- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00930241
Twice Daily Versus Once Daily Administration of the Tacrolimus in Lung Transplantation
Prospective Randomized Trial to Compare a Twice Daily to a Once Daily Administration of the Tacrolimus in Lung Transplanted Patients
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Prevalence data of non-compliance in solid organ transplantations fluctuate is reported in up to 39% of transplant recipients (z. B. for lung transplantations 13 - 22%; Kugler et al.). Non-compliance with immunosuppressive therapy is associated with an increased risk of late-acute rejections and the development of chronic transplant dysfunction. Chronic transplant dysfunction (bronchiolitis obliterans- syndrome-BOS) is the second most causing for organ failure after the first year following lung transplantation and often leads to re-transplantation or death. Preventative procedures for improving the compliance are simplification of the dose of the immunosuppressants (a once daily dose instead of a twice daily dose), the prescription of an immunosuppressants with less side-effects and to raise the patient´s awareness for having the greatest responsibility for the efficacy of his therapy. Prospective studies and metaanalysis revealed that the probability for a good compliance can be more than doubled at once daily administration in comparison to twice daily and the best predictor for a good compliance is an easy therapy. For this reason we want to investigate the extent of profit for our lung transplant patients receiving once daily basis immunosuppression in comparison to those who receive twice daily dose.
Hypothesis: Patients of the once daily administration group of the immunosuppressive medication will have a better compliance compared to the twice daily group (as measured by the endpoints variability and medication abstraction from the electronic devices)
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
-
Hannover, Germany, 30625
- Hannover Medical School
-
Hannover, Germany, 30625
- Department of Respiratory Medicine, Medizinische Hochschule Hannover
-
Hannover, Germany, 30625
- Hannover Medical School, Dept. of Respiratory Medicine
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients (Pts) more than 1 year after single lung, double lung or heart/lung transplantation
- Pts treated with cyclosporin, steroids and MMF
- Pts ≥ 18 and ≤ 70 years and
Pts with one of the following:
- pts with recurrent acute rejections (RAR)
two or more acute rejections in 3 months (first 3 years post Tx, 6 months (> 3 years post Tx) defined by:
- transbronchial biopsy > A1 (or A1 with clinical criteria below) nach ISHLT (B>1R) or
- decline of FEV1 > 10 % baseline after exclusion of infection, airway complication, effusion etc. and improvement to steroid-pulse therapy (methylprednisolone 15 mg/kg for three days) = FEV1 improvement > 10% compared to the last measurement before AR treatment
Pts with steroid-resistant or ongoing acute rejections (OAR) defined by:
- transbronchial biopsy > A1 (or A1 with clinical criteria above) at least 4 weeks following steroid-pulse therapy (methylprednisolone 15 mg/kg for three days) or
- no FEV1 improvement (< 5% baseline) at least 14 days following ACR steroid-pulse therapy (methylprednisolone 15 mg/kg for three days) after exclusion of infection, airway complication, effusion etc. or
- Pts with new onset of BOS (nBOS) Unexplained FEV1 < 80% of baseline after exclusion of Infection, airway complication, effusion etc
- Pts with CyA associated side effects (e.g., hyperlipidaemia, hypertriglyceridemia, hypertension, hirsutism, gingival hyperplasia)
Exclusion Criteria:
- Pregnant or breast feeding women
- Pts who are not using a double-barrier method of birth control
- Pts with systemic infections
- Pts with severe diarrhea, vomiting, active ulcer
- Pts with severe liver disease or liver cirrhosis
- Pts with m-Tor inhibitors
- Pts with hypersensitivity to Tacrolimus, other macrolides or other tablet ingredients
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Advagraf
Advagraf® (one daily dose of Tacrolimus)
|
Advagraf® (one daily dose of Tacrolimus)
|
Active Comparator: Prograf
Prograf® (two daily doses of Tacrolimus)
|
Prograf® (two daily doses of Tacrolimus)
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Improvement of adherence as measured by Tacrolimus trough level below the target level and dispensing of less than 50% of the prescribed doses in the last three days measured electronically before this subtherapeutic drug monitoring
Time Frame: 6 months
|
6 months
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Deterioration of graft function (FEV1) before and at month 12 after conversion
Time Frame: 6 months
|
6 months
|
Number of drug holidays (intake of less than 50% of prescribed doses in 24 hours) measured electronically
Time Frame: 6 months
|
6 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Jens T Gottlieb, M.D., Hannover Medical School
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 (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 5281M mono
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.
Clinical Trials on Lung Transplantation
-
Astellas Pharma Europe Ltd.Active, not recruitingLiver Transplantation | Kidney Transplantation | Heart Transplantation | Lung Transplantation | Intestine TransplantationBelgium, Czechia, France, Germany, Italy, Poland, United Kingdom
-
Emory UniversityCompletedLiver Transplantation | Kidney Transplantation | Heart Transplantation | Lung Transplantation | Heart-Lung TransplantationUnited States
-
Astellas Pharma IncCompletedHeart Transplantation | Lung Transplantation | Pancreas (Including SPK) TransplantationFrance, United Kingdom, Taiwan, Belgium, Italy, Austria
-
Hannover Medical SchoolUnknownExercise Training | Lung Transplantation | Psychotherapy | Heart-Lung Transplantation | "Rehabilitation"Germany
-
University of AlbertaNatera, Inc.; One LambdaRecruiting
-
Universidad Complutense de MadridHospital Universitario 12 de OctubreRecruiting
-
KU LeuvenCompleted
-
Hopital FochCompleted
-
Emory UniversityTerminated
-
Hannover Medical SchoolCorscience, Inc.CompletedLung TransplantationGermany
Clinical Trials on Advagraf®
-
University of British ColumbiaSimon Fraser University; Astellas Pharma Canada, Inc.CompletedRenal Transplant | Renal DiseaseCanada
-
Assistance Publique - Hôpitaux de ParisCompletedImmunosuppression After Liver TransplantationFrance
-
Chiesi Farmaceutici S.p.A.Completed
-
Chiesi Farmaceutici S.p.A.CompletedOrgan or Tissue Transplant; ComplicationsFrance
-
Astellas Pharma S.A.S.Completed
-
Astellas Pharma Canada, Inc.Completed
-
Technische Universität DresdenActive, not recruitingRenal Insufficiency, Chronic | Renal Insufficiency | Renal Failure | Renal DiseaseGermany
-
Yonsei UniversityCompleted
-
Linical KoreaNational Cancer Center, Korea; Astellas Pharma Korea, Inc.Completed
-
Astellas Pharma IncCompletedKidney TransplantationTaiwan, Korea, Republic of