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Prospective, Multicenter, Randomized, Double-blind, Controlled Parallel Group Study Designed to Assess the Risk-benefit Balance of the Gradual Withdrawal of a Calcineurin Inhibitor (Tacrolimus) in Renal Transplant Patients Over 4 Years and Clinically Selected


Phase 3
18 Years
80 Years
Open (Enrolling)
Both
Function of Renal Transplant

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Trial Information

Prospective, Multicenter, Randomized, Double-blind, Controlled Parallel Group Study Designed to Assess the Risk-benefit Balance of the Gradual Withdrawal of a Calcineurin Inhibitor (Tacrolimus) in Renal Transplant Patients Over 4 Years and Clinically Selected


Pre-inclusion criteria :

- Male or female aged between 18 and 80 years (inclusive),

- Having received a deceased donor transplant or living with ABO compatibility,

- First renal allograft for at least 4 years and under 10 years,

- Presenting a stable renal function : serum creatinine with a variation of ± 25% of
the average of the year before inclusion,

- Treated with tacrolimus (Prograf®) in combination with MPA (Cellcept® and Myfortic®)
+ / - steroids (between 5 and 10 mg per day),

- Patient has given informed consent,

- Patient insured,

- Patient (of childbearing age) with effective contraception.

Inclusion Criteria:



- Glomerular Filtration Rate (GFR), defined by the dosage of cystatin C ≥ 40 ml/min/1,
73m²,

- Proteinuria ≤ 0,5 g / day,

- Patient with serum levels of Tacrolimus between 5 to 10 ng / ml on average during the
last 6 months (inclusive). It is accepted that 25% of the assays performed during the
last 6 months, serum levels of tacrolimus are outside the limits mentioned above
(5-10 ng / ml). They must nevertheless be between 3.5 to 12.5 ng / ml (inclusive).

- Patient with serum levels of MPA (Cellcept® and Myfortic®) higher ≥ 30 mg / ml,

- No anti-HLA antibodies at the time of inclusion, verified using highly sensitive
techniques (Luminex HD),

- Lack of histological evidence of cellular or humoral acute or chronic or subclinical
rejection on renal graft according to the latest classification of Banff 2009.

Exclusion Criteria:

- Patients under age 18 or over 80 years,

- Transplanted from less than 4 years and over 10 years,

- Patients re-transplanted,

- Transplantation of several organs,

- Patient not treated with tacrolimus as maintenance therapy,

- Serum levels of Tacrolimus patient <5 or >10 ng / ml,

- Serum levels of MPA of the patient <30 mg / ml,

- Patients treated with other immunosuppressive drugs that Tacrolimus (Prograf®), MPA
(Cellcept® and Myfortic®) and steroids,

- Patient not having a stable graft function at baseline (change in serum creatinine >
25% of the average of the year before inclusion in the study), with a GFR defined by
the dosage of cystatin C <40 ml/min/1, 73m² at the time of inclusion,- Patients with
proteinuria > 0.5 g at study entry,

- Patient with HLA antibodies at study entry,

- Patient non-compliant,

- Presence of histological evidence of cellular or humoral acute or chronic or
subclinical rejection on renal graft according to the latest classification of Banff
2009,

- History of lymphoproliferative disorders,

- Diagnosis of a malignancy within 5 years before enrollment,

- Significantly abnormal hematologic data of a clinical standpoint, as determined by
the investigator for hematocrit, hemoglobin, white blood cell count or platelets,

- Data significantly abnormal blood biochemistry of a clinical standpoint, as
determined by the investigator,

- Abuse of significant drug or alcohol at the time of inclusion, determined by the
investigator,

- Patient positive for antibodies to hepatitis C or hepatitis B surface antigen of
hepatitis B (HBsAg) or HIV infection,

- Participation in a clinical study within 3 months,

- Pregnancy, Breastfeeding.

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment

Outcome Measure:

Renal function

Outcome Description:

The primary endpoint will be the improvement of renal function one year after complete withdrawal of Tacrolimus (Prograf®) assessed by measuring the glomerular filtration rate (GFR) calculated by the dosage of cystatin C according to the equation Bricon. The DFG will be compared between times J-30 and J480 (1 year after the withdrawal).

Outcome Time Frame:

one year after complete withdrawal of Tacrolimus

Safety Issue:

Yes

Principal Investigator

Magali GIRAL, Profesor

Investigator Role:

Principal Investigator

Investigator Affiliation:

CHU de Nantes

Authority:

France : AFSSAPS

Study ID:

09/7-D

NCT ID:

NCT01292525

Start Date:

February 2011

Completion Date:

October 2015

Related Keywords:

  • Function of Renal Transplant
  • Withdrawal of Tacrolimus and renal graft
  • renal allograft
  • stable renal function

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