- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03216967
Multicenter Randomized Two-arms Study Evaluating the BK Viral Clearance in Kidney Transplant Recipients With BK Viremia. (BK EVER)
August 18, 2023 updated by: University Hospital, Strasbourg, France
Multicenter Randomized Two-arms Study Evaluating the BK Viral Clearance in Kidney Transplant Recipients With BK Viremia After Reduction of Immunosuppression Alone vs. Reduction of Immunosuppression and Replacement of Mycophenolate Mofetil by Everolimus
BK virus nephropathy (BKVN), a consequence of the strong immunosuppressive therapy given after kidney transplantation, represents a growing problem in the kidney transplant (KT) setting.
In recent cohorts, BKVN concerns up to 10% of kidney transplant recipients and early signs of BK virus (BKV) infection as development of asymptomatic viruria and viremia are even much more frequent (40% and 20% of patients, respectively).
In this context, finding strategies to prevent BKV infection or treat patients before the occurrence of BKV nephropathy is challenging.
For several years, detection of BKV replication by real-time PCR in urine and/or blood of kidney transplant recipients at early stages of infection allowed adaptation of their therapy.
As BKV reactivates essentially in patients with over-immunosuppression, the first step of the treatment is the reduction of immunosuppression.
However, reducing immunosuppression (IS) can lead to acute rejection and allograft loss.
Other treatments have been proposed (cidofovir, quinolones) but their toxicity profile or their lack of clinical efficacy are now demonstrated.
Hence, an efficient and safe strategy against uncontrolled BKV replication is urgently needed.
MTor-inhibitors are well known immunosuppressive drugs used in organ transplantation to prevent graft-rejection.
They have furthermore anti-viral effects that can be beneficial for prevention of viral infections after transplantation.
Recent evidence that inhibition of mTor pathway had an impact on BK infected cells provides additional insight into the observed benefits associated with these drugs.
The aim of our study is to evaluate the effect of the mTor inhibitor everolimus on the prevention of severe BKV infection (BKV nephropathy or loss of the allograft) after kidney transplantation compared to the reduction of immunosuppression alone in kidney recipients with BK viremia.
Study Overview
Status
Active, not recruiting
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
130
Phase
- Phase 4
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
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Amiens, France, 80054
- CHU - Hôpital Sud
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Angers, France, 49033
- CHRU d'Angers
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Bois-guillaume, France, 76230
- CHU - Hôpital de la Cavale Blanche
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Brest, France, 29609
- CHU - Hôpital de la Cavale Blanche
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Caen, France, 14033
- CHU côte de Nacre
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Clermont-Ferrand, France, 63000
- CHU Hôpital Gabriel Montpied
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Limoges, France, 87042
- CHU - Hôpital Dupuytren
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Lyon, France, 69003
- Hôpital Edouard Herriot
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Paris, France, 75743
- AP-HP Hôpital Necker
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Paris, France, 75908
- AP-HP - Hôpital Georges Pompidou
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Poitiers, France, 86021
- CHU Poitiers - Hopital Jean Bernard
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Reims, France, 51092
- CHU - Hôpital Maison Blanche
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Rennes, France, 35033
- CHU Rennes - Hôpital Pontchaillou
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Strasbourg, France, 67000
- Les Hôpitaux Universitaires
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Tours, France, 37044
- CHRU - Hôpital Bretonneau
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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 and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Adult patients
- Kidney transplant recipients
- Patients treated by a calcineurin inhibitor and mycophenolic acid
- Viremia >= 2.8 log UI/ml
- Patients who have given written informed consent
- Negative pregnancy test (blood β-HCG dosage)
Exclusion Criteria:
- Known proved BKV nephropathy
- Hypersensitivity to everolimus, sirolimus or excipient
- Concomitant treatment by leflunomide, cidofovir, sirolimus, Millepertuis (Hypericum Perforatum)
- Pregnant or lactating women
- Women of child bearing potential unless they are using a birth control method
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 Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: IS lowering alone
50% decrease of the dose of mycophenolic acid at M1 (target AUC 20 mg.h/L)
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Patients with viremia above 2.8 log of copies/ml will be randomized (ratio 1:1) into either of 2 groups Group 1 : control group : immunosuppression lowering or Group 2 : experimental group : immunosuppression lowering and replacement of mycophenolate acid by everolimus Evolution of BKV viremia and allograft function will be assessed during 2 years after randomization
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Experimental: Everolimus + IS lowering
Stop mycophenolate acid (Cellcept or myfortic) Introduction of everolimus : 2 x 0.75 mg/d per os in patiens treated by ciclosporine
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Patients with viremia above 2.8 log of copies/ml will be randomized (ratio 1:1) into either of 2 groups Group 1 : control group : immunosuppression lowering or Group 2 : experimental group : immunosuppression lowering and replacement of mycophenolate acid by everolimus Evolution of BKV viremia and allograft function will be assessed during 2 years after randomization
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The main objective of our study is to evaluate the proportion of patients with BKV clearance 6 months after introduction of everolimus in kidney recipients who develop BKV viremia compared to patients managed with IS reduction alone
Time Frame: 6 months after randomization
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The primary end point is the proportion of patients with clearance of BK viremia assessed by blood PCR and functional graft 6 months after modification of immunosuppressive therapy
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6 months after randomization
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
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 (Actual)
January 15, 2018
Primary Completion (Estimated)
November 1, 2023
Study Completion (Estimated)
November 1, 2023
Study Registration Dates
First Submitted
July 4, 2017
First Submitted That Met QC Criteria
July 11, 2017
First Posted (Actual)
July 13, 2017
Study Record Updates
Last Update Posted (Actual)
August 21, 2023
Last Update Submitted That Met QC Criteria
August 18, 2023
Last Verified
August 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Virus Diseases
- Infections
- Systemic Inflammatory Response Syndrome
- Inflammation
- Sepsis
- Viremia
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Protein Kinase Inhibitors
- MTOR Inhibitors
- Everolimus
Other Study ID Numbers
- 6646
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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 BK Virus Nephropathy After Kidney Transplantation
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Centre Hospitalier Universitaire, AmiensRecruitingKidney Transplantation | Risk Factor | BK Virus NephropathyFrance
-
National Institute of Allergy and Infectious Diseases...Terminated
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Loma Linda UniversityWithdrawnBK Virus Infection | BK Virus NephropathyUnited States
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Columbia UniversityPfizer; Cornell UniversityCompleted
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Lee's Pharmaceutical LimitedNot yet recruitingBK Virus | Kidney Transplant RecipientsChina
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Medical University of ViennaUnknownKidney Function After Transplantation | Outcome After Kidney Transplantation
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SymBio PharmaceuticalsRecruitingBK Virus Infection | Kidney Transplantation | NephropathyAustralia, Japan
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