A Phase 2, Multicenter, Open-label, Active Comparator-controlled, Extension Trial To Evaluate The Long-term Safety And Efficacy Of Cp-690,550 In Renal Allograft Recipients
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 发起方
- Pfizer
- 入组人数
- 178
- 试验地点
- 64
- 主要终点
- Kaplan-Meier Analysis of Percentage of Participants With First Biopsy Proven Acute Rejection (BPAR) by Visit
研究概览
简要总结
This is a study that will follow transplant patients from Study A3921030 to monitor for long term safety, tolerability and efficacy for 5 additional years, except in Portugal where the study will follow transplant patients through Month 36 posttransplant. Patients will continue their study medications that were previously assigned.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 70 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Subjects who successfully completed Study A3921030
排除标准
- •Subjects who are on the waiting list for a second kidney transplant or any non-renal organ transplants
研究组 & 干预措施
Treatment Arm 2
Treatment Arm 2 will also receive standard of care medications
干预措施: CP-690,550 (Drug)
Treatment Arm 1
Treatment Arm 1 will also receive standard of care medications
干预措施: Cyclosporine (Drug)
Treatment Arm 3
Treatment Arm 3 will also receive standard of care medications
干预措施: CP-690,550 (Drug)
结局指标
主要结局
Kaplan-Meier Analysis of Percentage of Participants With First Biopsy Proven Acute Rejection (BPAR) by Visit
时间窗: Months 12, 15, 18, 24, 30, 36, 42, 48, 54, 60, 66, 72
BPAR was category acute rejection as interpreted by the central blinded pathologist according to the Banff 97 working classification. The 'Number' and 'Other Confidence Interval Level' columns represent cumulative proportions and 60% confidence intervals (CIs) as estimated from the fitted Kaplan-Meier curves for each treatment at scheduled visits.
Kaplan-Meier Analysis of Percentage of Participants With Clinically Significant Infection by Visit
时间窗: Months 12, 15, 18, 24, 30, 36, 42, 48, 54, 60, 66, 72
Clinically significant infection was defined as the presence of documented infection confirmed by culture, biopsy, genomic, or serologic findings post-randomization and requiring hospitalization or parenteral anti-infective treatment, or otherwise deemed significant by the investigator. The 'Number' and 'Other Confidence Interval Level' columns represent cumulative proportions and 60% confidence intervals (CIs) as estimated from the fitted Kaplan-Meier curves for each treatment at scheduled visits.
Percentage of Participants With Malignancies
时间窗: Months 12 through 72.
All treatment-emergent malignancies in Study A3921050 were included as collected on the Malignancy Case Report Form page.
Least Squares Means of Measured Glomerular Filtration Rate (GFR) (Iohexol Serum Clearance in Milliliters Per Minute [mL/Min])
时间窗: Month 36
Glomerular filtration rate (GFR): an index of kidney function. GFR described the flow rate of filtered fluid through the kidney. GFR was calculated using iohexol serum clearance. For determination of iohexol serum clearance, iohexol was administered as an intravenous (IV) bolus over 5 minutes immediately after morning dosing of Tofacitinib or CsA on day of GFR evaluation. Blood samples for iohexol (3 millilitres \[mL\] each to provide a minimum of 1 mL serum) were collected into appropriately labeled tubes containing no additives at 120, 180, 240, and 300 minutes after the end of the iohexol IV bolus. A normal GFR is greater than (\>) 90 mL/min, although children and older people usually have a lower GFR. Lower values indicated poor kidney function. A GFR less than (\<) 15 mL/min indicated kidney failure.
Percentage of Participants With Progression of Chronic Allograft Lesions at Month 36
时间窗: Month 36
Progression of chronic allograft lesions was defined as an increase in the Banff chronicity score (Banff-CS) in biopsy from the implantation (baseline) biopsy in a given participant. Banff-CS was the sum of the Banff scores for the 4 chronic basic lesions (allograft glomerulopathy \[cg\] + interstitial fibrosis \[ci\] + tubular atrophy \[ct\] + vascular intimal thickening \[cv\]). The Banff-CS ranged from 0-12, higher score indicated greater lesions and Month 36 Banff-CS greater than the implantation biopsy score indicated progression of lesions.
Kaplan-Meier Analysis of Percentage of Participants With Treated Clinical Acute Rejection by Visit
时间窗: Months 12, 15, 18, 24, 30, 36, 42, 48, 54, 60, 66, 72
Treated clinical acute rejection was defined as an acute rejection episode that was diagnosed based on local biopsy readout and received anti-rejection treatment. The 'Number' and 'Other Confidence Interval Level' columns represent cumulative proportions and 60% confidence intervals (CIs) as estimated from the fitted Kaplan-Meier curves for each treatment at scheduled visits.
次要结局
- Mean Hemoglobin (Hgb) (Grams Per Deciliter [g/dL]) by Visit(Months 15, 18, 24, 30, 36, 42, 48, 54, 60, 66, 72 and Follow-up)
- Kaplan-Meier Analysis of Percentage of Participants With Efficacy Failure by Visit(Months 12, 15, 18, 24, 30, 36, 42, 48, 54, 60, 66, 72)
- Least Squares Means of Total Serum High Density Lipoprotein (HDL) Cholesterol Levels (mg/dL) by Visit(Months 15, 18, 24, 30, 36, 42, 48, 54, 60, 66, 72)
- Least Squares Means of Total Serum Triglycerides (mg/dL) by Visit(Month 15, 18, 24, 30, 36, 42, 48, 54, 60, 66, 72)
- Mean Absolute Neutrophil Counts (ANC) (Kelvin Per Millimeter Cubed [K/mm^3]) by Visit(Months 15, 18, 24, 30, 36, 42, 48, 54, 60, 66, 72 and Follow-up)
- Percentage of Participants Discontinuing From the Study(Months 12 through 72.)
- Least Squares Means of Total Serum Cholesterol Levels (Milligrams Per Deciliter [mg/dL]) by Visit(Months 15, 18, 24, 30, 36, 42, 48, 54, 60, 66, 72)
- Least Squares Means of Total Serum Low Density Lipoprotein (LDL) Cholesterol Levels (mg/dL) by Visit(Months 15, 18, 24, 30, 36, 42, 48, 54, 60, 66, 72)
- Mean Glycosylated Hemoglobin (HBA1c) (Percent [%]) by Visit(Months 24, 36, 48, 60, 72)
- Least Squares Means of Fasting Serum Glucose Levels (mg/dL) by Visit(Months 15, 18, 24, 30, 36, 42, 48, 54, 60, 66, 72)
- Percentage of Participants by Proteinuria Category by Visit(Months 24, 36, 48, 60, 72 and Follow-up)
- Least Square Means of Estimated GFR Calculated Using the Nankivell Equation by Visit(Month 15, 18, 24, 30, 36, 42, 48, 54, 60, 66, 72)
- Kaplan-Meier Analysis of Percentage of Participants With Combined Banff Rejection by Visit(Months 12, 15, 18, 24, 30, 36, 42, 48, 54, 60, 66, 72)
- Kaplan-Meier Analysis of Percent of Participants With Graft Survival With Death Censored by Visit(Months 12, 15, 18, 24, 30, 36, 42, 48, 54, 60, 66, 72)
- Kaplan-Meier Analysis of Percentage of Participants Surviving by Visit(Months 12, 15, 18, 24, 30, 36, 42, 48, 54, 60, 66, 72)
- Least Squares Means of Estimated GFR Calculated Using the Cockcroft-Gault Equation by Visit(Months 15, 18, 24, 30, 36, 42, 48, 54, 60, 66, 72)
- Least Squares Means of Estimated GFR (eGFR) (mL/Min/1.73 Square Meter [m^2]) Calculated by the Modification of Diet in Renal Disease (MDRD) Equation With Last Observation Carried Forward (LOCF) Plus Imputation (eGFR=0 for Graft Loss/Death) by Visit(Months 15, 18, 24, 30, 36, 42, 48, 54, 60, 66, 72)
- Least Squares Means of Short Form 36 Version 2 (SF-36 V2) Component and Domain Scores at Months 24 and 36(Months 24, 36)
- Least Squares Means of End-Stage Renal Disease (ESRD) Symptom Checklist (SCL) -Transplantation Modules at Months 24 and 36(Months 24, 36)
- Least Squares Means of Severity of Dyspepsia Assessment (SODA) Subscales at Months 24 & 36(Months 24, 36)
- Mean Trough Levels of Tofacitinib by Visit(Months 18 and 24 (-2 hours, predose, 1 hour, 2 hours), Month 30 (predose, 1 hour and 2 hours), Month 36 (predose, 1, 2, and 4 hours), Months 42, 48, 54, 60, 66, 72 (predose and 2 hours))
- Mean Trough Levels of Cyclosporine by Visit(Predose: Months 18, 24, 36, 48, 60, 72)
