Efficacy and Safety of Everolimus in Liver Transplant Recipients of Living Donor Liver Transplants
- Conditions
- Adults with end stage liver disease patients requiring a liver transplant.MedDRA version: 19.0Level: LLTClassification code 10024716Term: Liver transplantationSystem Organ Class: 100000004865Therapeutic area: Body processes [G] - Immune system processes [G12]
- Registration Number
- EUCTR2010-024527-25-DE
- Lead Sponsor
- ovartis Pharma Services AG
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ot Recruiting
- Sex
- All
- Target Recruitment
- 280
1. Written informed consent must be obtained before any assessment is performed.
2. Subject aged =18 years of a primary, orthotopic liver allograft, from a living donor.
3. Subject negative for HIV (result obtained 6 months prior to screening is acceptable).
4. Subject HCV and HBV status must be known.
5. Subject was initiated on TAC-based immunosuppressive regimen with steroids and other immunosuppression, as per protocol.
6. Allograft condition acceptable at time of randomization as defined by AST, ALT, total
Bilirubin levels =3 times ULN.
7. Abbreviated MDRD eGFR = 30 mL/min/1.73m2 (based on most recent value available by the time of randomization).
8. Subject must be able to take oral medication at time of randomization.
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 270
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 10
1. Subjects transplanted for acute liver failure (does not apply to acute on chronic liver failure).
2. HCV negative subjects receiving transplant from HCV positive donor.
3. Subjects receiving multiple solid organ (including multiple liver lobes/segments) or islet cell tissue transplants, or have previously received organ or tissue transplant.
4. Subjects receiving ABO incompatible allograft.
5. MELD-score > 35 within 1 mo prior to transplantation.
6. Use of immunosuppressive or antibody induction agents not specified in the protocol.
7. History of malignancy of any organ system (except HCC or localized skin BCC), treated or untreated, within the past 5 y, regardless of evidence of local recurrence or metastases.
8. HCC with extrahepatic spread or macrovascular invasion.
9. Subjects with history of coagulopathy or medical condition requiring long-term anticoagulation precluding liver biopsy after transplantation (low dose aspirin treatment or interruption of chronic anticoagulant is allowed).
10. Any surgical, medical, mental conditions, other than the current transplantation, which, in the opinion of the investigator, might interfere with the objectives of the study.
11. Pregnant or nursing (lactating) women (pregnancy defined as state of a female after conception and until the termination of gestation, confirmed by a positive hCG test).
12. Women of child-bearing potential, unless using highly effective contraception methods during dosing and for 2 wks after the last dose of study medication. Highly effective contraception methods are described in the protocol.
13. History of hypersensitivity to any of the study drugs or to drugs with similar chemical class, or to any of the excipients.
14. Use of other investigational drugs at screening, or within 30 d or 5 half-lives of screening, whichever is longer.
15. Subjects who are requiring the administration of strongly interacting drugs of the CYP450 3A4 system. Please refer to Appendices 2 and 3.
16. Full-size, split, auxiliary, dual and or/domino liver allografts.
17. Small-for-size allograft, defined as allograft to recipient weight ratio (GRWR) of < 0.7% or a liver volume < 30% of standard estimated volume.
18. HIV positive donors.
19. HBsAg positive donors.
20. Donor with hepatic steatosis > 30%.
21. Any post-transplant history of thrombosis, occlusion or stent placement in any major hepatic arteries, hepatic veins, portal vein or inferior vena cava at any time during the run-in period prior to randomization. For subjects without such history Doppler ultrasound, angiographic procedure or angio MRI confirming absence of any graft vascular thrombosis or occlusion must be done prior to randomization.
22. Subjects with a confirmed spot urine protein/creatinine ratio that indicates = 1.0 g/24 hrs of proteinuria and that cannot be explained by other effects.
23. Subjects with severe hypercholesterolemia (>350 mg/dL; >9.1 mmol/L) or hypertriglyceridemia (>500 mg/dL; >5.6 mmol/L) at randomization. Subjects with controlled hyperlipidemia are acceptable at the time of randomization.
24. Subjects with platelet count < 30,000/mm3.
25. Subjects with an absolute neutrophil count of < 1,000/mm³ or white blood cell count of < 2,000/mm³.
26. Subjects with systemic infection requiring active use of IV antibiotics.
27. Subjects requiring life support measures such as ventilation, dialysis, vasopressor agents.
28. Subjects
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Main Objective: To demonstrate comparable efficacy as measured by the composite efficacy failure of tBPAR, graft loss or death with EVR in combination with rTAC compared to standard exposure TAC, at 12 months post-transplantation, in living donor liver transplant recipients.;Secondary Objective: As the key secondary objective to demonstrate at least comparable renal function, measured by change in eGFR from randomization to Month 12 post-Tx, with EVR in combination with rTAC, compared to standard exposure TAC, in living donor liver transplant recipients.;Primary end point(s): Composite efficacy failure of treated biopsy proven acute rejection (tBPAR), graft loss (GL) or death (D) at 12 months post-transplantation, in living donor liver transplant recipients.;Timepoint(s) of evaluation of this end point: At 12-month after transplantation.
- Secondary Outcome Measures
Name Time Method