Tidlige signaler på overgangen fra immun quiescens til aktivering i leverallograftmikromiljøet og i cirkulationen (iSYNAPSE)
Tidlige signaler på overgangen fra immunstillstand til aktivering i levertransplantatets mikromiljø og i cirkulationen (RTB-018)
This is a prospective multi-center, longitudinal study to determine efficacy of 50 percent Immunosuppression (IS) reduction. One hundred fully eligible participants will reduce IS by 50 percent in two steps. Liver tests will be checked every 0.5 months through month 4, once a month through month 12, and every other month through month 18. Liver transplant (LTx) center visits will take place at screening, months 6, 12 and 18 after initiating IS dose reduction. A protocol driven liver biopsy to adjudicate the endpoint will be performed at 18 months. The duration of the study from time of starting IS dose reduction to the primary endpoint assessment is 18 months.
The primary objective is to assess the efficacy of 50 percent IS dose reduction in children with Liver transplants (LTxs)
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 2
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Ada Chao
- Telefonnummer: 415-353-7004
- E-mail: ada.chao@ucsf.edu
Studiesteder
-
-
California
-
San Francisco, California, Forenede Stater, 94143
- Rekruttering
- UCSF Benioff Children's Hospital
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Kontakt:
- Emily Stekol Moore
- E-mail: emily.stekol@ucsf.edu
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Colorado
-
Aurora, Colorado, Forenede Stater, 80045
- Ikke rekrutterer endnu
- Children's Hospital Colorado
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Kontakt:
- Michelle Landis
- E-mail: Michelle.landis@childrenscolorado.org
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District of Columbia
-
Washington D.C., District of Columbia, Forenede Stater, 20007
- Rekruttering
- MedStar Georgetown University Hospital
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Kontakt:
- Iryna Asipenka
- E-mail: Iryna.M.Asipenka@medstar.net
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-
Georgia
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Atlanta, Georgia, Forenede Stater, 30307
- Ikke rekrutterer endnu
- Emory University School of Medicine/Children's Healthcare of Atlanta
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Kontakt:
- Jordyn Turner
- Telefonnummer: 404-785-3690
- E-mail: Jordyn.turner@choa.org
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Illinois
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Chicago, Illinois, Forenede Stater, 60611
- Rekruttering
- Ann and Robert H. Lurie Children's Hospital of Chicago
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Kontakt:
- Catherine Chapin
- Telefonnummer: 312-227-5511
- E-mail: cchapin@luriechildrens.org
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New York
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New York, New York, Forenede Stater, 10029
- Rekruttering
- Icahn School of Medicine at Mount Sinai
-
Kontakt:
- Puja Patel
- Telefonnummer: 212-659-8039
- E-mail: puja.patel4@mountsinai.org
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New York, New York, Forenede Stater, 10032
- Rekruttering
- Columbia University Medical Center
-
Kontakt:
- Ava Whalen
- E-mail: w3876@cumc.columbia.edu
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Ohio
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Cincinnati, Ohio, Forenede Stater, 45229
- Rekruttering
- Cincinnati Children's Hospital Medical Center
-
Kontakt:
- Jennifer Hawkins
- Telefonnummer: 513-636-7818
- E-mail: jennifer.hawkins@cchmc.org
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Pennsylvania
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Philadelphia, Pennsylvania, Forenede Stater, 15224
- Ikke rekrutterer endnu
- Children's Hospital of Philadelphia
-
Kontakt:
- Bryanna Domenick
- Telefonnummer: 267-425-1078
- E-mail: DOMENICKB@CHOP.edu
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Pittsburgh, Pennsylvania, Forenede Stater, 15213
- Rekruttering
- University of Pittsburgh Medical Center
-
Kontakt:
- Daniel Pieratt
- E-mail: pierattdw@upmc.edu
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Tennessee
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Nashville, Tennessee, Forenede Stater, 37232
- Ikke rekrutterer endnu
- Monroe Carell Jr. Children's Hospital at Vanderbilt
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Kontakt:
- Carly Bhave
- E-mail: carly.bhave@vumc.org
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Participant and parent or guardian must be able to understand and provide informed assent and consent, respectively
- Recipient of a living or deceased donor Liver transplant (LTx) at <7 years of age
- > 3 years but <7 years after LTx at the time of study enrollment
- Stable liver tests defined as baseline serum alanine aminotransferase (ALT) level < 30 IU/l and gamma-glutamyl transferase (GGT) level < 50 IU/l (based on the average of the 3 most recent values prior to screening; all must be within 1 year of screening; 2 must be within 6 months of screening)
- No Acute rejection (AR) or chronic rejection within 12 months of enrollment
- Tacrolimus monotherapy for > 6 months with baseline 12-hour trough levels <8 ng/mL (based on the average of 3 values prior to screening; all must be within 1 year of screening; 2 must be within 6 months of screening)
- Participants of childbearing potential must have a negative pregnancy test upon study entry
Exclusion Criteria:
- Liver transplant (LTx) for autoimmune disease, including autoimmune hepatitis or primary sclerosing cholangitis
- LTx for hepatitis B or hepatitis C
- Recipient of any other organ transplant or liver re-transplant, except for patients who have a repeat LTx within 30 days of first LTx who are eligible for enrollment
- >=50 percent dose increase in tacrolimus within 12 months of enrollment
- Discontinued a second Immunosuppression (IS) agent within 12 months of enrollment
- Systemic illness requiring chronic or recurrent use of IS for which there is a risk of reactivation if tacrolimus is reduced
- Use of medication to treat systemic conditions which in the judgement of the investigator could influence results of the study
- Active or chronic infection requiring treatment
- Inability or unwillingness to comply with the study protocol
- Use of investigational drug within 4 weeks (or 5 half-lives of investigational drug, whichever is longer) of enrollment
- Has any condition that, in the opinion of the investigator, will interfere with safe participation in the trial
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: IS dose reduction
Eligible participants will reduce immunosuppression (IS) by 50 percent in two steps. For subjects taking tacrolimus once daily:
For subjects taking tacrolimus twice daily:
For participants taking different doses of tacrolimus in the morning and evening, the clinical site will confer will the protocol chair and PI to determine the schedule for IS reduction |
Prospective multi-center, longitudinal study to determine the success rate of 50% immunosuppression (IS) dose reduction. One hundred fully eligible participants will reduce IS by 50% in two steps |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Achieving successful 50 percent Immunosuppression (IS) reduction
Tidsramme: At 18 months
|
Defined as meeting both biochemical and histological criteria of stability |
At 18 months
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Proportion of Acute Rejection (AR) Episodes Within Each Banff Severity Category
Tidsramme: At 18 months
|
The proportion of acute rejection (AR) episodes within each observed Banff severity category will be measured. |
At 18 months
|
|
The proportion of participants who experience Acute rejection (AR)
Tidsramme: At 18 months
|
Defined as either biopsy-proven or clinical AR |
At 18 months
|
|
Achieving clinically successful 50 percent Immunosuppression (IS) reduction
Tidsramme: At 18 months
|
Defined as meeting biochemical but not histological criteria of stability |
At 18 months
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Studiestol: Sandy Feng, MD, Ph.D., University of California San Francisco School of Medicine: Transplantation
- Studiestol: John Bucuvalas, M.D., Icahn School of Medicine at Mount Sinai: Transplantation
Publikationer og nyttige links
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
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
Nøgleord
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- DAIT RTB-018
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
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