A multi-centre, open, prospective, randomized, parallel-group, 24-month study to compare the outcome of receiving continued immunosuppression versus stopping immunosuppression at 6 months to safely prevent human leukocyte antigen (HLA) sensitization in patients with late renal graft failure

2023-506879-98-00 Protocol PREVSENSI Therapeutic use (Phase IV) Ongoing, recruiting

Start 22 Jan 2024 · Status Ongoing, recruiting · 1 EU/EEA countries · 6 sites · Protocol PREVSENSI

Overview

Sponsor-declared trial summary

Phase Therapeutic use (Phase IV)
Status Ongoing, recruiting
Participants planned 202
Countries 1
Sites 6

Renal transplantation

To compare the degree of HLA sensitization at 2 years in patients with late renal graft failure (> 3 months) when receiving reduced immunosuppressant treatment versus stopping immunosuppression at 6 months.

Key facts

Sponsor
Vall D'hebron Institut De Recerca
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male and Female
Therapeutic area
Diseases [C] - Pathological Conditions, Signs and Symptoms [C23]
Trial duration
22 Jan 2024 → ongoing
Decision date (initial)
2023-11-10
Transition trial
No
Low-intervention
Yes
Rare-disease indication
No
Vulnerable population
No
Funding sources
Instituto de Salud Carlos III

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Therapy, Safety, Efficacy

To compare the degree of HLA sensitization at 2 years in patients with late renal graft failure (> 3 months) when receiving reduced immunosuppressant treatment versus stopping immunosuppression at 6 months.

Secondary objectives 1

  1. (1) To compare the following outcomes at 2 years in patients with late renal graft failure (> 3 months) when receiving reduced immunosuppressant treatment versus stopping immunosuppression at 6 months: •Mortality for any reason • Days of hospitalization for any reason • Percentage of patients effectively relisted during follow-up • Percentage of patients transplanted • Percentage of patients delisted for any reason • Incidence of infection • Incidence of cardiovascular events • Incidence of cancer • Incidence of graft-intolerance syndrome requiring graft nephrectomy or percutaneous embolization of the non-functioning graft • Erythropoietin resistance index • Residual renal function • Number of circulating memory B-cells. (2) To compare the incidence of adverse events in both treatment arms.

Conditions and MedDRA coding

Renal transplantation

Study design 1 period

#TitleAllocationBlindingRoles blindedArms
1 PREVSENSI
Phase IV clinical trial, prospective, randomized, multicentric, open-labeled with parallel groups. Patients will beallocated to the control or investigation arm.
Randomised Controlled None Control arm: - Patients will continue to take CNI the first 3 months of the study (Day 1 to Day 90) to the same whole blood levels that they were taking before enrolling in the study (in general, 4-7 ng/ml tacrolimus or 50-100 ng/ml cyclosporine).
- CNI dose (tacrolimus or cyclosporine) will be reduced to one-half on Day 90 (month 3 visit) and completely withdrawn on Day 180 (month 6 visit).
Investigation arm: - Patients will continue to take CNI the first 3 months of the study (Day 1 to Day 90) to the same whole blood levels that they were taking before enrolling in the study (in general 4-7 ng ng/ml for tacrolimus or 50-100 ng/ml for cyclosporine).
- CNI dose (tacrolimus or cyclosporine) will be adjusted to maintain low tacrolimus (3-6 ng/ml) or cyclosporine (25-75 ng/ml) whole blood trough levels from Day 90 (month 3) to Day 720 (month 24 or End of Study).

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 1

  1. Patients eligible for the study must comply with all of the following at randomization; Patient must be able to understand and provide written informed consent; Patients older than 18 years who had received at least one previous renal transplant; Patients with a retained kidney graft failed for any reason which survived at least 3 months; Patients on dialysis, either hemodialysis or peritoneal dialysis. Patients can be on dialysis for a maximum of 6 months at the time of randomization, as long as the patients have taken an uninterrupted immunosuppressive regimen of calcineurin inhibitors (tacrolimus or cyclosporine) and steroids since dialysis was restarted. This period may be extended up to 12 months if the immunosuppressive regimen has remained stable and has not been reduced by more than 50%.; Patients already relisted or candidates to relist to deceased donor kidney transplantation according to the treating physician criteria; Patients taking immunosuppressants tacrolimus or cyclosporine; cPRA at the time of randomization ≤ 90%.

Exclusion criteria 1

  1. The following patients will be excluded from the study: Patients who have received another solid organ transplantation (liver, lung, heart or pancreas); Patients waiting for a living related / unrelated kidney transplant; Graft survival of the failed graft lower than 3 months; Patients in dialysis more than 6 months at the time of randomization, unless they have maintained a stable immunosuppressive regimen (calcineurin inhibitors and steroids, without reductions greater than 50%) since dialysis was restarted; in that case, patients will be excluded if they have been on dialysis for more than 12 months.; Patients not accomplishing criteria to relist in the transplantation list according to the treating physician criteria; Pregnant women; • Females of childbearing age who have not used or do not plan to use acceptable birth control measures, for the duration of the study; Patients should use one of the acceptable birth control measures recommended in the document “Recommendations related to contraception and pregnancy testing in clinical trials” published by the Clinical Trials Facilitation and Coordination Group (CTFG) (version 1.1, published 21/09/2020). Recommended birth control measures include oral, injected or implanted hormonal contraceptive, barrier methods (condom or diaphragm with spermicide), intrauterine device, surgical sterilization, transdermal delivery, or sexual abstinence. If sexually active, the subject must have been using one of the accepted birth control methods at least one month prior to study entry

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. The primary variable will be the difference between the two treatment arms in the degree of HLA sensitization at 2-years measured as cPRA (%).

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 22

Prograf 0,5 mg Cápsulas duras

PRD328850 · Product

Active substance
Tacrolimus
Pharmaceutical form
CAPSULE, HARD
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
14400 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD02 — -
Marketing authorisation
63.189
MA holder
ASTELLAS PHARMA S.A.
MA country
Spain
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Prograf 5 mg Cápsulas duras

PRD334469 · Product

Active substance
Tacrolimus
Pharmaceutical form
CAPSULE, HARD
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
14400 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD02 — -
Marketing authorisation
61.005
MA holder
ASTELLAS PHARMA S.A.
MA country
Spain
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Prograf 1 mg Cápsulas duras

PRD334470 · Product

Active substance
Tacrolimus
Pharmaceutical form
CAPSULE, HARD
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
14400 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD02 — -
Marketing authorisation
61.006
MA holder
ASTELLAS PHARMA S.A.
MA country
Spain
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Envarsus 4 mg prolonged-release tablets

PRD1609569 · Product

Active substance
Tacrolimus
Pharmaceutical form
PROLONGED-RELEASE TABLET
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
14400 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD02 — -
Marketing authorisation
EU/1/14/935/007
MA holder
CHIESI FARMACEUTICI S.P.A.
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Envarsus 1 mg prolonged-release tablets

PRD1609561 · Product

Active substance
Tacrolimus
Pharmaceutical form
PROLONGED-RELEASE TABLET
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
14400 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD02 — -
Marketing authorisation
EU/1/14/935/004
MA holder
CHIESI FARMACEUTICI S.P.A.
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Envarsus 0.75 mg prolonged-release tablets

PRD1609514 · Product

Active substance
Tacrolimus
Pharmaceutical form
PROLONGED-RELEASE TABLET
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
14400 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD02 — -
Marketing authorisation
EU/1/14/935/001
MA holder
CHIESI FARMACEUTICI S.P.A.
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Advagraf 1 mg prolonged-release hard capsules

PRD328675 · Product

Active substance
Tacrolimus
Pharmaceutical form
PROLONGED-RELEASE CAPSULE, HARD
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
14400 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD02 — -
Marketing authorisation
EU/1/07/387/003
MA holder
ASTELLAS PHARMA EUROPE B.V.
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Advagraf 3 mg prolonged-release hard capsules

PRD324632 · Product

Active substance
Tacrolimus
Pharmaceutical form
PROLONGED-RELEASE CAPSULE, HARD
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
14400 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD02 — -
Marketing authorisation
EU/1/07/387/011
MA holder
ASTELLAS PHARMA EUROPE B.V.
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Advagraf 5 mg prolonged-release hard capsules

PRD324633 · Product

Active substance
Tacrolimus
Pharmaceutical form
PROLONGED-RELEASE CAPSULE, HARD
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
14400 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD02 — -
Marketing authorisation
EU/1/07/387/007
MA holder
ASTELLAS PHARMA EUROPE B.V.
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Advagraf 0.5 mg prolonged-release hard capsules

PRD330537 · Product

Active substance
Tacrolimus
Pharmaceutical form
PROLONGED-RELEASE CAPSULE, HARD
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
14400 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD02 — -
Marketing authorisation
EU/1/07/387/001
MA holder
ASTELLAS PHARMA EUROPE B.V.
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sandimmun Neoral 50 mg cápsulas blandas

PRD2548632 · Product

Active substance
Ciclosporin
Pharmaceutical form
CAPSULE, SOFT
Route of administration
ORAL
Max daily dose
500 mg milligram(s)
Max total dose
360000 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD01 — -
Marketing authorisation
60.318
MA holder
NOVARTIS FARMACÉUTICA S.A.
MA country
Spain
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sandimmun Neoral 25 mg cápsulas blandas

PRD2548631 · Product

Active substance
Ciclosporin
Pharmaceutical form
CAPSULE, SOFT
Route of administration
ORAL
Max daily dose
500 mg milligram(s)
Max total dose
360000 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD01 — -
Marketing authorisation
60.319
MA holder
NOVARTIS FARMACÉUTICA S.A.
MA country
Spain
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sandimmun Neoral 100 mg cápsulas blandas

PRD2548629 · Product

Active substance
Ciclosporin
Pharmaceutical form
CAPSULE, SOFT
Route of administration
ORAL
Max daily dose
500 mg milligram(s)
Max total dose
360000 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD01 — -
Marketing authorisation
60.320
MA holder
NOVARTIS FARMACÉUTICA S.A.
MA country
Spain
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Conferoport 3 mg cápsulas duras de liberación prolongada EFG

PRD7711705 · Product

Active substance
Tacrolimus
Pharmaceutical form
PROLONGED-RELEASE CAPSULE, HARD
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
14400 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD02 — -
Marketing authorisation
84631
MA holder
SANDOZ FARMACÉUTICA, S.A.
MA country
Spain
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Conferoport 2 mg cápsulas duras de liberación prolongada

PRD7711698 · Product

Active substance
Tacrolimus
Pharmaceutical form
PROLONGED-RELEASE CAPSULE, HARD
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
14400 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD02 — -
Marketing authorisation
84630
MA holder
SANDOZ FARMACÉUTICA, S.A.
MA country
Spain
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Conferoport 0,5 mg cápsulas duras de liberación prolongada EFG

PRD7711696 · Product

Active substance
Tacrolimus
Pharmaceutical form
PROLONGED-RELEASE CAPSULE, HARD
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
14400 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD02 — -
Marketing authorisation
84607
MA holder
SANDOZ FARMACÉUTICA, S.A.
MA country
Spain
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Conferoport 1 mg cápsulas duras de liberación prolongada EFG

PRD7711697 · Product

Active substance
Tacrolimus
Pharmaceutical form
PROLONGED-RELEASE CAPSULE, HARD
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
14400 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD02 — -
Marketing authorisation
84629
MA holder
SANDOZ FARMACÉUTICA, S.A.
MA country
Spain
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Conferoport 5 mg cápsulas duras de liberación prolongada EFG

PRD7711706 · Product

Active substance
Tacrolimus
Pharmaceutical form
PROLONGED-RELEASE CAPSULE, HARD
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
14400 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD02 — -
Marketing authorisation
84632
MA holder
SANDOZ FARMACÉUTICA, S.A.
MA country
Spain
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Adoport 0,5 mg cápsulas duras EFG

PRD795761 · Product

Active substance
Tacrolimus
Pharmaceutical form
CAPSULE, HARD
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
14400 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD02 — -
Marketing authorisation
71673
MA holder
SANDOZ FARMACÉUTICA, S.A.
MA country
Spain
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Adoport 1 mg cápsulas duras EFG

PRD796006 · Product

Active substance
Tacrolimus
Pharmaceutical form
CAPSULE, HARD
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
14400 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD02 — -
Marketing authorisation
71674
MA holder
SANDOZ FARMACÉUTICA, S.A.
MA country
Spain
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Adoport 2 mg cápsulas duras

PRD2419821 · Product

Active substance
Tacrolimus
Pharmaceutical form
CAPSULE, HARD
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
14400 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD02 — -
Marketing authorisation
79456
MA holder
SANDOZ FARMACÉUTICA, S.A.
MA country
Spain
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Adoport 5 mg cápsulas duras EFG

PRD795764 · Product

Active substance
Tacrolimus
Pharmaceutical form
CAPSULE, HARD
Route of administration
ORAL
Max daily dose
20 mg milligram(s)
Max total dose
14400 mg milligram(s)
Max treatment duration
720 Day(s)
Authorisation status
Authorised
ATC code
L04AD02 — -
Marketing authorisation
71675
MA holder
SANDOZ FARMACÉUTICA, S.A.
MA country
Spain
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Vall D'hebron Institut De Recerca

2 Total trials 1 Recruiting
Academic / Non-commercial
Sponsor organisation
Vall D'hebron Institut De Recerca
Address
Passeig De La Vall D'hebron 119-129
City
Barcelona
Postcode
08035
Country
Spain

Scientific contact point

Organisation
Vall D'hebron Institut De Recerca
Contact name
Laura Cascales

Public contact point

Organisation
Vall D'hebron Institut De Recerca
Contact name
Laura Cascales

Locations

1 EU/EEA country · 6 investigational sites

By country

CountryMS statusPlanned subjectsSites
Spain Ongoing, recruiting 202 6
Rest of world 0

Investigational sites

Spain

6 sites · Ongoing, recruiting
Fundacio Puigvert
Nephrology, Calle De Cartagena 340-350, 08025, Barcelona
Bellvitge University Hospital
Nephrology, Carrer De La Feixa Llarga Sn, 08907, L'hospitalet De Llobregat
Hospital Clinic De Barcelona
Nephrology, Calle Villarroel 170, 08036, Barcelona
Hospital Del Mar
Nephrology, Passeig Maritim De La Barceloneta 25-29, 08003, Barcelona
Hospital Germans Trias I Pujol
Nephrology, Carretera Canyet 1a Planta, 08916, Badalona
Hospital Universitari Vall D Hebron
Nephrology, Edificio Materno-Infantil, Passeig De La Vall D'hebron 119-129, Barcelona

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Country Trial startTrial end Recruitment startRecruitment end Early termination
Spain 2024-01-22 2024-01-30

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 27 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1_Protocol_2023-506879-98-00 1
Protocol (for publication) D1_Protocol_EU CT 2023-506879-98-00_cambios 4.0
Protocol (for publication) D1_Protocol_EU CT 2023-506879-98-00_limpio 4.0
Protocol (for publication) D1_Protocol_SM1_2023-506879-98-00 2.0
Protocol (for publication) D1_SM2_Protocol_2023-506879-98-00 3.0
Recruitment arrangements (for publication) K1_Recruitment arrangements 1
Recruitment arrangements (for publication) K2_Satalite sites process 1
Recruitment arrangements (for publication) K2_SM2_Satalite sites process 2.0
Recruitment arrangements (for publication) K2_SM2_Satalite sites process_cambios 2.0
Subject information and informed consent form (for publication) L1_SIS and ICF Adults_ limpia 3.0
Subject information and informed consent form (for publication) L1_SIS and ICF Adults_cambios 3.0
Subject information and informed consent form (for publication) L1_SIS and ICF_patients 1
Subject information and informed consent form (for publication) L1_SIS and ICF_patients_SM1 2.0
Subject information and informed consent form (for publication) L1_SM2_SIS and ICF_patients 2.1
Summary of Product Characteristics (SmPC) (for publication) G2_SmPC_Adoport 1
Summary of Product Characteristics (SmPC) (for publication) G2_SmPC_Advagraf 1
Summary of Product Characteristics (SmPC) (for publication) G2_SmPC_Conferoport 1
Summary of Product Characteristics (SmPC) (for publication) G2_SmPC_Envarsus 1
Summary of Product Characteristics (SmPC) (for publication) G2_SmPC_Prograf 1
Summary of Product Characteristics (SmPC) (for publication) G2_SmPC_Sandimmun Neoral 1
Synopsis of the protocol (for publication) D1_Protocol synopsis EU CT 2023-506879-98-00 cambios 4.0
Synopsis of the protocol (for publication) D1_Protocol synopsis EU CT 2023-506879-98-00_limpia 4.0
Synopsis of the protocol (for publication) D1_Protocol synopsis Spanish EU CT 2023-506879-98-00 limpia 4.0
Synopsis of the protocol (for publication) D1_Protocol synopsis Spanish EU CT 2023-506879-98-00_cambios 4.0
Synopsis of the protocol (for publication) D1_Protocol synopsis_ESP_2023-506879-98-00 1
Synopsis of the protocol (for publication) D1_Protocol synopsis_ESP_SM1_2023-506879-98-00 2.0
Synopsis of the protocol (for publication) D1_SM2_Protocol synopsis_ESP_2023-506879-98-00 3.0

Application history

5 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2023-08-03 Spain Acceptable
2023-11-10
2023-11-10
2 SUBSTANTIAL MODIFICATION SM-1 2024-03-20 Spain Acceptable
2024-04-26
2024-04-26
3 SUBSTANTIAL MODIFICATION SM-2 2024-08-06 Spain Acceptable
2024-09-25
2024-09-25
4 SUBSTANTIAL MODIFICATION SM-3 2026-01-15 Spain Acceptable
2026-03-02
2026-03-06
5 NON SUBSTANTIAL MODIFICATION NSM-1 2026-03-25 Spain Acceptable
2026-03-02
2026-03-25