TocIlizumab in Late/Chronic Active Antibody-mediated Rejection in Kidney Transplant Recipients

NCT ID: NCT04561986

Last Updated: 2025-04-03

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

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-02-01

Study Completion Date

2028-12-31

Brief Summary

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This multi-center study is an investigator-driven randomized controlled parallel group open-label clinical trial designed to evaluate the efficacy of addition of anti-IL-6 antibody tocilizumab (TCZ) to the standard of care (SOC) treatment as compared to the SOC alone in reducing the decline of graft function in kidney transplant recipients with late or chronic antibody-mediated rejection (AMR). A total of 50 recipients will be allocated to receive either TCZ (n=25) added to the standard of care (SOC) or SOC alone (n=25) for a period of 24 months. Patients will be followed for an additional 12 months. Protocol kidney graft biopsies will be performed at 12 and 24 months. The primary outcome is the mean rate of change in graft function as assessed by estimated glomerular filtration rate (eGFR) slope from baseline to 24 months after start of treatment.

Detailed Description

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Conditions

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Antibody-mediated Rejection

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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Arm A: Standard of care (SOC) + tocilizumab (TCZ)

SOC, as below + TCZ (162 mg every week, subcuataneous administration)

Group Type ACTIVE_COMPARATOR

Tocilizumab

Intervention Type DRUG

Tocilizumab is a recombinant humanized monoclonal antibody directed against the human interleukin-6 (IL-6) receptor

Arm B: SOC

Tacrolimus (target concentration 6 ±1 µg/L) + MPA (1.5-2 g/day as tolerated) + prednisolone (not less than 5 mg/day), all oral administration

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Tocilizumab

Tocilizumab is a recombinant humanized monoclonal antibody directed against the human interleukin-6 (IL-6) receptor

Intervention Type DRUG

Other Intervention Names

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RoActemra

Eligibility Criteria

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Inclusion Criteria

1. The subject has given their written informed consent to participate in the study
2. Recipient of living donor or deceased donor kidney transplant
3. Age ≥18 years
4. At least 6 months post-transplantation at randomization
5. Biopsy-proven diagnosis of late active or chronic active ABMR (≥ 6 months after transplantation) according to the Banff 2022 criteria in index biopsy
6. eGFR ≥20 ml/min/1.73 m2
7. Epstein-Barr Virus (EBV) IgG-positive
8. For female participants of childbearing potential:

* use of adequate contraception and a negative pregnancy test
9. Subject known to have COVID-19 previously must meet all of the following conditions:

* Asymptomatic for at least 1 month before the start of screening
* Re-established on background immunosuppressants for at least 1 month prior to the randomization

Exclusion Criteria

1. Recipient of multi-organ transplants
2. De novo or recurrent renal disease that is considered to be the predominant cause of the current graft dysfunction
3. Active viral infections such as BK virus (BKV), cytomegalovirus (CMV), EBV, COVID-19, hepatitis C virus (HCV) or hepatitis B virus (HBV) infections based on polymerase chain reaction (PCR) testing
4. Ongoing serious infections as per Investigator's opinion
5. History of recurrent infections requiring hospitalization
6. Active tuberculosis (TB)
7. Latent untreatedTB (positive QuantiFERON-TB-Gold test, Chest X-ray)
8. Abnormal liver function tests alanine transaminase (ALT), aspartate transaminase (AST), bilirubin \> 1.5 x upper limit of normal)
9. Other significant liver disease as per Investigator's opinion
10. Neutropenia (\<2 x109/L) or thrombocytopenia (\<100 x109/L)
11. Signs of post-transplant lymphoproliferative disorder
12. Signs of malignancy. Exceptions are basal cell carcinoma/squamous cell carcinoma or non-malignant melanoma
13. History of malignancy, unless subject has been considered to have fully recovered from malignancy since \> 2 years, without any signs of relapse
14. History of diverticulitis, inflammatory bowel disease or gastrointestinal perforation
15. Ongoing alcohol or illicit substance abuse
16. Serious medical or psychiatric illness likely to interfere with participation in the study as per Investigator's opinion
17. Mental inability or reluctance that results in difficulties in understanding the meaning of study participation
18. Woman of childbearing potential who is unwilling/unable to use an acceptable method to avoid pregnancy for the entire study period and for up to 8 weeks after the last dose of study drug
19. Woman with a positive pregnancy test or who is pregnant or breastfeeding
20. Current or recent (within last 3 months) participation in another clinical drug trial
Minimum Eligible Age

18 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Karolinska University Hospital

OTHER

Sponsor Role collaborator

Uppsala University Hospital

OTHER

Sponsor Role collaborator

Skane University Hospital

OTHER

Sponsor Role collaborator

The Swedish Research Council

OTHER_GOV

Sponsor Role collaborator

Hospital del Mar

OTHER

Sponsor Role collaborator

Hospital Universitario Doctor Peset

OTHER

Sponsor Role collaborator

Complexo Hospitalario Universitario de A Coruña

OTHER

Sponsor Role collaborator

Hospital Universitario Marqués de Valdecilla

OTHER

Sponsor Role collaborator

Vastra Gotaland Region

OTHER_GOV

Sponsor Role lead

Responsible Party

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Seema Baid-Agrawal

Associate Professor and Consultant Nephrologist, Transplantation Center, Sahlgrenska University Hospital, Gothenburg

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Seema Baid-Agrawal, MD, FASN

Role: PRINCIPAL_INVESTIGATOR

Transplant Center, Sahlgrenska University Hospital, Gothenburg, Sweden

Locations

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Complejo Hospitalario Universitario A Coruña

A Coruña, , Spain

Site Status NOT_YET_RECRUITING

Hospital del Mar

Barcelona, , Spain

Site Status ACTIVE_NOT_RECRUITING

Marqués de Valdecilla Research Institute

Santander, , Spain

Site Status NOT_YET_RECRUITING

Hospital Universitario Dr. Peset

Valencia, , Spain

Site Status NOT_YET_RECRUITING

Skåne University Hospital

Malmo, Skåne County, Sweden

Site Status RECRUITING

Transplant Center, Sahlgrenska University Hospital

Gothenburg, Vastra Gotaland Regioin, Sweden

Site Status RECRUITING

Karolinksa University Hospital

Stockholm, , Sweden

Site Status RECRUITING

Uppsala University Hospital

Uppsala, , Sweden

Site Status RECRUITING

Countries

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Spain Sweden

Central Contacts

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Seema Baid-Agrawal, MD, FASN

Role: CONTACT

+4631-342 10 00

Marie Felldin, MD, PhD

Role: CONTACT

+4631-342 10 00

Facility Contacts

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Constantino Fernández Rivera, MD. PhD

Role: primary

+34 981 178 159

Juan Carlos Ruíz San Millán, MD. PhD

Role: primary

+34 942 202738

Asunción Sancho Calabuig, MD, PhD

Role: primary

+34 648 012 408

Carin Wallquist, MD, PhD

Role: primary

Seema Baid-Agrawal, MD

Role: primary

031-342 10 00

Marie Felldin, MD, PhD

Role: backup

031-342 10 00

Lars Wennberg, MD, PhD

Role: primary

+46 8 5858 2554

Tomas Lorant, MD, PhD

Role: primary

+46 18 611 7080

Bengt Felldström, MD, PhD

Role: backup

References

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Streichart L, Felldin M, Ekberg J, Mjornstedt L, Lindner P, Lennerling A, Brocker V, Molne J, Holgersson J, Daenen K, Wennberg L, Lorant T, Baid-Agrawal S. Tocilizumab in chronic active antibody-mediated rejection: rationale and protocol of an in-progress randomized controlled open-label multi-center trial (INTERCEPT study). Trials. 2024 Mar 22;25(1):213. doi: 10.1186/s13063-024-08020-0.

Reference Type BACKGROUND
PMID: 38519988 (View on PubMed)

Other Identifiers

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2024-510615-29-00

Identifier Type: CTIS

Identifier Source: secondary_id

2019-004302-10

Identifier Type: -

Identifier Source: org_study_id

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