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Kidney Pancreas TransplantationPhase 2/3NCT03769298

CIRTEN-Simultaneous Pancreas-Kidney Transplant Recipients

A Phase 2/3 study testing Envarsus XR in people with Kidney Pancreas Transplantation, run by University of Wisconsin, Madison at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This is a Phase II/III, Single-center, Prospective, Open-label, Single Arm Study of 20 Simultaneous Kidney Pancreas recipients who received a transplant at least 3 months, but no more than 5 years prior, with a history of tremors following transplantation. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Kidney Pancreas Transplantation
What is being tested?
Envarsus XR
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteUnited States
Study dates
27 Feb 2019to Dec 2027
Phase
Phase 2/3
Are there results?
Not yet: the study is under way

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

  • Adult, 18-70 years of age
  • Participant must be able to understand and provide consent
  • History of Diabetes Type 1 or Insulin-Dependent Diabetes Type 2 with Chronic Kidney Disease (CKD)
  • Recipient of a Simultaneous Pancreas Kidney (SPK) transplant, 3- 60 months prior to screening, per Principal Investigator's discretion.
  • Have a history of tremors following transplantation
  • Stable pancreas allograft function as evidenced by no requirement of exogenous insulin or oral anti-diabetic agents and stable pancreatic enzymes
Show all 9Show fewer
  • Stable kidney allograft function
  • Currently taking Immediate-Release (IR) tacrolimus
  • Women of child-bearing potential (WOCP) must have a negative pregnancy test at the time of study entry

Who cannot join

  • Currently maintained on an extended-release tacrolimus immunosuppressive regimen
  • Previous history of tremors prior to transplantation
  • Solitary pancreas transplant recipients
  • History of solid organ transplant other than a kidney or pancreas
  • Uncontrolled concomitant infection at the discretion of the investigator
  • Presence of Donor Specific Antibodies

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Jon S Odorico, MD contact

6082639903

jon@surgery.wisc.edu

United States1 site, 1 recruiting
  • University of Wisconsin

    Madison, Wisconsin, 53792

    Jon S Odorico, MD, 608-263-4768, jon@surgery.wisc.edu

    Recruiting

Other trials in United States

About this study

Official title: Conversion From Immediate Release Tacrolimus to Envarsus XR® in Simultaneous Pancreas-Kidney Recipients: Assessment of Functional, Safety and Quality of Life Outcomes (CIRTEN SPK)

This is a Phase II/III, Single-center, Prospective, Open-label, Single Arm Study of 20 Simultaneous Kidney Pancreas recipients who received a transplant at least 3 months, but no more than 5 years prior, with a history of tremors following transplantation.

Read the detailed description

Accrual objective: Enrollment of 2-3 participants per month and all participants within an 18 month period. With minimum of 1 year follow-up post-conversion, we anticipate the entire study would be completed within 2 ½ years.

Study design: This is a Phase II/III, Single-center, Prospective, Open-label, Single Arm Study of 20 Simultaneous Kidney Pancreas recipients who received a transplant at least 3 months, but no more than 5 years prior, with a history of tremors following transplantation.

Study duration: There will be a minimum of 1 year follow-up post-conversion, and it is expected that the entire study would be completed within 2 ½ years.

Study aims:

  • Determine if EnvarsusXR® reduces tremor severity compared to IR tacrolimus
  • Determine if EnvarsusXR® improves renal function or glycemic control compared to IR tacrolimus
  • Compare the efficacy of EnvarsusXR® by comparing the outcomes (patient, pancreas graft and kidney graft survival) of patients treated with Envarsus XR to those of contemporary and historical controls at our center treated with IR tacrolimus, with the goal of showing non-inferiority.
  • Compare insulin resistance and insulin sensitivity by defined measures post conversion between T1D and T2D recipients.

Primary Endpoint:

  1. Improvement in patient and physician-assessed degree of tremors based on FTM (Fahn-Tolosa-Martin Tremor Rating Scale) and QUEST (Quality of Life in Essential Tremor Questionnaire) scoring tools
  2. Scores on Quality of Life in Essential Tremor and Modified Transplant Symptom Occurrence and Symptom Distress Scale (MTSOSD) Questionnaires

Secondary Endpoints:

  1. Renal function - eGFR (estimated glomerular filtration rate) and serum creatinine
  2. Glycemic control - AUC by MMTT, fasting BG, fasting C-peptide, calculated C-peptide/glucose ratio, calculated 20/(fasting Cpeptide x fasting BG) as a measure of insulin resistance, calculated HOMA-IR (fasting insulin x fasting BG)/22.5 as a measure of insulin sensitivity/resistance, calculated BETA-2 score to sensitive estimate beta cell function, and HbA1c.
  3. Tacrolimus and Mycophenolate doses as well as TAC and MPA levels
Being tested
Envarsus XR
Keywords
Tremors
Medical subject headings
Tremor

What participants receive

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

  • Envarsus XRDrug

    Also called tacrolimus

    The Envarsus XR® drug will be administered to study participants once daily, orally. The dosage can be 0.75 mg, 1 mg or 4 mg. The tacrolimus whole blood trough concentrations will be monitored and titrate Envarsus XR® dosage to achieve target whole blood trough concentration.

Study groups in NCT03769298
Study groupRoleWhat they receive
Envarsus XRExperimentalEnvarsus XR (extended release) will be administered orally, once-daily, for 6 months.
Receives: Drug: Envarsus XR

What is being measured

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

  1. Change in patient and physician-assessed degree of tremors based on Fahn-Tolosa-Marin Tremor Rating Scale

    FTM-TRS will be used as a tool for essential tremor scoring. (0: no tremor, 1: barely perceptible tremor, 2: < 2 cm, 3: 2-4 cm, and 4: > 4 cm).

    Measured: Over 6 months

  2. Change in patient and physician-assessed degree of tremors based on Quality of Life in Essential Tremor (QUEST) Questionnaire

    QUEST Questionnaire, a scoring tool will be used to measure the quality of life among patients with Essential Tremor. It consists of 30 items which are rated on a five-point scale (score 0-4), corresponding to the frequency (never, rarely, sometimes, frequently, always) with which tremor was perceived to affect a function or to be associated with various feelings and attitudes. A few items (e.g. 'I had to quit my job because of tremor') could only be answered at the extremes (yes/no; true/false), and these were scored either 0 or 4.

    Measured: Over 6 months

  3. Scores on Quality of Life in Essential Tremor Questionnaires

    Use QUEST (Quality of Life in Essential Tremor Questionnaire) scoring tool

    Measured: Over 6 months

  4. Scores on Modified Transplant Symptom Occurrence and Symptom Distress Scale (MTSOSD) Questionnaire

    MTSOSD Questionnaire scores will be used to assess the presence and distress of side effects associated with the use of immunosuppressive drugs after transplantation.

    Measured: Over 6 months

Secondary outcomes (6)
  1. Renal function by eGFR (estimated Glomerular Filtration Rate)

    Change between baseline and post-conversion as measured by eGFR

    Measured: Over 6 months

  2. Renal function by serum creatinine

    Change between baseline and post-conversion as measured by serum creatinine

    Measured: Over 6 months

  3. Comparable or improved glycemic control as measured by mixed meal tolerance test

    Change between baseline and post-conversion

    Measured: Over 6 months

  4. Comparable or improved glycemic control as measured by HbA1c

    Change between baseline and post-conversion

    Measured: Over 6 months

  5. Tacrolimus doses and levels

    Change between baseline and post-conversion

    Measured: Over 6 months

  6. Mycophenolate doses and levels

    Change between baseline and post-conversion

    Measured: Over 6 months

Timeline

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

  1. First posted7 Dec 2018
  2. Study start27 Feb 2019
  3. Primary completionDec 2027 (estimated)
  4. Study completionDec 2027 (estimated)

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 2/3
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
This is a Phase II/III, Single-center, Prospective, Open-label, Single Arm Study of 20 Simultaneous Kidney Pancreas recipients who received a transplant at least 3 months, but no more than 2 years prior, with a history of tremors following transplantation.
Masking
None (open label)
Enrolment
20 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03769298
Sponsor's protocol ID
2018-0821
Other IDs
A539742, SMPH/SURGERY/TRANSPLANT, Protocol Version 3/10/2025
Status last verified
Oct 2026
First submitted
16 Nov 2018
Last updated
29 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Langone A, Steinberg SM, Gedaly R, Chan LK, Shah T, Sethi KD, Nigro V, Morgan JC; STRATO Investigators. Switching STudy of Kidney TRansplant PAtients with Tremor to LCP-TacrO (STRATO): an open-label, multicenter, prospective phase 3b study. Clin Transplant. 2015 Sep;29(9):796-805. doi: 10.1111/ctr.12581. Epub 2015 Aug 6.

    PubMed 26113208
  • Baraldo M. Meltdose Tacrolimus Pharmacokinetics. Transplant Proc. 2016 Mar;48(2):420-3. doi: 10.1016/j.transproceed.2016.02.002.

    PubMed 27109969
  • Kerstenetzky L, Descourouez JL, Jorgenson MR, Felix DC, Mandelbrot DA, Redfield RR, Odorico JS. A Single-Center Experience With Tacrolimus LCP (Envarsus XR) in Pancreas Transplant Recipients. Ann Pharmacother. 2018 Apr;52(4):392-396. doi: 10.1177/1060028017749076. Epub 2017 Dec 14. No abstract available.

    PubMed 29241340
  • Stacy MA, Elble RJ, Ondo WG, Wu SC, Hulihan J; TRS study group. Assessment of interrater and intrarater reliability of the Fahn-Tolosa-Marin Tremor Rating Scale in essential tremor. Mov Disord. 2007 Apr 30;22(6):833-8. doi: 10.1002/mds.21412.

    PubMed 17343274
  • Ohkura T, Shiochi H, Fujioka Y, Sumi K, Yamamoto N, Matsuzawa K, Izawa S, Kinoshita H, Ohkura H, Kato M, Taniguchi S, Yamamoto K. 20/(fasting C-peptide x fasting plasma glucose) is a simple and effective index of insulin resistance in patients with type 2 diabetes mellitus: a preliminary report. Cardiovasc Diabetol. 2013 Jan 22;12:21. doi: 10.1186/1475-2840-12-21.

    PubMed 23339473
  • Gutch M, Kumar S, Razi SM, Gupta KK, Gupta A. Assessment of insulin sensitivity/resistance. Indian J Endocrinol Metab. 2015 Jan-Feb;19(1):160-4. doi: 10.4103/2230-8210.146874.

    PubMed 25593845
  • Forbes S, Oram RA, Smith A, Lam A, Olateju T, Imes S, Malcolm AJ, Shapiro AM, Senior PA. Validation of the BETA-2 Score: An Improved Tool to Estimate Beta Cell Function After Clinical Islet Transplantation Using a Single Fasting Blood Sample. Am J Transplant. 2016 Sep;16(9):2704-13. doi: 10.1111/ajt.13807. Epub 2016 Apr 21.

    PubMed 27017888

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing Envarsus XR in people with Kidney Pancreas Transplantation, run by University of Wisconsin, Madison 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 9 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: looking for participants now, as of the sponsor's last update on 29 Oct 2026. 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 combined 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.

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?

This study is still under way. Results are not available in the source record yet.

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

Contact Jon S Odorico, MD (6082639903, jon@surgery.wisc.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in patient and physician-assessed degree of tremors based on Fahn-Tolosa-Marin Tremor Rating Scale (time frame: Over 6 months). The study lists 4 primary outcomes in all. 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 NCT03769298, which also lists 7 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 29 Oct 2026.

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