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OpenTrials
Completed

NCT Number: NCT02954198

Once-daily Regimen With Envarsus® to Optimize Immunosuppression Management and Outcomes in Kidney Transplant Recipients

With the availability of well-studied once-daily formulations of tacrolimus, the ability to achieve a true once-daily immunosuppressant regimen along with everolimus and steroids may finally be achievable and have the potential to optimize immunosuppression safety and efficacy in kidney transplantation.

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Key information

Conditions

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Medical University of South Carolina

Charleston, South Carolina, 29425, United States

About this study

A once-daily immunosuppressant regimen comprising of Envarsus-everolimus-prednisone will have 6-month treatment failure rates that are non-inferior to the twice-daily regimen of Envarsus-mycophenolate mofetil-prednisone and will have improved patient-reported adherence.

Who can participate

Healthy volunteers accepted: No

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

  • Inclusion criteria
  • Male or female adult (≥18 years old) with a history of solitary kidney transplant within 3 months (±2 months) of transplant with self-reported medication adherence issues, as indicated by a MMAS-8 of at least 1.
  • Patients must be capable of understanding the purposes and risks of the study and have the ability to give written informed consent and be willing to participate and comply with the study.
  • Women of childbearing potential must have a negative pregnancy test within the 48 hours prior to receiving study medication.
  • Women of childbearing potential and sexually active males must be willing to use contraception, as indicated in Section 6 of the protocol. Subjects who are not of reproductive potential (status post bilateral tubal ligation, bilateral oophorectomy, hysterectomy, or vasectomy), not sexually active, whose current partner(s) is not of reproductive potential, or whose sexual activity is exclusively homosexual are eligible without requiring the use of contraception.
  • Exclusion criteria
  • Patients will be excluded if they are pregnant or nursing females or males with a pregnant female partner
  • Recipient of multiple organ transplant
  • Recipient of a non-renal organ
  • Proteinuria > 800 mg/24 hour
  • eGFR < 30 ml/min
  • WBC ≤ 2k/mm3
  • Plt ≤ 50k/mm3
  • Triglycerides > 500 mg/dL
  • HIV positive (HIV ab +)
  • Unable to tolerate oral medications
  • Use of another investigational product within thirty days prior to receiving study medication
  • Acute graft rejection within the past month (Banff 1A or higher) or received an ABO incompatible donor organ.
  • A condition or disorder that, in the opinion of the investigator, may adversely affect the outcome of the study or the safety of the subject

Treatment and study plan

Tacrolimus

Drug

goal trough level 5-12ng/mL

Other names: Envarsus

Prednisone

Drug

goal dose 5mg QD

Other names: Corticosteroids, Methylprednisolone

Mycophenolate mofetil

Drug

goal dose 1g BID

Everolimus

Drug

goal trough level 3-8ng/mL

Primary outcomes

  1. Self-reported Medication Adherence From Baseline to 6 Months.

    Time frame: 6 months post conversion

    Percent of subjects reporting high medication adherence at baseline compared to 6 months post-conversion, using the Morisky Medication Adherence scale (MMAS). The MMAS rates medication adherence on a scale of 0 to 8. 0 is high adherence, 1-2 is medium adherence, and greater than or equal to 3 is low adherence.

Secondary outcomes

  1. Percent of Participants Experiencing Acute Allograft Rejection

    Time frame: Baseline to 6 months post conversion

    Estimate the composite of treatment failure rate, defined as acute allograft rejection with a Banff grade 1A or higher, graft loss, or death at six months post-conversion, in patients converted to a once-daily immunosuppressant regimen of Envarsus®, everolimus, and prednisone versus patients converted to a twice-daily regimen of Envarsus®, MMF, and prednisone.

Other outcomes

  1. Subject Specific Change on Medication Side Effect Scale

    Time frame: Baseline to 6 months post conversion

    Examine subject specific change on a validated Medication Side Effect Scale at the time of the conversion versus six months post-conversion, compared between the two arms. Side effect burden scale is from 0 to 180. A lower score is less side effect burden, a higher score is more side effect burden.

  2. Percent of Participants Who Experienced Kidney Transplant Graft Loss

    Time frame: Baseline to 6 months post conversion

    Measure and compare time-to-event analysis between the two arms graft loss (time to event analysis)

Sponsors and collaborators

Lead sponsor

Medical University of South Carolina

Other

Registry information

Important dates

Study start
2016
Primary completion
2018
Study completion
2018
First posted
Nov 3, 2016
Registry last updated
Dec 24, 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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