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Completed

NCT Number: NCT01292226

A Study of the Correlation Between Pharmacokinetic and Pharmacodynamic Parameters of CellCept (Mycophenolate Mofetil).

This study will evaluate the correlation between the pharmacokinetic and pharmacodynamic parameters of CellCept in patients undergoing primary kidney transplantation, in order to assess the impact on clinical outcome and the risks of acute rejection. All patients will receive oral CellCept, 1g twice daily, and pharmacokinetic and pharmacodynamic parameters will be measured at weeks 2, 4, 12 and 24. The anticipated time on study treatment is 24 weeks.

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Key information

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

Bari, Italy

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adult patients, 18 to 65 years of age
  • Patients undergoing primary kidney transplantation

Exclusion criteria

  • Recipients of multiple organ transplants
  • Prior therapy with CellCept
  • Presence or history of malignancies, except for successfully treated basal or squamous cell carcinoma of the skin
  • Active peptic ulcer or active serious digestive system disease that may affect the absorption of CellCept

Treatment and study plan

Mycophenolate mofetil

Drug

1 g PO BID for 24 weeks

Other names: CellCept

antibody induction

Drug

According to manufacturer recommendation

cyclosporine

Drug

According to manufacturer recommendation

Corticosteroid

Drug

According to manufacturer recommendation

Primary outcomes

  1. Percentage of Participants With Acute Rejection

    Time frame: Day 1, Weeks 2, 4, 12, 24, and 28

    Diagnosis of acute rejection was suspected in any participant with an increase in serum creatinine greater than or equal to (≥) 25 percent (%). All suspected acute rejections were confirmed by biopsy. The start date of acute rejection was identified as the date of biopsy.

  2. Time to Rejection

    Time frame: Day 1, Weeks 2, 4, 12, 24, and 28

    The mean time, in days, from the date of enrollment to date of biopsy confirming acute rejection.

  3. Percentage of Participants With Biopsy-Proven Acute Rejection (BPAR)

    Time frame: Day 1, Weeks 2, 4, 12, 24, and 28

    BPAR was defined according to 1997 Banff Criteria as a biopsy Banff grade of IA, IB, IIA, IIB, or III. Grade IA was defined as significant interstitial infiltration with greater than (>)25% of parenchyma affected, and foci of moderate tubulitis with >4 mononuclear cells per tubular cross section or group of 10 tubular cells. Grade IB was defined as significant interstitial infiltration with >25% parenchyma affected, and foci of severe tubulitis with >10% mononuclear cells per tubular cross section or group of 10 tubular cells. Grade IIA was defined as mild to moderate intimal arteritis. Grade IIB was defined as severe intimal arteritis comprising >25% of the luminal area. Grade III was defined as transmural arteritis and/or arterial fibrinoid changes and necrosis of medial smooth muscle cells.

Secondary outcomes

  1. Percentage of Participants With Graft Loss

    Time frame: Day 1, Weeks 2, 4, 12, 24, and 28

    An allograft was presumed to be lost if a participant started dialysis and was not able to subsequently be removed from dialysis.

  2. Percentage of Participants Surviving

    Time frame: Day 1, Weeks 2, 4, 12, 24, and 28

  3. Total Mycophenolate Acid (MPA) by Visit and Timepoint

    Time frame: Weeks 2, 4, 12, 24, and 28 (Safety Follow-Up Visit), and any unscheduled visits

    Drug quantification of total MPA (micrograms per milliliter [mcg/mL]) in the plasma was measured at time (T) = 0 minutes (min), 40 mins, and 120 mins.

  4. Free MPA (mcg/mL) by Visit

    Time frame: Weeks 2, 4, 12, 24, safety follow-up (Week 28), and any unscheduled visits

    Drug quantification of free MPA in the plasma was measured at T = 0, 40, and 120 mins.

  5. MPA Area Under the Concentration - Time Curve From Time 0 to 12 Hours (AUC0-12) (mcg/mL) by Visit

    Time frame: Predose and 40 minutes and 2 hours postdose at Weeks 2, 4, 12, and 24, and at the Safety follow-up (Week 28)

    The AUC0-12 of MPA was estimated on the validated limited sampling strategy, AUC (milligrams multiplied by height over liter [mg.h/L]) = 7.182 + 4.607 multiplied by (*) concentration at 0 minutes (C0)+ 0.998 * the concentration at 40 minutes (C0.67) + 2.149 * the concentration at 120 minutes (C2).

  6. Inosine MonoPhosphate DeHydrogenase (IMPDH) Activity by Visit and Timepoint

    Time frame: BL and Weeks 2, 4, 12, and 24, and safety follow-up (Week 28) and any unscheduled visits

    IMPDH activity in peripheral blood mononuclear cells (PBMCs) was measured at 2 timepoints per visit, 0 and 120 minutes and presented in enzyme units. The unit of measure of enzyme activity is "U". One U is defined as the amount of the enzyme that produces a certain amount of enzymatic activity that is, the amount that catalyzes the conversion of 1 micro mole of substrate per minute under pre-specified conditions (temperature, pH).

  7. IMPDH Expression I by Visit and Timepoint

    Time frame: BL and Weeks 2, 4, 12, and 24, and safety follow-up (Week 28) and any unscheduled visits

    IMPDH I gene expression was measured by real time polymerase chain reaction (QRT-PCR) based cytokine measurement of PBMCs at 2 timepoints per visit, 0 and 120 minutes and expressed as number of messenger ribonucleic acid (mRNA) copies per cell (copies/cell).

  8. IMPDH Expression II by Visit and Timepoint

    Time frame: BL and Weeks 2, 4, 12, and 24, and safety follow-up (Week 28) and any unscheduled visits

    IMPDH II gene expression was measured by QRT-PCR based cytokine measurement of PBMCs at 2 timepoints per visit, 0 and 120 minutes and expressed as number of mRNA copies/cell.

  9. Interleukin 8 (IL-8) Expression by Visit and Timepoint

    Time frame: BL and Weeks 2, 4, 12, and 24, and safety follow-up (Week 28) and any unscheduled visits

    IL-8 gene expression was measured by QRT-PCR based cytokine measurement of PBMCs at 2 timepoints per visit, 0 and 120 minutes and expressed as number of mRNA copies/cell.

  10. Tumor Necrosis Factor (TNF) Expression by Visit and Timepoint

    Time frame: BL and Weeks 2, 4, 12, and 24, and safety follow-up (Week 28) and any unscheduled visits

    TNF gene expression was measured by QRT-PCR based cytokine measurement of PBMCs at 2 timepoints per visit, 0 and 120 minutes and expressed as number of mRNA copies/cell.

  11. Percentage of Participants With Infection

    Time frame: BL and Weeks 2, 4, 12, 24, and 28 (Safety Follow-Up)

    Infections were graded according to the World Health Organization (WHO) worst grade observed.

  12. Percentage of Participants With Gastrointestinal Toxicities

    Time frame: BL and Weeks 2, 4, 12, 24, and 28 (Safety Follow-up Visit)

    Gastrointestinal adverse events (AEs) according to WHO worst grade observed.

  13. Percentage of Participants With Hematologic Toxicity

    Time frame: BL and Weeks 2, 4, 12, 24, and 28 (Safety Follow-Up)

    Hematological toxicities graded according to WHO worst grade observed (Grade 1=mild, Grade 2=moderate).

  14. Spearman's Rank Correlation Coefficient Between MPA Levels and IMPDH Activity

    Time frame: BL and Weeks 2, 4, 12, and 24

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

  15. Spearman's Rank Correlation Coefficient Between IMPDH I Expression and MPA Levels

    Time frame: BL and Weeks 2, 4, 12, and 24

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

  16. Spearman's Rank Correlation Coefficient Between IMPDH I Expression and Free Fraction

    Time frame: BL and Weeks 2, 4, 12, and 24

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

  17. Spearman's Rank Correlation Coefficient Between IMPDH II Expression and MPA Levels

    Time frame: BL and Weeks 2, 4, 12, and 24

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

  18. Spearman's Rank Correlation Coefficient Between IMPDH II Expression and Free Fraction

    Time frame: BL and Weeks 2, 4, 12, and 24

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

  19. Spearman's Rank Correlation Coefficient Between IMPDH Inhibition and Risk of Acute Rejection

    Time frame: BL and Weeks 2, 4, 12, and 24

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

  20. Spearman's Rank Correlation Coefficient Between IMPDH Expression and Risk of Infection

    Time frame: BL and Weeks 2, 4, 12, and 24

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

  21. Spearman's Rank Correlation Coefficient Between IMPDH Expression and Risk of Hematologic Toxicity

    Time frame: BL and Weeks 2, 4, 12, and 24

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

  22. Spearman's Rank Correlation Coefficient Between IMPDH Expression and Risk of Gastrointestinal Toxicity

    Time frame: BL and Weeks 2, 4, 12, and 24

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

  23. Spearman's Rank Correlation Coefficient Between MPA Levels and Risk of Infection

    Time frame: BL and Weeks 2, 4, 12, and 24

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

  24. Spearman's Rank Correlation Coefficient Between MPA Levels and Risk of Hematologic Toxicity

    Time frame: BL and Weeks 2, 4, 12, and 24

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

  25. Spearman's Rank Correlation Coefficient Between MPA Levels and Risk of Gastrointestinal Toxicity

    Time frame: BL and Weeks 2, 4, 12, and 24

    The Spearman's rank correlation coefficient was computed by ranking the data from 2 time points, 0 minutes and 120 minutes, and using the ranks in the Pearson product-moment correlation formula. In case of ties, the averaged ranks were used.

Sponsors and collaborators

Lead sponsor

Hoffmann-La Roche

Industry

Registry information

Official study title

Relationships Between Pharmacokinetic and Pharmacodynamic Strategies for Assessment of the Risks for Acute Rejection and Side Effects of Mycophenolate Mofetil

Important dates

Study start
2006
Primary completion
2008
Study completion
2008
First posted
Feb 9, 2011
Registry last updated
May 12, 2016

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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