A Study of CellCept (Mycophenolate Mofetil) in Combination Therapy in Liver Transplant Patients.
A Randomized, Open Label Study Comparing the Effect of CellCept With Therapeutic Drug Monitoring, Tacrolimus and a Corticosteroid-sparing Regimen Versus Fixed Dose CellCept, Tacrolimus and Corticosteroids Maintained up to 6 Months, on Acute Rejection and Safety in Liver Transplant Patients.
Aperçu de l'étude
Statut
Statut
Les conditions
Les conditions
Intervention / Traitement
Intervention / Traitement
Type d'étude
Type d'étude
Inscription (Réel)
Inscription
Phase
Phase
- Phase 4
Contacts et emplacements
Lieux d'étude
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Besancon, France, 25030
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Bordeaux, France, 33076
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Caen, France, 14033
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Clichy, France, 92118
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Creteil, France, 94010
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Grenoble, France, 38043
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Lille, France, 59037
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Lyon, France, 69317
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Lyon cedex 3, France, 69437
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Marseille, France, 13385
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Montpellier, France, 34295
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Nice, France, 06202
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Paris, France, 75679
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Rennes, France, 35033
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Toulouse, France, 31059
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Villejuif, France, 94804
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Critères de participation
Critère d'éligibilité
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- adult patients, >=18 years of age;
- recipient of a first orthotopic liver transplant.
Exclusion Criteria:
- history of organ transplants;
- patient receiving a multi-organ transplant;
- calculated creatinine clearance <=30mL/min before transplant;
- leukocyte count < 2000/mm3 at randomization;
- history of cancer within past 5 years, except for successfully treated basal cell or squamous cell cancer, or in situ cervical cancer;
- pregnant or breast-feeding females, or females of childbearing age not using effective contraception.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Nombre de bras
Armes et Interventions
Groupe de participants / BrasGroupe de participants / Bras |
Intervention / TraitementIntervention / Traitement |
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Expérimental: MMF, Adjusted Dose; Tacrolimus; Corticosteroids
Participants received mycophenolate mofetil (MMF) 3 grams per day (g/d), orally (PO), twice per day (BID) with meals from Day 0 to Day 4; the dose was adjusted based on total exposure (AUC) using the Bayesian method with limited sampling strategy on Days 5 and 14, Months 1, 13, 6, 9, and 12. Participants also received tacrolimus adjusted to a target trough level of 8 to (-) 12 nanograms per milliliter (ng/mL) from Day 0 to Month 1; the dose was adjusted to reach a target trough level of 3-8 ng/mL from the end of Month 1 through Month 12. Participants also received corticosteroids 10-15 milligrams per kilogram (mg/kg), intravenously (IV), pre-operation on Day 0.
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3 g/d PO BID during meals from Day 0 to Day 4, followed by dose adjustment based on AUC using the Bayesian method with limited sampling strategy on Days 5 and 14, Months 1, 13, 6, 9, and 12.
Autres noms:
Target trough level of 8-2 ng/mL from Day 0 to Month 1, adjusted to a target trough level of 3-8 ng/mL from the end of Month 1 through Month 12
10-15 mg/kg IV pre-operation on Day 0
Autres noms:
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Comparateur actif: MMF, Standard Dose; Tacrolimus; Corticosteroids
Participants received MMF 2 g/d, PO, BID with meals from Day 0 to Month 12. Participants also received tacrolimus adjusted to a target trough level of 8-12 ng/mL from Day 0 to Month 1; the dose was reduced to reach a target trough level of 3-8 ng/mL from the end of Month 1 through Month 12. Participants also received corticosteroids 10-15 mg/kg, IV, pre-operation on Day 0; followed by 20 mg/d, PO, 4 times per day (QDS) from Day 0 through Month 1; 15 mg/d, PO, 3 times per day (TID) from the end of Month 1 through Month 2; 10 mg/d, PO, BID from the end of Month 2 through Month 3; and 5 mg/d once per day from the end of Month 3 through Month 6.
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Target trough level of 8-2 ng/mL from Day 0 to Month 1, adjusted to a target trough level of 3-8 ng/mL from the end of Month 1 through Month 12
10-15 mg/kg IV pre-operation on Day 0
Autres noms:
2 g/d PO BID during meals from Day 0 to Month 12
Autres noms:
20 mg/d QDS from Day 0 through Month 1; 15 mg/day, TID from the end of Month 1 through Month 2; 10 mg/d BID from the end of Month 2 through Month 3; and 5 mg/d once per day from the end of Month 3 through Month 6.
Autres noms:
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Que mesure l'étude ?
Principaux critères de jugement
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
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Percentage of Participants With Treated Biopsy Proven Acute Rejection (BPAR) According to Banff Criteria up to 12 Months Post-Transplant
Délai: Days 0, 5, and 14, Month 1, 2, 3, 6, 9, and 12, 28 days after Month 12 or last dose of study treatment, and 6 and 12 months after the last dose of study treatment
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Banff criteria required at least 2 of the 3 following features for a histopathological diagnosis of acute rejection: portal inflammation, bile duct inflammation, and venous endothelial inflammation.
Each item was graded from 0 to 3 where 0 equals (=) mild, 2 = moderate, and 3 = severe.
The sum of the 3 individual scores, from 0 to 9, corresponded to the Rejection Activity Index (RAI).
If RAI = 0, 1, or 2, there was no evidence of rejection.
If RAI = 3, there was borderline acute rejection.
If RAI = 4 or 5, there was mild acute rejection.
If RAI = 6 or 7, there was moderate acute rejection.
If RAI = 8 or 9, there was severe acute rejection.
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Days 0, 5, and 14, Month 1, 2, 3, 6, 9, and 12, 28 days after Month 12 or last dose of study treatment, and 6 and 12 months after the last dose of study treatment
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Mesures de résultats secondaires
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
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Percentage of Participants With Graft Loss
Délai: Days 0, 5, and 14, Month 1, 2, 3, 6, 9, and 12, 28 days after Month 12 or last dose of study treatment, and 6 and 12 months after the last dose of study treatment.
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Graft survival was defined as the time between the randomization date and the graft loss date.
Participants were censored at the date of last follow up, the date of last contact or premature withdrawal, and date of death.
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Days 0, 5, and 14, Month 1, 2, 3, 6, 9, and 12, 28 days after Month 12 or last dose of study treatment, and 6 and 12 months after the last dose of study treatment.
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Graft Survival
Délai: Days 0, 5, and 14, Month 1, 2, 3, 6, 9, and 12, 28 days after Month 12 or last dose of study treatment, and 6 and 12 months after the last dose of study treatment.
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The median time, in months, between randomization and graft loss event.
Participants were censored at the date of last follow up, the date of last contact or premature withdrawal, and date of death.
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Days 0, 5, and 14, Month 1, 2, 3, 6, 9, and 12, 28 days after Month 12 or last dose of study treatment, and 6 and 12 months after the last dose of study treatment.
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Overall Survival (OS) at Month 12 - Percentage of Participants With an Event
Délai: Days 0, 5, and 14, Month 1, 2, 3, 6, 9, and 12
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OS was defined as the time between the date of randomization and death up to Month 12. Participants were censored at the date of last follow up and the date of last contact or premature withdrawal.
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Days 0, 5, and 14, Month 1, 2, 3, 6, 9, and 12
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Overall Survival at Month 12
Délai: Days 0, 5, and 14, Month 1, 2, 3, 6, 9, and 12
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The median time, in months, between randomization and OS event.
Participants were censored at the date of last follow up and the date of last contact or premature withdrawal.
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Days 0, 5, and 14, Month 1, 2, 3, 6, 9, and 12
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Percentage of Participants by Graft Histology at 12 Months Post-Transplant - Central Review
Délai: Days 0, 5, and 14, Month 1, 2, 3, 6, 9, and 12
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The percentage of participants with biopsies of grafts evaluated by central review and scored according to Banff criteria at Month 12 post-transplant.
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Days 0, 5, and 14, Month 1, 2, 3, 6, 9, and 12
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Collaborateurs et enquêteurs
Parrainer
Parrainer
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement primaire
Achèvement de l'étude (Réel)
Achèvement de l'étude
Dates d'inscription aux études
Première soumission
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Première publication
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour publiée
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
- Effets physiologiques des médicaments
- Mécanismes moléculaires de l'action pharmacologique
- Agents anti-infectieux
- Inhibiteurs d'enzymes
- Agents anti-inflammatoires
- Agents antinéoplasiques
- Agents immunosuppresseurs
- Facteurs immunologiques
- Glucocorticoïdes
- Les hormones
- Hormones, substituts hormonaux et antagonistes hormonaux
- Agents antinéoplasiques, hormonaux
- Agents neuroprotecteurs
- Agents protecteurs
- Agents antibactériens
- Antibiotiques, Antinéoplasiques
- Agents antituberculeux
- Antibiotiques, Antituberculeux
- Inhibiteurs de la calcineurine
- Hémisuccinate de méthylprednisolone
- Tacrolimus
- Acide mycophénolique
Autres numéros d'identification d'étude
Autres numéros d'identification d'étude
- ML21273
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