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Optimized TacrolimuS and MMF for HLA Antibodies after Renal Transplantatio

Not Applicable
Completed
Conditions
Topic: Renal and Urogenital
Subtopic: Renal and Urogenital (all Subtopics)
Disease: Renal
Injury, Occupational Diseases, Poisoning
Kidney transplant failure and rejection
Registration Number
ISRCTN46157828
Lead Sponsor
King's College London (UK)
Brief Summary

2014 Protocol article in https://www.ncbi.nlm.nih.gov/pubmed/24447519 protocol 2019 Protocol article in https://www.ncbi.nlm.nih.gov/pubmed/31383029 updated protocol and statistical analysis plan (added 07/08/2019) 2016 Abstract results in https://bts.org.uk/wp-content/uploads/2016/09/BTS_Abstract_pdf_2016.pdf (added 18/11/2021) 2023 Results article in https://pubmed.ncbi.nlm.nih.gov/36684392/ (added 24/01/2023)

Detailed Description

Not available

Recruitment & Eligibility

Status
Completed
Sex
All
Target Recruitment
2037
Inclusion Criteria

1. Renal transplant recipients >1 year post transplantation
2. Aged 18-70 years, male and female
3. Estimated glomerular filtration rate (eGFR) of >=30

Exclusion Criteria

1. Recipient requiring HLA desensitisation to remove antibody for a positive XM transplant
2. Recipient known already to have HLA antibody who has received specific intervention for that antibody or for CAMR / chronic rejection
3. Recipient of additional solid organ transplants (e.g. pancreas, heart, etc).
4. History of malignancy in previous 5 years (excluding non-melanomatous tumours limited to skin)
5. HBsAg+,HBcAb+, HepC+ or HIV+ recipient (on test performed within previous 5 years)
6. History of acute rejection requiring escalation of immunosuppression in the 6 months prior to screening.
7. History of an ongoing or previous infection (no time limit) that would prevent optimization of immunosuppression, including ocular Herpes simplex.
8. Known hypersensitivity to any of the IMPs
9. Known hereditary disorders of carbohydrate metabolism
10. Patient enrolled in any other studies involving administration of another IMP at time of recruitment
11. Pregnancy or breastfeeding females (based on verbal history of recipient)
12. Pre-menopausal females who refuse to consent to using suitable methods of contraception throughout the trial.

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
<br> Current primary outcome measure as of 12/05/2020:<br> Determine the time to graft failure in patients testing positive for HLA Ab at baseline or within 32 months of randomization who receive an optimized anti-rejection medication intervention with prednisone, Tac and MMF (‘treatment’), compared to a control group who test positive for HLA Ab at baseline or within 32 months post-randomization who remain on their established immunotherapy and whose clinicians are not aware of their Ab status. The primary endpoint will be assessed remotely when a minimum of 43 months post-randomisation has been achieved by all.<br><br> Previous primary outcome measure:<br> Renal Transplant Failure Rates; Timepoint(s): 3 Years post-recruitment<br>
Secondary Outcome Measures
NameTimeMethod
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