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Complication of TransplantPhase 4NCT02014103

Conversion From Brand to Generic Tacrolimus in High Risk Transplant Recipients

A Phase 4 study testing Prograf, Tacrolimus, Sandoz and Tacrolimus, Reddy Laboratory in people with Complication of Transplant, run by University of Cincinnati at 1 site in United States.

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 prospective study will compare the relative bioavailability at steady-state pharmacokinetics of 6 tacrolimus formulations in a prospective, 6-way cross-over study including CYP3A5 expressors (n=30) and non-expressor (n=30) transplant patients. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Complication of Transplant
What is being tested?
Prograf, Tacrolimus, Sandoz and Tacrolimus, Reddy Laboratory
Could I receive a placebo?
No, everyone receives an active treatment
How many people
71 participants
Where
1 siteUnited States
Study dates
Mar 2015to Aug 2015
Phase
Phase 4
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 18 years or older
  • Able to participate and willing to give written informed consent/ assent/ consent by parent or legal guardian and to comply with the study visits and restrictions.
  • Subject who has received a primary or secondary transplant.
  • Subject who is at least 6 months post-transplant and on a stable dose of tacrolimus as defined by physician, one tacrolimus trough level within the physician defined target range within past 6 months and one additional trough level during the screening period within 30% of the physician defined target range.
  • BMI less than or equal to 40.

Who cannot join

  • Evidence of any acute rejection
  • Subjects who require dialysis within 6 months prior to study entry
  • Recipients of multiple organ transplants
  • Subjects who have tested positive for HBsAG or HIV, or who are recipients of organ from donors who are known to be HBsAG or HIV positive. Virology screening at the time of transplant.
  • HepC positive subjects with liver biopsy proven recurrent disease considered relevant by physician oversight.
  • Subjects with any severe medical condition requiring acute or chronic treatment that in the investigator's opinion would interfere with study participation
Show all 20Show fewer
  • History of malignancy, treated or untreated, with the past 2 years with the exception of carcinoma in situ or excised basal cell carcinoma, or hepatocellular carcinoma prior to transplant.
  • GFR ≤ 35 ml/min measured as estimated using the MDRD4 formula
  • Subjects with AST, ALT, total bilirubin ≥ 3 X ULN or other evidence of severe liver disease
  • Subjects with white blood cell (WBC) count ≤2,000/ mm3 or with thrombocytopenia (platelet count ≤ 75,000/ mm3), with an absolute neutrophil count of ≤ 1,500/ mm3 or hemoglobin <8g/dL)
  • Subjects with clinically significant infections, requiring therapy, which, in the investigator's opinion, would interfere with the objectives of the study
  • Other mental or physical conditions which in the investigator's opinion, are considered clinically significant
  • Presence of intractable immunosuppressant complications or side effects resulting in dose adjustment of tacrolimus
  • Subjects who have been exposed to an investigational therapy within 30 days prior to enrollment or 5 half-lives of the investigational product, whichever is greater.
  • An anticipated change in the immunosuppressive regimen during subject participation other than that required by the protocol
  • Subject with severe GI disturbance or diarrhea which could interfere with tacrolimus absorption
  • Severe diabetic gastroparesis
  • Initiation of any medications that could interfere with tacrolimus blood levels, including OTC medications, herbal supplements, grapefruit or grapefruit juice.
  • Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive BhCG laboratory test (> 5 mIU/mL)
  • Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they are: 1) women whose career, lifestyle, or sexual orientation precludes intercourse with a male partner; 2)women whose partners have been sterilized by vasectomy or 3)using a highly effective method of birth control (i.e. one that results in a less than 1% per year failure rate when used consistently and correctly, such as implants, injectables, combined oral contraceptives, and some intrauterine devices (IUDs); periodic abstinence (e.g. calendar, ovulation, symptothermal, post-ovulation methods) is not acceptable.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Cincinnati Medical Center

    Cincinnati, Ohio, 45267

Other trials in United States

About this study

Official title: Evaluation of Clinical and Safety Outcomes Associated With Conversion From Brand-Name to Generic Tacrolimus Products in High Risk Transplant Recipients

The prospective study will compare the relative bioavailability at steady-state pharmacokinetics of 6 tacrolimus formulations in a prospective, 6-way cross-over study including CYP3A5 expressors (n=30) and non-expressor (n=30) transplant patients.

Read the detailed description

Comparison of the relative bioavailability and steady-state pharmacokinetics of 6 tacrolimus formulations in a prospective, 6-way cross-over study including CYP3A5 expressors (n=30) and non-expressor (n=30) transplant patients. Six tacrolimus formulations will be tested and each patient will receive each formulation once. As we proposed to test bioequivalence in the steady-state, patients will receive the test formulations for one week prior to pharmacokinetic evaluation. The pharmacokinetic evaluation will incorporate limited sampling strategies with a focus on fully characterizing the Cmax out to hour 4 post dose. Subsequent PK sampling and trough blood concentrations will be monitored on a daily basis using dried blood spots that the study subjects will collect by themselves at home. It will be critical that the patients are adherent to their test medication to ensure that they have reached steady state. This will be monitored using test diaries, pill counts and MEMS caps (Medication Event Monitoring System (MEMS), AARDEX Corp, Palo Alto, CA. Bioequivalence will be tested using average bioequivalence metrics. A combination of limited sampling strategy and dry spot analysis in combination with population pharmacokinetic modeling will be utilized to fully characterize the PK profile of these formulations.

Being tested
Prograf, Tacrolimus, Sandoz, Tacrolimus, Reddy Laboratory, Tacrolimus, Mylan, Tacrolimus, Accord
Keywords
bioequivalence, tacrolimus, transplant, CYP3A5 expressors/non expressors

What participants receive

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

  • PrografDrug

    Administration of each formulation will be determined by sequence.

  • Tacrolimus, SandozDrug

    Also called Sandoz tacrolimus

    Administration of each formulation will be determined by sequence.

  • Tacrolimus, Reddy LaboratoryDrug

    Also called Reddy's Laboratory tacrolimus

    Administration of each formulation will be determined by sequence.

  • Tacrolimus, MylanDrug

    Also called Mylan tacrolimus

    Administration of each formulation will be determined by sequence.

  • Tacrolimus, AccordDrug

    Also called Accord Healthcare tacrolimus

    Administration of each formulation will be determined by sequence.

  • Tacrolimus, Pancea Biotech LimitedDrug

    Also called Panacea Biotech Limited tacrolimus

    Administration of each formulation will be determined by sequence.

Study groups in NCT02014103
Study groupRoleWhat they receive
Sequence 1Active comparatorPatients will be randomized to a sequence of administration of the various 6 tacrolimus formulations. Sequence 1: Formulation Sandoz, Panacea, Accord, Mylan, Dr. Reddy's, Astellas Patients will be receiving the same tacrolimus dose identified at baseline for each formulation.
Receives: Drug: Prograf; Drug: Tacrolimus, Sandoz; Drug: Tacrolimus, Reddy Laboratory; Drug: Tacrolimus, Mylan; Drug: Tacrolimus, Accord; Drug: Tacrolimus, Pancea Biotech Limited
Sequence 2Active comparatorPatients will be randomized to a sequence of administration of the various 6 tacrolimus formulations. Sequence 2: Formulation Accord, Sandoz, Dr. Reddy's, Panacea, Astellas, Mylan Patients will be receiving the same tacrolimus dose identified at baseline for each formulation.
Receives: Drug: Prograf; Drug: Tacrolimus, Sandoz; Drug: Tacrolimus, Reddy Laboratory; Drug: Tacrolimus, Mylan; Drug: Tacrolimus, Accord; Drug: Tacrolimus, Pancea Biotech Limited
Sequence 3Active comparatorPatients will be randomized to a sequence of administration of the various 6 tacrolimus formulations. Sequence 3: Formulation Dr. Reddys, Accord, Astellas, Sandoz, Mylan, Panacea Patients will be receiving the same tacrolimus dose identified at baseline for each formulation.
Receives: Drug: Prograf; Drug: Tacrolimus, Sandoz; Drug: Tacrolimus, Reddy Laboratory; Drug: Tacrolimus, Mylan; Drug: Tacrolimus, Accord; Drug: Tacrolimus, Pancea Biotech Limited
Sequence 4Active comparatorPatients will be randomized to a sequence of administration of the various 6 tacrolimus formulations. Sequence 4: Formulation Astellas, Dr. Reddy's, Mylan, Accord, Panacea, Sandoz Patients will be receiving the same tacrolimus dose identified at baseline for each formulation.
Receives: Drug: Prograf; Drug: Tacrolimus, Sandoz; Drug: Tacrolimus, Reddy Laboratory; Drug: Tacrolimus, Mylan; Drug: Tacrolimus, Accord; Drug: Tacrolimus, Pancea Biotech Limited
Sequence 5Active comparatorPatients will be randomized to a sequence of administration of the various 6 tacrolimus formulations. Sequence 5: Formulation Mylan, Astellas, Panacea, Dr. Reddy's, Sandoz, Accord Patients will be receiving the same tacrolimus dose identified at baseline for each formulation.
Receives: Drug: Prograf; Drug: Tacrolimus, Sandoz; Drug: Tacrolimus, Reddy Laboratory; Drug: Tacrolimus, Mylan; Drug: Tacrolimus, Accord; Drug: Tacrolimus, Pancea Biotech Limited
Sequence 6Active comparatorPatients will be randomized to a sequence of administration of the various 6 tacrolimus formulations. Sequence 6: Formulation Panacea, Mylan, Sandoz, Astellas, Accord, Dr. Reddy's Patients will be receiving the same tacrolimus dose identified at baseline for each formulation.
Receives: Drug: Prograf; Drug: Tacrolimus, Sandoz; Drug: Tacrolimus, Reddy Laboratory; Drug: Tacrolimus, Mylan; Drug: Tacrolimus, Accord; Drug: Tacrolimus, Pancea Biotech Limited

What is being measured

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

  1. Compare AUC 0-12hr of Each Tacrolimus Formulation in Expressor and Non Expressor Transplant Recipients

    Report the geometric mean and 95% confidence interval for AUC 0-12hr (ng*hr/ml) for each formulation in expressor and non expressor transplant recipients

    Measured: Whole blood samples were collected immediately prior to dosing, at 1, 1.5, 1.75, 2, 2.5, 3 and 4 hours following dosing. Subjects were then instructed to performed fingersticks using dried blood spot cards at 8 and 12 hours post dose.

  2. Compare Cmax of Each Tacrolimus Formulation in Expressor and Non Expressor Transplant Recipients

    Report the geometric mean and 95% confidence interval for Cmax (ng/ml) for each formulation in expressor and non expressor transplant recipients

    Measured: Whole blood samples were collected immediately prior to dosing, at 1, 1.5, 1.75, 2, 2.5, 3 and 4 hours following dosing. Subjects were then instructed to performed fingersticks using dried blood spot cards at 8 and 12 hours post dose.

Secondary outcomes (1)
  1. To Compare the Safety and Efficacy of Each Tacrolimus Formulation in Stable Transplant Subjects

    Conduct safety lab testing specific to transplanted organ function and clinical assessments for adverse events.

    Measured: Assessed at baseline and weekly for 6 weeks at each pharmacokinetic profile

Timeline

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

  1. First posted18 Dec 2013 (estimated)
  2. Study startMar 2015
  3. Primary completionAug 2015
  4. Study completionAug 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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
None (open label)
Enrolment
71 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02014103
Sponsor's protocol ID
13-223-SOL-00102
Other IDs
FDA
Status last verified
Oct 2024
First submitted
21 Oct 2013
Last updated
15 Oct 2024
Data monitoring committee
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Prograf, Tacrolimus, Sandoz and Tacrolimus, Reddy Laboratory in people with Complication of Transplant, run by University of Cincinnati at 1 site in United States.

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 5 inclusion and 20 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 15 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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 15 Oct 2024). 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?

Compare AUC 0-12hr of Each Tacrolimus Formulation in Expressor and Non Expressor Transplant Recipients (time frame: Whole blood samples were collected immediately prior to dosing, at 1, 1.5, 1.75, 2, 2.5, 3 and 4 hours following dosing. Subjects were then instructed to performed fingersticks using dried blood spot cards at 8 and 12 hours post dose.). The study lists 2 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 15 Oct 2024.

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