Envarsus XL Immunosuppression Following Liver Transplantation

NCT ID: NCT03828058

Last Updated: 2021-01-12

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

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

110 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-04-01

Study Completion Date

2020-12-31

Brief Summary

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The standard immunosuppressive regimen for liver transplantation includes twice daily tacrolimus (Prograf). In other transplantation models, there are potential benefits to extended release formulations as lower peak concentrations are thought to have lower rates of nephrotoxicity. Additionally, compliance with once daily medications is felt to be easier than twice daily medications. Our aim is to look at our prospective liver transplant group and see if once daily tacrolimus (Envarsus XR) results in improved renal function as well as improved health care quality of life.

Detailed Description

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Conditions

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Recipients of Liver Transplant

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

The study will be a prospective, randomized, open label study comparing Envarsus XR with twice daily prograf.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Envarsus XR

Envarsus XR orally administered Daily

Group Type EXPERIMENTAL

Envarsus XR

Intervention Type DRUG

Envarsus XR to be administered orally, once a day. Dosage will be adjusted as determined by trough blood levels.

Prograf

Prograf PO administered twice daily Generic Name: tacrolimus

Dosage of prograf will be determined by trough levels and adjusted accordingly

Group Type ACTIVE_COMPARATOR

Prograf

Intervention Type DRUG

Prograf 2 mg BID to be administered orally, twice a day. Dosage will be adjusted as determined by trough blood levels.

Interventions

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Envarsus XR

Envarsus XR to be administered orally, once a day. Dosage will be adjusted as determined by trough blood levels.

Intervention Type DRUG

Prograf

Prograf 2 mg BID to be administered orally, twice a day. Dosage will be adjusted as determined by trough blood levels.

Intervention Type DRUG

Other Intervention Names

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ENVARSUS XR 0.75Mg Extended-Release Tablet ENVARSUS XR 1Mg Extended-Release Tablet ENVARSUS XR 4Mg Extended-Release Tablet Tacrolimus

Eligibility Criteria

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Inclusion Criteria

1. Provision of signed and dated informed consent form
2. Stated willingness to comply with all study procedures and availability for the duration of the study
3. Male or female, aged 18 years or older
4. Recipients of a first-time liver transplant
5. Serum Creatinine level less than 2.0 on Post-Operative Day 3-7
6. Ability to take oral medication and be willing to adhere to the assigned immunosuppression regimen
7. Agreement to adhere to Lifestyle Considerations (see section 5.3) throughout study duration

Exclusion Criteria

1. Any prior use of tacrolimus or cyclosporine
2. Recipients of prior organ transplant
3. Need for hemodialysis in the week preceding or following liver transplantation
4. Recipients of living donor liver or split deceased donor liver allografts
5. Recipients of combined liver/kidney transplants
6. Pregnancy or lactation
7. Recipients of ABO incompatible liver allografts
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Methodist Healthcare

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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James Eason, MD

Role: STUDY_DIRECTOR

The University of Tennessee Health Science Center, Department of Transplant

Locations

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Methodist Healthcare, University Hospital

Memphis, Tennessee, United States

Site Status

Countries

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United States

References

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Kadam P, Bhalerao S. Sample size calculation. Int J Ayurveda Res. 2010 Jan;1(1):55-7. doi: 10.4103/0974-7788.59946. No abstract available.

Reference Type BACKGROUND
PMID: 20532100 (View on PubMed)

Abdelmalek MF, Humar A, Stickel F, Andreone P, Pascher A, Barroso E, Neff GW, Ranjan D, Toselli LT, Gane EJ, Scarola J, Alberts RG, Maller ES, Lo CM; Sirolimus Liver Conversion Trial Study Group. Sirolimus conversion regimen versus continued calcineurin inhibitors in liver allograft recipients: a randomized trial. Am J Transplant. 2012 Mar;12(3):694-705. doi: 10.1111/j.1600-6143.2011.03919.x. Epub 2012 Jan 10.

Reference Type RESULT
PMID: 22233522 (View on PubMed)

Backman L, Nicar M, Levy M, Distant D, Eisenstein C, Renard T, Goldstein R, Husberg B, Gonwa TA, Klintmalm G. FK506 trough levels in whole blood and plasma in liver transplant recipients. Correlation with clinical events and side effects. Transplantation. 1994 Feb 27;57(4):519-25.

Reference Type RESULT
PMID: 7509516 (View on PubMed)

Kong Y, Wang D, Shang Y, Liang W, Ling X, Guo Z, He X. Calcineurin-inhibitor minimization in liver transplant patients with calcineurin-inhibitor-related renal dysfunction: a meta-analysis. PLoS One. 2011;6(9):e24387. doi: 10.1371/journal.pone.0024387. Epub 2011 Sep 9.

Reference Type RESULT
PMID: 21931704 (View on PubMed)

Langone A, Steinberg SM, Gedaly R, Chan LK, Shah T, Sethi KD, Nigro V, Morgan JC; STRATO Investigators. Switching STudy of Kidney TRansplant PAtients with Tremor to LCP-TacrO (STRATO): an open-label, multicenter, prospective phase 3b study. Clin Transplant. 2015 Sep;29(9):796-805. doi: 10.1111/ctr.12581. Epub 2015 Aug 6.

Reference Type RESULT
PMID: 26113208 (View on PubMed)

Yoo MC, Vanatta JM, Modanlou KA, Campos L, Nezakatgoo N, Nair S, Eason JD. Steroid-free Liver Transplantation Using Rabbit Antithymocyte Globulin Induction in 500 Consecutive Patients. Transplantation. 2015 Jun;99(6):1231-5. doi: 10.1097/TP.0000000000000477.

Reference Type RESULT
PMID: 25539464 (View on PubMed)

Garnock-Jones KP. Tacrolimus prolonged release (Envarsus(R)): a review of its use in kidney and liver transplant recipients. Drugs. 2015 Feb;75(3):309-20. doi: 10.1007/s40265-015-0349-2.

Reference Type RESULT
PMID: 25613762 (View on PubMed)

Niel OR, Berthoux F, Albano L, Dahan P, Aoudia R, Gugenheim J, Cassuto E. Long-term glomerular filtration rate in liver allograft recipients according to the type of calcineurin inhibitors. Transplant Proc. 2009 Oct;41(8):3329-32. doi: 10.1016/j.transproceed.2009.09.034.

Reference Type RESULT
PMID: 19857743 (View on PubMed)

Other Identifiers

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18-05876-FB

Identifier Type: -

Identifier Source: org_study_id

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