Use of DNA Testing and Gene Expression Profiling to Help Transition Kidney Transplant Recipients to Belatacept-only Immunosuppression
An Extension Protocol for Subjects Previously Enrolled in the "Use of Donor Derived-cell Free DNA (AlloSure) and Gene Expression Profiling (AlloMap Kidney) to Facilitate Belatacept Monotherapy in Kidney Transplant Patients"
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: David Wojciechowski, DO
- Phone Number: 214-645-7846
- Email: David.Wojciechowski@UTSouthwestern.edu
Study Locations
-
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Texas
-
Dallas, Texas, United States, 75390
- University of Texas Southwestern Medical Center
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Completion of the parent study (STU-2020-1339)
- Able to provide informed consent
- Absence of donor specific antibodies
- Stable renal function (eGFR>40mL/min for 3 months prior to enrollment)
Exclusion Criteria:
- Female participant who is pregnant, lactating or planning pregnancy during the course of the trial
- Significant hepatic impairment
- Any other significant disease or disorder which, in the opinion of the Investigator, may either put the participants at risk because of participation in the trial, or may influence the result of the trial, or the participant's ability to participate in the trial
- Proteinuria > 0.5 g/g creatinine on spot urine sample within 3 months of enrollment
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Immunosuppression Taper
Eligible patients who are deemed immune quiescent will undergo sequential withdrawal of immunosuppression medications over a 12-month period from a multi-drug regimen to a Belatacept monotherapy using precision medicine.
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Precision medicine will be employed to withdraw immunosuppression in kidney transplant recipients.
An immunosuppression taper will be employed over a 12-month period for those that are deemed immune quiescent.
|
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Other: Multi-Drug Regimen
Eligible patients who are not deemed immune quiescent will continue on a multi-drug regimen.
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Precision medicine will be employed to withdraw immunosuppression in kidney transplant recipients.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of acute kidney graft rejection
Time Frame: 12 months after informed consent
|
Number of patients with biopsy-proven acute kidney graft rejection
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12 months after informed consent
|
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Incidence of facilitation to Belatacept monotherapy
Time Frame: 12 months after the first study visit
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Percentage of subjects successfully weaned to a Belatacept monotherapy
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12 months after the first study visit
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Patient Survival after Immunosuppression Wean
Time Frame: 12 months after informed consent
|
Number of patients who died
|
12 months after informed consent
|
|
Kidney Graft Failure after Immunosuppression Wean
Time Frame: 12 months after informed consent
|
Number of patients with kidney graft failure.
Graft failure is defined as date of patient death or date of re-transplant
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12 months after informed consent
|
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Mean change in Estimated Glomerular Filtration Rate (eGFR) after Immunosuppression Wean
Time Frame: 12 months after informed consent
|
Estimated glomerular filtration rate (eGFR) in blood will be measured at the beginning of enrollment and the difference will be measured to the end of the study as a measure of change in kidney function.
|
12 months after informed consent
|
|
Incidence of Proteinuria after Immunosuppression Wean
Time Frame: 12 months after informed consent
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Proteinuria will be detected by a semiquantitative method of the protein concentration in urine.
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12 months after informed consent
|
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Incidence of de-novo donor specific antibodies (dnDSA)
Time Frame: 12 months after informed consent
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HLA type I and type II in blood will be used to detect the presence of de-novo donor specific antibodies (dnDSA) in those who have started the immunosuppression wean.
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12 months after informed consent
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: David Wojciechowski, DO, University of Texas Southwestern Medical Center
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
Other Study ID Numbers
Other Study ID Numbers
- STU-2023-1151
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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