A Study of Mezagitamab in Adults With Late Antibody-Mediated Rejection (AMR) After a Kidney Transplant
A Double-Blind, Placebo-Controlled, Multicenter, Randomized, Phase 2 Trial to Evaluate the Safety and Efficacy of Mezagitamab (TAK-079) in Kidney Transplant Recipients With Late Antibody-Mediated Rejection (AMR)
Antibody-mediated rejection (AMR) is a major cause of worsening kidney function after a kidney transplant (kidney allograft dysfunction) and can lead to kidney failure. AMR happens when the kidney recipient's immune system makes antibodies that attack the donor kidney. Antibodies are proteins made by the immune system to recognize foreign cells. Over time, this attack can damage kidney tissue and cause the transplant to fail. Because AMR can be serious, there is a need for treatments that are safe, work well, and are supported by good evidence.
The main aim of this study is to find out how safe mezagitamab is and how well adults with AMR tolerate it compared with placebo. A placebo looks like medicine but has no active ingredients. The study will also look at whether mezagitamab helps to control inflammation in the transplanted kidney and helps keep kidney function stable, compared with placebo.
Participants will be placed by chance in 1 of the 3 treatment groups in equal numbers. Two groups will receive mezagitamab in two different doses. One group will receive placebo. This means that out of every 3 participants, 2 will receive mezagitamab and 1 will receive placebo.
During the study, participants will visit their study clinic several times.
Aperçu de l'étude
Statut
Statut
Les conditions
Les conditions
Intervention / Traitement
Intervention / Traitement
Type d'étude
Type d'étude
Inscription (Estimé)
Inscription
Phase
Phase
- Phase 2
Contacts et emplacements
Coordonnées de l'étude
Coordonnées de l'étude
- Nom: Takeda Contact
- Numéro de téléphone: +1-877-825-3327
- E-mail: medinfoUS@takeda.com
Lieux d'étude
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München, Allemagne, 81377
- Ludwig-Maximilians-Universitaet Muenchen (LMU) Klinikum der Universitaet Muenchen
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Chercheur principal:
- Michael Fischereder
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Münster, Allemagne
- Universitaetsklinikum Muenster
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Chercheur principal:
- Stefan Reuter
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North Rhine-Westphalia
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Bochum, North Rhine-Westphalia, Allemagne, 44892
- Kliniken Universitatsklinikum Bochum GmbH
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Chercheur principal:
- Andreas Schnitzbauer
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Essen, North Rhine-Westphalia, Allemagne, 45122
- Universitaetsklinikum Essen
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Chercheur principal:
- Benjamin Wilde
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Beijing Municipality
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Beijing, Beijing Municipality, Chine, 100050
- Beijing Friendship hospital, Capital Medical University
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Contact:
- E-mail: yczhu82@gmail.com
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Chercheur principal:
- Yichen Zhu
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Guangdong
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Guangdong, Guangdong, Chine, 510080
- The First Affiliated Hospital of Sun Yat-sen University
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Contact:
- E-mail: wangchx@mail.sysu.edu.cn
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Chercheur principal:
- Changxi Wang
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Guangxi
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Nanning, Guangxi, Chine, 530007
- The Second Affiliated Hospital of Guangxi Medical University
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Contact:
- E-mail: sxywn@sohu.com
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Chercheur principal:
- Xuyong Sun
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Hubei
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Wuhan, Hubei, Chine, 430075
- Tongji Hospital Affiliated to Tongji Medicine University
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Chercheur principal:
- Gang Chen
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Contact:
- E-mail: gchen@tjh.tjmu.edu.cn
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Shaanxi
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Xi'an, Shaanxi, Chine
- The First Affiliated Hospital of Xi'an Jiaotong University
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Contact:
- E-mail: xwujun126@mail.xjtu.edu.cn
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Chercheur principal:
- Wujun Xue
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Shandong
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Jinan, Shandong, Chine, 250013
- Shandong Provincial Qianfoshan Hospital
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Chercheur principal:
- Jianning Wang
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Contact:
- E-mail: docjianning_wang@yeah.net
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Sichuan
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Chengdu, Sichuan, Chine, 610000
- West China Hospital Sichuan University
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Contact:
- E-mail: yyshi_130@126.com
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Chercheur principal:
- Yunying Shi
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Zhejiang
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Hangzhou, Zhejiang, Chine, 310003
- The First Affiliated Hospital of Zhejiang University school of medicine
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Contact:
- E-mail: rd_wangjia@zju.edu.cn
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Chercheur principal:
- Rending Wang
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Bordeaux, France, 33076
- CHU Bordeaux, CHU Pellegrin
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Chercheur principal:
- Lionel Couzi
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Contact:
- E-mail: lionel.couzi@chu-bordeaux.fr
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Créteil, France, 94000
- Hopital Henri Mondor
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Contact:
- E-mail: marie.matignon@aphp.fr
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Chercheur principal:
- Marie Matignon
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Lyon, France, 69003
- Hopital Edouard Herriot (HEH)
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Chercheur principal:
- Olivier Thaunat
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Contact:
- E-mail: olivier.thaunat@chu-lyon.fr
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Toulouse, France
- CHU de Toulouse - Hopital Rangueil
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Chercheur principal:
- Nassim Kamar
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Contact:
- E-mail: kamar.n@chu-toulouse.fr
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Niigata, Japon, 951-8520
- Niigata University Medical and Dental Hospital
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Contact:
- E-mail: masa1214@med.niigata-u.ac.jp
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Chercheur principal:
- Masayuki Tasaki
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Osaka, Japon, 545-8585
- Osaka Metropolitan university Hospital
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Contact:
- E-mail: uchida@omu.ac.jp
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Chercheur principal:
- Junji Uchida
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Aichi-ken
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Nagoya, Aichi-ken, Japon, 466-8650
- Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital
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Chercheur principal:
- Kenta Futamura
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Contact:
- E-mail: kenta88@nagoya2.jrc.or.jp
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Kumamoto
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Kumamoto, Kumamoto, Japon, 861-8520
- Japanese Red Cross Kumamoto Hospital
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Chercheur principal:
- Shigeyoshi Yamanaga
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Contact:
- Numéro de téléphone: 096-384-2111
- E-mail: yamanaga@kumamoto-med.jrc.or.jp
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Tokyo
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Shinjuku-ku, Tokyo, Japon, 162-0055
- Yochomachi Clinic
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Contact:
- Numéro de téléphone: 81353122059
- E-mail: omotokazuya@yahoo.co.jp
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Chercheur principal:
- Kazuya Omoto
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California
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Los Angeles, California, États-Unis, 90024
- UCLA University of California Los Angeles
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Chercheur principal:
- Suphamai Bunnapradist
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Contact:
- E-mail: bunnapradist@mednet.ucla.edu
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San Francisco, California, États-Unis, 94118
- Kaiser Permanente-San Francisco Medical Center - Kidney Transplant Clinic
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Contact:
- E-mail: anshul.x.bhalla@kp.org
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Chercheur principal:
- Anshul Bhalla
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Florida
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Miami, Florida, États-Unis, 33136
- University of Miami Hospital and Clinics
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Chercheur principal:
- Adela Mattiazzi
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Contact:
- E-mail: amattiazzi@med.miami.edu
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Tampa, Florida, États-Unis, 33606
- Tampa General Hospital
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Chercheur principal:
- Luis Beltran
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Contact:
- E-mail: lbeltran@flkidney.com
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Maryland
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Baltimore, Maryland, États-Unis, 21201
- University of Maryland
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Contact:
- E-mail: jbromberg@smail.umaryland.edu
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Chercheur principal:
- Jonathan Bromberg
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Missouri
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St Louis, Missouri, États-Unis, 63110
- Washington University School of Medicine
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Chercheur principal:
- Tarek Alhamad
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Contact:
- E-mail: talhamad@wustl.edu
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New Jersey
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Livingston, New Jersey, États-Unis, 07039
- Cooperman Barnabas Medical Center
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Chercheur principal:
- Anup Patel
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Contact:
- E-mail: anup.patel@rwjbh.org
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New York
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New York, New York, États-Unis, 10016
- NYU Langone Health - Transplant Associates
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Contact:
- E-mail: Aprajita.Mattoo@nyulangone.org
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Chercheur principal:
- Aprajita Mattoo
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New York, New York, États-Unis, 10021
- Weill Cornell Medicine - Nephrology and Kidney Transplantation Medicine
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Chercheur principal:
- Darshana Dadhania
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Contact:
- E-mail: dmd2001@med.cornell.edu
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Ohio
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Cleveland, Ohio, États-Unis, 44195
- Cleveland Clinic - Cleveland
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Contact:
- E-mail: augustj4@ccf.org
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Chercheur principal:
- Joshua Augustine
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Texas
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Dallas, Texas, États-Unis, 75390
- University of Texas Southwestern Medical Center
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Chercheur principal:
- David Wojciechowski
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Contact:
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Utah
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Murray, Utah, États-Unis, 84107
- Intermountain Healthcare
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Chercheur principal:
- Sanjiv Anand
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Contact:
- E-mail: sanjivanand@yahoo.com
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Virginia
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Richmond, Virginia, États-Unis, 23298
- Virginia Commonwealth University (VCU) - Medical Center - Hume-Lee Transplant Center (HLTC)
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Chercheur principal:
- Gaurab Gupta
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Wisconsin
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Milwaukee, Wisconsin, États-Unis, 53226
- Froedtert and The Medical College of Wisconsin
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Chercheur principal:
- Matthew Cooper
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Contact:
- E-mail: macooper@mcw.edu
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Critères de participation
Critère d'éligibilité
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La description
Key inclusion criteria:
- The participant aged 18 to 80 years.
- The participant must have a biopsy-confirmed diagnosis of active or chronic active late AMR (defined as greater than [>] 6 month after kidney transplant) without concurrent definitive TCMR (Grade 1a and above) as defined by the 2022 Banff classification.
- Biopsy within 30 days prior to screening, or performed during screening period within protocol-defined window.
- If the participant has received treatment for rejection, then the repeat biopsy and donor specific antibody (DSA) testing must have been performed at least 6 weeks after stopping the treatment.
- The participant with either human leukocyte antigen (HLA) class I and/or II DSA.
- eGFR > 30 milliliters per minute per 1.73 square meters (mL/min/1.73m^2).
Key exclusion criteria:
- The participant has blood type A, B, AB, or O (ABO) incompatible transplant.
- The participant has a history of multiple organ transplants, including en bloc and dual kidney transplants.
- Participant likely to require renal replacement therapy within the subsequent 30 days.
- Participants who have received an anti-cluster of differentiation 38 (CD38) therapy in the last 1 year or have past history of failing to achieve AMR resolution despite treatment with an anti-CD38 therapy.
The participant has received any previous treatment with other immunosuppressant or immunomodulatory therapy:
a) Within 6 months of signing the informed consent form (ICF) as listed below:
- Complement system inhibitors (such as, eculizumab).
- Proteasome inhibitors (such as, bortezomib).
- Interleukin-6 (IL-6)/IL-6R antibody (such as, tocilizumab).
- Anti-cluster of differentiation 20 (CD20) antibody (such as, rituximab). b) Within 6 weeks of signing the ICF as listed below:
- Intravenous immunoglobulin (IVIG) or subcutaneous immunoglobulin (SCIG) or plasmapheresis
- The participant has active infection with hepatitis B virus, hepatitis C virus (HCV), or human immunodeficiency virus (HIV).
- Participant with serious infection within 2 weeks or with opportunistic infection within 2 months prior to signing ICF. Participant with active or untreated tuberculosis, or those with high suspicion of tuberculosis are also excluded.
- History of malignancy (including myelodysplastic syndrome) within 5 years of signing the ICF, except for adequately treated non-melanoma skin cancer, superficial bladder cancer, and curatively treated cervical carcinoma-in-situ.
Key Note: Other protocol specified inclusion and exclusion criteria apply.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Quadruple
Nombre de bras
Armes et Interventions
Groupe de participants / BrasGroupe de participants / Bras |
Intervention / TraitementIntervention / Traitement |
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Expérimental: Arm A: Mezagitamab + Placebo
Participants will receive mezagitamab up to Week 24, followed by placebo up to Week 48, followed by an observation period up to Week 70.
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Mezagitamab subcutaneous (SC) injection.
Autres noms:
Mezagitamab-matching placebo SC injection.
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Expérimental: Arm B: Mezagitamab
Participants will receive mezagitamab up to Week 48, followed by an observation period up to Week 70.
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Mezagitamab subcutaneous (SC) injection.
Autres noms:
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Comparateur actif: Arm C: Placebo
Participants will receive placebo up to Week 48, followed by an observation period up to Week 70.
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Mezagitamab-matching placebo SC injection.
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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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Arms A, B, and C: Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
Délai: Up to Week 70
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An adverse event (AE) is any untoward medical occurrence in a clinical trial participant, temporally associated with the use of the trial intervention, whether or not the occurrence is considered related to the trial intervention.
An AE can be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of the trial intervention.
TEAEs are defined as AEs with start dates at the time of or following the first exposure to investigational medicinal product (IMP).
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Up to Week 70
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Arms A, B, and C: Number of Participants With Related TEAEs
Délai: Up to Week 70
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A related AE is an AE that is considered related to the IMP.
Related TEAEs are defined as related AEs with start dates at the time of or following the first exposure to IMP.
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Up to Week 70
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Arms A, B, and C: Number of Participants With Serious Adverse Events (SAEs)
Délai: Up to Week 70
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An SAE is any untoward medical occurrence that results in death, is life threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity or is a congenital anomaly/birth defect.
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Up to Week 70
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Arms A, B, and C: Number of Participants With AEs of Special Interest
Délai: Up to Week 70
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AEs of special interest are AEs that are considered specific to the IMP.
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Up to Week 70
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Arms A, B, and C: Number of Participants With AE Leading to Treatment Discontinuation
Délai: Up to Week 70
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Up to Week 70
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Arms A, B, and C: Number of Participants With Clinically Significant Abnormal Laboratory Test Results and Vital Signs
Délai: Up to Week 70
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Up to Week 70
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Mesures de résultats secondaires
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Arms A, B, and C: Percentage of Participants With Achievement of Biopsy-Proven Histologic Resolution of AMR Activity at Weeks 24 and 48
Délai: Weeks 24 and 48
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Achievement of biopsy-proven histological resolution of AMR activity will be assessed by the 2022 Banff classification criteria.
The Banff 2022 Classification provides a standardized framework for evaluating kidney transplant biopsies using lesion scoring.
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Weeks 24 and 48
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Arms A, B, and C: Microvascular Inflammation (MVI) Score in Biopsy Samples at Weeks 24 and 48
Délai: Weeks 24 and 48
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MVI is an important marker of allograft loss and is defined as the sum of glomerulitis and peritubular capillaritis scores (g+ptc) on kidney histology.
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Weeks 24 and 48
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Arms A, B, and C: Percentage of Participants Who Achieve a MVI Score of 0 at Weeks 24 and 48
Délai: Weeks 24 and 48
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Weeks 24 and 48
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Arms A, B, and C: Change From Baseline in MVI score at Weeks 24 and 48
Délai: Baseline, Weeks 24 and 48
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Baseline, Weeks 24 and 48
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Arms A, B, and C: Change From Baseline in Estimated Glomerular Filtration Rate (eGFR) at Weeks 24, 48 and 70
Délai: Baseline, Weeks 24, 48 and 70
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eGFR is a measure of kidney function calculated from serum creatinine using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation.
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Baseline, Weeks 24, 48 and 70
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Arms A, B, and C: Change From Baseline in Donor-Derived Cell-Free DNA (dd-cfDNA) at Weeks 24, 48 and 70
Délai: Baseline, Weeks 24, 48 and 70
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dd-cfDNA are DNA fragments released from injured donor cells.
It serves as a noninvasive, quantitative method that reflects allograft injury and is associated with AMR activity in kidney transplant recipients.
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Baseline, Weeks 24, 48 and 70
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Arms A, B, and C: Change From Baseline in Urine Protein Creatinine Ratio (UPCR) at Weeks 24, 48 and 70
Délai: Baseline, Weeks 24, 48 and 70
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UPCR is a measure of protein excretion calculated from a urine sample, as the ratio of urine protein to creatinine, and used to assess kidney function.
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Baseline, Weeks 24, 48 and 70
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Arm B: Percentage of Participants With Achievement of Biopsy-Proven Histologic Resolution of AMR Activity at Week 70
Délai: Week 70
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Week 70
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Arm B: MVI Score in Biopsy Samples at Week 70
Délai: Week 70
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Week 70
|
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Arm B: Percentage of Participants Who Achieve a MVI Score of 0 at Week 70
Délai: Week 70
|
Week 70
|
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Arm B: Change From Baseline in MVI score at Week 70
Délai: Week 70
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Week 70
|
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Arms A, B, and C: Percentage of Participants With T-Cell Mediated Rejection (TCMR) by Biopsy at Weeks 24 and 48
Délai: Weeks 24 and 48
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Weeks 24 and 48
|
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Arm B: Percentage of Participants With TCMR by Biopsy at Week 70
Délai: Week 70
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Week 70
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Arms A and B: Serum Concentration of Mezagitamab
Délai: Pre-dose and at multiple time points post-dose up to Week 70
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Pre-dose and at multiple time points post-dose up to Week 70
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Arms A, B and C: Number of Participants With Anti-Drug Antibody
Délai: Pre-dose and at multiple time points post-dose up to Week 70
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Pre-dose and at multiple time points post-dose up to Week 70
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|
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Arms A, B and C: Number of Participants With Neutralizing Antibody
Délai: Pre-dose and at multiple time points post-dose up to Week 70
|
Pre-dose and at multiple time points post-dose up to Week 70
|
Collaborateurs et enquêteurs
Parrainer
Parrainer
Les enquêteurs
Les enquêteurs
- Directeur d'études: Study Director, Takeda
Publications et liens utiles
Liens utiles
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Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Estimé)
Début de l'étude
Achèvement primaire (Estimé)
Achèvement primaire
Achèvement de l'étude (Estimé)
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 (Réel)
Première publication
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
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
Mots clés
Autres numéros d'identification d'étude
Autres numéros d'identification d'étude
- TAK-079-2002
- 2026-526239-20-00 (Ctis)
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Description du régime IPD
Critères d'accès au partage IPD
Type d'informations de prise en charge du partage d'IPD
- PROTOCOLE D'ÉTUDE
- SÈVE
- CIF
- RSE
Informations sur les médicaments et les dispositifs, documents d'étude
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