6
14.3%
1/7
Metabolism and nutrition disorders
Dyslipidaemia
0.00%
0/3
0.00%
0/6
14.3%
1/7
Metabolism and nutrition disorders
Hypercalcaemia
33.3%
1/3
0.00%
0/6
0.00%
0/7
Metabolism and nutrition disorders
Hypercholesterolaemia
0.00%
0/3
33.3%
2/6
0.00%
0/7
Metabolism and nutrition disorders
Hyperglycaemia
0.00%
0/3
0.00%
0/6
14.3%
1/7
Metabolism and nutrition disorders
Hyperkalaemia
0.00%
0/3
0.00%
0/6
14.3%
1/7
Metabolism and nutrition disorders
Hyperlipidaemia
0.00%
0/3
0.00%
0/6
28.6%
2/7
Metabolism and nutrition disorders
Hypocalcaemia
33.3%
1/3
0.00%
0/6
14.3%
1/7
Metabolism and nutrition disorders
Hypokalaemia
0.00%
0/3
16.7%
1/6
0.00%
0/7
Metabolism and nutrition disorders
Hypophosphataemia
0.00%
0/3
16.7%
1/6
14.3%
1/7
Musculoskeletal and connective tissue disorders
Arthralgia
0.00%
0/3
16.7%
1/6
0.00%
0/7
Musculoskeletal and connective tissue disorders
Myalgia
0.00%
0/3
16.7%
1/6
0.00%
0/7
Musculoskeletal and connective tissue disorders
Rhabdomyolysis
0.00%
0/3
16.7%
1/6
0.00%
0/7
Musculoskeletal and connective tissue disorders
Tendonitis
0.00%
0/3
16.7%
1/6
0.00%
0/7
Nervous system disorders
Hemiparesis
0.00%
0/3
0.00%
0/6
14.3%
1/7
Nervous system disorders
Presyncope
0.00%
0/3
0.00%
0/6
14.3%
1/7
Renal and urinary disorders
Haematuria
33.3%
1/3
0.00%
0/6
0.00%
0/7
Renal and urinary disorders
Renal failure acute
0.00%
0/3
0.00%
0/6
14.3%
1/7
Reproductive system and breast disorders
Metrorrhagia
0.00%
0/3
16.7%
1/6
0.00%
0/7
Respiratory, thoracic and mediastinal disorders
Lung disorder
0.00%
0/3
16.7%
1/6
14.3%
1/7
Skin and subcutaneous tissue disorders
Hirsutism
0.00%
0/3
16.7%
1/6
0.00%
0/7
Skin and subcutaneous tissue disorders
Rash
0.00%
0/3
0.00%
0/6
14.3%
1/7
Vascular disorders
Hypertension
66.7%
2/3
16.7%
1/6
57.1%
4/7
Vascular disorders
Intra-abdominal haematoma
0.00%
0/3
0.00%
0/6
28.6%
2/7
Vascular disorders
Phlebitis superficial
0.00%
0/3
0.00%
0/6
14.3%
1/7

Additional Information

Study Director

Novartis Pharmaceuticals

Phone: 862-778-8300

Results disclosure agreements

  • Principal investigator is a sponsor employee The terms and conditions of Novartis' agreements with its investigators may vary. However, Novartis does not prohibit any investigator from publishing. Any publications from a single-site are postponed until the publication of the pooled data (i.e., data from all sites) in the clinical trial or disclosure of trial results in their entirety.
  • Publication restrictions are in place

Restriction type: OTHER