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BK Virus InfectionNCT02758288

BK Virus Post-Kidney Transplant: New Practice Versus Traditional Approach

An observational study of BK Virus Infection and BK Virus Nephropathy, run by Loma Linda University at 1 site in United States.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

The investigator's aim in this study is to evaluate the impact of a new standard of care protocol for the treatment of BK viremia and nephropathy (BKVAN), which includes switching from Tacrolimus to equivalent dose of Cyclosporine in patients who have been diagnosed with BK viremia or BKVAN based on their viral load… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
BK Virus Infection, BK Virus Nephropathy
What is being tested?
New Protocol - BK viremia or BK virus nephropathy and Standard Protocol - BK viremia or BK virus nephropathy
How many people
0 participants
Where
1 siteUnited States
Study dates
Sep 2015to Jul 2022
Phase
Observational
Are there results?
None posted in the registry

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

Study population: Adult kidney recipients who are determined to have BK viremia post-transplant

Who may be able to join

  • Age ≥ 18 years
  • Recipient of kidney or combined kidney and pancreas
  • BK viremia confirmed with blood PCR test with viral load over 500
  • BK virus nephropathy confirmed by kidney biopsy

Who cannot join

  • Recipient of combined organ transplant except kidney and pancreases
  • Patient age < 18 years
  • If patient does not consent for kidney biopsy
  • Currently on treatment for acute rejection
  • Patients with HIV, Hep C or Hep B infection
  • Patients who are on other immunosuppression beside our standard regimen which includes Prograf, cellcept / Myfortic and prednisone

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Loma Linda University Medical Center

    Loma Linda, California, 92354

Other trials in United States

About this study

Official title: BK Viremia and BK Virus Nephropathy Post Kidney Transplant Comparison of New Practices With Traditional Approach: A Combined Retrospective Chart Review and Prospective Observational Study

The investigator's aim in this study is to evaluate the impact of a new standard of care protocol for the treatment of BK viremia and nephropathy (BKVAN), which includes switching from Tacrolimus to equivalent dose of Cyclosporine in patients who have been diagnosed with BK viremia or BKVAN based on their viral load, overall graft function (estimated glomerular filtration rate), acute rejection, and rate of graft loss due to rejection or BKVAN.

Read the detailed description

This study will be a combined retrospective chart review and prospective observational study. This will be a single center project that will take place at Loma Linda University Transplant Institute. All adult kidney recipients who are determined to have BK viremia with a BK PCR viral load over 500 copy post-transplant and meet the inclusion criteria but no exclusion criteria will be enrolled and observed per study protocol.

All kidney transplant recipients are routinely assessed for BK virus nephropathy and viremia post transplant as part of their standard care. Patients with BK viremia or BK virus nephropathy will have adjustments in their immunosuppressive medication based on current guidelines and recommendations which include reduction in immunosuppression, treatment with medications with antiviral activity (Cidofovir, Ciprofloxacin, Leflunomide, IVIG) or switching from a Tacrolimus (Prograf)-based regimen to a Cyclosporine-based regimen. Retrospectively, the investigator will collect data on patients who have been diagnosed with BK viremia or BK virus nephropathy and have had such a management in past 66 months (from 1/1/2010 till 06/30/2015). Prospectively, the investigator will enroll and collect data on patients who will be treated for BK viremia or BK virus nephropathy.

As standard of care, all kidney transplant recipients will be seen routinely on weekly-biweekly basis in post-transplant clinic for up to 3 months then every 3 months for up to a year and yearly thereafter. All kidney transplant recipients will be monitored for BK viremia by having blood PCR tested on a monthly basis at 1, 2, 3, 6, and 12 months after transplant. Also, all patients post-kidney transplant will be tested for BK viremia if there is an acute rise in their creatinine.

Being tested
New Protocol - BK viremia or BK virus nephropathy, Standard Protocol - BK viremia or BK virus nephropathy
Keywords
Kidney transplant, BK Viremia, BK Nephropathy

What participants receive

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

  • New Protocol - BK viremia or BK virus nephropathyOther

    Data collected prospectively that will follow new clinical practice guidelines that were developed by Loma Linda Nephrology group with collaboration with Transplant surgeons to improve care of patients complicated with BK viremia or BK virus nephropathy.

  • Standard Protocol - BK viremia or BK virus nephropathyOther

    Data collected retrospectively that followed standard clinical practice guidelines that were developed by Loma Linda Nephrology group with collaboration with Transplant surgeons to improve care of patients complicated with BK viremia or BK virus nephropathy.

Study groups in NCT02758288
Study groupRoleWhat they receive
New Protocol to treat BK viremia or BKVANAdult kidney recipients who are determined to have BK viremia with a BK PCR viral load over 500 copy post-transplant treated with a new treatment protocol, prospective data collection approach
Receives: Other: New Protocol - BK viremia or BK virus nephropathy
Standard Protocol to treat BK viremia or BKVANAdult kidney recipients who are determined to have BK viremia with a BK PCR viral load over 500 copy post-transplant treated with a traditional standard of care protocol, retrospective data collection approach
Receives: Other: Standard Protocol - BK viremia or BK virus nephropathy

What is being measured

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

  1. Kidney function to compare effectiveness of a new care protocol for the treatment of BK viremia (BK PCR viral load over 500 copy) and BKVAN (confirmed by kidney biopsy) with a similar cohort treated with traditional methods.

    Measured: 12 months

Secondary outcomes (4)
  1. Rate of BK nephropathy in both treatment groups confirmed by kidney biopsy

    Measured: 24 months

  2. Rate of acute cellular or humoral rejection in both treatment groups confirmed by kidney biopsy

    Measured: 24 months

  3. Rate of graft loss in both group as determined by elevated creatinine level and kidney biopsy

    Measured: 24 months

  4. Estimated glomerular filtration rate (eGFR) at start of the study (0) , 3, 6, 12 and 24 months between two groups

    Measured: 3, 6, 12, 24 months

Timeline

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

  1. First posted2 May 2016 (estimated)
  2. Study startSep 2015
  3. Primary completionJul 2021 (estimated)
  4. Study completionJul 2022 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Other
Time perspective
Prospective
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02758288
Sponsor's protocol ID
5150278
Status last verified
Oct 2020
First submitted
2 Mar 2016
Last updated
5 Oct 2020
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Publications

  • Tonelli M, Wiebe N, Knoll G, Bello A, Browne S, Jadhav D, Klarenbach S, Gill J. Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes. Am J Transplant. 2011 Oct;11(10):2093-109. doi: 10.1111/j.1600-6143.2011.03686.x. Epub 2011 Aug 30.

    PubMed 21883901
  • Port FK, Wolfe RA, Mauger EA, Berling DP, Jiang K. Comparison of survival probabilities for dialysis patients vs cadaveric renal transplant recipients. JAMA. 1993 Sep 15;270(11):1339-43.

    PubMed 8360969
  • Schnuelle P, Lorenz D, Trede M, Van Der Woude FJ. Impact of renal cadaveric transplantation on survival in end-stage renal failure: evidence for reduced mortality risk compared with hemodialysis during long-term follow-up. J Am Soc Nephrol. 1998 Nov;9(11):2135-41. doi: 10.1681/ASN.V9112135.

    PubMed 9808102
  • Padgett BL, Walker DL. Prevalence of antibodies in human sera against JC virus, an isolate from a case of progressive multifocal leukoencephalopathy. J Infect Dis. 1973 Apr;127(4):467-70. doi: 10.1093/infdis/127.4.467. No abstract available.

    PubMed 4571704
  • Bressollette-Bodin C, Coste-Burel M, Hourmant M, Sebille V, Andre-Garnier E, Imbert-Marcille BM. A prospective longitudinal study of BK virus infection in 104 renal transplant recipients. Am J Transplant. 2005 Aug;5(8):1926-33. doi: 10.1111/j.1600-6143.2005.00934.x.

    PubMed 15996241
  • Ginevri F, Azzi A, Hirsch HH, Basso S, Fontana I, Cioni M, Bodaghi S, Salotti V, Rinieri A, Botti G, Perfumo F, Locatelli F, Comoli P. Prospective monitoring of polyomavirus BK replication and impact of pre-emptive intervention in pediatric kidney recipients. Am J Transplant. 2007 Dec;7(12):2727-35. doi: 10.1111/j.1600-6143.2007.01984.x. Epub 2007 Oct 1.

    PubMed 17908275
  • Brennan DC, Agha I, Bohl DL, Schnitzler MA, Hardinger KL, Lockwood M, Torrence S, Schuessler R, Roby T, Gaudreault-Keener M, Storch GA. Incidence of BK with tacrolimus versus cyclosporine and impact of preemptive immunosuppression reduction. Am J Transplant. 2005 Mar;5(3):582-94. doi: 10.1111/j.1600-6143.2005.00742.x.

    PubMed 15707414
  • Kadambi PV, Josephson MA, Williams J, Corey L, Jerome KR, Meehan SM, Limaye AP. Treatment of refractory BK virus-associated nephropathy with cidofovir. Am J Transplant. 2003 Feb;3(2):186-91. doi: 10.1034/j.1600-6143.2003.30202.x.

    PubMed 12614296
  • Moscarelli L, Caroti L, Antognoli G, Zanazzi M, Di Maria L, Carta P, Minetti E. Everolimus leads to a lower risk of BKV viremia than mycophenolic acid in de novo renal transplantation patients: a single-center experience. Clin Transplant. 2013 Jul-Aug;27(4):546-54. doi: 10.1111/ctr.12151. Epub 2013 Jun 13.

    PubMed 23758330
  • Araya CE, Garin EH, Neiberger RE, Dharnidharka VR. Leflunomide therapy for BK virus allograft nephropathy in pediatric and young adult kidney transplant recipients. Pediatr Transplant. 2010 Feb;14(1):145-50. doi: 10.1111/j.1399-3046.2009.01183.x. Epub 2009 Mar 31.

    PubMed 19344337
  • Williams JW, Javaid B, Kadambi PV, Gillen D, Harland R, Thistlewaite JR, Garfinkel M, Foster P, Atwood W, Millis JM, Meehan SM, Josephson MA. Leflunomide for polyomavirus type BK nephropathy. N Engl J Med. 2005 Mar 17;352(11):1157-8. doi: 10.1056/NEJM200503173521125. No abstract available.

    PubMed 15784677
  • Leung AY, Chan MT, Yuen KY, Cheng VC, Chan KH, Wong CL, Liang R, Lie AK, Kwong YL. Ciprofloxacin decreased polyoma BK virus load in patients who underwent allogeneic hematopoietic stem cell transplantation. Clin Infect Dis. 2005 Feb 15;40(4):528-37. doi: 10.1086/427291. Epub 2005 Jan 21.

    PubMed 15712075
  • Randhawa PS. Anti-BK virus activity of ciprofloxacin and related antibiotics. Clin Infect Dis. 2005 Nov 1;41(9):1366-7; author reply 1367. doi: 10.1086/497080. No abstract available.

    PubMed 16206122
  • Hirsch HH, Vincenti F, Friman S, Tuncer M, Citterio F, Wiecek A, Scheuermann EH, Klinger M, Russ G, Pescovitz MD, Prestele H. Polyomavirus BK replication in de novo kidney transplant patients receiving tacrolimus or cyclosporine: a prospective, randomized, multicenter study. Am J Transplant. 2013 Jan;13(1):136-45. doi: 10.1111/j.1600-6143.2012.04320.x. Epub 2012 Nov 8.

    PubMed 23137180
  • Renner FC, Dietrich H, Bulut N, Celik D, Freitag E, Gaertner N, Karoui S, Mark J, Raatz C, Weimer R, Feustel A. The risk of polyomavirus-associated graft nephropathy is increased by a combined suppression of CD8 and CD4 cell-dependent immune effects. Transplant Proc. 2013 May;45(4):1608-10. doi: 10.1016/j.transproceed.2013.01.026.

    PubMed 23726630

Questions about this trial

What is this clinical trial studying?

An observational study of BK Virus Infection and BK Virus Nephropathy, run by Loma Linda University 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 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: withdrawn, as of the sponsor's last update on 5 Oct 2020. 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.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

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?

Kidney function to compare effectiveness of a new care protocol for the treatment of BK viremia (BK PCR viral load over 500 copy) and BKVAN (confirmed by kidney biopsy) with a similar cohort treated with traditional methods. (time frame: 12 months). 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 NCT02758288, which also lists 47 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 5 Oct 2020; AzTrials last refreshed its copy on 6 Nov 2026.

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