NCT03323476

Brief Summary

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.

Trial Health

75
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
136

participants targeted

Target at P25-P50 for phase_3

Timeline
58mo left

Started Feb 2018

Longer than P75 for phase_3

Geographic Reach
1 country

57 active sites

Status
active not recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress63%
Feb 2018Mar 2031

First Submitted

Initial submission to the registry

October 13, 2017

Completed
14 days until next milestone

First Posted

Study publicly available on registry

October 27, 2017

Completed
3 months until next milestone

Study Start

First participant enrolled

February 2, 2018

Completed
10.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 1, 2028

Expected
3 years until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2031

Last Updated

March 20, 2026

Status Verified

March 1, 2026

Enrollment Period

10.1 years

First QC Date

October 13, 2017

Last Update Submit

March 18, 2026

Conditions

Outcome Measures

Primary Outcomes (1)

  • The primary end point will be the time between inclusion and the first severe prejudicial event (measured in days) during 24 months of follow-up.

    Severe prejudicial event is defined by the occurrence of: severe infection, major AAV relapse, death

    During the 24 months of follow-up

Study Arms (2)

Discontinuation of maintenance treatment

EXPERIMENTAL
Other: Discontinuation (or not initiation) of Immunosuppressive Therapy

Maintenance of immunosuppressive treatment

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

Interventions

Discontinuation (or not initiation) of Immunosuppressive Therapy

Discontinuation of maintenance treatment

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

Maintenance of immunosuppressive treatment

Eligibility Criteria

Age18 Years - 90 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • 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

You may not qualify if:

  • 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 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.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (57)

Centre Hospitalier Universitaire Amiens

Amiens, France

Location

CHU Angers

Angers, France

Location

Centre Hospitalier Angoulême

Angoulême, France

Location

Centre Hospitalier ARRAS

Arras, France

Location

Centre Hospitalier Avignon

Avignon, France

Location

AUB Santé

Avranches, France

Location

CHRU Besançon

Besançon, France

Location

Centre Hospitalier Universitaire Bordeaux

Bordeaux, France

Location

APHP Ambroise Paré

Boulogne-Billancourt, France

Location

Centre Hospitalier Boulogne sur Mer

Boulogne-sur-Mer, France

Location

Centre Hospitalier Universitaire de Brest

Brest, France

Location

Centre Hospitalier René Dubois - Pontoise

Cergy-Pontoise, France

Location

Centre Hospitalier Chartres

Chartres, France

Location

Centre Hospitalier Universitaire G. Montpied

Clermont-Ferrand, France

Location

Hopital Louis Pasteur

Colmar, France

Location

Centre Hospitalier Universitaire de Dijon

Dijon, France

Location

CHI Eure Seine

Évreux, France

Location

Centre Hospitalier Universitaire Grenoble

Grenoble, France

Location

Centre Hospitalier Départemental Vendée

La Roche-sur-Yon, 85925, France

Location

Centre Hospitalier La Rochelle

La Rochelle, France

Location

Centre ECHO - Le Mans

Le Mans, France

Location

Centre Hospitalier Le Mans

Le Mans, France

Location

Centre Hospitalier Emile ROUX

Le Puy-en-Velay, France

Location

Hôpital Privé La Louvière

Lille, 59042, France

Location

CHRU Lille

Lille, France

Location

Centre Hospitalier Universitaire Dupuytren

Limoges, France

Location

AUB Santé - Lorient

Lorient, France

Location

Centre Hospitalier Lyon Sud

Lyon, France

Location

Hopital de la Conception - APHM

Marseille, France

Location

Centre Hospitalier de Mont de Marsan

Mont-de-Marsan, France

Location

Centre Hospitalier Universitaire Lapeyronie

Montpellier, France

Location

GHR Mulhouse Sud Alsace

Mulhouse, France

Location

Centre Hospitalier Universitaire de Nantes

Nantes, France

Location

Centre Hospitalier Universitaire Nice

Nice, France

Location

CHU de Nimes

Nîmes, France

Location

Aphp - Bichat

Paris, France

Location

Aphp - Hegp

Paris, France

Location

APHP - Henri Mondor

Paris, France

Location

CHU Kremlin - Bicêtre

Paris, France

Location

Hôpital Saint Louis

Paris, France

Location

Hôpital Tenon

Paris, France

Location

Centre Hospitalier Universitaire Poitiers

Poitiers, France

Location

Centre Hospitalier Quimper

Quimper, France

Location

AUB Santé - Rennes

Rennes, France

Location

Centre Hospitalier Universitaire Rennes

Rennes, France

Location

Centre Hospitalier Universitaire Rouen

Rouen, France

Location

Centre Hospitalier Saint Brieuc

Saint-Brieuc, France

Location

Centre Hospitalier Universitaire Saint Etienne

Saint-Etienne, France

Location

Centre Hospitalier Saint-Nazaire

Saint-Nazaire, France

Location

Centre Hospitalier Alpes Léman

Sallanches, France

Location

Centre Hospitalier Saint-Malo

St-Malo, France

Location

Centre Hospitalier Universitaire Strasbourg

Strasbourg, France

Location

CHU Toulouse

Toulouse, France

Location

Clinique Saint Exupéry

Toulouse, France

Location

CHRU Bretonneau

Tours, France

Location

Centre Hospitalier Valenciennes

Valenciennes, France

Location

Centre Hospitalier Bretagne Atlantique

Vannes, France

Location

MeSH Terms

Conditions

Anti-Neutrophil Cytoplasmic Antibody-Associated VasculitisKidney Failure, Chronic

Interventions

Immunosuppression TherapyMaintenancePrednisone

Condition Hierarchy (Ancestors)

Systemic VasculitisVasculitisVascular DiseasesCardiovascular DiseasesSkin Diseases, VascularSkin DiseasesSkin and Connective Tissue DiseasesAutoimmune DiseasesImmune System DiseasesRenal Insufficiency, ChronicRenal InsufficiencyKidney DiseasesUrologic DiseasesFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesMale Urogenital DiseasesChronic DiseaseDisease AttributesPathologic ProcessesPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

ImmunotherapyImmunomodulationBiological TherapyTherapeuticsImmunologic TechniquesInvestigative TechniquesHealth Care Facilities Workforce and ServicesPregnadienediolsPregnadienesPregnanesSteroidsFused-Ring CompoundsPolycyclic Compounds

Study Officials

  • Grégoire COUVRAT-DESVERGNES

    CHD Vendée

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

October 13, 2017

First Posted

October 27, 2017

Study Start

February 2, 2018

Primary Completion (Estimated)

March 1, 2028

Study Completion (Estimated)

March 1, 2031

Last Updated

March 20, 2026

Record last verified: 2026-03

Locations