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A Study to Assess Renal Function Response to Treatment in Patients With Relapsed Multiple Myeloma and Creatinine Clearance

Completed
Conditions
Multiple Myeloma
Interventions
Other: Anti-myeloma treatment at physician discretion
Registration Number
NCT02849444
Lead Sponsor
Celgene
Brief Summary

A prospective, multicentre, post-authorisation observational study. The objective of this study is assess the response of renal function in clinical practice to anti-multiple myeloma therapy in patients with relapsed MM and CrCl \<50 mL/min/1.73 m2.

Detailed Description

Prospective, multicentre, post-authorisation observational study. Study population: Patients with relapsed multiple myeloma and with CrCl \<50 mL/min/1.73 m2, for whom the investigator decides to start a new line of anti-myeloma treatment as per normal clinical practice. The decision to prescribe treatment will be clearly disassociated from the decision to include the patient in the study.

300 patients are expected to be recruited (225 for Group 1 and 75 for Group 2) from 40 sites (approximately 7-8 patients for each site). Patients will be included consecutively in the study.

The inclusion will be stratified to ensure the presence of all stages of renal impairment (RI) in two groups:

Documentation of 300 patients is planned (a maximum of 225 in group 1 and a minimum of 75 in group 2) at 40 sites (approximately 7-8 patients per each site). The patients will be included in the study in a consecutive manner.

In order to ensure the correct stratification of the sample group a real time central registry will be kept for the patients included in each group. Once the required number of patients for one of the groups is completed, inclusion in that group will be closed at all sites, keeping inclusion for other groups open, and so on until the entire sample size is complete.

Primary objective: To assess the response of renal function in clinical practice to anti-multiple myeloma therapy in patients with relapsed MM and creatinine clearance \<50 mL/min/1.73 m2 (CrCl \<50 mL/min/1.73m2).

The prospective follow-up period will cover two phases:

1. Treatment phase: covers the entire time the patient is receiving the first anti-myeloma treatment for relapse\* for which he/she is included in this study.

2. Follow-up phase: A 36-month extension period after the end of the first anti-myeloma treatment for relapse for which he/she was included in the study.

* Any change in therapeutic regimens, for example, discontinuation or addition of a drug (except for changes in dose for some of the initial drugs) will mark the end of the treatment phase and the passing of the patient to the follow-up phase. In case of temporary interruptions in treatment under 30 days (or of any duration if the reason for interruption is toxicity) the patient will continue in the treatment phase, provided that the initial treatment regimen for the relapse it resumed.

Secondary objectives:

* To describe the clinical and demographic characteristics of patients with relapsed multiple myeloma and CrCl \<50 mL/min/1.73 m2.

* To assess the response rate of renal function in clinical practice to anti-multiple myeloma therapy in patients with relapsed multiple myeloma and CrCl \<50 mL/min/1.73 m2.

* To assess the response of renal function based on the therapeutic regimens administered.

* To explore the concordance of the kidney function response and that of the myeloma in the clinical practice to the anti-myeloma treatment between consecutive relapses in the same patient.

* To assess time-dependent response parameters.

* To analyse the safety of treatments administered in clinical practice.

* To describe the use of resources associated with anti-myeloma therapy in clinical practice that can be measured financially, and to explore the possible differences between the various therapeutic regimens administered.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
326
Inclusion Criteria
  1. Patients of both genders, aged equal or more than 18 years.

  2. Patients with documented relapsed multiple myeloma according to International Myeloma Working Group ( IMWG) criteria.

  3. Patients with documented renal damage defined as creatinine clearance <50 ml / min / 1.73 m2 (CrCl <50ml / min / 1.73m2).

  4. Patients to whom the researcher decides to initiate anti-myeloma treatment for relapse with one or more agents according to clinical practice *.

  5. Patients who consent in writing after it has been clearly explained to them the nature and purpose of the study (written informed consent).

  6. Subject with any of the following characteristics (at least one of the 2 following options must be Yes):

    • Subjects who have not previously participated in the study

    • Subjects who have previously participated in the study, who meet all the inclusion criteria again and to whom none of the exclusion criteria apply, and whose current relapse is consecutive to the relapse that prompted their initial inclusion in the study.

      • The decision to prescribe treatment will be clearly dissociated from the decision to include the patient in the study

        • Clarification is provided as to the aim of the study, which is to encompass all relapse subcategories included in the International Myeloma Working Group consensus document published in 2006. Therefore, all patients with clinically relapsed multiple myeloma, who are in relapse following a complete response or in progression (including refractory cases) as defined in point 8.1 and in table 4 of the protocol, are considered eligible candidates for participation in the EPA-MIR 50 study, as long as they meet all the other criteria
Exclusion Criteria
  1. Patients who are participating in an interventional clinical trial * or who refuse to participate in the study.

  2. Patients with CrCl <50 ml / min / 1.73m2 due to a cause other than multiple myeloma properly documented at the discretion of the investigator *.

    • The inclusion of patients who are participating in another observational study is permitted.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Severe kidney failureAnti-myeloma treatment at physician discretionCrCl \< 30 mL/min/1.73 m2
Moderate kidney failureAnti-myeloma treatment at physician discretion30 ≤ CrCl \< 50 mL/min/1.73 m2
Primary Outcome Measures
NameTimeMethod
Age of participants at baseline to determinates Renal function responseBaseline visit

Patient Age record to determinates Creatinine clearance with the Cockcroft-Gault formula.

Creatinine levels to determinates Renal function responseUp to 12 months

Creatinine records from basal visit to last visit to determinates Creatinine clearance with the Cockcroft-Gault formula.

Gender of participants at baseline to determinates Renal function responseBaseline visit

Patient gender recorded in basal visit to determinates Creatinine clearance with the Cockcroft-Gault formula.

Weight of participants at baseline to determinates Renal function responseBaseline visit

Patient weight recorded in each visit to determinates Creatinine clearance with the Cockcroft-Gault formula.

Secondary Outcome Measures
NameTimeMethod
Renal response rate assessment in clinical practice.Up to 12 months

Describe response rate of renal function according to eGFR and total proteinuria

Time dependent Renal response rate assessment in clinical practice.Up to 12 months

Time to best renal response

MM response to Time to ProgressionUp to 12 months

Time to progression is defined as time from baseline to the appearance of the event; considering as an event progression or death from any cause.

MM response to Time to first responseUp to 12 months

Time to response is defined as time from the date of the first dose of study treatment to the date of the first documented hematologic improvement.

MM response to Progression Free SurvivalUp to 12 months

Progression free survival is defined as time from the date of the first dose of study treatment to the date of the first documented disease progression or relapse per IWG 2006 criteria.

Cost of visit to hospital/primary health care associated with anti-myeloma therapyUp to 12 months

To describe the costs associated with anti-myeloma therapy in clinical practice that can be measured financially, and to explore the possible differences between the various therapeutic regimens administered. This includes, visits to hospital/primary health care center.

Race of participants at BaselineBaseline visit

To describe the demographic characteristics of patients with relapsed multiple myeloma and CrCl \<50 mL/min/1.73 m2.

Clinical Outcome of participants with Multiple Myeloma (MM) clinical descriptionUp to 12 months

To describe the clinical characteristics of patients with relapsed multiple myeloma and CrCl \<50 mL/min/1.73 m2.

Type of Anti-myeloma therapeutic regimens.Up to 12 months

Describe various types of anti-myeloma regimens participants will receive.

Multiple Myeloma (MM) response to anti-myeloma treatmentUp to 12 months

MM response evaluation according to IMWG criteria

Adverse events (AEs)Up to 12 months

Number of participants with adverse events

Number of participants with relapsed kidney functionUp to 36 months

Concordance of the kidney function response and that of the myeloma in the clinical practice to the anti-myeloma treatment between consecutive relapses in the same patient.

Trial Locations

Locations (40)

Hospital Universitario Puerta del Mar

🇪🇸

Cádiz, Andalucía, Spain

Hospital Miguel Servet

🇪🇸

Zaragoza, Aragón, Spain

Hospital del Mar

🇪🇸

Barcelona, Cataluña, Spain

Hospital Torrecárdenas

🇪🇸

Almería, Andalucía, Spain

Hospital de Burgos

🇪🇸

Burgos, Castilla Y León, Spain

Hospital Santa Lucía

🇪🇸

Cartagena, Murcia, Spain

Hospital Virgen de Arrixaca

🇪🇸

El Palmar, Murcia, Murcia, Spain

Hospital general de jeréz

🇪🇸

Jerez de la Frontera, Andalucía, Spain

Hospital Son Espases

🇪🇸

Palma de Mallorca, Islas Baleares, Spain

Hospital Mutua terrassa

🇪🇸

Terrassa, Cataluña, Spain

Hospital Universitario Josep Trueta de Girona

🇪🇸

Girona, Cataluña, Spain

Complejo Universitario de San Carlos

🇪🇸

Madrid, Spain

Hospital san pedro

🇪🇸

Logroño, La Rioja, Spain

Hospital Puerta de Hierro

🇪🇸

Majadahonda, Madrid, Spain

Hospital Clínico Universitario Valencia

🇪🇸

Valencia, Comunidad Valenciana, Spain

Hospital Ramon y Cajal

🇪🇸

Madrid, Spain

Hospital General de Alicante

🇪🇸

Alicante, Valencia, Spain

Hospital Universitario Ciudad de Jaen

🇪🇸

Jaen, Andalucia, Spain

Hospital Virgen de la Nieves

🇪🇸

Granada, Andalucía, Spain

Hospital General de Ciudad Real

🇪🇸

Ciudad Real, Castilla La Mancha, Spain

Rio Hortega de Valladolid

🇪🇸

Valladolid, Castilla Y León, Spain

Hospital La Ribera

🇪🇸

Alzira, Cataluña, Spain

Hospital Duran reynls

🇪🇸

Barcelona, Cataluña, Spain

Complejo Hospitalario Universitario de Vigo

🇪🇸

Vigo, Galicia, Spain

Hospital de Insular de Gran Canaria

🇪🇸

Las Palmas de Gran Canaria, Canarias, Spain

Hospital de Cabueñes

🇪🇸

Gijón, Asturias, Spain

Hospital Virgen de la macarena

🇪🇸

Sevilla, Andalucía, Spain

Hospital de Basurto

🇪🇸

Bilbao, Castilla Y León, Spain

Hospital de León

🇪🇸

León, Castilla Y León, Spain

Hospital Vall d´Hebron

🇪🇸

Barcelona, Cataluña, Spain

Hospital Clinic I Provincial de Barcelona

🇪🇸

Barcelona, Cataluña, Spain

Hospital Arnau de Vilanova de Lleida

🇪🇸

Lleida, Cataluña, Spain

Hospital Sant Joan de manresa

🇪🇸

Manresa, Cataluña, Spain

Hospital de Sabadell ( Parc Taulí)

🇪🇸

Sabadell, Cataluña, Spain

Hospital La fe

🇪🇸

Valencia, Comunidad Valenciana, Spain

Complejo Hospitalario Universitario Santiago

🇪🇸

Santiago de Compostela, Galicia, Spain

Hospital Fundación de Alcorcón

🇪🇸

Alcorcón, Madrid, Spain

Hospital Gregorio marañon

🇪🇸

Madrid, Spain

Hospital Universitario La paz

🇪🇸

Madrid, Spain

Hospital Dr peset

🇪🇸

Valencia, Spain

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