This will be a single center, prospective, open-label, randomized, controlled trial comparing Envarsus XR® to twice-daily tacrolimus. The targeted population will be patients with end stage renal disease listed for primary solitary kidney transplant. Transplant Surgery is not part of the study.
Participants will be identified through the Department of Transplantation Surgery at the University of Kentucky. Participants will be pre-screened by the department for entry into the study. The investigator will determine if the participant meets study eligibility requirements. The purpose of this research is to gather information on how safe and effective of Envarsus® is when compared to twice-daily tacrolimus. The results of this study will be shared with the company providing financial support for the study, the Food and Drug Administration and other federal agencies, if required. All participants that successfully meeting inclusion criteria will be randomized (like the flipping of coin) to Envarsus vs. Tacrolimus at the time of transplant. Participants will be randomized to one of two treatment arms. Treatment begins on post-op day 1. * Treatment: Envarsus® 0.07-0.14 mg/kg/day every morning * Control: Generic tacrolimus 0.1-0.2 mg/kg/day in 2 divided doses given every 12 hours The total amount of time a person will be asked to volunteer for this study is 9-18 hours over the next 6 months. Participants will need to complete 9 study visits each of these visits will take approximately 1-2 hours to complete. Participants will be given medication dosing diaries to complete throughout the study and will undergo 2 kidney biopsies. Participants will be screened for HIV, Hepatitis B and Hepatitis C viruses.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
78
0.1-0.2 mg/kg/day orally divided into two doses every 12 hours orally
0.07-0.14 mg/kg/day every morning orally
Deepa Valvi
Lexington, Kentucky, United States
RECRUITING1. Change in the percentage of donor specific antibodies
We will check these donor specific antibodies to: HLA-A, -B and -C; or HLA-DR, -DQ and -DP. We will quantify the expression of these markers by Flow Cytometry analysis and reported as mean fluorescence intensity (MFI) units.
Time frame: Time of transplant and six months post-transplant
Changes in the percentage of blood immunologic markers
We will monitor the lymphocyte profile in blood in response to these 2 different treatments. The lymphocyte profile test will be performed by multi-parametric flow cytometry analysis with a panel of specific flourochrome-conjugated antibodies to selectively determine the following sub-populations: 1. Circulating T cells: CD4/CD8 rates and determine the following CD4 subpopulations: effector TH1, TH2, TH9, Tfh, and regulatory/suppressor T cells. 2. Circulating B cells (number and percentage of naïve, activated, memory and plasma B cells. 3. Circulating NK cells (mature and immature)
Time frame: Time of transplant and six months post-transplant
Changes in creatinine clearance
Baseline creatinine will be considered the creatinine plasma levels several days after transplantation once the kidney function is stabilized.
Time frame: Time of transplant and six months post-transplant
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