Cardiac Improvement by Eplerenone Among Patients Under Cyclosporine or Tacrolimus for Kidney Transplantation. (KT-CANOPY)
Randomized Controlled Trial Evaluating the Impact of Mineralocorticoid Receptor Blockade by Eplerenone on Echocardiographic Abnormalities Among Kidney Graft Recipient Under Calcineurin Inhibitors. KT-CANOPY: Cardiac Improvement by Eplerenone Among Patients Under Cyclosporine or Tacrolimus for Kidney Transplantation.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 3
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Nesrine BAILI, MD
- Telefonnummer: +33 03 83 85 85 85
- E-mail: N.BAILI@chru-nancy.fr
Undersøgelse Kontakt Backup
- Navn: Adrien FLAHAULT, Md PhD
- E-mail: A.FLAHAULT@chru-nancy.fr
Studiesteder
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Nantes, Frankrig
- CHU Nantes
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Kontakt:
- Simon VILLE
- Telefonnummer: +33 02 40 08 33 33
- E-mail: simon.ville@chu-nantes.fr
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Ledende efterforsker:
- Simon VILLE, MD PhD
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Strasbourg, Frankrig
- CHU Strasbourg - nouvel hôpital Civil
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Kontakt:
- Nans FLORENS
- Telefonnummer: +33 3 88 11 67 68
- E-mail: nans.florens@chru-strasbourg.fr
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Ledende efterforsker:
- Nans FLORENS, MD PhD
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Vandœuvre-lès-Nancy, Frankrig
- CHRU Nancy - hôpital Brabois
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Kontakt:
- Nesrine BAILI, MD
- Telefonnummer: +33 3 83 85 85 85
- E-mail: N.BAILI@chru-nancy.fr
-
Ledende efterforsker:
- Nesrine BAILI
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Male or female with 18 years old or older.
- Transplant patient for at least one year.
- Patient on long-term cyclosporine or tacrolimus.
- Patient whose clinical situation has been stable for at least 3 months, without major treatment modification and without an episode of acute rejection.
- Patient with renal function with a GFR (glomerular filtration rate) greater than or equal to 40 ml/min/1.73m2.
- Patient with systolic blood pressure greater than or equal to 110 mmHg, with or without antihypertensive treatment.
- Patient with the following echocardiographic abnormalities at baseline : an left ventricular mass > to 88 g/m2 in females or > to 102 g/m2 in males and/or left atrial volume > 34 ml/m2.
Exclusion Criteria:
- Kidney transplant recipient more than 5 years post-transplantation.
- Patient with permanent atrial fibrillation.
- Patient with valvular heart disease (grade ≥ 3).
- Patient considered to be at very high risk of mortality within the next year.
- Patient with documented serum potassium ≥ 5.0 mmol/L within the previous month or receiving long-term potassium-binding resin therapy.
- Patient with documented serum bicarbonate < 20 mmol/L within the previous month, with or without bicarbonate supplementation.
- Patient receiving treatment with a mineralocorticoid receptor antagonist or having a formal indication for such treatment.
- Patient receiving another potassium-sparing diuretic.
- Patient receiving combined treatment with an ACE inhibitor and an angiotensin receptor blocker (each agent being permitted individually).
- Patient receiving digoxin therapy.
- Left ventricular ejection fraction (LVEF) < 40% on the baseline echocardiographic assessment.
- Planned closure of an existing arteriovenous fistula within the following year.
- Known hypersensitivity or allergy to eplerenone or any of its excipients.
- Patient with severe hepatic impairment (Child-Pugh class C).
- Patient currently receiving treatment with a strong CYP3A4 inhibitor (e.g., itraconazole, ketoconazole, ritonavir, nelfinavir, clarithromycin, telithromycin, or nefazodone).
- Patient with known galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption syndrome.
- Patient with a contraindication to Kayexalate®: history of hypersensitivity to polystyrene sulfonate resins, obstructive bowel disease, or concomitant treatment with sorbitol-containing laxatives.
- Woman of childbearing potential not using an effective method of contraception or planning to become pregnant within the next 12 months.
- Patient participating in another interventional clinical study involving modifications to therapeutic management.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Eksperimentel: Intervention group (under Eplerenone):
Standard treatment according to usual care, combined with eplerenone for 36 weeks.
Start of treatment with eplerenone at the initial dose of 25 mg/day, then adjusted according to clinical and biological tolerance: 12.5 mg/day (i.e., 25 mg/48h), 25 mg/day, and 50 mg/day.
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The intervention group will receive standard treatment according to usual care, coupled with eplerenone for 36 weeks from randomization.
Start of treatment with eplerenone at the initial dose of 25 mg/day, then adjusted according to clinical and biological tolerance: 12.5 mg/day (i.e., 25 mg/48h), 25 mg/day, and 50 mg/day.
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Ingen indgriben: Controle group (without eplerenone):
Standard treatment according to usual care, it can or cannot include a renin-angiotensin system blocker, left to the discretion of the physician in charge of the patient.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
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Hierarchical composite endpoint (win ratio) : 1/ Death or hospitalization for heart failure or acute coronary syndrome, 2/ Variation in indexed left ventricular mass, 3/Variation in indexed left atrial volume.
Tidsramme: at 36 weeks
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at 36 weeks
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Evolution of Nt-ProBNP concentration
Tidsramme: randomization, at 12 and 36 weeks
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randomization, at 12 and 36 weeks
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Evolution of collagen biomarkers (PICP )
Tidsramme: at 36 weeks
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at 36 weeks
|
|
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Evolution of Biological markers of endothelial dysfunction (endothelin)
Tidsramme: at 36 weeks
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at 36 weeks
|
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The occurrence of hyperkalaemia
Tidsramme: at 36 weeks
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hyperkalaemia between 5 - 5.49; 5.5 - 6; >6mmol/L
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at 36 weeks
|
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Proportion of creatinine increase > 50%
Tidsramme: at 36 weeks
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Assessment of the proportion of acute kidney injury (AKI), defined as a >50% increase in serum creatinine from baseline.
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at 36 weeks
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Evolution of parameters of systolic function (LVEF, strain)
Tidsramme: at 36 weeks
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at 36 weeks
|
|
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Evolution of parameters of remodeling (left ventricular volume)
Tidsramme: at 36 weeks
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at 36 weeks
|
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Evolution of parameters of filling pressures (E/e')
Tidsramme: at 36 weeks
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at 36 weeks
|
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Evolution of peripheral systolic blood pressure (mmHg)
Tidsramme: at 36 weeks
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at 36 weeks
|
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Evolution of peripheral diastolic blood pressure (mmHg)
Tidsramme: at 36 weeks
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at 36 weeks
|
|
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Evolution of peripheral pulse pressure (mmHg)
Tidsramme: at 36 weeks
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at 36 weeks
|
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Evolution of Graft function assessed with serum creatinine (micromol/L)
Tidsramme: at 36 weeks
|
Graft function assessed with serum creatinine with estimation of glomerular filtration rate according to the CKD-EPI formula. The percentage of patients with GFR ≥ 90, 60-89, 45-59, 30-44, 15-29, <15ml/min/1.73m2 will also be assessed. |
at 36 weeks
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Evolution of proteinuria (mg/g)
Tidsramme: at 36 weeks
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Proteinuria measured by the proteinuria/creatininuria ratio.
The percentage of patients with proteinuria/creatininuria ratio <500; 500-1000, 1000-2000, 2000-3000, >3000mg/g will also be assessed.
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at 36 weeks
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Evolution of parameters of remodeling (left atrial volumes)
Tidsramme: at 36 weeks
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at 36 weeks
|
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Evolution of collagen biomarkers ( PIIINP)
Tidsramme: at 36 weeks
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at 36 weeks
|
|
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Evolution of Biological markers of endothelial dysfunction ( soluble endothelium selectin)
Tidsramme: at 36 weeks
|
at 36 weeks
|
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Evolution of Biological markers of endothelial dysfunction (von Willebrand factor)
Tidsramme: at 36 weeks
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at 36 weeks
|
|
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Evolution of parameters of filling pressures (E-wave deceleration time).
Tidsramme: at 36 weeks
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at 36 weeks
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Evolution of parameters of filling pressures (Systolic Pulmonary Artery Pressure (PAPs)).
Tidsramme: at 36 weeks
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at 36 weeks
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Studiestol: Nicolas GIRERD, Md PhD, CHRU NANCY
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
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
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 2019PI092
- 2024-515860-29-00 (Ctis)
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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