Gengraf Conversion Study in Stable Renal Allograft Transplant Recipients

The introduction of cyclosporine (CsA) into clinical practice resulted in improvements in acute renal allograft rejection rate and graft survival in renal transplant patients. Gengraf a microemulsion formulation of CsA though granted an AB-rated equivalent to Neoral, because of concerns over the use of generic drugs in transplantation, we undertook this study to evaluate the clinical efficacy and safety of Gengraf.

We conducted a multicenter, randomized, open labeled study to establish the equivalence between Gengraf and Neoral in stable renal transplant recipients for a treatment period of 6 months. 6 months post transplant patients with stable graft function and receiving a stable dose of neoral were recruited into the study. Eligible patients were randomly assigned to remain on Neoral or convert to an equal milligram-for-milligram dose of Gengraf. The primary end-point was serum creatinine at 26 weeks.

Inclusion criteria

• Written informed consent obtained from patient or parents/guardian.
• Patients who are more than 6 months post transplant
• Stable graft function i.e. serum creatinine less than 300 umol/l
• Patients currently on a stable dose of capsule Neoral within last one month

Exclusion criteria

• Multiple organ transplantation
• Pregnant or nursing woman, or women of childbearing potential without an effective method of birth control. Effective birth control methods are oral contraception, Norplant, surgical sterilization, Intra Uterine Device or diaphragms in conjunction with spermicidal foam and condom on the male partner.
• Participation in any drug trial in which the patient received an investigational drug within 30 days preceding the screening phase of this study.
• Those persons directly involved in the conduct of the study.
• Active infection at the time of screening for enrollment into trial.
• Acute graft rejection within the past 3 months
• Mentally unstable or history of mental diseases
• History of drug or alcohol abuse within the past 2 years.
• History of non-compliance to medical regimen and patients who are unwilling or unable to comply with the protocol.
• Decompensated liver disease
• Any serious medical conditions or disability, which in the opinion of the investigator, would interfere with treatment or assessment or preclude completion of this study