Denne side blev automatisk oversat, og nøjagtigheden af ​​oversættelsen er ikke garanteret. Der henvises til engelsk version for en kildetekst.

Bayesian Dose Adjustment of Immunosuppressants After Lung Transplantation (BASALT)

23. april 2011 opdateret af: University Hospital, Limoges

Evaluation of the Interest of Therapeutic Drug Monitoring of Immunosuppressants (Tacrolimus, Mycophenolate Mofetil) Based on Bayesian Estimation During the Three First Years Following Lung Transplantation, in Patients With or Without Cystic Fibrosis

The purpose of this study is to evaluate in lung or heart-lung transplant patients on tacrolimus and mycophenolate the impact of optimized mofetil (MMF) therapeutic drug monitoring and dose adjustment of both drugs on the incidence of treatment failure over the first three years post-transplantation.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This research will be based on a prospective randomized trial comparing optimized TDM of tacrolimus and MMF to the current strategy of tacrolimus and MMF dose adjustment in lung transplant recipients. The study will focus on the first three years post-transplantation, as treatment failures (including BOS) occur mainly during this post-transplantation period. As the aim of tacrolimus and MMF dose individualization is to avoid over- or underexposure, for the purpose of this study treatment failure will be a composite criterion gathering events which reflect both over- and underexposure to tacrolimus and MMF.

Optimized TDM of tacrolimus and MMF based on blood tacrolimus and plasma MPA AUC Bayesian estimation will be compared to current strategies: tacrolimus dose adjustment based on trough levels (C0) and administration of a standard dose of MMF, decreased by the pulmonologist in case of adverse drug reactions or increased in case of inefficacy. The efficacy of optimized strategy vs. current strategies will be mainly evaluated through the incidence of treatment failure.

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

180

Fase

  • Fase 4

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Belgien
      • Bruxelles, Belgien
        • Service de Pneumologie
  • Frankrig
      • Grenoble, Frankrig
        • Pôle Médecine Aiguë et Communautaire, Clinique de Pneumologie,
      • Lyon, Frankrig
        • Service de Pneumologie, HCL Lyon
      • Marseille, Frankrig
        • ApHm -Chirurgie thoracique
      • Nantes, Frankrig
        • Service de Pneumologie-CHU de Nantes
      • Paris, Frankrig
        • Service de Chirurgie Cardiovasculaire - Hôpital Georges Pompidou
      • Paris, Frankrig
        • Service de Pneumologie - CH de Suresnes
      • Paris, Frankrig
        • Service de Pneumologie - Phtisiologie - Hôpital Bichat
      • Strasbourg, Frankrig
        • Service de Pneumologie - CHU de Strasbourg

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria

  • Male and female patients aged 18 years or more
  • CF and non-CF patients receiving single-lung or double-lung or heart-lung transplantation for the first time
  • Patients on oral tacrolimus and MMF for at least 48 hours at the time of inclusion (administration via a naso-gastric tube possible if necessary)
  • Patients without progressive chronic pathology jeopardizing short term patient and graft survival
  • Patients accepting to comply with at least the evaluation visits planned in the investigation center over the first three years post-transplantation (D7, D14, M1, M3, M6, M12, M18, M24, M30, M36)
  • Patients giving their free and informed written consent to participate in this study
  • Patients with a health insurance policy or registered under a health insurance program

Exclusion Criteria:

  • Patients aged less than 18 years or patients over 18 years under guardianship
  • Patients who disagree with this research
  • Patients with a contra-indication to receiving tacrolimus or MMF
  • Patients on cyclosporine, sirolimus or everolimus
  • Patients who have already benefited from a solid organ transplantation in the past (including lung or heart-lung transplantation)
  • Patients infected by Burkholderia cenocepacia (Burkholderia cepacia genomovar III)
  • Patients receiving HIV protease inhibitors (major pharmacokinetic interaction with tacrolimus)
  • Pregnant or breastfeeding women or those of child-bearing age who do not use an efficient contraceptive method
  • Drug users or patients suffering from neuro-psychiatric disorders preventing them from both proper comprehension of the protocol and reliable consent
  • Patients already participating in another interventional clinical trial

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: 1
Optimized TDM of tacrolimus and MMF dosing
Medicin: Tacrolimus and MMF
Tacrolimus: daily oral dose divided into 2 doses (morning and evening). MMF: daily dose divided into 2 doses at 12 hour intervals or 3 doses at 8 hour intervals.
Aktiv komparator: 2
Current tacrolimus and MMF dosing strategies
Medicin: Tacrolimus and MMF
Tacrolimus: daily oral dose divided into 2 doses (morning and evening). MMF: daily dose divided into 2 doses at 12 hour intervals or 3 doses at 8 hour intervals.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Tidsramme
Immunosuppressive treatment failure
Tidsramme: Day 7, day 14, day 21; months 3, 6 and every six months afterwards up to 3 years posttransplantation
Day 7, day 14, day 21; months 3, 6 and every six months afterwards up to 3 years posttransplantation

Sekundære resultatmål

Resultatmål
Tidsramme
Efficacy score
Tidsramme: Day 7, day 14, day 21; months 3, 6 and every six months afterwards up to 3 years posttransplantation
Day 7, day 14, day 21; months 3, 6 and every six months afterwards up to 3 years posttransplantation
Toxicity score
Tidsramme: Day 7, day 14, day 21; months 3, 6 and every six months afterwards up to 3 years posttransplantation
Day 7, day 14, day 21; months 3, 6 and every six months afterwards up to 3 years posttransplantation
Benefit/risk ratio
Tidsramme: Day 7, day 14, day 21; months 3, 6 and every six months afterwards up to 3 years posttransplantation
Day 7, day 14, day 21; months 3, 6 and every six months afterwards up to 3 years posttransplantation
Each event composing the composite criterion
Tidsramme: Day 7, day 14, day 21; months 3, 6 and every six months afterwards up to 3 years posttransplantation
Day 7, day 14, day 21; months 3, 6 and every six months afterwards up to 3 years posttransplantation
Overall cost of patients monitoring
Tidsramme: Day 7, day 14, day 21; months 3, 6 and every six months afterwards up to 3 years posttransplantation
Day 7, day 14, day 21; months 3, 6 and every six months afterwards up to 3 years posttransplantation
Pharmacogenetic and proteomic analysis
Tidsramme: Day 7, day 14, day 21; months 3, 6 and every six months afterwards up to 3 years posttransplantation
Day 7, day 14, day 21; months 3, 6 and every six months afterwards up to 3 years posttransplantation

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

University Hospital, Limoges

Efterforskere

  • Studieleder: Pierre MARQUET, MD, CHU Limoges

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. september 2009

Primær færdiggørelse (Faktiske)

1. februar 2011

Studieafslutning (Faktiske)

1. februar 2011

Datoer for studieregistrering

Først indsendt

10. september 2009

Først indsendt, der opfyldte QC-kriterier

10. september 2009

Først opslået (Skøn)

11. september 2009

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

26. april 2011

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

23. april 2011

Sidst verificeret

1. april 2011

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • I07038

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Lung and Heart-lung Transplantation

Kliniske forsøg med Tacrolimus and MMF

Søg i lignende forsøg

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

CROs by country

CROs in Oman

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

Abonner