A Study Looking at Diabetes in Kidney Transplant Recipients Receiving Immunosuppressive Regimen With or Without Steroids

Kidney Transplantation Clinical Trial

— ADVANCE  

Official title:

Investigating New Onset Diabetes Mellitus in Kidney Transplant Recipients Receiving an Advagraf-Based Immunosuppressive Regimen With or Without Corticosteroids - A Multicenter, Two Arm, Randomized, Open Label Clinical Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01304836
• Other study ID #: PMR-EC-1211
• Secondary ID: 2010-019638-28
• Status: Completed
• Phase: Phase 4
• First received: February 3, 2011
• Last updated: August 31, 2017
• Start date: January 22, 2011
• Est. completion date: May 22, 2013

Study information

• Verified date: August 2017
• Source: Astellas Pharma Inc
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to focus on potential differences in the occurrence of new-onset Diabetes Mellitus (a glucose metabolism disorder) when two different regimens of immunosuppressive treatment are compared.

Description:

The primary objective of this study is to compare an Immunosuppressive regimen with 10 days of corticosteroids with a regimen with only an optional intra-op bolus of corticosteroids with regard to incidence of new onset Diabetes Mellitus as per the American Diabetic Association (ADA) criteria at any point up to 24 weeks after kidney transplantation.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 1166
• Est. completion date: May 22, 2013
• Est. primary completion date: May 22, 2013
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• End stage kidney disease and a suitable candidate for primary

kidney transplantation or re-transplantation (unless the graft was

lost from rejection within one year)

• Receiving a kidney transplant from a deceased or living (non

Human Leukocyte Antigen identical) donor with compatible AB0 blood type

• Female subjects of childbearing potential must have a

negative serum or urine pregnancy test at enrollment and must

agree to maintain highly effective birth control during the study.

A highly effective method of birth control is defined as those

which result in a low failure rate (CPMP/ICH/286/95 modified)

of less than 1% per year when used consistently and correctly

such as implants, injectables, combined oral contraceptives,

some IUDs, sexual abstinence or vasectomized partner

Exclusion Criteria:

• Receiving or having previously received an organ transplant

other than a kidney

• Cold ischemia time of the donor kidney > 30 hours

• Panel Reactive Antibody >20% (Highest level in 6 months prior to transplant)

• Previous renal transplant lost within one year for immunological reasons

• Receiving a graft from a non-heart-beating donor other than of Maastricht category 3 (withdrawal of support awaiting cardiac arrest)

• Significant liver disease, defined as having continuously

elevated SGPT/ALT and/or SGOT/AST and/or total bilirubin

levels = 2 times the upper value of the normal range of the

investigational site or is receiving a graft from a hepatitis C or B

positive donor

• Diagnosis of Diabetes Mellitus prior to transplantation (treated with prescribed medications or diet controlled) or where there is evidence of a previous positive Oral Glucose Tolerance Test (OGTT) in the patients medical history or previous diagnosis of gestational diabetes or pre-baseline HbA1C =6.5%

• Requiring initial sequential or parallel therapy with immunosuppressive antibody preparation(s).

• Requiring ongoing dosing with a systemic immunosuppressive drug prior to transplantation (e.g. for Lupus Disease, FSGN etc) other than minimal levels of immunosuppressant following failure of a previous transplantation without nephrectomy

• Where Physician considers long term steroid treatment is necessary for the prevention of recurrent auto immune mediated renal disease or if the subject requires ongoing dosing with corticosteroids during the study for any other condition

• Significant, uncontrolled concomitant infections and/or severe diarrhea, vomiting, active upper gastro-intestinal tract malabsorption or active peptic ulcer

• Pregnant woman or breast-feeding mother

• Subject or donor known to be HIV positive

• Known allergy or intolerance to tacrolimus, macrolide antibiotics, corticosteroids, basiliximab, mycophenolate mofetil or any of the product excipients

• Evidence of malignant disease within the last 5 years other than Basal Cell Carcinoma or Squamous Cell Carcinoma

• Currently participating in another clinical trial and/or has taken an investigational drug within 28 days prior to randomization

• Any form of substance abuse, psychiatric disorder or condition which, in the opinion of the investigator, may complicate communication with the investigator

• Unlikely to comply with the visits scheduled in the protocol

Related Conditions & MeSH terms

• Kidney Transplantation

Intervention

Drug:
• Advagraf
oral
• Mycophenolate Mofetil
oral
• Simulect
IV
• Corticosteroids
IV & oral

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Astellas Pharma Inc

Countries where clinical trial is conducted

Australia,  Belgium,  Colombia,  Czechia,  Estonia,  Finland,  France,  Germany,  Hungary,  Italy,  Korea, Republic of,  Latvia,  Lithuania,  Mexico,  Netherlands,  Norway,  Poland,  Portugal,  Romania,  Russian Federation,  Slovakia,  Spain,  Sweden,  Switzerland, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Diagnosis of new onset Diabetes Mellitus as per ADA criteria at any point up to 24 weeks after kidney transplantation		up to 6 months
Secondary	Efficacy failure using a composite endpoint consisting of graft loss, biopsy confirmed acute rejection or graft dysfunction		up to 6 months
Secondary	Positive Oral Glucose Tolerance Test		8 weeks
Secondary	Repeat Positive Oral Glucose Tolerance Test		6 months
Secondary	Renal function		at 6 months
Secondary	Acute Rejections		up to 6 months
Secondary	Biopsy confirmed acute rejections		up to 6 months
Secondary	Subject survival		up to 6 months
Secondary	Graft survival		up to 6 months
Secondary	Change from Baseline in HbA1C levels		Baseline, week 12 and week 24

External Links

•   Link to results on the Astellas Clinical Study Results website.