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OpenTrials
Completed

NCT Number: NCT00035555

Study Comparing the Safety and Efficacy of Belatacept With That of Cyclosporine in Patients With a Transplanted Kidney

The purpose of this study is to determine whether treatment with Belatacept (BMS-224818) is as efficacious as treatment with cyclosporine at preventing acute rejection and with a superior safety/tolerability profile (better kidney function and blood pressure, fewer lipid problems, less diabetes mellitus).

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

Univ. of Calif. - San Francisco, San Francisco, California, United States

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Who can participate

Healthy volunteers accepted: No

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

Key inclusion criteria

  • Recipients of first kidney transplant

Key exclusion criteria

  • Those at high risk for acute allograft rejection, including those who receive a second or more renal transplant, those with a history of panel reactive antibody levels >20%, and those considered by investigators to be at relatively higher risk for acute rejection
  • Human leukocyte antigen-identical donor-recipient pairs
  • Cold ischemia time >36 hours (donor kidney)
  • Participants who are positive for hepatitis C antibody, on polymerase chain reaction, for hepatitis B surface antigen, and for human immunodeficiency virus
  • A positive purified protein derivative tuberculosis test (test performed within 1 year of enrollment), unless previously vaccinated with Bacille-Calmette-Guérin or those who had a history of adequate chemoprophylaxis
  • Any active infection that would normally exclude transplantation
  • Recipients of multiple organ transplants
  • Donor age >60 or <6 years or donors whose hearts were not beating
  • Recipients with underlying renal disease of (due to risk of rapid disease recurrence in the allograft): focal segmental glomerulosclerosis, Type I or II membranoproliferative glomerulonephritis, or hemolytic uremic syndrome/ thrombotic thrombocytopenic purpura
  • A positive T-cell lymphocytoxic crossmatch using donor lymphocytes and recipient serum
  • A history of true allergy to intravenous iodinated roentgenographic contrast agents
  • Participants with life expectancy severely limited by disease state or other underlying medical condition
  • A history of cancer (other than nonmelanoma skin cell cancers cured by local resection) within the last 5 years
  • Mammogram film with any clinically significant abnormality requiring further investigation or biopsies
  • History of substance abuse (drug or alcohol) or psychotic disorders that were not compatible with adequate study follow-up
  • A currently functioning, nonrenal transplant
  • Previous treatment with basiliximab for any reason
  • Active peptic ulcer disease, chronic diarrhea, or gastrointestinal malabsorption
  • Those who had used any investigational drug within 30 days before the Day 1 visit.

Treatment and study plan

Belatacept

Drug

Solution, intravenous

Other names: LEA29Y, BMS-224818

cyclosporine

Drug

Oral, capsule

Other names: The cyclosporine used in this study will be in the modified formulation with enhanced bioavailability.

Mycophenolate Mofetil (MMF)

Drug

Oral, capsule

Corticosteroids

Drug

Corticosteroids given daily, orally or intravenously (IV). Day of transplant (Day 1): methylprednisolone, 500 mg, given IV on arrival in operating room; Day 2: methylprednisolone, 250 mg, given IV once daily; Day 3: prednisone, 100 mg, given orally once daily; Day 4: prednisone, 50 mg, given orally once daily; Days 5 through 30: prednisone, 25 mg, given orally once daily; Days 31-44: prednisone, 22.5 mg, given orally once daily; Days 45-58: prednisone, 20 mg, given orally once daily

Primary outcomes

  1. Number of Participants With an Episode of Clinically-suspected and Biopsy-proven Acute Rejection (CSPAR)

    Time frame: By Month 6 posttransplant (From Day 1 to Month 6)

    No participant was to receive treatment for acute rejection without a biopsy to confirm the diagnosis. CSPAR=Clinically-suspected rejection, defined as an increase in serum creatinine ≥0.5 mg/dL compared with the baseline value in the absence of other factors known to adversely affect renal function, and biopsy-proven rejection, which includes all cases in which a biopsy was read by the central pathologist as demonstrating acute rejection regardless of the reason why the biopsy was performed.

Secondary outcomes

  1. Percentage of Participants With Biopsy-proven Acute Rejection (BPAR) Through Months 6 and 12

    Time frame: Through Months 6 and 12 posttransplant (From Day 1 to Months 6 and 12)

    BPAR includes all cases in which a biopsy read by the central pathologist demonstrates acute rejection, regardless of the reason that the biopsy was performed.

  2. Percentage of Participants With Biopsy-proven Acute Rejection (BPAR) or Who Received Treatment for Acute Rejection

    Time frame: By Months 3, 6, and 12 posttransplant (Day 1 to Months 3, 6, and 12)

    BPAR includes all cases in which a biopsy read by the central pathologist demonstrates acute rejection, regardless of the reason that the biopsy was performed. A participant was reported as having had an episode of treated acute rejection if he or she received antirejection therapy during an episode of rejection (clinically-suspected or biopsy-proven rejection).

  3. Percentage of Participants With Acute Rejection or Presumed Acute Rejection (PAR)

    Time frame: By Months 6 and 12 posttransplant (Day 1 to Months 6 and 12)

    Throughout this study, acute rejection=clinically-suspected and biopsy-proven acute rejection (BPAR). Clinically-suspected rejection is defined as an increase in serum creatinine ≥0.5 mg/dL compared with the baseline value in the absence of other factors known to adversely affect renal function. BPAR includes all cases in which a biopsy was read by the central pathologist as demonstrating acute rejection regardless of the reason why the biopsy was performed. PAR is defined as an elevation in SCr ≥0.5 mg/dL compared with the baseline value in the absence of other factors known to adversely affect renal function that led the investigator to suspect that the participant had experienced acute rejection, and in whom either the biopsy did not confirm acute rejection and the participant received treatment for acute rejection or the participant received treatment for acute rejection without a biopsy to confirm the diagnosis.

  4. Percentage of Participants Who Had Chronic Allograft Nephropathy

    Time frame: By Months 6 and 12 posttransplant (Day 1 to Months 6 and 12)

    Based on postbaseline biopsies

  5. Mean Iohexol Clearance

    Time frame: By Months 1, 6, and 12 posttransplant (Day 1 to Months 1, 6, and 12)

    Iohexol, a true glomerular filtration marker, is used to measure glomerular filtration rate.

  6. Percentage of Participants Who Used Antihypertensive Medication

    Time frame: By Months 6 and 12 posttransplant (Day 1 to Months 6 and 12)

    Hypertension is defined as diastolic blood pressure ≥90 mm Hg and/or systolic blood pressure ≥140 mm Hg

  7. Number of Participants With Hypertension

    Time frame: By Months 6 and 12 posttransplant (Day 1 to Months 6 and 12)

    Hypertension is defined as diastolic blood pressure ≥90 mm Hg and/or systolic blood pressure ≥140 mm Hg or, the use of any antihypertensive medication.

  8. Mean LDL Cholesterol, HDL Cholesterol, Total Cholesterol, Triglyceride, and Non-HDL Levels

    Time frame: By Months 1, 6, and 12 posttransplant (Day 1 to Months 1, 6, and 12)

    LDL=low-density lipoprotein; HDL=high-density lipoprotein. Total cholesterol=LDL + HDL + very low-density (VLDL) cholesterol. VLDL=triglycerides divided by 5. Non-HDL cholesterol=Total cholesterol minus HDL cholesterol.

  9. Number of Participants With Posttransplant Diabetes Mellitus

    Time frame: By Months 1, 3, 6, 9, and 12 posttransplant (Day 1 to Months 1, 3, 6, 9, and 12 )

    Posttransplant diabetes mellitus is defined as the need for treatment of hyperglycemia with either an oral agent or insulin for a total of >4 weeks or hemoglobin A1c (HbA1c) >7% in a participant not known to be diabetic prior to transplantation

Other outcomes

  1. Number of Participants With Death as Outcome, Serious Adverse Events (SAEs), Treatment-related SAEs, Discontinuations Due to SAEs, Adverse Events (AEs), Treatment-related AEs, and Discontinuations Due to AEs

    Time frame: Day 1 (posttransplant) continuously to 56 days following last dose of study medication

    AE=any new unfavorable symptom, sign, or disease or worsening of a preexisting condition that may not have a causal relationship with treatment. SAE=a medical event that at any dose results in death, persistent or significant disability/incapacity, or drug dependency/abuse; is life-threatening, an important medical event, or a congenital anomaly/birth defect; or requires or prolongs hospitalization. Treatment-related=having certain, probable, possible, or missing relationship to study drug.

  2. Number of Participants Meeting Marked Abnormality Criteria for Select Hemolytic, Blood Chemistry, and Urinalysis Laboratory Test Results

    Time frame: Days 8 and Months 1, 3, 6, 9, and 12 posttransplant (from Day 1)

    Normal laboratory values: Hemoglobin (g/dL): Males (18-64 years) 13.8-17, (65 years and older) 11.8-16.8; Females (18-64 years) 12.0-15.6, F (65 years and older) 11.1-15.5. Platelets (per mm^3) 130,000-400,000. Leukocytes (18 years and older) 3.8-10.8 1000/uL. ALT (u/L)(13 years and older) 0-48.

Sponsors and collaborators

Lead sponsor

Bristol-Myers Squibb

Industry

Registry information

Official study title

Phase II/III, Open-Label, Randomized, Controlled, Multiple-Dose Study of Efficacy and Safety of BMS-224818 (Belatacept) as Part of a Quadruple Drug Regimen in First Renal Transplant Recipients

Important dates

Study start
2001
Primary completion
2004
Study completion
2012
First posted
May 6, 2002
Registry last updated
Jan 13, 2014

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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