A Twelve-month, Multicenter, Open-label, Randomized Study of the Safety, Tolerability and Efficacy of Everolimus With Basiliximab, Corticosteroids and Two Different Exposure Levels of Tacrolimus in de Novo Renal Transplant Recipients

NCT00369161 | Completed Phase 4 Results

• 1 other identifier: CRAD001A2426
• Study Type: interventional
• Target: 228
• Locations: 1 country
• Sites: 1

Brief Summary

This study is designed to evaluate whether tacrolimus dose reduction in de novo renal recipients receiving everolimus can preserve renal function while maintaining efficacy.

Conditions

Renal Transplantation

Outcome Measures

Primary Outcomes (1)

• Renal Function Assessed by Calculated Glomerular Filtration Rate (cGFR)

  Renal function was assessed by calculated glomerular filtration rate (cGFR) using Modification of Diet in Renal Disease (MDRD)formula. GFR \[mL/min/1.73m\^2\] = 186.3\*(C-1.154)\*(A-0.203)\*G\*R, where: * C is the serum concentration of creatinine \[mg/dL\], * A is patient age at sample collection date \[years\], * G=0.742 when gender is female, otherwise G=1, * R=1.21 when race is black, otherwise R=1

  12 months post -transplant

Secondary Outcomes (2)

• Number of Participants With Incidence of Biopsy-proven Acute Rejection (BPAR)

  from Month 4 through to Month 12

• Percentage of Participants With Efficacy Failure

  Month 12

Study Arms (2)

Very low dose tacrolimus

ACTIVE COMPARATOR

The first dose of everolimus was to be administered not later than 24 hours after transplantation with a starting dose of 1.5 mg bis in diem/twice a day (b.i.d.) thereafter adjusted to maintain the trough blood levels between 3 and 8 ng/ml. Tacrolimus was to be initiated within 24 hours after reperfusion of the graft with a starting dose of 0.1 mg/kg/day thereafter adjusted to maintain the trough blood levels between 4 and 7 ng/ml. Up to months three all patients received the same treatment and after three months patients in this arm received tacrolimus to reach a trough blood level between 1.5 and 3 ng/ml. All patients received two doses of 20 mg basiliximab, administered as an intravenous bolus injection. The first dose was given on the day of transplantation, with the second dose being administered on the fourth day post-transplant. Intravenous (i.v.) prednisone (or equivalent) was given pre- or intra-operatively according to center practice.

Drug: Everolimus (RAD001); Drug: Tacrolimus; Drug: Basiliximab; Drug: Corticosteroids

Low dose tacrolimus

ACTIVE COMPARATOR

The first dose of everolimus was to be administered not later than 24 hours after transplantation with a starting dose of 1.5 mg bis in diem/twice a day (b.i.d.) thereafter adjusted to maintain the trough blood levels between 3 and 8 ng/ml. Tacrolimus was to be initiated within 24 hours after reperfusion of the graft with a starting dose of 0.1 mg/kg/day thereafter adjusted to maintain the trough blood levels between 4 and 7 ng/ml. Up to months three all patients received the same treatment and after three months patients in this arm received tacrolimus to reach a trough blood level between 4 and 7 ng/ml. All patients received two doses of 20 mg basiliximab, administered as an intravenous bolus injection. The first dose was given on the day of transplantation, with the second dose being administered on the fourth day post-transplant. Intravenous (i.v.) prednisone (or equivalent) was given pre- or intra-operatively according to center practice.

Drug: Everolimus (RAD001); Drug: Tacrolimus; Drug: Basiliximab; Drug: Corticosteroids

Interventions

Everolimus (RAD001) DRUG

Low dose tacrolimus; Very low dose tacrolimus

Tacrolimus DRUG

Low dose tacrolimus; Very low dose tacrolimus

Basiliximab DRUG

Low dose tacrolimus; Very low dose tacrolimus

Corticosteroids DRUG

Low dose tacrolimus; Very low dose tacrolimus

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Male or female of 18-65 years old
• Patient who has received a primary kidney transplant from a cadaveric, living unrelated or non-human leucocyte antigen (HLA) identical living related donor
• Recipient of a kidney with a cold ischemia time (CIT) \< 30 hours
• Recipient of a kidney from a donor 10-65 years old
• Patient able to receive the first dose of tacrolimus within 24 hours from graft reperfusion
• Female capable of becoming pregnant must have a negative pregnancy test and is required to practice a medically approved method of birth control for the duration of the study and for a period of three months following discontinuation of investigational drug
• Patient willing and capable of giving written informed consent for study participation and able to participate in the study for 12 months

You may not qualify if:

• Patient who has previously received an organ transplant
• Recipient of multiple organ transplants
• Recipient of a kidney transplant from a non heart-beating donor
• Recipient of donor specific transfusions
• Recipient of A-B-O incompatible transplant or T-cell cross-match positive transplant
• Patient with current Panel Reactive Antibodies (PRA) level ≥ 50%
• Recipient of a kidney from a donor who tests positive for hepatitis B surface antigen or hepatitis C antibodies
• Patient who is human immunodeficiency virus (HIV) positive
• Patient who has a positive hepatitis C serology or who is hepatitis B surface antigen positive with evidence of liver injury as indicated by aspartate aminotransferase (AST)/alanine aminotransferase (ALT) levels ≥2.5 times upper limit of normal (UNL). Viral serology results obtained within 6 months prior to the administration of the first dose of Certican™ are acceptable
• Patient with severe hypercholesterolemia (350 mg/dL, 9.1 mmoL/dL) or hypertriglyceridemia ( 500 mg/dL, 5.6 mmoL/L)
• Patient with white blood cell (WBC) count 3,000/mm3 or with platelet count 75,000/mm3
• Patient with any severe allergy requiring acute (within 4 weeks of baseline) or chronic treatment, or with hypersensitivity to drugs similar to Certican (e.g., macrolides)
• Patient who has been treated with an immunosuppressive drug or an investigational drug within 4 weeks prior to the administration of the first dose of Certican
• Patient with uncontrolled infection
• Patient with any surgical or medical condition, other than the current transplant, which in the opinion of the investigator, precludes enrollment in this trial

Sponsors & Collaborators

• Novartis: lead

Study Sites (1)

Novartis

Basel, Switzerland

Location

Related Publications (1)

• Langer RM, Hene R, Vitko S, Christiaans M, Tedesco-Silva H Jr, Ciechanowski K, Cassuto E, Rostaing L, Vilatoba M, Machein U, Ulbricht B, Junge G, Dong G, Pascual J. Everolimus plus early tacrolimus minimization: a phase III, randomized, open-label, multicentre trial in renal transplantation. Transpl Int. 2012 May;25(5):592-602. doi: 10.1111/j.1432-2277.2012.01465.x. Epub 2012 Mar 26.

  PMID: 22471345 DERIVED

MeSH Terms

Interventions

Everolimus; Tacrolimus; Basiliximab; Adrenal Cortex Hormones

Intervention Hierarchy (Ancestors)

Sirolimus; Macrolides; Lactones; Organic Chemicals; Antibodies, Monoclonal, Humanized; Antibodies, Monoclonal; Antibodies; Immunoglobulins; Immunoproteins; Blood Proteins; Proteins; Amino Acids, Peptides, and Proteins; Serum Globulins; Globulins; Hormones; Hormones, Hormone Substitutes, and Hormone Antagonists

Results Point of Contact

• Title: Study Director
• Organization: Novartis Pharmaceuticals

862-778-8300

Study Officials

• Novartis

  Novartis

  STUDY DIRECTOR

Publication Agreements

• PI is Sponsor Employee: No
• Restriction Type: OTHER
• Restrictive Agreement: Yes

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: INDUSTRY

Study Record Dates

• First Submitted: August 25, 2006
• First Posted: August 29, 2006
• Study Start: June 1, 2006
• Primary Completion: December 1, 2008
• Study Completion: December 1, 2008
• Last Updated: March 3, 2017
• Results First Posted: January 19, 2011

Record last verified: 2017-02

Locations

CH (1)