Safety and Efficacy Study of Voclosporin and Tacrolimus in Transplantation

Renal Transplantation Clinical Trial

— INSPIRE  

Official title:

A Phase III, Randomized, Multicentre, Open-Label, Concentration-Controlled, Safety and Efficacy Study of Voclosporin and Tacrolimus in Renal Transplantation

Clinical Trial Details — Status: Withdrawn

Administrative data

• NCT number: NCT01586845
• Other study ID #: ISA10-12
• Status: Withdrawn
• Phase: Phase 3
• First received: April 25, 2012
• Last updated: January 16, 2014
• Start date: March 2013
• Est. completion date: December 2015

Study information

• Verified date: January 2014
• Source: Aurinia Pharmaceuticals Inc.
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Food and Drug AdministrationCanada: Health CanadaEuropean Union: European Medicines Agency
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to demonstrate the efficacy and safety of voclosporin administered orally twice daily for the prevention of acute allograft rejection in recipients of a kidney transplant.

Description:

This will be a phase III, randomized, multicentre, open-label, concentration-controlled study in subjects undergoing a first or second renal transplant, with induction immunosuppression with an IL-2 receptor antibody (basiliximab), mycophenolate mofetil and steroids.

The primary endpoint to assess non-inferiority will be efficacy failure at the end of Month 12 after randomization.

Recruitment information / eligibility

• Status: Withdrawn
• Enrollment: 0
• Est. completion date: December 2015
• Est. primary completion date: December 2015
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years to 65 Years

Eligibility

Inclusion Criteria:

• Males and females aged 18-65 years inclusive at the time of screening.

• Recipients of a first or second deceased donor or living donor renal transplant.

Exclusion Criteria:

• Subjects presently receiving immunosuppression for a previously failed transplant.

• Females who are pregnant or nursing or planning to become pregnant during the course of the study, or 3 months after last dose of study medication.

• Sexually-active women of child-bearing potential (including those who are < 1 year postmenopausal) and sexually-active men who are not practicing a highly effective method of birth control.

• Subjects receiving a HLA identical living related transplant.

• Subjects wth a positive T-cell lymphocytotoxic cross match, or positive flow T and B cell cross match.

• Subjects undergoing primary transplant with a current PRA (or CPRA) = 25%.

• Subjects who experienced graft loss within 1 year of transplant.

• Subjects receiving a kidney from a ABO incompatible donor.

• Subjects receiving a kidney from a deceased donor positive for HIV, HBV, HCV or tuberculosis.

• Subjects receiving a a kidney from a non-heart beating donor.

• Subjects receiving paired (en bloc or paired) kidney transplants.

• Transplantation of multiple grafts (e.g. kidney and pancreas).

• Subjects receiving a kidney with a cold ischemia time > 30 hours.

• Subjects receiving any transplanted organ other than a kidney.

• Recipients of a bone marrow or stem cell transplant.

• Any systemic infections requiring continued therapy at the time of entry into this study. (Prophylaxis against CMV and/or PCP infection will be permitted).

• Subjects with positive results of the following serological tests: HIV I Ab, hepatitis B virus (HBV) surface antigen (HBsAg), anti-hepatitis B core antibody (HBcAb), and the anti-hepatitis C virus antibody (HCV Ab). Negative results for these serological tests must be documented within 12 months prior to randomization.

• Subjects with active tuberculosis (Tb) requiring treatment within the last 3 years. Subjects with a known positive purified protein derivative (PPD) test are not eligible unless they have completed treatment for latent Tb and have a negative chest X-ray at time of enrollment. PPD testing must have been done within the last 12 months, and a positive result is defined as = 10 mm induration, a Heaf score of >1 in non-Bacille Calmette-Guérin (BCG) immunized subjects, or >2 in BCG immunized subjects.

• Subjects with a current malignancy or history of malignancy within 5 years or a history of lymphoma at any time. Subjects can be enrolled with a history of squamous or basal cell carcinoma that has been surgically excised or removed with curettage and electrodessication.

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Prevention

Related Conditions & MeSH terms

• Renal Transplantation

Intervention

Drug:
• voclosporin
Initial dose of voclosporin 0.8 mg/kg BID, then concentration controlled
• tacrolimus
tacrolimus as per labeled dose

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Aurinia Pharmaceuticals Inc.

References & Publications (3)

Bîrsan T, Dambrin C, Freitag DG, Yatscoff RW, Morris RE. The novel calcineurin inhibitor ISA247: a more potent immunosuppressant than cyclosporine in vitro. Transpl Int. 2005 May;17(12):767-71. Epub 2005 Apr 13. — View Citation

Busque S, Cantarovich M, Mulgaonkar S, Gaston R, Gaber AO, Mayo PR, Ling S, Huizinga RB, Meier-Kriesche HU; PROMISE Investigators. The PROMISE study: a phase 2b multicenter study of voclosporin (ISA247) versus tacrolimus in de novo kidney transplantation. Am J Transplant. 2011 Dec;11(12):2675-84. doi: 10.1111/j.1600-6143.2011.03763.x. Epub 2011 Sep 22. — View Citation

Kuglstatter A, Mueller F, Kusznir E, Gsell B, Stihle M, Thoma R, Benz J, Aspeslet L, Freitag D, Hennig M. Structural basis for the cyclophilin A binding affinity and immunosuppressive potency of E-ISA247 (voclosporin). Acta Crystallogr D Biol Crystallogr. 2011 Feb;67(Pt 2):119-23. doi: 10.1107/S0907444910051905. Epub 2011 Jan 15. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	The primary endpoint to assess non-inferiority will be efficacy failure at the end of Month 12 after randomization.	FDA Efficacy Failure is biopsy-proven acute rejection (BPAR, Banff Grade = 1A as determined by the central pathologist) where subjects who experience death, graft loss (return to dialysis for >30 days, allograft nephrectomy or re-transplantation), or lost to follow-up are included in the analysis as treatment failures. EMA Efficacy Failure includes any subject experiencing any of the following: biopsy-proven acute rejection (BPAR, Banff Grade = 1A as determined by the central pathologist), death, graft loss or graft dysfunction (Cockcroft-Gault CrCl < 40 mL/min).	1 Year post-Transplant	No