Sirolimus Associated With Tacrolimus at Low Doses in Elderly Kidney Transplant Patients
Sirolimus Associated With Tacrolimus at Low Doses in Elderly Kidney Transplant Patients: A Prospective Randomized Controlled Trial
Studieoversikt
Status
Detaljert beskrivelse
Study Design
This will be a single-center, prospective, 12-month randomized controlled trial aiming to compare sirolimus associated with tacrolimus in elderly renal transplant patients as to safety and incidence of cytomegalovirus (CMV) infection.
Treatments
In the control group (Tacrolimus + Mycophenolate) the investigators will use tacrolimus (starting with 0.1 mg/kg twice daily adjusted to target serum levels by 4-8ng/ml at the third month and then 3-7ng/ml from the third month to the 12th month) and mycophenolate sodium 720 mg twice daily. A dose reduction of mycophenolate sodium to 720 mg/day will be accepted due to possible side effects of the drug.
In the treatment group (Tacrolimus + sirolimus) the investigators will use tacrolimus (starting with 0.1 mg/kg twice daily adjusted to target serum levels by 4-8 ng/ml at the third month and then 3-7 ng/ml from the third month to the 12th month) and sirolimus 2 mg/day (adjusted serum levels at 4-8 ng/ml throughout the study period).
In all groups, patients will receive prednisone 30 mg/day (in the first month with weekly reductions up to 5 mg/day at the end of the second month). Induction therapy consisted of basiliximab or antithymocyte globulin (Thymoglobulin, Genzyme®). Thymoglobulin will be used in patients with panel reactivity class I greater than 50 % (at a dose of 1mg/kg for 5 days).
Studietype
Registrering (Faktiske)
Fase
- Fase 4
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria:
1. Patients aged more than 60 years and recipients of compatible renal transplant
Exclusion Criteria:
- Receptors of multiple organs;
- non-heart beating donors;
- donors aged under 5 or over 65 years;
- Patients with body mass index greater than 35
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Enkelt
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Aktiv komparator: Tacrolimus + Mycophenolate
The investigators wil be used tacrolimus (starting with 0.1 mg/kg twice daily adjusted to target serum levels by 4-8ng/ml at the third month and then 3-7ng/ml from the third month to the 12th month) and mycophenolate sodium 720 mg twice daily. A dose reduction of mycophenolate sodium to 720 mg/day will be accepted due to possible side effects of the drug. Prednisone 30 mg/day in the first month. Induction therapy consisted of basiliximab or thymoglobulin if panel reactivity class I greater than 50 % |
Andre navn:
Andre navn:
Prednisone 30mg/day
Andre navn:
Basiliximab 20mg (first and fourth day) if panel reactivity class I less than 50 %
Andre navn:
Thymoglobulin at a dose of 1mg/kg for 5 days if panel reactivity class I greater than 50 %
Andre navn:
|
|
Eksperimentell: Tacrolimus + Sirolimus
The investigators will be used tacrolimus (starting with 0.1 mg/kg twice daily adjusted to target serum levels by 4-8 ng/ml at the third month and then 3-7 ng/ml from the third month to the 12th month) and sirolimus 2 mg/day (adjusted serum levels at 4-8 ng/ml throughout the study period). Prednisone 30 mg/day in the first month. Induction therapy consisted of basiliximab or thymoglobulin if panel reactivity class I greater than 50 % |
Andre navn:
Prednisone 30mg/day
Andre navn:
Basiliximab 20mg (first and fourth day) if panel reactivity class I less than 50 %
Andre navn:
Thymoglobulin at a dose of 1mg/kg for 5 days if panel reactivity class I greater than 50 %
Andre navn:
Andre navn:
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Change in estimated glomerular filtration rate from baseline
Tidsramme: Baseline, 1 month, 3 months, 6 months and 12 months
|
The primary end-point will be evaluated the estimated glomerular filtration rate (eGFR) over 12 months of renal transplantation.
The investigators will be measure the change in eGFR during 12 month follow-up.
Glomerular filtration rate will be estimated by the MDRD equation (Modification of Diet in Renal Disease).
|
Baseline, 1 month, 3 months, 6 months and 12 months
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Incidence of cytomegalovirus Infection (CMV)
Tidsramme: Weekly from baseline until the third month. After in 4, 5, 6, 8, 10 and 12 months.
|
The secondary end-point will be evaluated the incidence of cytomegalovirus (CMV) infection.
CMV infection will be defined based on detection of CMV viral replication (CMV pp65 antigenemia more than zero) in asymptomatic patients.
CMV disease will be defined based on the evidence of CMV infection with related symptoms.
For the positive cases treatment will be carried out with ganciclovir 5 mg/kg/day twice daily adjusted for renal function for a minimum of 14 days.
|
Weekly from baseline until the third month. After in 4, 5, 6, 8, 10 and 12 months.
|
Samarbeidspartnere og etterforskere
Studierekorddatoer
Studer hoveddatoer
Studiestart
Primær fullføring (Faktiske)
Studiet fullført (Faktiske)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Anslag)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Anslag)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
- Virussykdommer
- Infeksjoner
- DNA-virusinfeksjoner
- Herpesviridae-infeksjoner
- Cytomegalovirusinfeksjoner
- Fysiologiske effekter av legemidler
- Molekylære mekanismer for farmakologisk virkning
- Anti-infeksjonsmidler
- Enzymhemmere
- Anti-inflammatoriske midler
- Antineoplastiske midler
- Immunsuppressive midler
- Immunologiske faktorer
- Glukokortikoider
- Hormoner
- Hormoner, hormonsubstitutter og hormonantagonister
- Antineoplastiske midler, hormonelle
- Antibakterielle midler
- Antibiotika, antineoplastisk
- Antifungale midler
- Antituberkulære midler
- Antibiotika, Antituberkulær
- Calcineurin-hemmere
- Prednison
- Takrolimus
- Mykofenolsyre
- Sirolimus
- Basiliximab
- Thymoglobulin
- Antilymfocyttserum
Andre studie-ID-numre
- 16966913.6.0000.5411
Plan for individuelle deltakerdata (IPD)
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