- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02882828
PK Assessment of Tacrolimus Exposure Before and After a Switch From Twice Daily Immediate-release (Prograf®) to Once-daily Prolonged Release Tacrolimus (Envarsus®) (ENVARSWITCH)
Pharmacokinetic Assessment of Tacrolimus Exposure Before and After a Switch From Twice Daily Immediate-release (Prograf®) to Once-daily Prolonged Release Tacrolimus (Envarsus®)
Tools have been developed in our unit to calculate the inter-dose AUC (Area Under Curve) of immunosuppressive drugs (ISD) based on a limited number of blood concentrations (i.e., blood samples) using Bayesian methods. Since 2005, we have implemented these tools in an expert system and made them available to the transplant community through our very successful ISBA (Immunosuppressive drugs Bayesian dose Adjustment) website.
Briefly, we first need to develop a population pharmacokinetic model using rich pharmacokinetic (PK) profiles (about 10 samples per patient over the dosing interval). The model developed can then be used for inference of ISD PK parameters in new patients using Bayesian estimation. Bayes' theorem is based on conditional probability: individual PK parameters are estimated based on the known PK parameters in the population (mean and distribution), given the dose and concentrations observed in a patient. Our previous studies have shown that a limited sampling strategy (LSS) based on 3 samples collected within the first 3 hours after drug intake can estimate adequately the interdose AUC of ISD. In the present study, the AUC0-24h and the recommended dose will be calculated using Bayesian estimators previously developed using PK data from the clinical trials run by Veloxis, and proposed to the clinicians via a dedicated website comparable with ISBA.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Pierre MARQUET, MD
- Phone Number: +33 555 05 60 17
- Email: pierre.marquet@unilim.fr
Study Locations
-
-
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Amiens, France
- Recruiting
- University Hospital of Amiens
-
Contact:
- Gabriel CHOUKROUN, MD
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Bordeaux, France
- Recruiting
- University Hospital of Bordeaux
-
Contact:
- Pierre MERVILLE, MD
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Lille, France
- Recruiting
- University Hospital of Lille
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Contact:
- Sébastien DHARANCY, MD
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Limoges, France, 87 042
- Recruiting
- Limoges hospital
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Contact:
- Pierre MARQUET, MD
- Phone Number: +33 555 05 60 17
- Email: pierre.marquet@unilim.fr
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Principal Investigator:
- Marie ESSIG, MD
-
Principal Investigator:
- Marilyne DEBETTE-GRATIEN, MD
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Paris, France
- Recruiting
- AP-HP
-
Contact:
- Dany ANGLICHEAU, MD
-
Principal Investigator:
- Christophe DUVOUX, MD
-
Principal Investigator:
- Faouzi SALIBA, MD
-
Principal Investigator:
- Filomena CONTI, MD
-
Poitiers, France
- Recruiting
- University Hospital of Poitiers
-
Contact:
- Antoine THIERRY, MD
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Reims, France
- Recruiting
- University Hospital of Reims
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Contact:
- Charlotte COLOSIO, MD
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Rouen, France
- Recruiting
- University Hospital of Rouen
-
Contact:
- Isabelle ETIENNE, MD
-
Tours, France
- Recruiting
- University Hospital of Tours
-
Contact:
- Matthias BÜCHLER, MD
-
Principal Investigator:
- Ephrem SALAME, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Adult (≥ 18 year-old) male and female patients
- Recipient of a single kidney or liver allograft
- Patient transplanted for more than 2 weeks and less than 1 year at enrolment
Patient with stable Prograf® dose, defined by the following criteria:
- Criterion 1: unchanged Prograf® dose for at least one week; if not, apply criterion #2
- Criterion 2: unchanged Prograf® dose since the last two therapeutic drug monitorings (TDM)
- Patient for whom the decision is made to switch from Prograf® to Envarsus®
- Written informed consent obtained prior to any study-related procedure
- Patient with tacrolimus C0 between 4 and 12 µg/L at V1
- Patient with hematocrit > 27% at V1
Exclusion Criteria:
- Patient presenting any contra-indication to tacrolimus according to the summary of product characteristics (SmPC) of Envarsus®
- Recipient of any transplanted organ other than kidney or liver
- Patient treated by Prograf® for less than 7 days at enrolment
- Patient previously treated by any other investigational agent if it is not stopped at least 7 days prior to enrolment
- Pregnant or lactating woman (based on declaration)
- Patient under judicial protection
- Patient incapable of understanding the purposes and risks of the study, who cannot give written informed consent, or who are unwilling to comply with the study protocol.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: DBS (dried blood spots) collection
In this study, we make a switch from Prograf® to Envarsus®.
Patients will be trained to collect their blood from a finger prick on filter paper.
DBS will be done at home, collected on filter paper and mailed by the patients to a centralized laboratory (Department of Pharmacology, Toxicology and Pharmacovigilance at Limoges University Hospital), where tacrolimus concentration will be determined by HPLC-MS/MS
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Difference between the post-switch tacrolimus steady-state AUC0-24h (V4) and the pre-switch AUC0-24h (V2).
Time Frame: 3 days
|
The tacrolimus AUC0-24h at V2 (patient on Prograf®) will be calculated by summing the morning and the evening tacrolimus AUC0-12h.
|
3 days
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
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
- I160015
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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