The primary objective of this trial is to show non-inferiority of a CNI-free regimen with respect to the renal function at Month 9 post Tx assessed by glomerular filtration rate - Nankivell method - as compared to the standard CNI-based regimen in de novo renal transplant patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
36
One tablet containing 0.25, 0.5mg or 0.75 mg. Initially 2 mg/day. Afterwards based on blood level (target 6-10 ng/mL)
Capsules 0.5 mg, 1 mg. Dosing according to blood level.
One vial containing 20 mg lyophilisate. 2 x 20 mg \[day 0 (2 hrs prior to Tx) and day 4 post Tx\] to be applied as 10 sec. bolus injection, i.v.
Novartis Investigative Site
Haifa, Israel
Novartis Investigative Site
Petah Tikva, Israel
Novartis Investigative Site
Tel Aviv, Israel
Renal Function Assessed as Glomerula Filtration Rate (GFR) - Nankivell Method - 9 Months After Renal Transplantation (LOCF)
The glomerular filtration rate (GFR) is the best clinical estimate of renal function in health and disease, and correlates well with the clinical severity of renal function disturbances. The GFR, calculated according to the Nankivell formula, was used as the primary outcome measure in this study. This equation has been validated in renal transplant patients against the true GFR measured by a radionuclide method and has been confirmed as a very accurate method to calculate the GFR in this specific population (Gaspari et al., 2004)GFR = 6.7 / Scr + BW / 4 - Surea / 2-100 / (height)² + C Scr = serum creatinine concentration expressed in mmol/L. BW = body weight in kg, Surea = serum urea in mmol/L and Height is expressed in meters.The Last Observation Carried Forward (LOCF) imputation technique was used for this analysis.
Time frame: 9 months
Assessment of GFR by the Cockcroft-Gault Method (LOCF)
the GFR was also calculated using the Cockcroft-Gault method (Cockcroft and Gault 1976) and the Modification of Diet in Renal Disease (MDRD) method (Levey et al., 1999, Rodrigo et al., 2003; Pierrat et al., 2003).Cockcroft-Gault formula For men: GFR= (140-Age)X Body Weight\[kg\]/72X Serum Creatinine\[mg/dl\] For women: GFR= 0,85x(140-Age) x Body Weight\[kg\]/72x Serum Creatinine \[mg/dl\] The Last Observation Carried Forward (LOCF) imputation technique was used for this analysis.
Time frame: 9 months
Participants Who Had Occurrence of Biopsy Proven Acute Rejection, Graft Loss or Death.
Biopsy-proven acute rejection was defined as a biopsy gradeed IA, IB, IIA, IIB, or III. The allograft was presumed to be lost if the patient started dialysis and was not able to subsequently be removed from dialysis. If the patient underwent a graft nephrectomy, then the day of nephrectomy was the day of graft loss.
Time frame: 9 months
Participants Who Had Occurrence of Treatment Failure.
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One tablet containing 180 mg or 360 mg. 1440 mg/day (2x720 mg). If tolerated, dose reduction due to side effectis were possible (min. dose at BL@: 720 mg/day)
Used according to Israeli standards. A minimum dose of 5mg \[prednisone, or equivalent, was used throughout the study period.
Treatment failure was defined as a composite endpoint of biopsy-proven acute rejection, graft loss, death, loss to follow up, discontinuation due to lack of efficacy or toxicity or conversion to another regimen.
Time frame: 9 months
Change in Renal Function (Creatinine Slope)
X(slope)=(1/value of creatinine).
Time frame: 3 months, 5 months, 7 months, 9 months