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A Study to Evaluate the Effect of ASP8597 in Adult Kidney Transplant Patients

Phase 2
Terminated
Conditions
Kidney Transplantation
Interventions
Drug: Placebo
Registration Number
NCT01442337
Lead Sponsor
Astellas Pharma Inc
Brief Summary

The purpose of this study is to evaluate the efficacy, safety and tolerability of a single intravenous dose of ASP8597 in kidney transplant recipients.

Detailed Description

This is a two-part study. Part 1 (Phase 2) has completed enrollment. Subjects are currently being followed per protocol. Data from Part 1 will be used to determine the doses used in Part 2 (Phase 3). Part 2 will enroll approximately 573 subjects and is planned to have 2 doses of ASP8597 (low dose and either the high or highest dose) along with placebo.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
21
Inclusion Criteria
  • Subject is scheduled to receive a kidney transplant from a deceased donor meeting at least one of the following criteria:

    1. Expanded Criteria Donor (ECD)

      • i Donor was > 60 years of age, OR

      • ii. Donor was 50-59 years of age, inclusive, and met at least two of the following criteria:

        1. Donor died of a cerebral bleed
        2. Donor had a history of hypertension
        3. Donor's terminal serum creatinine concentration was > 1.5 mg/dL
    2. Donation after Cardiac Death (DCD) - Donor was pronounced dead prior to procurement of the kidney

    3. Standard Criteria Donor (SCD)

      • i. Donor with terminal serum creatinine < 1.5 mg/dL where kidney is anticipated to have a minimum of 24 hours of cold ischemia prior to transplantation, OR
      • ii. Donor with terminal serum creatinine > 1.5 mg/dL and any cold ischemic time up to exclusion limit
  • Female subject is not pregnant and agrees to use an acceptable form of contraception throughout study

  • Male subject agrees to use an adequate method of contraception and agrees to no sperm donation throughout the study

Exclusion Criteria
  • Female subject is pregnant or lactating
  • Donor kidney is anticipated to have more than 40 hours of cold ischemia time
  • Donor is > 66 years of age
  • Donor meets both DCD and ECD criteria
  • Subject has previously received, or is receiving an organ transplant other than a kidney
  • Subject has a positive T or B cell crossmatch by the investigational site's standard method of determination. For recipients where only a flow cytometry crossmatch is performed and is positive in either T or B cell testing, recipients are excluded only if donor specific, anti-HLA antibody is detected by flow cytometry based, specific anti-HLA antibody testing
  • Subject has ABO blood type incompatibility with his/her organ donor
  • Recipient or donor is known by medical history to be seropositive for human immunodeficiency virus (HIV)
  • Subject has a known bleeding diathesis
  • Subject has a International Normalized Ratio (INR) > 1.5 times upper limit of normal at Screening
  • Subject has a platelet count < 100,000 platelets/µL at Screening
  • Subject used anti-platelet agents [e.g., Plavix® (clopidogrel bisulfate), Brilinta® (ticagrelor)] (with the exception of aspirin < 100 mg/day for cardiovascular prophylaxis), anti-coagulants [e.g., Pradaxa® (dabigatran), Xarelto® (rivaroxaban)], anti-thrombotics, and/or blood-thinning agents within the 10 days prior to Screening; and/or subject is expected to require use of any of these agents during the first 15 days of the study period (with the exception of standard of care peri-operative administration of heparin for DVT prophylaxis)
  • Subject has an uncontrolled concomitant infection
  • Subject has a current malignancy or a history of any malignancy (within the past 5 years), except non-metastatic basal or squamous cell carcinoma of the skin that has been treated successfully
  • Subject currently is participating in an investigational drug study, or participated in an investigational drug study within the last 30 days)
  • Subject has a history of or is believed to have used an illicit drug(s) and/or abused alcohol within the last 3 months
  • Subject has an unstable psychiatric illness
  • Subject has previously received ASP8597 or participated in a study involving ASP8597

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ASP8597 low doseASP8597-
ASP8597 high doseASP8597-
PlaceboPlaceboPlacebo comparator used in Part 2 only
ASP8597 highest doseASP8597-
Primary Outcome Measures
NameTimeMethod
Pharmacokinetic (PK) variable for ASP8597: Maximum concentration (Cmax)3 days

Part 1 PK variable

Pharmacokinetic variable for ASP8597: Area under the concentration-time curve from time 0 to last quantifiable concentration (AUClast)3 days

Part 1 PK variable

Pharmacokinetic variable for ASP8597: Area under the concentration-time curve from time 0 to infinity (AUCinf)3 days

Part 1 PK variable

Estimated glomerular filtration rate (eGFR) using abbreviated Modified Diet in Renal Disease (MDRD) formula - Part 212 months

Part 2 efficacy variable

Secondary Outcome Measures
NameTimeMethod
Pharmacokinetic variable for ASP8597: Time to attain Cmax (Tmax)3 days

Part 1 PK variable

Pharmacokinetic variable for ASP8597: Clearance (CL)3 days

Part 1 PK variable

Pharmacokinetic variable for ASP8597: Volume of Distribution (Vz)3 days

Part 1 PK variable

Pharmacokinetic variable for ASP8597: Apparent terminal elimination half-life (t1/2)3 days

Part 1 PK variable

Requirement of dialysis within the first 7 days post transplant - Part 17 days

Part 1 efficacy variable

eGFR using abbreviated MDRD formula - Part 112 months

Part 1 efficacy variable

Requirement of dialysis within the first 7 days post transplant - Part 27 days

Part 2 efficacy variable

Patient survival12 months

Part 2 efficacy variable

Graft survival12 months

Part 2 efficacy variable

Biopsy-proven acute rejection (BPAR)12 Months

Part 2 efficacy variable

Clinically treated rejection12 months

Subjects who receive immunosuppressive medications for the treatment of suspected or biopsy-proven acute rejection. Part 2 efficacy variable

Trial Locations

Locations (19)

Baylor University Medical Center

🇺🇸

Dallas, Texas, United States

St. Vincent Medical Center

🇺🇸

Los Angeles, California, United States

Sharp Memorial

🇺🇸

San Diego, California, United States

New York Presbyterian Hospital

🇺🇸

New York, New York, United States

Duke University

🇺🇸

Durham, North Carolina, United States

East Carolina University

🇺🇸

Greenville, North Carolina, United States

University of Virginia

🇺🇸

Charlottesville, Virginia, United States

California Pacific Medical Center

🇺🇸

San Francisco, California, United States

University of Colorado

🇺🇸

Aurora, Colorado, United States

University of California at San Francisco

🇺🇸

San Francisco, California, United States

University of Michigan

🇺🇸

Ann Arbor, Michigan, United States

Washington University

🇺🇸

St. Louis, Missouri, United States

St. Barnabas Medical Center

🇺🇸

Livingston, New Jersey, United States

Carolinas Medical Center

🇺🇸

Charlotte, North Carolina, United States

Pinnacle Health at Harrisburg

🇺🇸

Harrisburg, Pennsylvania, United States

The Methodist Hospital

🇺🇸

Houston, Texas, United States

Baylor All Saints Medical Center

🇺🇸

Fort Worth, Texas, United States

University of Wisconsin

🇺🇸

Madison, Wisconsin, United States

Montefiore Medical Center

🇺🇸

Bronx, New York, United States

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