Sirolimus Associated With Tacrolimus at Low Doses in Elderly Kidney Transplant Patients
Sirolimus Associated With Tacrolimus at Low Doses in Elderly Kidney Transplant Patients: A Prospective Randomized Controlled Trial
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Study Design
This will be a single-center, prospective, 12-month randomized controlled trial aiming to compare sirolimus associated with tacrolimus in elderly renal transplant patients as to safety and incidence of cytomegalovirus (CMV) infection.
Treatments
In the control group (Tacrolimus + Mycophenolate) the investigators will use tacrolimus (starting with 0.1 mg/kg twice daily adjusted to target serum levels by 4-8ng/ml at the third month and then 3-7ng/ml from the third month to the 12th month) and mycophenolate sodium 720 mg twice daily. A dose reduction of mycophenolate sodium to 720 mg/day will be accepted due to possible side effects of the drug.
In the treatment group (Tacrolimus + sirolimus) the investigators will use tacrolimus (starting with 0.1 mg/kg twice daily adjusted to target serum levels by 4-8 ng/ml at the third month and then 3-7 ng/ml from the third month to the 12th month) and sirolimus 2 mg/day (adjusted serum levels at 4-8 ng/ml throughout the study period).
In all groups, patients will receive prednisone 30 mg/day (in the first month with weekly reductions up to 5 mg/day at the end of the second month). Induction therapy consisted of basiliximab or antithymocyte globulin (Thymoglobulin, Genzyme®). Thymoglobulin will be used in patients with panel reactivity class I greater than 50 % (at a dose of 1mg/kg for 5 days).
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Fase 4
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
1. Patients aged more than 60 years and recipients of compatible renal transplant
Exclusion Criteria:
- Receptors of multiple organs;
- non-heart beating donors;
- donors aged under 5 or over 65 years;
- Patients with body mass index greater than 35
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Enkelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Aktiv komparator: Tacrolimus + Mycophenolate
The investigators wil be used tacrolimus (starting with 0.1 mg/kg twice daily adjusted to target serum levels by 4-8ng/ml at the third month and then 3-7ng/ml from the third month to the 12th month) and mycophenolate sodium 720 mg twice daily. A dose reduction of mycophenolate sodium to 720 mg/day will be accepted due to possible side effects of the drug. Prednisone 30 mg/day in the first month. Induction therapy consisted of basiliximab or thymoglobulin if panel reactivity class I greater than 50 % |
Andre navne:
Andre navne:
Prednisone 30mg/day
Andre navne:
Basiliximab 20mg (first and fourth day) if panel reactivity class I less than 50 %
Andre navne:
Thymoglobulin at a dose of 1mg/kg for 5 days if panel reactivity class I greater than 50 %
Andre navne:
|
|
Eksperimentel: Tacrolimus + Sirolimus
The investigators will be used tacrolimus (starting with 0.1 mg/kg twice daily adjusted to target serum levels by 4-8 ng/ml at the third month and then 3-7 ng/ml from the third month to the 12th month) and sirolimus 2 mg/day (adjusted serum levels at 4-8 ng/ml throughout the study period). Prednisone 30 mg/day in the first month. Induction therapy consisted of basiliximab or thymoglobulin if panel reactivity class I greater than 50 % |
Andre navne:
Prednisone 30mg/day
Andre navne:
Basiliximab 20mg (first and fourth day) if panel reactivity class I less than 50 %
Andre navne:
Thymoglobulin at a dose of 1mg/kg for 5 days if panel reactivity class I greater than 50 %
Andre navne:
Andre navne:
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Change in estimated glomerular filtration rate from baseline
Tidsramme: Baseline, 1 month, 3 months, 6 months and 12 months
|
The primary end-point will be evaluated the estimated glomerular filtration rate (eGFR) over 12 months of renal transplantation.
The investigators will be measure the change in eGFR during 12 month follow-up.
Glomerular filtration rate will be estimated by the MDRD equation (Modification of Diet in Renal Disease).
|
Baseline, 1 month, 3 months, 6 months and 12 months
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Incidence of cytomegalovirus Infection (CMV)
Tidsramme: Weekly from baseline until the third month. After in 4, 5, 6, 8, 10 and 12 months.
|
The secondary end-point will be evaluated the incidence of cytomegalovirus (CMV) infection.
CMV infection will be defined based on detection of CMV viral replication (CMV pp65 antigenemia more than zero) in asymptomatic patients.
CMV disease will be defined based on the evidence of CMV infection with related symptoms.
For the positive cases treatment will be carried out with ganciclovir 5 mg/kg/day twice daily adjusted for renal function for a minimum of 14 days.
|
Weekly from baseline until the third month. After in 4, 5, 6, 8, 10 and 12 months.
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Virussygdomme
- Infektioner
- DNA-virusinfektioner
- Herpesviridae infektioner
- Cytomegalovirus infektioner
- Lægemidlers fysiologiske virkninger
- Molekylære mekanismer for farmakologisk virkning
- Anti-infektionsmidler
- Enzymhæmmere
- Anti-inflammatoriske midler
- Antineoplastiske midler
- Immunsuppressive midler
- Immunologiske faktorer
- Glukokortikoider
- Hormoner
- Hormoner, hormonsubstitutter og hormonantagonister
- Antineoplastiske midler, hormonelle
- Antibakterielle midler
- Antibiotika, antineoplastisk
- Antifungale midler
- Antituberkulære midler
- Antibiotika, Antituberkulær
- Calcineurin-hæmmere
- Prednison
- Tacrolimus
- Mycophenolsyre
- Sirolimus
- Basiliximab
- Thymoglobulin
- Antimfocyt serum
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 16966913.6.0000.5411
Plan for individuelle deltagerdata (IPD)
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