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Cardiac Improvement by Eplerenone Among Patients Under Cyclosporine or Tacrolimus for Kidney Transplantation. (KT-CANOPY)

2026年9月14日 更新者：Pr. Nicolas GIRERD、Central Hospital, Nancy, France

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.

The main objective of this research is to evaluate the effect, for 36 weeks, of eplerenone on abnormalities observed on cardiac ultrasound in patients with kidney transplantation for at least one year, under cyclosporine or tacrolimus. The intervention group will receive the usual standard treatment coupled with eplerenone for 36 weeks from randomization, while the control group will only receive the standard treatment. The main hypothesis is that anticalcineurins (cyclosporin or tacrolimus) lead to activation of the MR of vascular smooth muscle cells, vasoconstriction and vascular inflammation, which contributes to the persistence or recurrence of heart abnormalities in these patients after the initial post-transplant phase. The administration of eplerenone could antagonize this hyperactivation, reduce the cardiovascular effects of anticalcineurins and thus ultimately improve the cardiovascular prognosis of transplant patients.

研究概览

地位

尚未招聘

条件

干预/治疗

研究类型

介入性

注册 (估计的)

132

阶段

  • 第三阶段

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习联系方式

研究联系人备份

学习地点

  • 法国
      • Nantes、法国
        • CHU Nantes
        • 接触：
        • 首席研究员：
          • Simon VILLE, MD PhD
      • Strasbourg、法国
        • CHU Strasbourg - nouvel hôpital Civil
        • 接触：
        • 首席研究员：
          • Nans FLORENS, MD PhD
      • Vandœuvre-lès-Nancy、法国
        • CHRU Nancy - hôpital Brabois
        • 接触：
        • 首席研究员：
          • Nesrine BAILI

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

  • 成人
  • 年长者

接受健康志愿者

不

描述

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.

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 主要用途：治疗
  • 分配：随机化
  • 介入模型：并行分配
  • 屏蔽：无（打开标签）

武器和干预

参与者组/臂
干预/治疗
实验性的：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.
药品：Eplerenone
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.
无干预：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.

研究衡量的是什么？

主要结果指标

结果测量
大体时间
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.
大体时间：at 36 weeks
at 36 weeks

次要结果测量

结果测量
措施说明
大体时间
Evolution of Nt-ProBNP concentration
大体时间：randomization, at 12 and 36 weeks
randomization, at 12 and 36 weeks
Evolution of collagen biomarkers (PICP )
大体时间：at 36 weeks
at 36 weeks
Evolution of Biological markers of endothelial dysfunction (endothelin)
大体时间：at 36 weeks
at 36 weeks
The occurrence of hyperkalaemia
大体时间：at 36 weeks
hyperkalaemia between 5 - 5.49; 5.5 - 6; >6mmol/L
at 36 weeks
Proportion of creatinine increase > 50%
大体时间：at 36 weeks
Assessment of the proportion of acute kidney injury (AKI), defined as a >50% increase in serum creatinine from baseline.
at 36 weeks
Evolution of parameters of systolic function (LVEF, strain)
大体时间：at 36 weeks
at 36 weeks
Evolution of parameters of remodeling (left ventricular volume)
大体时间：at 36 weeks
at 36 weeks
Evolution of parameters of filling pressures (E/e')
大体时间：at 36 weeks
at 36 weeks
Evolution of peripheral systolic blood pressure (mmHg)
大体时间：at 36 weeks
at 36 weeks
Evolution of peripheral diastolic blood pressure (mmHg)
大体时间：at 36 weeks
at 36 weeks
Evolution of peripheral pulse pressure (mmHg)
大体时间：at 36 weeks
at 36 weeks
Evolution of Graft function assessed with serum creatinine (micromol/L)
大体时间：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
Evolution of proteinuria (mg/g)
大体时间：at 36 weeks
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.
at 36 weeks
Evolution of parameters of remodeling (left atrial volumes)
大体时间：at 36 weeks
at 36 weeks
Evolution of collagen biomarkers ( PIIINP)
大体时间：at 36 weeks
at 36 weeks
Evolution of Biological markers of endothelial dysfunction ( soluble endothelium selectin)
大体时间：at 36 weeks
at 36 weeks
Evolution of Biological markers of endothelial dysfunction (von Willebrand factor)
大体时间：at 36 weeks
at 36 weeks
Evolution of parameters of filling pressures (E-wave deceleration time).
大体时间：at 36 weeks
at 36 weeks
Evolution of parameters of filling pressures (Systolic Pulmonary Artery Pressure (PAPs)).
大体时间：at 36 weeks
at 36 weeks

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

Central Hospital, Nancy, France

调查人员

  • 学习椅：Nicolas GIRERD, Md PhD、CHRU NANCY

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (估计的)

2027年2月1日

初级完成 (估计的)

2030年12月1日

研究完成 (估计的)

2030年12月1日

研究注册日期

首次提交

2026年9月14日

首先提交符合 QC 标准的

2026年9月14日

首次发布 (实际的)

2026年9月18日

研究记录更新

最后更新发布 (实际的)

2026年9月18日

上次提交的符合 QC 标准的更新

2026年9月14日

最后验证

2026年9月1日

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

  • 2019PI092
  • 2024-515860-29-00 (克蒂斯)

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.

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