- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00617604
A Study to Assess the Efficacy and Safety of Alefacept in Kidney Transplant Recipients
Efficacy and Safety of Alefacept in Combination With Tacrolimus, Mycophenolate Mofetil and Steroids in de Novo Kidney Transplantation - a Multicenter, Randomized, Double-Blind, Placebo Controlled, Parallel Group Study
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
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Vienna, Austria, 1090
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Bruxelles, Belgium, 1070
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Bruxelles, Belgium, 1200
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Gent, Belgium, 9000
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Leuven, Belgium, 3000
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Liege, Belgium, 4000
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Praha, Czech Republic, 140 21
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Creteil, France, 94010
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Le Kremlin Bicetre Cedex, France, 94275
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Montpellier, France, 34295
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Nantes Cedex 1, France, 44093
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Nice Cedex 1, France, 6002
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Paris, France, 75475
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Toulouse Cedex, France, 31054
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Bochum, Germany, 44892
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Regensburg, Germany, 93053
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Budapest, Hungary, 1082
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Bologna, Italy, 40138
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Padova, Italy, 35128
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Rome, Italy, 00168
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Siena, Italy, 53100
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Maastricht, Netherlands, 6229
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Bydgoszcz, Poland, 85-094
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Poznan, Poland, 60-479
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Szczecin, Poland, 70-111
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Barcelona, Spain, 8036
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Llobregat, Spain, 8907
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Madrid, Spain, 28041
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Malaga, Spain, 29010
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Santander, Spain, 39008
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Goteborg, Sweden, 41345
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Uppsala, Sweden, 75185
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Manchester, United Kingdom, M13 9WL
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Subject with end stage kidney disease who is a suitable candidate for primary kidney transplantation or retransplantation
- Male or female subject at least 18 years of age and younger than 65 years
- Subject receiving a kidney transplant from a non-human leucocyte antigen (HLA) identical living donor or deceased HLA identical/non-HLA identical donor between 5 and 59 years of age with compatible ABO blood type (Blood group system A, B, AB and 0)
Exclusion Criteria:
- Subject has a panel reactivity antibody grade > 20% in the previous 6 months and/or had had a previous graft survival shorter than 1 year due to immunological reasons
- Subject received a kidney transplant from a non-heart beating donor
- Subject has received a kidney transplant from a 50 - 59 year old donor with two of the following three factors: history of hypertension, cerebrovascular accident as cause of death, final pre-procurement serum creatinine > 1.5 mg/dL (united network for organ sharing [UNOS] expanded criteria donor)
- Cold ischemia time of the donor kidney is ≥ 30 hours
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Placebo Comparator: Placebo
Participants received placebo administered intra-operatively as an intravenous (IV) bolus on Day 0, another IV bolus on Day 3 and weekly subcutaneous injections thereafter for 12 weeks.
Participants also received tacrolimus, mycophenolate mofetil (MMF) and steroid treatment.
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IV and subcutaneous injection
The initial daily dose was 0.2 mg/kg orally given in 2 doses commencing 24 hours after completion of surgery.
Mycophenolic mofetil was administered as 750 mg twice per day orally
Methylprednisolone or equivalent: Day 0: 500 - 1000 mg IV bolus Day 1: 125 - 250 mg IV bolus Prednisone or equivalent: Days 2 - 14: 20 - 30 mg orally Days 15 - 28: 10 - 20 mg orally Days 29 - 60: 10 - 15 mg orally Days 61 onwards: 5 - 10 mg orally |
Experimental: Alefacept
Participants received 7.5 mg alefacept administered intra-operatively as an IV bolus on Day 0, another 7.5 mg IV bolus on Day 3, and weekly subcutaneous injections of 15 mg alefacept thereafter for 12 weeks.
Participants also received tacrolimus, MMF and steroid treatment.
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The initial daily dose was 0.2 mg/kg orally given in 2 doses commencing 24 hours after completion of surgery.
Mycophenolic mofetil was administered as 750 mg twice per day orally
Methylprednisolone or equivalent: Day 0: 500 - 1000 mg IV bolus Day 1: 125 - 250 mg IV bolus Prednisone or equivalent: Days 2 - 14: 20 - 30 mg orally Days 15 - 28: 10 - 20 mg orally Days 29 - 60: 10 - 15 mg orally Days 61 onwards: 5 - 10 mg orally
IV and subcutaneous injection
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Percentage of Participants With Biopsy-confirmed Acute T-cell Mediated Rejection at Month 6 Assessed by Local Review
Time Frame: 6 months
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Biopsies were graded by the clinical site pathologist.according to the Banff 97/05 updated histological classification:
A biopsy confirmed acute rejection was an event of suspected acute rejection confirmed by a graft biopsy result of Banff grade ≥ 1. The Kaplan-Meier estimate of biopsy-confirmed acute T-cell mediated rejection within the first 6 months following transplantation is reported. Participants lost to follow-up or with missing outcomes were censored at their last follow up visit. |
6 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Percentage of Participants With Biopsy Confirmed Antibody-Mediated Acute Rejection at Month 6
Time Frame: 6 months
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Biopsies were graded by the clinical site pathologist.according to the Banff 97/05 updated histological classification: Acute antibody-mediated rejection - documented anti-donor antibody ('suspicious for' if antibody not demonstrated):
A biopsy confirmed acute rejection was an event of suspected acute rejection confirmed by a graft biopsy result of Banff grade ≥ 1. The Kaplan-Meier estimate of biopsy-confirmed antibody-mediated acute rejection within the first 6 months following transplantation is reported. Participants lost to follow-up or with missing outcomes were censored at their last follow up visit. |
6 months
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Percentage of Participants With Biopsy Confirmed Acute Rejection (T-Cell Mediated or Antibody Mediated) at Month 6
Time Frame: 6 months
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Biopsies were graded by the clinical site pathologist.according to the Banff 97/05 updated histological classification. A biopsy confirmed acute rejection was an event of suspected acute rejection confirmed by a graft biopsy result of Banff grade ≥ 1. The Kaplan-Meier estimate of biopsy-confirmed acute T-cell mediated or antibody-mediated rejection within the first 6 months following transplantation is reported. Participants lost to follow-up or with missing outcomes were censored at their last follow up visit. |
6 months
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Percentage of Participants With Biopsy Confirmed Acute Mixed T-Cell Mediated and Antibody-Mediated Rejection at Month 6
Time Frame: 6 months
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Biopsies were graded by the clinical site pathologist.according to the Banff 97/05 updated histological classification. A biopsy confirmed acute rejection was an event of suspected acute rejection confirmed by a graft biopsy result of Banff grade ≥ 1. The Kaplan-Meier estimate of biopsy-confirmed acute mixed T-cell mediated and antibody-mediated rejections within the first 6 months following transplantation is reported. Participants lost to follow-up or with missing outcomes were censored at their last follow up visit. |
6 months
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Percentage of Participants With Acute Rejection Diagnosed by Signs and Symptoms at Month 6
Time Frame: 6 months
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Acute rejection diagnosed by signs and symptoms, including biopsy-confirmed or suspected (not confirmed by biopsy - i.e. no biopsy was performed or biopsy did not confirm an acute T-cell mediated rejection).
The Kaplan-Meier estimate of acute rejection diagnosed by signs and symptoms within the first 6 months following transplantation is reported.
Participants lost to follow-up or with missing outcomes were censored at their last follow up visit.
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6 months
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Percentage of Participants With Clinically Treated Acute Rejection at Month 6
Time Frame: 6 months
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Patients who received immunosuppressive medications for the treatment of suspected or biopsy-confirmed acute rejections were considered to have a clinically-treated acute rejection.
The Kaplan-Meier estimate of clinically treated acute rejection within the first 6 months following transplantation is reported.
Participants lost to follow-up or with missing outcomes were censored at their last follow-up visit.
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6 months
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Percentage of Participants With Steroid-resistant Acute Rejection at Month 6
Time Frame: 6 months
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A steroid-resistant acute rejection is defined as a rejection episode which did not resolve following treatment with corticosteroids. In the case that a rejection episode was not treated with corticosteroids first but only with antibodies, it was included in this category. The Kaplan-Meier estimate of steroid-resistant acute rejection within the first 6 months following transplantation is reported. Participants lost to follow-up or with missing outcomes were censored at their last follow up visit. |
6 months
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Percentage of Participants With Biopsy-Confirmed Acute T-cell Mediated Rejection as Assessed by Central Review at Month 6
Time Frame: 6 months
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Biopsies were graded by the central reviewer according to the Banff 97/05 updated histological classification. A biopsy confirmed acute rejection was an event of suspected acute rejection confirmed by a graft biopsy result of Banff grade ≥ 1. The Kaplan-Meier estimate of biopsy-confirmed acute T-cell mediated rejection within the first 6 months following transplantation is reported. Participants lost to follow-up or with missing outcomes were censored at their last follow up visit. |
6 months
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Patient Survival
Time Frame: 6 months
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Patient survival is any participant known to be alive at Month 6.
The Kaplan-Meier estimate of patient survival within the first 6 months following transplantation is reported.
Participants lost to follow-up were censored at the time of last assessment.
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6 months
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Graft Survival
Time Frame: 6 months
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Graft survival was defined as any participant who was known to have a functioning graft (i.e., not graft loss) at 6 months. Graft loss is defined as re-transplantation, nephrectomy, death or as dialysis ongoing at end of study or at discontinuation of the participant unless superseded by follow-up information. The Kaplan-Meier estimate of graft survival within the first 6 months following transplantation is reported. Participants lost to follow-up were censored at the time of last assessment. |
6 months
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Maximum Histological Grade of All Biopsies After Local Review
Time Frame: 6 months
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The grade of acute rejection was classified according to Banff 97/05 updated version. If a patient had more than 1 rejection episode, the episode with the most severe grade was used. Acute T-cell mediated rejection:
Acute antibody-mediated rejection:
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6 months
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Percentage of Participants With Anti-Lymphocyte Antibody Therapy for Treatment of Rejection at Month 6
Time Frame: 6 months
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The Kaplan-Meier estimate of anti-lymphocyte antibody therapy for acute rejection (clinically-treated or biopsy-confirmed) within the first 6 months following transplantation is reported.
Participants lost to follow-up or with missing outcomes were censored at their last follow-up visit.
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6 months
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Change From Month 1 in Serum Creatinine
Time Frame: Month 1, 3, and 6
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Month 1, 3, and 6
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Change From Month 1 in Glomerular Filtration Rate (GFR)
Time Frame: Month 1, 3, and 6
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The GFR was calculated using the Modification of Diet in Renal Disease (MDRD) formula.
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Month 1, 3, and 6
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Change From Month 1 in Creatinine Clearance
Time Frame: Month 1, 3, and 6
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The creatinine clearance was calculated according to the Cockcroft-Gault formula.
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Month 1, 3, and 6
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GFR Measured by Iothalamate Clearance at Month 6
Time Frame: Month 6
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GFR measured using the iothalamate clearance method and determined by a central laboratory.
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Month 6
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Percentage of Participants With Efficacy Failure at Month 6
Time Frame: 6 months
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Efficacy failure is defined as death, graft loss, biopsy-confirmed acute T-cell mediated rejection assessed by local reading or lost to follow-up. The Kaplan-Meier estimate of efficacy failure within the first 6 months following transplantation is reported. |
6 months
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Percentage of Participants With Delayed Graft Function
Time Frame: 1 week
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Delayed graft function was defined as the requirement for dialysis within the first week post-transplant.
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1 week
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Percentage of Participants With Treatment Failure at Month 6
Time Frame: 6 months
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Treatment failure is defined as efficacy failure (death, graft loss, biopsy-confirmed acute T-cell mediated rejection assessed by local reading, lost to follow-up) or early discontinuation of alefacept/placebo at any time (during the 12-week administration period) for any reason.
The Kaplan-Meier estimate of treatment failure within the first 6 months following transplantation is reported.
Participants lost to follow-up or with missing outcomes were censored at their last follow-up visit.
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6 months
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Number of Participants With Adverse Events
Time Frame: 6 Months
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Causally related was defined as adverse events (AEs) assessed by the Investigator as possibly or probably related to study drug or records where the relationship was missing. A serious adverse event (SAE) was any untoward medical occurrence that, at any dose:
All rejections and any BK virus, Epstein Barr virus and/or cytomegalovirus infection had to be reported as an SAE |
6 Months
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Collaborators and Investigators
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Enzyme Inhibitors
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Dermatologic Agents
- Anti-Bacterial Agents
- Antibiotics, Antineoplastic
- Antitubercular Agents
- Antibiotics, Antitubercular
- Calcineurin Inhibitors
- Tacrolimus
- Mycophenolic Acid
- Alefacept
Other Study ID Numbers
- 0485-CL-E201
- 2007-002092-14 (EudraCT Number)
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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