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Evaluation of the Safety of Use of Anti-IL6 Receptor Antibodies to Reduce Allo-sensitization Post Allograft Nephrectomy

Phase 2
Recruiting
Conditions
Kidney Transplantation
Graft Failure
Interventions
Registration Number
NCT04779957
Lead Sponsor
University Hospital, Toulouse
Brief Summary

Graft nephrectomy is associated with massive allo-sensitization following this event. The occurrence of anti-HLA antibodies is a major barrier to perform a second kidney transplantation. Investigators propose here to evaluate in a phase II pilot study, the safety of the use of a single dose of Tocilizumab immediately before or after graft nephrectomy. The primary endpoint evaluated here is the occurrence of serious infectious complications following graft nephrectomy, with a treatment by Tocilizumab. Secondary endpoints evaluated here are - to evaluate all complications after graft nephrectomy, - and the Tocilizumab effectiveness to reduce anti-HLA antibodies at one year post nephrectomy.

Detailed Description

Background: graft nephrectomy is associated with massive allo-sensitization following this event The occurrence of anti-HLA antibodies is a major barrier to perform a second kidney transplantation. Moreover, a systemic inflammatory response syndrome can occur which could lead to serious patient's complications, in case of early graft thrombosis. To date, no treatment or strategy is available to reduce these risks, after graft nephrectomy. IL-6 is a key cytokine in inflammation, but also in the development of T and B cells activation. This treatment previously demonstrated a major role in the occurrence of allo-antibodies. Tocilizumab is a monoclonal antibody blocking IL6 receptor, previously used with success in kidney transplantation to reduce anti-HLA antibodies mediated rejection.

Objectives: Investigators hypothesize that Tocilizumab is useful to prevent allo-sensitization post graft nephrectomy. They propose here to evaluate in a phase II pilot study, the safety of the use of a single dose of Tocilizumab immediately before or after graft nephrectomy.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
18
Inclusion Criteria
  • Adult recipients,
  • affiliated to the social security
  • requiring a graft nephrectomy, with a project to retransplantation
Exclusion Criteria
  • combined transplantations, PRA >20%.
  • Patient under protective measures,
  • Rituximab used for immunosuppression induction
  • Previous transplants not removed,
  • Active infectious complications at graft nephrectomy, need for immunosuppressive treatments after graft nephrectomy,
  • Participation to another interventional studies using Rituximab, polyclonal antibodies, Eculizumab, or Tocilizumab.
  • adults under guardianship or other legal protection, deprived of their liberty by judicial or administrative decision,
  • pregnancy or breastfeeding.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
TocilizumabTocilizumabEvaluation of the use of Tocilizumab after allograft nephrectomy.
Primary Outcome Measures
NameTimeMethod
serious infectious complication1 year post graft nephrectomy

serious infectious complication rate at 1 year post graft nephrectomy

Secondary Outcome Measures
NameTimeMethod
The effectiveness of the treatment1 year post graft nephrectomy

The effectiveness of the treatment assessed by the rate of immunization after a post nephrectomy

Complications after treatment1 year post graft nephrectomy

Safety excluding serious infectious complications one year after nephrectomy, used by:

* The occurrence of post-nephrectomy complications

* The occurrence of death

* The occurrence of hospitalizations

* The occurrence of surgical complications

* The occurrence of infectious complications (mild and moderate)

Trial Locations

Locations (1)

CHU Toulouse

🇫🇷

Toulouse, France

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