Gengraf Conversion Study in Stable Renal Allograft Transplant Recipients

A Randomized, Multi-center, Open Label Trial to Establish the Therapeutic Equivalence Between Neoral® and Gengraf® in Stable Renal Allograft Recipients [Gengraf Conversion Study]

The purpose of this study is to establish the therapeutic equivalence of Gengraf® with the standard treatment Neoral® for a treatment period of 6 months in stable renal allograft transplant recipients with respect to drug levels, dosage, and acute graft rejection and other adverse events.

Study Overview

• Status: Completed
• Conditions: End Stage Renal Failure
• Intervention / Treatment: Drug: Neoral; Drug: Gengraf® capsule containing 25mg or 100mg cyclosporine

Detailed Description

The introduction of cyclosporine (CsA) into clinical practice resulted in improvements in acute renal allograft rejection rate and graft survival in renal transplant patients. Gengraf a microemulsion formulation of CsA though granted an AB-rated equivalent to Neoral, because of concerns over the use of generic drugs in transplantation, we undertook this study to evaluate the clinical efficacy and safety of Gengraf.

We conducted a multicenter, randomized, open labeled study to establish the equivalence between Gengraf and Neoral in stable renal transplant recipients for a treatment period of 6 months. 6 months post transplant patients with stable graft function and receiving a stable dose of neoral were recruited into the study. Eligible patients were randomly assigned to remain on Neoral or convert to an equal milligram-for-milligram dose of Gengraf. The primary end-point was serum creatinine at 26 weeks.

• Study Type: Interventional
• Enrollment (Actual): 106
• Phase: Phase 4

Contacts and Locations

Study Locations

• Malaysia
  • Penang
    • George Town, Penang, Malaysia, 10990
      • Clinical Research Centre, Penang Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 70 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Written informed consent obtained from patient or parents/guardian.
2. Patients who are more than 6 months post transplant
3. Stable graft function i.e. serum creatinine less than 300 umol/l
4. Patients currently on a stable dose of capsule Neoral within last one month

Exclusion Criteria:

1. Multiple organ transplantation
2. Pregnant or nursing woman, or women of childbearing potential without an effective method of birth control. Effective birth control methods are oral contraception, Norplant, surgical sterilization, Intra Uterine Device or diaphragms in conjunction with spermicidal foam and condom on the male partner.
3. Participation in any drug trial in which the patient received an investigational drug within 30 days preceding the screening phase of this study.
4. Those persons directly involved in the conduct of the study.
5. Active infection at the time of screening for enrollment into trial.
6. Acute graft rejection within the past 3 months
7. Mentally unstable or history of mental diseases
8. History of drug or alcohol abuse within the past 2 years.
9. History of non-compliance to medical regimen and patients who are unwilling or unable to comply with the protocol.
10. Decompensated liver disease
11. Any serious medical conditions or disability, which in the opinion of the investigator, would interfere with treatment or assessment or preclude completion of this study

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
ACTIVE_COMPARATOR: Neoral; Patients who continued to be treated with the drug Neoral.	Drug: Neoral; Neoral® capsule containing 25mg or 100mg cyclosporine; Other Names: Cyclosporine
EXPERIMENTAL: Gengraf arm; Patients were randomly selected to be converted to 'Gengraf® capsule containing 25mg or 100mg cyclosporine'	Drug: Gengraf® capsule containing 25mg or 100mg cyclosporine; Transplant patients who were stable on Neoral were converted to Gengraf; Other Names: Generic Cyclosporine

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Serum creatinine level at 12 weeks	Serum creatinine level at 12 weeks after conversion from Neoral to Gengraf	at 12 weeks

Secondary Outcome Measures

Outcome Measure	Time Frame
CsA trough concentration and at 2 hour after CsA administration, at 2 weeks, 6 weeks 12 weeks, 6 months, 9 months and 12 months post randomization.	weeks 2, 6, 12, months 6, 9 and 12.

Collaborators and Investigators

• Sponsor: Penang Hospital, Malaysia
• Investigators: Principal Investigator: Dr.Ong L Meng, MBBS, FRCP, Penang Hospital, Ministry of Health Malaysia

Study record dates

Study Major Dates

• Study Start: November 1, 2004
• Primary Completion (ACTUAL): December 1, 2005
• Study Completion (ACTUAL): May 1, 2006

Study Registration Dates

• First Submitted: March 4, 2010
• First Submitted That Met QC Criteria: November 15, 2013
• First Posted (ESTIMATE): November 21, 2013

Study Record Updates

• Last Update Posted (ESTIMATE): November 21, 2013
• Last Update Submitted That Met QC Criteria: November 15, 2013
• Last Verified: November 1, 2013

More Information

Terms related to this study

• Keywords: Cyclosporine; Renal transplant; Renal allograft rejection; Gengraf
• Additional Relevant MeSH Terms: Kidney Diseases; Urologic Diseases; Renal Insufficiency; Renal Insufficiency, Chronic; Kidney Failure, Chronic; Physiological Effects of Drugs; Molecular Mechanisms of Pharmacological Action; Anti-Infective Agents; Enzyme Inhibitors; Antirheumatic Agents; Immunosuppressive Agents; Immunologic Factors; Dermatologic Agents; Antifungal Agents; Calcineurin Inhibitors; Cyclosporine; Cyclosporins
• Other Study ID Numbers: 15.041