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SEQUENTIAL THERAPY WITH TACROLIMUS AND RITUXIMAB IN PRIMARY MEMBRANOUS NEPHROPATHY

Conditions
Primary membranous nephropathy
Therapeutic area: Diseases [C] - Symptoms and general pathology [C23]
MedDRA version: 17.0Level: LLTClassification code 10027170Term: Membranous nephropathySystem Organ Class: 100000004857
Registration Number
EUCTR2013-000226-55-NL
Lead Sponsor
Fundacion Renal Iñigo Alvarez Toledo
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Authorised-recruitment may be ongoing or finished
Sex
All
Target Recruitment
175
Inclusion Criteria

- Patients are willing and are able to read and correctly understand the patient?s information sheet and give their consent for participation in the study (by correctly signing and dating the informed consent form document, which has been previously approved by an Ethics Committee/ International Review Board), before initiating any protocol-specific selection procedure
- Ability to understand study procedures and to comply with them for the entire length of the study.
- Age over 18 years.
- Biopsy-proven primary MN whitin the last two years. Patients with nephrotic syndrome relapse after remission (either spontaneous or induced by immunosupression) can be included without a new renal biopsy, provided that they meet all the other inclusion/exclusion criteria.
- Estimated GFR >= 45 ml/min/1.73m2.
- Nephrotic-range proteinuria (>4 g/day and remaining >50% of the baseline value) accompanied by hypoalbuminemia (<3 g/dL) during at least a six-month period before screening.
- Treatment with an ACEI or ARB for at least 2 months before screening, with a controlled blood pressure in at least last three months (target < 140/90 mmHg).
- Negative urine pregnancy test for female potentially fertile.
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 125
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 50

Exclusion Criteria

- Diagnosis of secondary causes of membranous nephropathy: diagnosis of type 1 or 2 diabetes mellitus, malignancy (cancer), systemic infections (which include viral, malaria, B and C hepatitis, leprosy and syphilis), systemic autoimmune diseases (e.g. Systemic Lupus Erythematosus; SLE), amyloidosis, or any other acute or chronic inflammatory disease.
- HIV infection.
- Moderate or severe liver disease (AST and ALT > 2.5x upper range limit and total bilirrubin > 1.5 x upper range limit).
- Patients are taking part in any other study with an investigational study and/or are receiving or have received treatment with another investigational drug or intervention (within the first month prior to the study).
- Suspected or known hypersensitivity, allergy and/or immunogenic reaction history of either rituximab, cyclosporine, tacrolimus, corticosteroids, CYC or any of their ingredients (which include excipients) and of any other drug from the same pharmacotherapeutic group (i.e. calcineurin inhibitors, specific monoclonal antibodies or alkylating agents).
- Previous treatment with corticosteroids or any other immunosuppressive drug in the two-year period before screening.
- Patients who were non responders to previous immunosuppressors.
- Women showing a positive pregnancy test or during lactation period or plans to become pregnant. Women not using contraceptive methods during the complete study.
- Inability or unwillingness of individual or legal guardian/representative to give written informed consent.
- Any other medical unstable, uncontrolled, or severe condition or any other relevant laboratory test finding which, at the investigator?s own discretion, could possibly increase the associated risk of the patient?s participation in the study.
- Current drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements

Study & Design

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