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Completed

NCT Number: NCT01404325

Efficacy Regarding Renal Function of Everolimus in Combination With Specific Standard Immunosuppressive Regimen Lung Transplant Recipients

This trial evaluated the efficacy of an everolimus-based quadruple low immunosuppressive regimen versus a standard immunosuppressive regimen concerning kidney function in lung transplant recipients.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Novartis Investigative Site, Berlin, Germany

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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 recipients of de novo cadaveric lung transplants 3-18 months prior to enrollment

Exclusion criteria

  • Patients with thrombocytopenia (platelets <100,000/mm³), with an absolute neutrophil count of <1,500/mm³ or leucopenia (leucocytes <3000/mm³), with anemia with Hb < 8g/dl at time of screening
  • Patients with uncontrolled hypercholesterolemia (> 350 mg/dL; > 9.1 mmol/L) or hypertriglyceridemia (> 750 mg/dL; > 8.5 mmol/L) at time of screening
  • Patients with a history of malignancy of any organ system, treated or untreated, during the last five years, whether or not there is evidence of local recurrence or metastases, except squamous or basal cell carcinoma of the skin Other protocol-defined inclusion/exclusion criteria may apply

Treatment and study plan

Standard therapy

Drug

centre specific CNI-based triple drug immunosuppression

Everolimus

Drug

quadruple immunosuppressive regimen consisting of everolimus, CNI, MPA and steroids

Other names: RAD001

Primary outcomes

  1. Calculated Glomerular Filtration Rate (cGFR) According to Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) at 12 Months

    Time frame: Month 12

    Calculated Glomerular Filtration Rate (cGFR) according to Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) at 12 months The CKD-EPI equation, expressed as a single equation, is GFR = 141 × min(Scr/κ, 1)α × max(Scr/κ, 1)^-1.209 × 0.993Age × 1.018 (if female) × 1.159 (if black), where Scr is serum creatinine, κ is 0.7 for females and 0.9 for males, α is -0.329 for females and -0.411 for males, min indicates the minimum of Scr/ĸ or 1, and max indicates the maximum of Scr/κ or 1

Secondary outcomes

  1. Calculated Glomerular Filtration Rate (cGFR) According to Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) at Month 1, 3, 6, 9, 12

    Time frame: Month 1, 3, 6, 9, 12

    Calculated Glomerular Filtration Rate (cGFR) according to Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) at Month 1, 3, 6, 9 and 12. The CKD-EPI equation, expressed as a single equation, is GFR = 141 × min(Scr/κ, 1)α × max(Scr/κ, 1)^-1.209 × 0.993Age × 1.018 (if female) × 1.159 (if black), where Scr is serum creatinine, κ is 0.7 for females and 0.9 for males, α is -0.329 for females and -0.411 for males, min indicates the minimum of Scr/ĸ or 1, and max indicates the maximum of Scr/κ or 1

  2. Calculated Glomerular Filtration Rate (cGFR) According to Cystatin C-based Hoek's Formula at Month 1, 3, 6, 9, 12

    Time frame: Month 1, 3, 6, 9, 12

    Calculated Glomerular Filtration Rate (cGFR) according to Cystatin C-based Hoek's formula at Month 1, 3, 6, 9, 12

  3. Calculated Glomerular Filtration Rate (cGFR) Using Modification of Diet in Renal Disease (MDRD) Formula at Month 1, 3, 6, 9, 12

    Time frame: Month 1, 3, 6, 9, 12

    Calculated Glomerular Filtration Rate (cGFR) Using Modification of Diet in Renal Disease (MDRD) Formula at Month 1, 3, 6, 9, 12 cGFR (in mL/min/1.73 m2) = 186.3*(C-1.154)*(A-0.203)*G*R where C = the serum concentration of creatinine (mg/dL), A = age (years), G = 0.742 when gender is female, otherwise G = 1, R = 1.21 when race is black, otherwise R = 1.

  4. Calculated Glomerular Filtration Rate (cGFR) According to Cockcroft-Gault at Month 1, 3, 6, 9, 12

    Time frame: Month 1, 3, 6, 9, 12

    Calculated Glomerular Filtration Rate (cGFR) according to Cockcroft-Gault at Month 1, 3, 6, 9, 12 For men: GFR=(140-Age) x Body weight (kg) / 72 x Serum Creatinine (mg/dl) For women: GFR=0.85 (140 -Age) x Body weight(kg)/ 72 x Serum Creatinine (mg/dl)

  5. Incidence of Patients Experiencing a Decline in GFR of < 10, 10-15, 15-20, 20-25 and > 25 mL/Min From Baseline to Month 6 and 12.

    Time frame: Baseline, Month 6, Month 12

    Incidence of patients experiencing a decline in GFR of < 10, 10-15, 15-20, 20-25 and > 25 mL/min from Baseline to Month 6 and 12calculated by the CKD-EPI method. Participants are counted in each decline level observed for that participant; this means participants may be counted in more than 1 decline level.

  6. Incidence of Renal Replacement Therapy at Month 6 and Month 12

    Time frame: Month 6, Month 12

    Incidence of renal replacement therapy at Month 6 and Month 12: There were no incidences in either group where renal replacement therapy was required

  7. Time to Renal Replacement Therapy at Month 6 and Month 12

    Time frame: Month 6, Month 12

    Time to renal replacement therapy at Month 6 and Month 12: There were no incidences in either group where renal replacement therapy was required

  8. Incidence of Acute Rejection Episodes at Month 6 and Month 12

    Time frame: Month 6, Month 12

    Incidence of acute rejection episodes at Month 6 and Month 12. This table counts multiple occurrences of rejection in the same patient as different incidents. Every incident is associated with both an A and a B classification.

    Classification A: Acute Rejection Grade 0 - none, Grade 1-minimal, Grade 2- mild, Grade 3-moderate, Grade 4-Severe; Classification B: Airway Inflammation-Grade 0-none, Grade 1R-low grade, Grade 2R-high grade, Grade X-ungradeable

  9. Incidence of Graft Loss/Re-transplantation at Month 6 and Month 12

    Time frame: Month 6, Month 12

    Incidence of graft loss/re-transplantation at Month 6 and Month 12

  10. Incidence of Bronchiolitis Obliterans Syndrome (BOS) at Month 6 and Month 12

    Time frame: Month 6, Month 12

    Incidence of Bronchiolitis obliterans syndrome (BOS) at Month 6 and Month 12 BOS 0 is FEV1 > 90% of baseline and FEF25-75% > 75% of baseline; BOS 0-p is FEV1 81-90% of baseline and/or FEF25-75% ≤ 75% of baseline; BOS 1 is FEV1 66-80% of baseline; BOS 2 is FEV1 51-65% of baseline; BOS 3 is FEV1 ≤ 50% of baseline

  11. Incidence of Death at Month 6 and Month 12

    Time frame: Month 6, Month 12

    Incidence of death at Month 6 and Month 12

  12. Quality of Life (QoL, SF36) at Month 6 and Month 12

    Time frame: Month 6, Month 12

    Quality of Life (QoL, SF36) at Month 6 and Month 12 Scores can range from a minimum of 0 (maximum disability) to a maximum of 100 (no disability).

  13. Exercise Capacity 6-Minute Walk Test(6MWT) at Month 6 and Month 12

    Time frame: Month 6, Month 12

    Exercise capacity (6MWT) at Month 6 and Month 12 Measured by the Borg Scale. THE BORG SCALE 0 is Nothing at all, 0.5 is Very, very slight (just noticeable); 1 is Very slight, 2 is Slight (light); 3 is Moderate; 4 is Somewhat severe; 5 is Severe (heavy), 7 is Very severe, 10 is Very, very severe (maximal)The higher the Borg score implies increased shortness of breath and/or increased fatigue.

  14. Incidence of Treated Arterial Hypertension up to Month 12

    Time frame: up to Month 12

    Incidence of treated of arterial hypertension up to Month 12

  15. Incidence of Diabetes Mellitus up to Month 12

    Time frame: up to Month 12

    Incidence of Diabetes Mellitus up to Month 12

  16. Trough Levels of Everolimus at Month 1, 3, 6, 9, 12

    Time frame: Month 1, 3, 6, 9, 12

    Trough levels of everolimus at Month 1, 3, 6, 9, 12

  17. Adherence to Target Ranges of Everolimus at Month 1, 3, 6, 9, 12

    Time frame: Month 1, 3, 6, 9, 12

    Adherence to target ranges of everolimus at Month 1, 3, 6, 9, 12

  18. Trough Levels of Cyclosporine A (CsA) at Month 1, 3, 6, 9, 12

    Time frame: Month 1, 3, 6, 9, 12

    Trough levels of Cyclosporine A (CsA) at Month 1, 3, 6, 9, 12

  19. Adherence to Target Ranges of Cyclosporine A (CsA) at Month 1, 3, 6, 9, 12

    Time frame: Month 1, 3, 6, 9, 12

    Adherence to target ranges of Cyclosporine A (CsA) at Month 1, 3, 6, 9, 12

  20. Trough Levels of Tacrolimus at Month 1, 3, 6, 9, 12

    Time frame: Month 1, 3, 6, 9, 12

    Trough levels of Tacrolimus at Month 1, 3, 6, 9, 12

  21. Adherence to Target Ranges of Tacrolimus at Month 1, 3, 6, 9, 12

    Time frame: Month 1, 3, 6, 9, 12

    Adherence to target ranges of Tacrolimus at Month 1, 3, 6, 9, 12

  22. Incidence of Bacterial, Viral, and Fungal Infections at Month 12

    Time frame: Month 12

    Incidence of bacterial, viral, and fungal infections at Month 12

  23. Triglyceride Levels at Month 1, 3, 6, 9, 12

    Time frame: Month 1, 3, 6, 9, 12

    Triglyceride levels at Month 1, 3, 6, 9, 12

  24. Total Cholesterol Levels at Month 1, 3, 6, 9, 12

    Time frame: Month 1, 3, 6, 9, 12

    Total Cholesterol levels at Month 1, 3, 6, 9, 12

  25. Low-Density Lipoprotein (LDL)Cholesterol Levels at Month 1, 3, 6, 9, 12

    Time frame: Month 1, 3, 6, 9, 12

    LDL Cholesterol levels at Month 1, 3, 6, 9, 12

  26. High-Density Lipoprotein (HDL)Cholesterol Levels at Month 1, 3, 6, 9, 12

    Time frame: Month 1, 3, 6, 9, 12

    HDL Cholesterol levels at Month 1, 3, 6, 9, 12

Sponsors and collaborators

Lead sponsor

Novartis Pharmaceuticals

Industry

Registry information

Official study title

A 2-arm, Prospective, Randomized, Controlled, Open-label, 12 Month Phase III Trial to Evaluate the Efficacy Regarding Renal Function of Everolimus in Combination With a Centre Specific Standard Immunosuppressive Regimen Consisting of CNI, Purinantagonists and Steroids Versus a Standard Triple Immunosuppressive Regimen in Lung Transplant Recipients.

Acronym: 4EVERLUNG

Important dates

Study start
2012
Primary completion
2017
Study completion
2017
First posted
Jul 28, 2011
Registry last updated
Mar 14, 2019

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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