RESCUE Study - Everolimus in Liver Transplantation Recipients With Renal Insufficiency

April 11, 2011 updated by: Novartis Pharmaceuticals

A 6-month, Multicenter, Randomized, Open-label Study of Safety and Efficacy of Everolimus-based Regimen Versus Calcineurin Inhibitor (CNI)-Based Regimen in Maintenance Liver Transplant Recipients

The purpose of the study is to assess the effect of everolimus initiation together with reduction or discontinuation of calcineurin inhibitor (CNI) on renal function in maintenance liver transplant recipients with CNI-related renal impairment, while maintaining efficacy.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

145

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Germany
      • Germany, Germany
        • Novartis Investigational site
  • Switzerland
      • Basel, Switzerland
        • Novartis Investigative Site

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 70 years (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

N/A

Genders Eligible for Study

All

Description

Inclusion criteria

  • Male or female 18 - 70 years old
  • Patient who has undergone a primary liver transplantation 12 to 60 months ago from a cadaveric or a living donor
  • Patient with a calculated GFR ≤ 60 and ≥ 20mL/min
  • Patient receiving tacrolimus with C0-h level ≥ 3 and ≤ 8 ng/mL or Neoral® with C0-h level ≥ 50 and ≤ 150 ng/mL or with C2-h level ≥ 250 ng/mL and ≤ 650 ng/mL with or without any of the following (MPA or AZA or steroids)
  • Patient willing and capable of giving written informed consent for study participation and able to participate in the study for 6 months
  • Patient in whom an allograft biopsy will not be contraindicated
  • Female capable of becoming pregnant must have a negative pregnancy test prior to randomization and are required to practice a medically approved method of birth control for the duration of the study

Exclusion criteria

  • Recipient of multiple solid organ transplants
  • Patient on dialysis
  • Patient with an identifiable cause of renal dysfunction other than CNI toxicity
  • Patient with proteinuria ≥ 1.0 g/24h
  • Patient with any acute rejection within 6 months prior to randomization
  • Patient with platelet count of ≤ 50,000/mm³ or white blood cell count of ≤ 2,000/mm³ or hemoglobin value ≤ 8 g/dL
  • Undergone a liver transplantation for a hepatocellular carcinoma with sign of recurrence;
  • Severe graft dysfunction;
  • HCV positive patient who needs an active anti-viral treatment
  • HIV positive patient
  • Patient who is breast feeding
  • Patient with a current severe systemic infection
  • Patient who has received an unlicensed drug or therapy within one month prior to study entry
  • Presence of any hypersensitivity to drugs similar to everolimus (e.g. macrolides)
  • Use of any other immunosuppressive drugs than tacrolimus/cyclosporine microemulsion, steroids, azathioprine and mycophenolic acid

Additional protocol-defined inclusion/exclusion criteria may apply.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: TREATMENT
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: NONE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
ACTIVE_COMPARATOR: Reduced CNI dose + everolimus ± steroids
Reduced CNI dose + everolimus (1.5 mg twice daily (b.i.d)) ± steroids
Drug: Steroids
Drug: Everolimus
1.5 mg bid adjusted in order to achieve a trough level between 3 and 8 ng/mL while in combination with CNI and between 6 and 12 ng/mL after CNI discontinuation
Other Names:
  • Certican
  • RAD001
  • Neoral®/Prograf®
Drug: Calcineurin inhibitors (CNI)
Other Names:
  • Neoral/Prograf
EXPERIMENTAL: CNI continuation ± MPA/AZA ± Steroids
Standard CNI dose ± MPA/AZA ± steroids
Drug: Steroids
Drug: Calcineurin inhibitors (CNI)
Other Names:
  • Neoral/Prograf
Drug: Mycophenolate acid (MPA)/ Azathioprine (AZA)
Other Names:
  • Myfortic/Cellecept

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Mean Change From Baseline in Cockcroft-Gault Calculated Creatinine Clearance (CrCl)
Time Frame: From baseline to 6 months

The primary variable was renal function assessed by calculated creatinine clearance using the Cockcroft-Gault formula, and was assessed at all visits.

CrCl[mL/min] = (140 - A) * W / (72 * C) * R. Where A is age at sample date [years], W is body weight at specific visit [kg], C is the serum concentration of creatinine [mg/dL], R = 1 if the patient is male and = 0.85 if female.
From baseline to 6 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percentage of Patients With Efficacy Failure (Biopsy Proven Acute Rejection [BPAR], Graft Loss or Death)
Time Frame: 6 months
The composite efficacy failure endpoint encompasses at least one of: biopsy proven acute rejection, graft loss, or death for the patient. BPAR was defined as a clinically suspected acute rejection confirmed by biopsy. Acute rejection episodes were recorded as Liver Allograft Rejection. The allograft was presumed to be lost if a patient had a liver retransplant or died.
6 months
Number of Patients With Discontinuation of Study Medication
Time Frame: 6 months
6 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Novartis Pharmaceuticals

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

November 1, 2005

Primary Completion (ACTUAL)

November 1, 2007

Study Completion (ACTUAL)

November 1, 2007

Study Registration Dates

First Submitted

December 19, 2005

First Submitted That Met QC Criteria

December 19, 2005

First Posted (ESTIMATE)

December 20, 2005

Study Record Updates

Last Update Posted (ESTIMATE)

April 13, 2011

Last Update Submitted That Met QC Criteria

April 11, 2011

Last Verified

April 1, 2011

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • CRAD001H2401

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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