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A study to measure how safe and successful Clazakizumab is in preventing kidney transplant rejectio

Phase 1
Conditions
Chronic Active Antibody-Mediated Rejection (CABMR) in Kidney Transplant Recipients
Therapeutic area: Diseases [C] - Nutritional and Metabolic Diseases [C18]
Registration Number
EUCTR2018-003682-34-ES
Lead Sponsor
Vitaeris Inc.
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
350
Inclusion Criteria

1. Age 18-70 years.
2. Living donor/deceased donor kidney transplant recipients =6 months from time of transplant.
3. Diagnosis of CABMR (according to Banff 2015 diagnostic criteria) to include all of the following:
• Biopsy-proven CABMR (i.e., chronic glomerulopathy (cg) >0) with/without C4d staining. Repeat biopsy to be performed if previous biopsy is not within 6 months of the start of the screening period. The local pathologist’s diagnosis will be reviewed by a central pathologist to confirm eligibility for entry into the study. Subjects without evidence of chronic tissue injury on light microscopy but who have glomerular basement membrane double contours on electron microscopy (cg1a) are eligible.
• Positive for human leukocyte antigen (HLA) DSA (using single-antigen bead-based assays) post-transplant. Local laboratory DSA results will be reviewed by the central HLA reviewer to confirm eligibility for entry into the study. A single antigen bead MFI >1,000 will be considered positive. If presence of HLA DSA is confirmed within 6 months of the start of the screening period, the test does not need to be repeated for eligibility. • Note: Treatments for ABMR (including CABMR) or TCMR are not allowed within 3 months of the start of screening (see Exclusion Criterion 3). If a subject has received one of these treatments at any
time prior, a repeat biopsy and repeat DSA must be performed after halting / completing treatment (to show continuing CABMR).
4. Written informed consent obtained from subject (or legally Written informed consent obtained from subject (or legally acceptable representative) before any trial-related procedures.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 310
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 40

Exclusion Criteria

1. Participant is unable or unwilling to comply with study procedures in the opinion of the Investigator.
2. Multi-organ transplant recipient or cell transplant (islet, bone marrow, stem cell) recipient.
3. Treatment for ABMR (including CABMR) or TCMR within 3 months of the start of screening.
4. Received T cell depleting agents (e.g., alemtuzumab, anti-thymocyte globulin) within 3 months of the start of the screening.
5. Treatment with mTOR inhibitors within 4 weeks of the start of the screening.
6. Biopsy showing pure TCMR or advanced interstitial fibrosis (ci3), advanced tubular atrophy (ct3), vascular fibrous intimal thickening (cv3) or other significant causes of renal dysfunction (e.g., polyoma BK virus (BKV) nephropathy, glomerulonephritis).
7. Impaired renal function due to disorders in the transplanted allograft (e.g., renal artery stenosis, hydronephrosis).
8. eGFR <25 mL/min/1.73 m^2 or >65 mL/min/1.73 m^2
9. Nephrotic range proteinuria defined as spot urine protein creatinine ratio (UPCR) =3,000 mg/g (=300 mg/mmol) or spot urine albumin creatinine ratio (UACR) =2,200 mg/g (=220 mg/mmol). If spot UPCR or UACR is above defined limits, repeat test on separate day to confirm ineligibility (or collect 24-hour urine to confirm nephrotic range proteinuria (=3.0 g/day)).
10. Pregnant, breastfeeding, or unwillingness to practice highly effective birth control during the study and for 5 months after last dose of investigational drug.
11. History of anaphylaxis.
12. Abnormal liver function tests (LFTs) (alanine aminotransferase (ALT)/aspartate aminotransferase (AST)/bilirubin >1.5 x upper limit of normal) or other significant liver disease.
13. History of active tuberculosis (TB).
14. History of latent TB (e.g., positive QuantiFERON-TB test) without history of active TB unless subject has completed a full course of prophylactic treatment.
15. History of human immunodeficiency virus (HIV) infection or positive for HIV.
16. Seropositive for hepatitis B surface antigen (HBsAg).
17. Hepatitis C virus (HCV) RNA positive.
18. Known Epstein-Barr virus (EBV) mismatch: donor seropositive, recipient seronegative.
19. History of gastrointestinal perforation, diverticular disease or diverticulitis, or inflammatory bowel disease.
20. Neutropenia (<1,000/mm^3) or thrombocytopenia (<50,000/mm^3).
21. Active infections requiring systemic antimicrobial agents and unresolved prior to screening.
22. History of or current invasive fungal infection or other opportunistic infection, including (but not limited to) the following: a nontuberculous mycobacterial infection, aspergillosis, pneumocystosis, and toxoplasmosis.
23. Active viral infections such as BKV, CMV, or EBV based on polymerase chain reaction (PCR) testing.
24. Current or recent (within 3 months) participation in an interventional trial.
25. Administration of a live vaccine within 6 weeks of the start of screening, including but not limited to the following:
• Adenovirus
• Measles, mumps, and rubella
• Oral polio
• Oral typhoid
• Rotavirus
• Varicella zoster
• Yellow fever
26. History of alcohol or illicit substance (including marijuana) abuse.
27. Present or previous (within 3 years) malignancy except for basal cell carcinoma, fully excised squamous cell carcinoma of the skin, or non-recurrent (within 5 years) cervical carcinoma in-situ.
28. Presence of a condition or abnormality (i.e., clinically significant endocrine, autoimmune, metabolic, neurological, psychiatric/psychological, renal, ga

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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