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Kidney TransplantationPhase 3NCT00514514

Study Investigating a Standard Regimen in de Novo Kidney Transplant Patients Versus a Calcineurin Inhibitor (CNI)-Free Regimen and a CNI-low Dose Regimen

A Phase 3 study testing Everolimus, Myfortic and Sandimmun Optoral in people with Kidney Transplantation, run by Novartis Pharmaceuticals at 18 sites in 2 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 renal function of immunosuppressive regimens with different relevance of the calcineurin inhibitor (CNI) cyclosporine: standard dose CNI, low dose CNI, CNI free in de novo kidney transplant patients after 12 months of therapy. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Kidney Transplantation
What is being tested?
Everolimus, Myfortic and Sandimmun Optoral
Could I receive a placebo?
No, everyone receives an active treatment
How many people
802 participants
Where
18 sitesin 2 countries
Study dates
Jul 2007to Jun 2015
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 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Males or females, aged 18 - 70 years
  • Recipients of de novo cadaveric, living unrelated or living related kidney transplants
  • Females capable of becoming pregnant must have a negative serum pregnancy test within 7 days prior to or at screening, and are required to practice an approved method of birth control for the duration of the study and for a period of 6 weeks following discontinuation of study medication, even where there has been a history of infertility.
  • Patients who are willing and able to participate in the study and from whom written informed consent has been obtained.

Who cannot join

  • More than one previous renal transplantation
  • Multi-organ recipients (e.g., kidney and pancreas) or previous transplant with any other organ, different from kidney
  • Patients receiving a kidney from a non-heart beating donor
  • Donor age: < 5 years or > 70 years
  • Graft loss due to immunological reasons in the first year after transplantation (in case of secondary transplantation)
  • Other protocol-defined inclusion/exclusion criteria may apply

Trial locations and contacts

18 sites in 2 countries.

18 sites in 2 countries

Germany17 sites
  • Novartis Investigative Site

    Aachen, 52074

  • Novartis Investigative Site

    Berlin, 10117

  • Novartis Investigative Site

    Berlin, 13353

  • Novartis Investigative Site

    Cologne, 51109

  • Novartis Investigative Site

    Erlangen, 91054

  • Novartis Investigative Site

    Essen, 45122

  • Novartis Investigative Site

    Frankfurt am Main, 60596

  • Novartis Investigative Site

    Freiburg im Breisgau, 79106

  • Novartis Investigative Site

    Hamburg, 20246

  • Novartis Investigative Site

    Hannover Muenden, 34346

  • Novartis Investigative Site

    Hanover, 30625

  • Novartis Investigative Site

    Heidelberg, 69120

  • Novartis Investigative Site

    Kaiserslautern, 67655

  • Novartis Investigative Site

    Lübeck, 23538

  • Novartis Investigative Site

    München, 81377

  • Novartis Investigative Site

    München, 81675

  • Novartis Investigative Site

    Regensburg, 93053

Other trials in Germany

Switzerland1 site
  • Novartis Investigative Site

    Bern, 3010

Other trials in Switzerland

About this study

Official title: Multi-center, Open-label, Prospective, Randomized, Parallel Group, Long-term Study Investigating a Standard Regimen in de Novo Kidney Transplant Patients Versus a CNI-free Regimen and a CNI-low Dose Regimen

The purpose of this study is to compare renal function of immunosuppressive regimens with different relevance of the calcineurin inhibitor (CNI) cyclosporine: standard dose CNI, low dose CNI, CNI free in de novo kidney transplant patients after 12 months of therapy.

Being tested
Everolimus, Myfortic, Sandimmun Optoral, Simulect®
Keywords
Everolimus, mycophenolate, CNI-free, kidney transplantation

What participants receive

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

  • EverolimusDrug

    Also called Certican

    Tablet containing 0.5 mg or 0.75 mg. Dosing schedule: Initially 1.5 mg/day, then based on blood level (5-10 ng/mL in CNI free, 3-8 ng/mL in CNI low regimen

  • MyforticDrug

    Also called Enteric Coated Mycophenolate Sodium

    1 tablet containing 180 mg or 360 mg

    Dosing schedule:

    Initially 1.5 mg/day, then based on blood level (5-10 ng/mL in CNI free, 3-8 ng/mL in CNI low regimen) According to blood level 1440 mg/day (2 x 720 mg), if tolerated. Dose reduction possible in case of side effects (min. dose at BL2 (Month 3): 720 mg/day)

  • Sandimmun OptoralDrug

    Also called Cyclosporine A

    1 capsule containing 10, 25, 50, or 100mg. Dosing: According to blood level

  • Simulect®Drug

    Also called Basiliximab

    Lyophilisate in vials with ampoules of sterile water for injection (5 ml). Dosing: 1 vial containing 20 mg lyophilisate. Dosing schedule: 2 x 20 mg to be applied as 10 sec. bolus injection, i.v. on Day 0 (2 h before transplant) and on Day 4

Study groups in NCT00514514
Study groupRoleWhat they receive
CNI standard regimenActive comparatorMyfortic, Sandimmun Optoral and corticosteroids
Receives: Drug: Myfortic; Drug: Sandimmun Optoral; Drug: Simulect®
CNI free regimenExperimentalCNI free regimen: comprising the following steps for switching treatment: Step 1 at BL2 + 1 day: Myfortic, Certican 1.5 mg, Sandimmun Optoral (50% of standard dose) and corticosteroids Step 2 at BL2 + 8 days: Myfortic, Certican 3 mg and corticosteroids
Receives: Drug: Everolimus; Drug: Myfortic; Drug: Sandimmun Optoral
CNI low regimenActive comparatorCNI low regimen: comprising the following steps for switching treatment: Step 1 at BL2 + 1 day: Certican 1.5 mg, Sandimmun Optoral and corticosteroids Step 2 at BL2 + 8 days: Certican 1.5 mg, Sandimmun Optoral (low dose) and corticosteroids
Receives: Drug: Everolimus; Drug: Sandimmun Optoral

What is being measured

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

  1. GFR Via Nankivell Method at Month 12 - CNI-Free vs Standard Regimen

    Demonstrate superiority of CNI-Free vs Standard Regimen in GFR using the Nankivell formula (GFR = 6.7 / Scr + BW / 4 - Surea / 2-100 / (height)² + C where where Scr is the serum creatinine concentration expressed in mmol/L, BW the body weight in kilograms, Surea the serum urea in mmol/L, height in m, and the constant C is 35 for male and 25 for female patients. The calculated GFR is expressed in mL/min per 1.73m², last observation carried forward (LOCF) was used for imputation of missing values, ANCOVA model, with treatment, center, donor type (deceased vs. living) as factors and BL2-value at V4/M3/BL2 as covariate. P-values are not adjusted

    Measured: From randomization at BL2 (Month 3) to Month 12 post-transplant

Secondary outcomes (12)
  1. GFR Via Nankivell Formula at Month 12 - All Regimens

    Change in GFR using the Nankivell formula (GFR = 6.7 / Scr + BW / 4 - Surea / 2-100 / (height)² + C where where Scr is the serum creatinine concentration expressed in mmol/L, BW the body weight in kilograms, Surea the serum urea in mmol/L, height in m, and the constant C is 35 for male and 25 for female patients. The calculated GFR is expressed in mL/min per 1.73m², last observation carried forward (LOCF) was used for imputation of missing values, ANCOVA model, with treatment, center, donor type (deceased vs. living) as factors and BL2-value at V4/M3/BL2 as covariate.

    Measured: From randomization at BL2 (Month 3) to Month 12 post-transplant

  2. GFR at Month 12 Utilizing Modification of Diet in Renal Disease (MDRD) Method

    Change in GFR (Modification of Diet in Renal Disease calculated using the -MDRD formulat:

    For men: GFR = 170 × (serum creatinine -0,999)×(age-0,176) x (urea nitrogen -0,17) × (albumin0,318) For women: GFR = 170 × (serum creatinine -0,999) × (age-0,176) × (urea nitrogen -0,17) x (albumin0,318) × 0.762 with urea nitrogen = urea / 2.144. ), last observation carried forward (LOCF) was used for imputation of missing values, ANCOVA model, with treatment, center, donor type (deceased vs. living) as factors and BL2-value at V4/M3/BL2 as covariate.

    Measured: From randomization at BL2 (Month 3) to Month 12 post-transplant

  3. GFR at Month 12 Utilizing Cockcroft-Gault Formula

    Cockcroft-Gault formula: For men: GFR= ((140-age) × body weight in kg)∕(72 x serum creatinine in mg∕dl)For women: GFR= (0.85×(140-age) × body weight in kg)∕(72 x serum creatinine in mg/dl), ), last observation carried forward (LOCF) was used for imputation of missing values, ANCOVA model

    Measured: From randomization at BL2 (Month 3) to Month 12 post-transplant

  4. Mean Change in Serum Creatinine From Month 3 to Month 12

    Change in venous blood serum creatinine. Last observation carried forward (LOCF) was used for imputation of missing values, ANCOVA model

    Measured: From randomization at BL2 (Month 3) to Month 12 post-transplant

  5. Efficacy Event Data From Baseline 2 (Month 3) to Month 6

    Efficacy events were: Biopsy-proven acute rejection (BPAR), graft loss, death, and treatment failure (defined as composite endpoint of BPAR, graft loss, death, loss to follow-up, discontinuation due to lack of efficacy or due to toxicity).

    Measured: From Baseline 2 (Month 3) to Month 6

  6. Efficacy Event Data Baseline 2 (Month 3) to Month 12

    Efficacy events were: Biopsy-proven acute rejection (BPAR), graft loss, death, and treatment failure (defined as composite endpoint of BPAR, graft loss, death, loss to follow-up, discontinuation due to lack of efficacy or due to toxicity).

    Measured: From Baseline 2 (Month 3) to Month 12

  7. Change From BL2 (Month 3) to Month 12 in Cardiovascular Risk (Framingham Score; 10-year Cardiovascular Risk)

    The Framingham Score (based on LDL cholesterol level) estimates the coronary heart disease risk (%) of developing one of the following coronary heart diseases: angina pectoris, myocardial infarction, or coronary disease death, over the course of 10 years.

    Measured: From Baseline 2 (Month 3) to Month 12

  8. GFR Calculated Via Nankivell Formula at Month 60

    Change in GFR using the Nankivell formula (GFR = 6.7 / Scr + BW / 4 - Surea / 2-100 / (height)² + C where where Scr is the serum creatinine concentration expressed in mmol/L, BW the body weight in kilograms, Surea the serum urea in mmol/L, height in m, and the constant C is 35 for male and 25 for female patients. The calculated GFR is expressed in mL/min per 1.73m², last observation carried forward (LOCF) was used for imputation of missing values, ANCOVA model, with treatment, center, donor type (deceased vs. living) as factors and BL2-value at V4/M3/BL2 as covariate.

    Measured: From randomization at BL2 (Month 3) to Month 60

  9. GFR at Month 60 Utilizing Cockcroft-Gault Formula

    Cockcroft-Gault formula: For men: GFR= ((140-age) × body weight in kg)∕(72 x serum creatinine in mg∕dl) For women: GFR= (0.85×(140-age) × body weight in kg)∕(72 x serum creatinine in mg/dl), ), last observation carried forward (LOCF) was used for imputation of missing values, ANCOVA model

    Measured: From randomization at BL2 (Month 3) to Month 60 post-transplant

  10. GFR at Month 60 Utilizing Modification of Diet in Renal Disease (MDRD) Method

    Change in GFR (Modification of Diet in Renal Disease calculated using the -MDRD formulat:

    For men: GFR = 170 × (serum creatinine -0,999)×(age-0,176) x (urea nitrogen -0,17) × (albumin0,318) For women: GFR = 170 × (serum creatinine -0,999) × (age-0,176) × (urea nitrogen -0,17) x (albumin0,318) × 0.762 with urea nitrogen = urea / 2.144. ), last observation carried forward (LOCF) was used for imputation of missing values, ANCOVA model, with treatment, center, donor type (deceased vs. living) as factors and BL2-value at V4/M3/BL2 as covariate.

    Measured: From randomization at BL2 (Month 3) to Month 60 post-transplant

  11. Mean Change in Serum Creatinine From Month 3 to Month 60

    Change in venous blood serum creatinine. Last observation carried forward (LOCF) was used for imputation of missing values, ANCOVA model

    Measured: From randomization at BL2 (Month 3) to Month 60 post-transplant

  12. Efficacy Event Data After Month 12 to Month 60

    Efficacy events were: Biopsy-proven acute rejection (BPAR), graft loss, death, and treatment failure (defined as composite endpoint of BPAR, graft loss, death, loss to follow-up, discontinuation due to lack of efficacy or due to toxicity).

    Measured: Events starting after Month 12

Timeline

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

  1. First posted10 Aug 2007 (estimated)
  2. Study startJul 2007
  3. Primary completionJun 2015
  4. Study completionJun 2015

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
802 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00514514
Sponsor's protocol ID
CRAD001ADE13
Other IDs
2006-007021-32
Status last verified
Nov 2016
First submitted
9 Aug 2007
Last updated
18 Jan 2017

Publications

  • Sommerer C, Witzke O, Lehner F, Arns W, Reinke P, Eisenberger U, Vogt B, Heller K, Jacobi J, Guba M, Stahl R, Hauser IA, Kliem V, Wuthrich RP, Muhlfeld A, Suwelack B, Duerr M, Paulus EM, Zeier M, Porstner M, Budde K; ZEUS and HERAKLES study investigators. Onset and progression of diabetes in kidney transplant patients receiving everolimus or cyclosporine therapy: an analysis of two randomized, multicenter trials. BMC Nephrol. 2018 Sep 19;19(1):237. doi: 10.1186/s12882-018-1031-1.

    PubMed 30231851
  • Budde K, Zeier M, Witzke O, Arns W, Lehner F, Guba M, Jacobi J, Kliem V, Reinke P, Hauser IA, Vogt B, Stahl R, Rath T, Duerr M, Paulus EM, May C, Porstner M, Sommerer C; HERAKLES Study Group. Everolimus with cyclosporine withdrawal or low-exposure cyclosporine in kidney transplantation from Month 3: a multicentre, randomized trial. Nephrol Dial Transplant. 2017 Jun 1;32(6):1060-1070. doi: 10.1093/ndt/gfx075.

    PubMed 28605781

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Everolimus, Myfortic and Sandimmun Optoral in people with Kidney Transplantation, run by Novartis Pharmaceuticals at 18 sites in 2 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 4 inclusion and 6 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 18 Jan 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 18 sites in Germany, Switzerland. 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 18 Jan 2017). 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?

GFR Via Nankivell Method at Month 12 - CNI-Free vs Standard Regimen (time frame: From randomization at BL2 (Month 3) to Month 12 post-transplant). 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 NCT00514514, which also lists 2 linked publications.

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 18 Jan 2017.

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