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Kidney TransplantationPhase 2NCT01292226

A Study of the Correlation Between Pharmacokinetic and Pharmacodynamic Parameters of CellCept (Mycophenolate Mofetil).

A Phase 2 study testing mycophenolate mofetil, antibody induction and Cyclosporine in people with Kidney Transplantation, run by Hoffmann-La Roche at 7 sites in Italy.

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

This study will evaluate the correlation between the pharmacokinetic and pharmacodynamic parameters of CellCept in patients undergoing primary kidney transplantation, in order to assess the impact on clinical outcome and the risks of acute rejection. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Kidney Transplantation
What is being tested?
mycophenolate mofetil, antibody induction and Cyclosporine
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
45 participants
Where
7 sitesItaly
Study dates
Dec 2006to Sep 2008
Phase
Phase 2
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 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adult patients, 18 to 65 years of age
  • Patients undergoing primary kidney transplantation

Who cannot join

  • Recipients of multiple organ transplants
  • Prior therapy with CellCept
  • Presence or history of malignancies, except for successfully treated basal or squamous cell carcinoma of the skin
  • Active peptic ulcer or active serious digestive system disease that may affect the absorption of CellCept

Trial locations and contacts

7 sites in 1 country.

7 sites in 1 country

Italy7 sites
  • Study site

    Bari, 70124

  • Study site

    Brescia, 25123

  • Study site

    Coppito, 67100

  • Study site

    Naples, 80131

  • Study site

    Roma, 00168

  • Study site

    Torino, 10126

  • Study site

    Verona, 37126

Other trials in Italy

About this study

Official title: Relationships Between Pharmacokinetic and Pharmacodynamic Strategies for Assessment of the Risks for Acute Rejection and Side Effects of Mycophenolate Mofetil

This study will evaluate the correlation between the pharmacokinetic and pharmacodynamic parameters of CellCept in patients undergoing primary kidney transplantation, in order to assess the impact on clinical outcome and the risks of acute rejection. All patients will receive oral CellCept, 1g twice daily, and pharmacokinetic and pharmacodynamic parameters will be measured at weeks 2, 4, 12 and 24. The anticipated time on study treatment is 24 weeks.

Being tested
mycophenolate mofetil, antibody induction, Cyclosporine, corticosteroid

What participants receive

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

  • mycophenolate mofetilDrug

    Also called CellCept

    1 g PO BID for 24 weeks

  • antibody inductionDrug

    According to manufacturer recommendation

  • CyclosporineDrug

    According to manufacturer recommendation

  • corticosteroidDrug

    According to manufacturer recommendation

Study groups in NCT01292226
Study groupRoleWhat they receive
Mycophenolate Mofetil MonotherapyExperimentalParticipants received an initial dose of mycophenolate mofetil (MMF), 1 gram (g), orally (PO), twice per day (BID), within 5 days of transplant for 24 weeks. Participants also received concurrent antibody induction, cyclosporine, and corticosteroids as needed according to center's practice.
Receives: Drug: mycophenolate mofetil; Drug: antibody induction; Drug: Cyclosporine; Drug: corticosteroid

What is being measured

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

  1. Percentage of Participants With Acute Rejection

    Diagnosis of acute rejection was suspected in any participant with an increase in serum creatinine greater than or equal to (≥) 25 percent (%). All suspected acute rejections were confirmed by biopsy. The start date of acute rejection was identified as the date of biopsy.

    Measured: Day 1, Weeks 2, 4, 12, 24, and 28

  2. Time to Rejection

    The mean time, in days, from the date of enrollment to date of biopsy confirming acute rejection.

    Measured: Day 1, Weeks 2, 4, 12, 24, and 28

  3. Percentage of Participants With Biopsy-Proven Acute Rejection (BPAR)

    BPAR was defined according to 1997 Banff Criteria as a biopsy Banff grade of IA, IB, IIA, IIB, or III. Grade IA was defined as significant interstitial infiltration with greater than (>)25% of parenchyma affected, and foci of moderate tubulitis with >4 mononuclear cells per tubular cross section or group of 10 tubular cells. Grade IB was defined as significant interstitial infiltration with >25% parenchyma affected, and foci of severe tubulitis with >10% mononuclear cells per tubular cross section or group of 10 tubular cells. Grade IIA was defined as mild to moderate intimal arteritis. Grade IIB was defined as severe intimal arteritis comprising >25% of the luminal area. Grade III was defined as transmural arteritis and/or arterial fibrinoid changes and necrosis of medial smooth muscle cells.

    Measured: Day 1, Weeks 2, 4, 12, 24, and 28

Secondary outcomes (25)
  1. Percentage of Participants With Graft Loss

    An allograft was presumed to be lost if a participant started dialysis and was not able to subsequently be removed from dialysis.

    Measured: Day 1, Weeks 2, 4, 12, 24, and 28

  2. Percentage of Participants Surviving

    Measured: Day 1, Weeks 2, 4, 12, 24, and 28

  3. Total Mycophenolate Acid (MPA) by Visit and Timepoint

    Drug quantification of total MPA (micrograms per milliliter [mcg/mL]) in the plasma was measured at time (T) = 0 minutes (min), 40 mins, and 120 mins.

    Measured: Weeks 2, 4, 12, 24, and 28 (Safety Follow-Up Visit), and any unscheduled visits

  4. Free MPA (mcg/mL) by Visit

    Drug quantification of free MPA in the plasma was measured at T = 0, 40, and 120 mins.

    Measured: Weeks 2, 4, 12, 24, safety follow-up (Week 28), and any unscheduled visits

  5. MPA Area Under the Concentration - Time Curve From Time 0 to 12 Hours (AUC0-12) (mcg/mL) by Visit

    The AUC0-12 of MPA was estimated on the validated limited sampling strategy, AUC (milligrams multiplied by height over liter [mg.h/L]) = 7.182 + 4.607 multiplied by (*) concentration at 0 minutes (C0)+ 0.998 * the concentration at 40 minutes (C0.67) + 2.149 * the concentration at 120 minutes (C2).

    Measured: Predose and 40 minutes and 2 hours postdose at Weeks 2, 4, 12, and 24, and at the Safety follow-up (Week 28)

  6. Inosine MonoPhosphate DeHydrogenase (IMPDH) Activity by Visit and Timepoint

    IMPDH activity in peripheral blood mononuclear cells (PBMCs) was measured at 2 timepoints per visit, 0 and 120 minutes and presented in enzyme units. The unit of measure of enzyme activity is "U". One U is defined as the amount of the enzyme that produces a certain amount of enzymatic activity that is, the amount that catalyzes the conversion of 1 micro mole of substrate per minute under pre-specified conditions (temperature, pH).

    Measured: BL and Weeks 2, 4, 12, and 24, and safety follow-up (Week 28) and any unscheduled visits

  7. IMPDH Expression I by Visit and Timepoint

    IMPDH I gene expression was measured by real time polymerase chain reaction (QRT-PCR) based cytokine measurement of PBMCs at 2 timepoints per visit, 0 and 120 minutes and expressed as number of messenger ribonucleic acid (mRNA) copies per cell (copies/cell).

    Measured: BL and Weeks 2, 4, 12, and 24, and safety follow-up (Week 28) and any unscheduled visits

  8. IMPDH Expression II by Visit and Timepoint

    IMPDH II gene expression was measured by QRT-PCR based cytokine measurement of PBMCs at 2 timepoints per visit, 0 and 120 minutes and expressed as number of mRNA copies/cell.

    Measured: BL and Weeks 2, 4, 12, and 24, and safety follow-up (Week 28) and any unscheduled visits

  9. Interleukin 8 (IL-8) Expression by Visit and Timepoint

    IL-8 gene expression was measured by QRT-PCR based cytokine measurement of PBMCs at 2 timepoints per visit, 0 and 120 minutes and expressed as number of mRNA copies/cell.

    Measured: BL and Weeks 2, 4, 12, and 24, and safety follow-up (Week 28) and any unscheduled visits

  10. Tumor Necrosis Factor (TNF) Expression by Visit and Timepoint

    TNF gene expression was measured by QRT-PCR based cytokine measurement of PBMCs at 2 timepoints per visit, 0 and 120 minutes and expressed as number of mRNA copies/cell.

    Measured: BL and Weeks 2, 4, 12, and 24, and safety follow-up (Week 28) and any unscheduled visits

  11. Percentage of Participants With Infection

    Infections were graded according to the World Health Organization (WHO) worst grade observed.

    Measured: BL and Weeks 2, 4, 12, 24, and 28 (Safety Follow-Up)

  12. Percentage of Participants With Gastrointestinal Toxicities

    Gastrointestinal adverse events (AEs) according to WHO worst grade observed.

    Measured: BL and Weeks 2, 4, 12, 24, and 28 (Safety Follow-up Visit)

  13. Percentage of Participants With Hematologic Toxicity

    Hematological toxicities graded according to WHO worst grade observed (Grade 1=mild, Grade 2=moderate).

    Measured: BL and Weeks 2, 4, 12, 24, and 28 (Safety Follow-Up)

  14. Spearman's Rank Correlation Coefficient Between MPA Levels and IMPDH Activity

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

    Measured: BL and Weeks 2, 4, 12, and 24

  15. Spearman's Rank Correlation Coefficient Between IMPDH I Expression and MPA Levels

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

    Measured: BL and Weeks 2, 4, 12, and 24

  16. Spearman's Rank Correlation Coefficient Between IMPDH I Expression and Free Fraction

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

    Measured: BL and Weeks 2, 4, 12, and 24

  17. Spearman's Rank Correlation Coefficient Between IMPDH II Expression and MPA Levels

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

    Measured: BL and Weeks 2, 4, 12, and 24

  18. Spearman's Rank Correlation Coefficient Between IMPDH II Expression and Free Fraction

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

    Measured: BL and Weeks 2, 4, 12, and 24

  19. Spearman's Rank Correlation Coefficient Between IMPDH Inhibition and Risk of Acute Rejection

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

    Measured: BL and Weeks 2, 4, 12, and 24

  20. Spearman's Rank Correlation Coefficient Between IMPDH Expression and Risk of Infection

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

    Measured: BL and Weeks 2, 4, 12, and 24

  21. Spearman's Rank Correlation Coefficient Between IMPDH Expression and Risk of Hematologic Toxicity

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

    Measured: BL and Weeks 2, 4, 12, and 24

  22. Spearman's Rank Correlation Coefficient Between IMPDH Expression and Risk of Gastrointestinal Toxicity

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

    Measured: BL and Weeks 2, 4, 12, and 24

  23. Spearman's Rank Correlation Coefficient Between MPA Levels and Risk of Infection

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

    Measured: BL and Weeks 2, 4, 12, and 24

  24. Spearman's Rank Correlation Coefficient Between MPA Levels and Risk of Hematologic Toxicity

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

    Measured: BL and Weeks 2, 4, 12, and 24

  25. Spearman's Rank Correlation Coefficient Between MPA Levels and Risk of Gastrointestinal Toxicity

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

    Measured: BL and Weeks 2, 4, 12, and 24

Timeline

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

  1. First posted9 Feb 2011 (estimated)
  2. Study startDec 2006
  3. Primary completionSep 2008
  4. Study completionSep 2008

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 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
45 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01292226
Sponsor's protocol ID
ML19835
Status last verified
Apr 2016
First submitted
3 Feb 2011
Last updated
12 May 2016

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing mycophenolate mofetil, antibody induction and Cyclosporine in people with Kidney Transplantation, run by Hoffmann-La Roche at 7 sites in Italy.

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 4 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 12 May 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites in Italy. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 2 Mar 2015). 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 Acute Rejection (time frame: Day 1, Weeks 2, 4, 12, 24, and 28). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 12 May 2016.

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