Maintaining or Stopping Immunosuppressive Therapy in Patients With ANCA Vasculitis and End-stage Renal Disease

NCT ID: NCT03323476

Last Updated: 2026-01-28

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

136 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-02-02

Study Completion Date

2031-03-31

Brief Summary

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This prospective randomized trial aims to evaluate the feasibility, risk and benefit of the discontinuation of immunosuppressive maintenance treatments in AAV (Antineutrophil Cytoplasmic Autoantibodies (ANCA)-associated vasculitis) patients who have reached ESRD (end-stage renal disease). Our hypothesis is that discontinuation of immunosuppressive therapy in AAV patients with ESRD will not expose these patients to an excessive risk of extra-renal AAV relapse, while reducing the rate of complications due to immunosuppression, particularly infections.

Patients with ESRD related to AAV will be randomized into 2 arms:

arm 1: discontinuation (or not initiation) of maintenance treatment (Experimental group) arm 2: maintenance (or initiation) of immunosuppressive treatment (Control group).

The main objective of this study is to demonstrate a superiority of immunosuppression discontinuation in ESRD-AAV patients compared to standard maintenance immunosuppressive therapy in terms of severe prejudicial event-free survival at 24 months. The second objectives include the frequency of major and minor relapses, of infectious episodes and leukopenia in both groups and the establishment of a prospective database regarding the outcome of ESRD-AAV patients.

Detailed Description

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Conditions

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Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis End Stage Renal Disease

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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Discontinuation of maintenance treatment

Group Type EXPERIMENTAL

Discontinuation (or not initiation) of Immunosuppressive Therapy

Intervention Type OTHER

Discontinuation (or not initiation) of Immunosuppressive Therapy

Maintenance of immunosuppressive treatment

Group Type ACTIVE_COMPARATOR

Maintenance (or initiation) of immunosuppressive treatment: Imurel®, Mabthera®,Cellcept®, Cortancyl®

Intervention Type DRUG

Maintenance (or initiation) of Immunosuppressive Therapy: Imurel®, Mabthera®,Cellcept®, Cortancyl®

Interventions

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Discontinuation (or not initiation) of Immunosuppressive Therapy

Discontinuation (or not initiation) of Immunosuppressive Therapy

Intervention Type OTHER

Maintenance (or initiation) of immunosuppressive treatment: Imurel®, Mabthera®,Cellcept®, Cortancyl®

Maintenance (or initiation) of Immunosuppressive Therapy: Imurel®, Mabthera®,Cellcept®, Cortancyl®

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18 years and ≤ 90 years
* Patients affected by a GPA or MPA AAV with a renal injury
* Patients with initial manifestation or relapse of AAV
* Patients with ESRD, defined by a glomerular filtration rate estimated using the MDRD formula ≤15 mL/min or requirement for dialysis for more than 60 days
* Patients with ESRD on native kidney
* Patients who gave written informed consent for participation in the study
* Patients with affiliation to the French social security system

Exclusion Criteria

* Patients who experienced severe extra-renal disease due to AAV (intra-alveolar haemorrhage with blood oxygen saturation ≤ 85% on room air or ventilated, or central nervous system disease) in the last 12 months prior to inclusion
* Patients with AAV-associated renal involvement (with active inflammatory lesions in kidney biopsy) diagnosed less than three months and receiving induction treatment with cyclophosphamide or rituximab or diagnosed less than 45 days for patients who have receveid only treatment based on steroid infusion without cyclophosphamide or rituximab
* Patients who received maintenance immunosuppressive treatment for more than 6 months during the last 12 months
* Patient with a diagnosis of vasculitis other than GPA or MPA
* Patients with another immunologic systemic disease (Lupus, sarcoidosis…) Patients with active HCV, HBV or HIV infection
* Patients with a history of serious viral infection (CMV, HHV8, etc.) in the 2 months prior to the inclusion, or severe uncontrolled chronic infection (tuberculosis, etc.)
* Patients with uncontrolled cancer or hemopathy
* Kidney transplant patient
* Inability to understand and sign the informed consent
* Pregnant women.
* Women of child-bearing age without effective method of contraception
* Age \< 18 years or \> 90 years.
* Patients under guardianship or trusteeship.
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centre Hospitalier Departemental Vendee

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Grégoire COUVRAT-DESVERGNES

Role: PRINCIPAL_INVESTIGATOR

CHD Vendée

Locations

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Centre Hospitalier Universitaire Amiens

Amiens, , France

Site Status RECRUITING

CHU Angers

Angers, , France

Site Status RECRUITING

Centre Hospitalier Angoulême

Angoulême, , France

Site Status NOT_YET_RECRUITING

Centre Hospitalier ARRAS

Arras, , France

Site Status RECRUITING

Centre Hospitalier Avignon

Avignon, , France

Site Status RECRUITING

AUB Santé

Avranches, , France

Site Status NOT_YET_RECRUITING

CHRU Besançon

Besançon, , France

Site Status NOT_YET_RECRUITING

Centre Hospitalier Universitaire Bordeaux

Bordeaux, , France

Site Status NOT_YET_RECRUITING

APHP Ambroise Paré

Boulogne-Billancourt, , France

Site Status NOT_YET_RECRUITING

Centre Hospitalier Boulogne sur Mer

Boulogne-sur-Mer, , France

Site Status RECRUITING

Centre Hospitalier Jacques Coeur

Bourges, , France

Site Status WITHDRAWN

Centre Hospitalier Universitaire de Brest

Brest, , France

Site Status RECRUITING

Centre Hospitalier René Dubois - Pontoise

Cergy-Pontoise, , France

Site Status NOT_YET_RECRUITING

Centre Hospitalier Chartres

Chartres, , France

Site Status RECRUITING

Centre Hospitalier Universitaire G. Montpied

Clermont-Ferrand, , France

Site Status RECRUITING

Hopital Louis Pasteur

Colmar, , France

Site Status RECRUITING

Centre Hospitalier Universitaire de Dijon

Dijon, , France

Site Status NOT_YET_RECRUITING

CHI Eure Seine

Évreux, , France

Site Status RECRUITING

Centre Hospitalier Universitaire Grenoble

Grenoble, , France

Site Status RECRUITING

Centre Hospitalier Départemental Vendée

La Roche-sur-Yon, , France

Site Status RECRUITING

Centre Hospitalier La Rochelle

La Rochelle, , France

Site Status RECRUITING

Centre ECHO - Le Mans

Le Mans, , France

Site Status RECRUITING

Centre Hospitalier Le Mans

Le Mans, , France

Site Status RECRUITING

Centre Hospitalier Emile ROUX

Le Puy-en-Velay, , France

Site Status ACTIVE_NOT_RECRUITING

Hôpital Privé La Louvière

Lille, , France

Site Status RECRUITING

CHRU Lille

Lille, , France

Site Status RECRUITING

Centre Hospitalier Universitaire Dupuytren

Limoges, , France

Site Status NOT_YET_RECRUITING

AUB Santé - Lorient

Lorient, , France

Site Status RECRUITING

Centre Hospitalier Lyon Sud

Lyon, , France

Site Status RECRUITING

Hopital de la Conception - APHM

Marseille, , France

Site Status RECRUITING

Centre Hospitalier de Mont de Marsan

Mont-de-Marsan, , France

Site Status RECRUITING

Centre Hospitalier Universitaire Lapeyronie

Montpellier, , France

Site Status RECRUITING

GHR Mulhouse Sud Alsace

Mulhouse, , France

Site Status RECRUITING

Centre Hospitalier Universitaire de Nantes

Nantes, , France

Site Status RECRUITING

Centre Hospitalier Universitaire Nice

Nice, , France

Site Status RECRUITING

CHU de Nimes

Nîmes, , France

Site Status RECRUITING

Aphp - Bichat

Paris, , France

Site Status RECRUITING

Aphp - Hegp

Paris, , France

Site Status RECRUITING

APHP - Henri Mondor

Paris, , France

Site Status RECRUITING

CHU Kremlin - Bicêtre

Paris, , France

Site Status NOT_YET_RECRUITING

Hôpital Saint Louis

Paris, , France

Site Status RECRUITING

Hôpital Tenon

Paris, , France

Site Status RECRUITING

Centre Hospitalier Universitaire Poitiers

Poitiers, , France

Site Status RECRUITING

Centre Hospitalier Quimper

Quimper, , France

Site Status RECRUITING

AUB Santé - Rennes

Rennes, , France

Site Status RECRUITING

Centre Hospitalier Universitaire Rennes

Rennes, , France

Site Status RECRUITING

Centre Hospitalier Universitaire Rouen

Rouen, , France

Site Status RECRUITING

Centre Hospitalier Saint Brieuc

Saint-Brieuc, , France

Site Status RECRUITING

Centre Hospitalier Universitaire Saint Etienne

Saint-Etienne, , France

Site Status RECRUITING

Centre Hospitalier Saint-Nazaire

Saint-Nazaire, , France

Site Status RECRUITING

Centre Hospitalier Alpes Léman

Sallanches, , France

Site Status RECRUITING

Centre Hospitalier Saint-Malo

St-Malo, , France

Site Status RECRUITING

Centre Hospitalier Universitaire Strasbourg

Strasbourg, , France

Site Status RECRUITING

CHU Toulouse

Toulouse, , France

Site Status RECRUITING

Clinique Saint Exupéry

Toulouse, , France

Site Status NOT_YET_RECRUITING

CHRU Bretonneau

Tours, , France

Site Status RECRUITING

Centre Hospitalier Valenciennes

Valenciennes, , France

Site Status RECRUITING

Centre Hospitalier Bretagne Atlantique

Vannes, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Chloé MOREAU

Role: CONTACT

0251446572

Other Identifiers

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CHD005-17

Identifier Type: -

Identifier Source: org_study_id

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