Thymoglobulin® Pharmacokinetics in Patients Undergoing Hematopoietic Stem Cell Transplantation (PHASAL-GA)
Thymoglobulin® Pharmacokinetics for Graft-versus Host Disease in Children and Adults Undergoing Hematopoietic Stem Cell Transplantation
Thymoglobulin is widely applied as serotherapy in order to prevent acute graft-versus-host disease (GvHD) and graft rejection in patients undergoing non-Human Leukocyte Antigen (HLA)-identical hematopoietic stem cell transplantations (HSCT), with a delicate balance between prevention of GvHD and the promotion of immune reconstitution. Thymoglobulin is known as a drug with high pharmacokinetic (PK) variability. This variability influences drug exposure, which in turn determines the drug response of pharmacodynamics (PD). In order to maintain efficacy while reducing adverse effects of drugs across the entire age range, identification of the PK/PD relationships and the effect of growth and maturation on the different PK and PD parameters involved are crucial.
The investigators hypothesise that a better knowledge of Thymoglobulin PK and its covariates would help to individualise dosage regimen and would improve clinical outcomes, such as GvHD and immune reconstitution.
The investigators aim to build a population PK model of Thymoglobulin in order to study PK variability and its covariates. This model will help in optimizing dosage regimen in an individually way.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: Michael Philippe, MD, PhD
- Phone Number: +33 0469166595
- Email: michael.philippe@lyon.unicancer.fr
Study Contact Backup
- Name: Sylvain Goutelle, PU, PH
- Email: sylvain.goutelle@chu-lyon.fr
Study Locations
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-
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Lyon, France, 69008
- Recruiting
- Institut d'Hématologie et d'Oncologie Pédiatrique
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Contact:
- Cécile RENARD, MD, PhD
- Phone Number: +33 0469166570
- Email: cecile.renard@ihope.fr
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Principal Investigator:
- Cécile RENARD, MD, PhD
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Pierre-Bénite, France, 69495
- Recruiting
- Centre Hospitalier Lyon Sud
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Contact:
- Marie BALSAT, MD, PhD
- Phone Number: +33 0478862240
- Email: marie.balsat@chu-lyon.fr
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Contact:
- Hélène LABUSSIERE-WALLET, MD, PhD
- Phone Number: +33 0478862240
- Email: helene.labussiere-wallet@chu-lyon.fr
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Principal Investigator:
- Marie BALSAT, MD, PhD
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Sub-Investigator:
- Hélène LABUSSIERE-WALLET, MD, PhD
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patient receiving Thymoglobulin therapy as part of a first HSCT
- Age ≥ 2 years
- Lansky or karnofsky score ≥ 50%.
- Enrolled in a social security plan
- Patient 18 years of age or older who is informed and has consented to participate in the study or minor patient whose parents/guardians have been informed and have given consent for the minor patient to participate in the study
- Female patients of childbearing potential must have an effective method of contraception (a pregnancy test will also be performed at inclusion).
Exclusion Criteria:
- Patient having received serotherapy (Thymoglobulin® or other) within 3 months before this HSCT
- Patient receiving another serotherapy during conditioning (Campath®)
- Patients with uncontrolled acute or chronic infections for which any form of immunosuppression would be contraindicated
- Known hypersensitivity to Thymoglobulin®.
- Pregnant or lactating women
- Patient participating simultaneously in another study of an investigational drug (no exclusion period)
- Patient under legal protection or deprived of liberty
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Experimental treatment arm
Children over two years and adults undergoing a first hematopoietic stem cell transplantation will receiveThymoglobulin® as part of the conditioning.
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Patients will receive thymoglobulin between 5 and 20 milligrams/kilograms (mg/kg) as an intravenous infusion over a period of 2 to 5 days depending on the dose and the transplant package chosen by the physician.
Thymoglobulin® serum levels Time frame : samples will be drawn at the following points :
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Area under the concentration-time curve (AUC)
Time Frame: until elimination tf the drug (maximum 3 weeks post hematopoietic stem cell transplantation)
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Measure of the Thymoglobulin® exposure by the PK criteria : Area under the concentration-time curve (AUC) . AUC is measured by day since the first day of Thymoglobulin infusion during conditioning (day 0) until elimination tf the drug. AUC is expressed as milligrams/hour/Liter. (mg/h/L) |
until elimination tf the drug (maximum 3 weeks post hematopoietic stem cell transplantation)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Objective function value (OFV)
Time Frame: until elimination tf the drug (maximum 3 weeks post hematopoietic stem cell transplantation)
|
Comparison of the OFV of different build population pharmacokinetic models based on results of pharmacokinetic analysis, from start of thymoglobulin® infusion until elimination of the drug
|
until elimination tf the drug (maximum 3 weeks post hematopoietic stem cell transplantation)
|
|
Coefficient of variation of AUC
Time Frame: until elimination tf the drug (maximum 3 weeks post hematopoietic stem cell transplantation)
|
Ratio of typical variation of AUC to the mean AUC.
AUC is measured by day since the first day of Thymoglobulin infusion during conditioning (day 0) until elimination of the drug
|
until elimination tf the drug (maximum 3 weeks post hematopoietic stem cell transplantation)
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 69HCL21_1186
- 2022-501594-39-00 (Other Identifier: EU-CT)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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