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Kidney TransplantationPhase 3NCT00064701

Comparative Study of Modified Release (MR) Tacrolimus/Mycophenolate Mofetil (MMF) in de Novo Kidney Transplant Recipients

A Phase 3 study testing Tacrolimus Modified Release (MR), Tacrolimus and cyclosporine microemulsion in people with Kidney Transplantation, run by Astellas Pharma Inc at 57 sites in 3 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to compare the safety and efficacy of tacrolimus/mycophenolate mofetil (MMF), cyclosporine/MMF and tacrolimus modified release/MMF in de novo kidney transplant recipients. Read more about this study

Who is it for?
Ages 12 years and older
Conditions the study is for
Kidney Transplantation
What is being tested?
Tacrolimus Modified Release (MR), Tacrolimus and cyclosporine microemulsion
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
668 participants
Where
57 sitesin 3 countries
Study dates
Jun 2003to Mar 2009
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 12 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Recipient of a primary or retransplanted non-human leukocyte antigen (HLA)-identical living or non-HLA-identical cadaveric kidney transplant
  • Age greater or equal to 12 years

Who cannot join

  • Recipient or donor is known seropositive for human immunodeficiency virus (HIV)
  • Has current malignancy or history of malignancy
  • Has significant liver disease
  • Has uncontrolled concomitant infection or any other unstable medical condition
  • Is receiving everolimus or enteric coated mycophenolic acid at any time during the study
  • Received kidney with a cold ischemia time of equal or more than 36 hours
  • Received kidney transplant from a cadaveric donor equal or more than 60 years of age
  • Received intravenous immunoglobulin (IVIG) therapy prior to randomization

Trial locations and contacts

57 sites in 3 countries.

57 sites in 3 countries

United States48 sites
  • Study site

    Albany, New York, 12208

  • Study site

    Ann Arbor, Michigan, 48109-0364

  • Study site

    Augusta, Georgia, 30912

  • Study site

    Birmingham, Alabama, 35294

  • Study site

    Boston, Massachusetts, 02214

  • Study site

    Buffalo, New York, 14203

  • Study site

    Chapel Hill, North Carolina, 27599-7211

  • Study site

    Chicago, Illinois, 60612

  • Study site

    Chicago, Illinois, 60637

  • Study site

    Cincinnati, Ohio, 45267

  • Study site

    Dallas, Texas, 75235

  • Study site

    Dallas, Texas, 75246

  • Study site

    Denver, Colorado, 80262

  • Study site

    Detroit, Michigan, 48202

  • Study site

    Durham, North Carolina, 27710

  • Study site

    Fairfax, Virginia, 22031

  • Study site

    Gainesville, Florida, 32610-0224

  • Study site

    Harrisburg, Pennsylvania, 17104

  • Study site

    Houston, Texas, 77030

  • Study site

    Indianapolis, Indiana, 46202

  • Study site

    Jacksonville, Florida, 32216

  • Study site

    Lexington, Kentucky, 40536

  • Study site

    Livingston, New Jersey, 07039

  • Study site

    Loma Linda, California, 92354

  • Study site

    Los Angeles, California, 90033

  • Study site

    Los Angeles, California, 90057

  • Study site

    Los Angeles, California, 90058

  • Study site

    Los Angeles, California, 90095-7306

  • Study site

    Madison, Wisconsin, 53792-7375

  • Study site

    Milwaukee, Wisconsin, 53226

  • Study site

    Mobile, Alabama, 36617

  • Study site

    Nashville, Tennessee, 37212-4750

  • Study site

    New Brunswick, New Jersey, 08901

  • Study site

    New Orleans, Louisiana, 70112

  • Study site

    New Orleans, Louisiana, 70121

  • Study site

    New York, New York, 10029

  • Study site

    Palo Alto, California, 94304

  • Study site

    Philadelphia, Pennsylvania, 19104

  • Study site

    Philadelphia, Pennsylvania, 19107

  • Study site

    Portland, Oregon, 97210

  • Study site

    Portland, Oregon, 97239-2940

  • Study site

    Salt Lake City, Utah, 84132

  • Study site

    San Antonio, Texas, 78229-3900

  • Study site

    San Diego, California, 92103

  • Study site

    San Diego, California, 92123

  • Study site

    San Francisco, California, 94115

  • Study site

    Valhalla, New York, 10595

  • Study site

    Washington D.C., District of Columbia, 20010

Other trials in United States

Brazil5 sites
  • Study site

    Porto Alegre, 90240-520

  • Study site

    Rio de Janeiro, 21041-003

  • Study site

    São Paulo, 04013-043

  • Study site

    São Paulo, 04038-002

  • Study site

    São Paulo, 05465-040

Other trials in Brazil

Canada4 sites
  • Study site

    Edmonton, Alberta

  • Study site

    Montreal, Quebec

  • Study site

    Toronto, Ontario

  • Study site

    Vancouver, British Columbia

Other trials in Canada

About this study

Official title: A Phase III, Randomized, Open-Label, Comparative, Multi-Center Study to Assess the Safety and Efficacy of Prograf (Tacrolimus)/MMF, Modified Release (MR) Tacrolimus/MMF and Neoral (Cyclosporine)/MMF in de Novo Kidney Transplant Recipients

The purpose of this study is to compare the safety and efficacy of tacrolimus/mycophenolate mofetil (MMF), cyclosporine/MMF and tacrolimus modified release/MMF in de novo kidney transplant recipients.

Read the detailed description

This was a 3 arm randomized, open-label, comparative, multi-center study in de novo kidney transplant recipients at 60 centers in the U.S., Canada and Brazil.

The study consisted of a 1-year post-transplant efficacy and safety study with a clinical continuation phase of a minimum of 2 years or until commercial availability of tacrolimus modified release, unless the Data Safety Monitoring Board or sponsor specified otherwise.

Being tested
Tacrolimus Modified Release (MR), Tacrolimus, cyclosporine microemulsion, mycophenolate mofetil
Keywords
De Novo Kidney Transplant, cyclosporine, Prograf®, mycophenolate mofetil, tacrolimus

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Tacrolimus Modified Release (MR)Drug

    Also called Advagraf, FK506, FKMR, MR4, Astagraf XL

    The target range for whole blood tacrolimus trough concentrations was 7 to 16 ng/mL for days 0 through 90, and 5 to 15 ng/mL thereafter.

  • TacrolimusDrug

    Also called Prograf, FK506

    The target range for whole blood tacrolimus trough concentrations was the recommended trough concentration range for Prograf: 7 to 16 ng/mL for days 0 through 90 and 5 to 15 ng/mL thereafter.

  • cyclosporine microemulsionDrug

    Also called Neoral, CsA

    The target range for whole blood cyclosporine trough concentrations was 125 to 400 ng/mL for days 0 through 90, and 100 to 300 ng/mL thereafter.

  • mycophenolate mofetilDrug

    Also called CellCept, MMF

    Oral

Study groups in NCT00064701
Study groupRoleWhat they receive
TacrolimusExperimentalParticipants received a first dose of tacrolimus between 0.075 and 0.10 mg/kg twice daily, orally prior to or within 48 hours of the completion of the transplant procedure, and subsequently as twice daily oral doses adjusted based on clinical evidence of efficacy, blood concentrations of tacrolimus and adverse events. Participants also received 1.0 g mycophenolate mofetil orally twice daily throughout the study.
Receives: Drug: Tacrolimus; Drug: mycophenolate mofetil
Tacrolimus Modified ReleaseActive comparatorParticipants received a first dose of tacrolimus modified release between 0.15 and 0.20 mg/kg/day, given as a single oral dose in the morning, prior to or within 48 hours following the completion of the transplant procedure, and subsequently as once daily oral doses adjusted based on clinical evidence of efficacy, blood concentrations of tacrolimus and adverse events. Participants also received 1.0 g mycophenolate mofetil orally twice daily throughout the study.
Receives: Drug: Tacrolimus Modified Release (MR); Drug: mycophenolate mofetil
CyclosporineActive comparatorParticipants received a first dose of cyclosporine between 4 to 5 mg/kg orally prior to or within 48 hours following the completion of the transplant procedure and subsequently as twice daily oral doses adjusted based on clinical evidence of efficacy, blood concentrations of tacrolimus and adverse events. Participants also received 1.0 g mycophenolate mofetil orally twice daily throughout the study.
Receives: Drug: cyclosporine microemulsion; Drug: mycophenolate mofetil

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Participants With Efficacy Failure

    Efficacy failure is defined as any participant who died, experienced a graft failure (permanent return to dialysis [> 30 days] or retransplant), had a biopsy-confirmed (Banff Grade ≥ I) acute rejection (BCAR), or was lost to follow-up.

    Biopsies were graded according to the 1997 Banff criteria:

    Borderline: No intimal arteritis present but foci of mild tubulitis; Grade I: Significant interstitial infiltration and foci of moderate to severe tubulitis; Grade II: Mild to severe intimal arteritis Grade III: Transmural arteritis and/or arterial fibrinoid change and necrosis of medial smooth muscle cells with accompanying lymphocytic infiltrate in vessel.

    Measured: one year

Secondary outcomes (14)
  1. Patient Survival at One Year

    Patient survival is defined as any participant who is known to be alive one year after the skin closure date. Participants who died or whose outcome was unknown at one year were considered to be non-survivors.

    Measured: One year

  2. Graft Survival at One Year

    Graft survival defined as any participant who did not meet the criteria for graft loss, where graft loss is defined as any re-transplant, permanent return to dialysis (> 30 days), patient death, or participant whose outcome at one year was unknown.

    Participants were only counted once regardless of how many criteria were met.

    Measured: One year

  3. Percentage of Participants With Biopsy Confirmed Acute Rejection at 6 and 12 Months

    Rejection episodes were confirmed by biopsy by the clinical site pathologist. Biopsies were graded according to the 1997 Banff criteria:

    Borderline: No intimal arteritis present but foci of mild tubulitis; Grade I: Significant interstitial infiltration and foci of moderate to severe tubulitis; Grade II: Mild to severe intimal arteritis Grade III: Transmural arteritis and/or arterial fibrinoid change and necrosis of medial smooth muscle cells with accompanying lymphocytic infiltrate in vessel.

    Acute rejection is defined as a grade ≥ I.

    Measured: Six months and 12 months

  4. Time to First Biopsy-confirmed Acute Rejection Episode

    Time to first biopsy-confirmed acute rejection episode defined as the number of days from skin closure (Day 0) to the date of biopsy. Rejection episodes were confirmed by biopsy by the clinical site pathologist and graded according to the 1997 Banff criteria:

    Borderline: No intimal arteritis present but foci of mild tubulitis; Grade I: Significant interstitial infiltration and foci of moderate to severe tubulitis; Grade II: Mild to severe intimal arteritis Grade III: Transmural arteritis and/or arterial fibrinoid change and necrosis of medial smooth muscle cells with accompanying lymphocytic infiltrate in vessel.

    Acute rejection is defined as a grade ≥ I.

    Measured: one year

  5. Number of Participants Requiring Anti-lymphocyte Antibody Therapy for Treatment of Rejection

    Rejection episodes were confirmed by biopsy by the clinical site pathologist. Participants with histologically-proven Banff Grade II or III rejection or participants with steroid-resistant rejection were treated with anti-lymphocyte antibody treatment according to institutional practice.

    Biopsies were graded according to the 1997 Banff criteria:

    Borderline: No intimal arteritis present but foci of mild tubulitis; Grade I: Significant interstitial infiltration and foci of moderate to severe tubulitis; Grade II: Mild to severe intimal arteritis Grade III: Transmural arteritis and/or arterial fibrinoid change and necrosis of medial smooth muscle cells with accompanying lymphocytic infiltrate in vessel.

    Measured: one year

  6. Severity of Acute Rejection

    Rejection episodes were confirmed by biopsy by the clinical site pathologist. Biopsies were graded according to the 1997 Banff criteria:

    Borderline: No intimal arteritis present but foci of mild tubulitis; Grade IA: Significant interstitial infiltration and foci of moderate tubulitis; Grade IB: Significant interstitial infiltration and foci of severe tubulitis; Grade IIA: Mild to moderate intimal arteritis in at least 1 arterial cross section Grade IIB: Severe intimal arteritis comprising >25% of the luminal area lost in at least 1 arterial cross section; Grade III: Transmural arteritis and/or arterial fibrinoid change and necrosis of medial smooth muscle cells with accompanying lymphocytic infiltrate in vessel.

    Measured: one year

  7. Number of Participants Experiencing Multiple Rejection Episodes

    This analysis includes rejection episodes that were either confirmed by biopsy by the clinical site pathologist or were clinically treated.

    Measured: one year

  8. Number of Participants With Clinically Treated Acute Rejection Episodes

    A clinically treated acute rejection episode was any biopsy-confirmed or suspected rejection episode that was treated with immunosuppressive therapy.

    Measured: one year

  9. Number of Participants With Treatment Failure

    Treatment failure was defined as the discontinuation of randomized study drug for any reason. Participants who met the definition of treatment failure were to be followed throughout the 12-month treatment period.

    Measured: one year

  10. Number of Participants Who Crossed Over Due to Treatment Failure

    Participants were allowed to cross over to an alternative primary immunosuppressive regimen (either to the tacrolimus or cyclosporine treatment arms) to address an adverse event which led to randomized study drug discontinuation or in the case of severe or refractory rejection. Crossover to the modified release tacrolimus treatment arm was not permitted.

    Measured: one year

  11. Change From Month 1 in Serum Creatinine at Month 6 and Month 12

    Renal function was assessed by the change from Month 1 in serum creatinine six months and 12 months after transplant.

    Measured: Month 1, Month 6, and Month 12

  12. Change From Month 1 in Creatinine Clearance at Month 6 and Month 12

    Renal function was assessed by creatinine clearance, calculated using the Cockcroft-Gault formula.

    Measured: Month 1, Month 6, and Month 12

  13. Kaplan-Meier Estimate of Patient Survival at the End of the Study

    Patient survival was defined as any participant who was alive at the end of the study. Patient survival was censored at the time of last follow-up contact.

    Measured: End of study (maximum time on study was 1,941 days).

  14. Kaplan-Meier Estimate of Graft Survival at the End of the Study

    Graft survival was defined as any participant who did not meet the definition of graft loss, where graft loss was any retransplant or the permanent return to dialysis (more than 30 days) or patient death.

    Graft survival was censored at the time of last follow-up contact.

    Measured: End of study (maximum time on study was 1,941 days).

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Jul 2003 (estimated)
  2. Study startJun 2003
  3. Primary completionMar 2005
  4. Study completionMar 2009

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
668 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00064701
Sponsor's protocol ID
02-0-158
Status last verified
Nov 2013
First submitted
10 Jul 2003
Last updated
5 Dec 2013
Data monitoring committee
Yes

Publications

  • Silva HT Jr, Yang HC, Abouljoud M, Kuo PC, Wisemandle K, Bhattacharya P, Dhadda S, Holman J, Fitzsimmons W, First MR. One-year results with extended-release tacrolimus/MMF, tacrolimus/MMF and cyclosporine/MMF in de novo kidney transplant recipients. Am J Transplant. 2007 Mar;7(3):595-608. doi: 10.1111/j.1600-6143.2007.01661.x. Epub 2007 Jan 11.

    PubMed 17217442

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Tacrolimus Modified Release (MR), Tacrolimus and cyclosporine microemulsion in people with Kidney Transplantation, run by Astellas Pharma Inc at 57 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 5 Dec 2013. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 57 sites in United States, Brazil, Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 26 Sep 2013). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Participants With Efficacy Failure (time frame: one year). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00064701, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Dec 2013.

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