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临床试验/NCT02115503
NCT02115503终止不适用

A Prospective, Global, Multi-center, Treatment Registry Study of Intravenous Immunoglobulin Maintenance Therapy in Alloantibody Positive Renal Allograft Recipients

Databean8 个研究点 分布在 1 个国家目标入组 52 人开始时间: 2014年7月最近更新:
适应症

试验速览

阶段
不适用
状态
终止
发起方
Databean
入组人数
52
试验地点
8
主要终点
Difference in mean change from screening to 36 months in graft survival and glomerular filtration rates (GFR)

研究概览

简要总结

The purpose of this treatment registry study is to determine if monthly infusions of Intravenous Immunoglobulin (IVIg) for 6 months will neutralize donor specific antibodies that are thought to be responsible for chronic rejection episodes in renal transplant subjects. 162 renal transplant subjects will receive IVIg 5% at 2gm/kg/month for 6 months and be followed for 3 years.

研究设计

研究类型
Observational
观察模型
Cohort
时间视角
Prospective

入排标准

年龄范围
18 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Subject is 18 years of age or older
  • Able to provide voluntary written informed consent
  • Renal transplant recipient at least 1 month post-transplant
  • On stable doses of maintenance immunosuppression for at least 14 days prior to study entry and remains on stable maintenance doses for the duration of the study
  • Presence of DSA greater than or equal to 1000 mean fluorescence intensity (MFI) single antigen bead assay via Luminex (normalized 2,000 - 15,000 MFI, inclusive) measured within 6 months prior to consent
  • Female subjects must be post-menopausal for at least 1 year, or surgically sterilized, or must agree to use two effective methods of birth control from the time of consent through 30 days after the last dose of IVIg.
  • Male subjects must be surgically sterilized, or must agree to use two effective methods of birth control from the time of consent through 30 days after the last dose of IVIg
  • Subject is compliant and intends to be available for follow-up study period of 3 years

排除标准

  • Multi-organ transplant
  • History of anaphylactic or severe systemic reactions to human immunoglobulin
  • IgA deficient subjects with antibodies against IgA and a history of hypersensitivity
  • Serum creatinine > 3.0 mg/dL within 90 days prior to consent
  • Recipients of ABO incompatible kidney transplants
  • Acute rejection within 180 days (6 months) prior to consent defined as:
  • Biopsy proven acute Cellular Rejection [Banff grade I (including IA and IB), grade II (including IIA and IIB) or grade III]; or
  • an antibody-mediated rejection with C4d positivity, or
  • chronic rejection with C4d positivity (C4d positivity is defined as staining diffuse in peritubular capillary area. Isolated C4d glomerular staining or C4d staining of < 50% of the peritubular capillaries will not be exclusion criteria). Borderline cellular rejection will not be excluded (Banff 2005), or
  • Clinical signs and symptoms of acute rejection including elevated creatinine, fever over 100 degrees, pain or tenderness around the transplanted kidney, fluid retention of the hands, legs, feet, ankles or eyelids, sudden weight gain (2-4 pounds in a day, or 5 pounds or more in a week), decrease in urine output with the same amount of fluid intake, or dark yellow or orange urine output, flu-like symptoms, such as chills, aches, tiredness, dizziness, nausea, loss of appetite, weakness, fatigue, vomiting or general sense of not feeling well (Note: NOT all signs and symptoms need to be present to document acute rejection)
  • Evidence of proteinuria (> 3 grams) within 90 days (3 months) prior to consent
  • Active CMV+ or EBV+ viremia that requires, or will require, anti-viral therapy
  • History of HCV, HIV and/or HBsAg positivity
  • History of post-transplant lymphoproliferative disease.
  • Active BK/polyomavirus nephropathy, or BK/polyomavirus nephritis that requires, or will require, anti-viral therapy (not prophylactic)
  • Recipients of a kidney from a donor who tests positive for HIV, HBsAg or anti-HCV.
  • History of malignancy within the past 5 years that is not considered to be cured, with the exception of complete resection of localized basal cell carcinoma of the skin (excised ≥ 1 years prior to enrollment).
  • Subjects who are receiving everolimus, sirolimus or azathioprine as immunosuppressive agents and who are unwilling, or unable, to change to mycophenolate mofetil or mycophenolic acid within 14 days prior to consent
  • White blood cell count of <1,000/mm3 within 90 days prior to consent
  • Platelet count <60,000/mm3 within 90 days prior to consent
  • Evidence of severe liver disease with abnormal liver profile (aspartate aminotransferase [AST] or alanine aminotransferase [ALT] > 3 times upper limit of normal [ULN]) within 90 days prior to consent
  • Total bilirubin > 1.5 times ULN within 90 days prior to consent
  • Post-transplant history of cardiovascular disease within 180 days (6 months) prior to consent defined as:
  • Electrocardiographic evidence of MI,
  • Electrocardiographic evidence of acute ischemia,
  • Electrocardiographic evidence of severe conduction system abnormalities OR
  • New York Heart Association (NYHA) Class II - IV heart failure (Subjects with other cardiac abnormalities may be included if documented by the investigator as not clinically significant)
  • Pregnant or nursing (lactating) women
  • Enrolled in any other treatment study within 30 days of consent
  • Serious medical illness (other than renal disease), or psychiatric illness likely to interfere with study participation

结局指标

主要结局

Difference in mean change from screening to 36 months in graft survival and glomerular filtration rates (GFR)

时间窗: 3 years

Success is defined as: Allograft survival as compared to the performance goal (PG) at 36 months. For the purposes of this study, a graft will be presumed to be lost is when a subject is started on dialysis and is not able to subsequently be removed from dialysis; or a subject's serum creatinine reaches 4.0 mg/dL, is sustained for \>48hours and is not thought to be due to other causes; or the subject is re-transplanted; or the subject dies. AND: A change in extended GFR, defined as \<15% decrease in mean GFR from baseline to 36 months

次要结局

  • Allograft Survival(3 years)

研究者

发起方
Databean
申办方类型
Industry
责任方
Sponsor

研究点 (8)

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