Phase 3
N=109
Canadian Cardiology de Novo Study: A Comparison Between Tacrolimus- and Cyclosporine- Based Immunoprophylactic Regimens
Heart Diseases · Heart Transplantation
Bottom Line
View on ClinicalTrials.gov: NCT00157014 ↗Enrolled (actual)
109
Serious AEs
48.6%
Results posted
Feb 2011
Primary outcome: Primary: The Change in the Markers of Growth, Apoptosis, Inflammation and Oxidation Measured in Endomyocardial Biopsies — 0.70; 0.90; 0.87; 0.79 Densitometry / Densitometry of GAPDH
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Tacrolimus (Drug); Cyclosporine (Drug); Mycophenolate mofetil (Drug); Methylprednisolone (Drug); Prednisone (Drug)
- Age
- Pediatric, Adult, Older Adult
- Sex
- All
- Sponsor
- Astellas Pharma Inc
- Primary completion
- Jul 2008
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY The Change in the Markers of Growth, Apoptosis, Inflammation and Oxidation Measured in Endomyocardial Biopsies |
0.70; 0.90; 0.87; 0.79; 0.05; -0.05 | — |
| PRIMARY The Change in the Markers of Growth, Apoptosis, Inflammation and Oxidation Measured in Endomyocardial Biopsies (Pediatric Population) |
1.74; 1.67; 0.93; 1.22; -0.09; -0.27 | — |
| SECONDARY Changes in Circulating Markers of Inflammation, Oxidation, Growth, Apoptosis, Differentiation and Survival: MCP-1 |
233.05; 193.63; 229.96; 180.90; 42.92; -16.49 | — |
| SECONDARY Changes in Circulating Markers of Inflammation, Oxidation, Growth, Apoptosis, Differentiation and Survival: s-ICAM |
766.58; 674.46; 590.30; 503.71; -227.58; -183.96 | — |
| SECONDARY Changes in Circulating Markers of Inflammation, Oxidation, Growth, Apoptosis, Differentiation and Survival: E-selectin |
90.40; 98.96; 68.60; 80.93; -18.58; -19.16 | — |
| SECONDARY Changes in Circulating Markers of Inflammation, Oxidation, Growth, Apoptosis, Differentiation and Survival: Homocysteine |
14.2; 15.9; 13.5; 15.8; 0.3; 0.7 | — |
| SECONDARY Changes in Circulating Markers of Inflammation, Oxidation, Growth, Apoptosis, Differentiation and Survival: hsCRP |
32.85; 21.83; 3.01; 3.95; -34.32; -18.69 | — |
| SECONDARY Changes in Circulating Markers of Inflammation, Oxidation, Growth, Apoptosis, Differentiation and Survival: F2 Isoprostanes |
52.03; 53.94; 30.08; 50.44; -13.29; -3.43 | — |
| SECONDARY Changes in Circulating Markers of Inflammation, Oxidation, Growth, Apoptosis, Differentiation and Survival: T-bars |
3.78; 3.91; 3.25; 3.14; -0.64; -0.77 | — |
| SECONDARY Changes in Circulating Markers of Inflammation, Oxidation, Growth, Apoptosis, Differentiation and Survival: Nitrotyrosine |
422.63; 482.43; 451.88; 368.95; 71.44; -99.79 | — |
| SECONDARY Changes in Circulating Markers of Inflammation, Oxidation, Growth, Apoptosis, Differentiation and Survival: GSH/GSSG |
55.07; 58.83; 51.69; 53.72; -2.07; -5.55 | — |
| SECONDARY Changes in Circulating Markers of Inflammation, Oxidation, Growth, Apoptosis, Differentiation and Survival: BNP |
4314.8; 4240.8; 670.1; 1856.8; -4018.4; -1446.7 | — |
| SECONDARY Changes in Circulating Markers of Inflammation, Oxidation, Growth, Apoptosis, Differentiation and Survival: Troponin T |
0.30; 0.28; 0.03; 0.04; -0.32; -0.27 | — |
| SECONDARY Changes in Circulating Markers of Inflammation, Oxidation, Growth, Apoptosis, Differentiation and Survival: Osteopontin |
11.88; 11.14; 8.77; 10.49; -2.22; 0.20 | — |
| SECONDARY Changes in Circulating Markers of Inflammation, Oxidation, Growth, Apoptosis, Differentiation and Survival: Fibrinogen |
4.4; 4.4; 3.4; 3.8; -1.1; -0.5 | — |
| SECONDARY Changes in Circulating Markers of Inflammation, Oxidation, Growth, Apoptosis, Differentiation and Survival: IL-6 |
3.36; 2.54; 0.98; 0.90; -2.84; -1.56 | — |
| SECONDARY Changes in Circulating Markers of Inflammation, Oxidation, Growth, Apoptosis, Differentiation and Survival: IL-18 |
574.0; 496.2; 534.6; 427.2; 5.2; -71.0 | — |
| SECONDARY Changes in Circulating Markers of Inflammation, Oxidation, Growth, Apoptosis, Differentiation and Survival: Cystatin-C |
1.21; 1.29; 1.29; 1.48; 0.06; 0.27 | — |
| SECONDARY Number of Acute Rejection Episodes by International Society of Heart and Lung Transplantation (ISHLT) Criteria |
8; 8; 3; 7; 6; 2 | — |
| SECONDARY Time to First Acute Rejection Episode Following de Novo Cardiac Transplant |
55.0; 35.60 | — |
| SECONDARY Number of Patients Requiring Antilymphocyte Antibodies or Steroids for Treatment of Severe Acute Rejection |
0; 0 | — |
| SECONDARY Number of Cardiac Rejection Episodes Requiring Treatment |
12; 11 | — |
| SECONDARY Mean Cases of Acute Rejection (MCAR) Per Patient |
0.15; 0.17 | 0.4725 |
| SECONDARY Number of Patients With Successful Steroid Taper or Withdrawal at Weeks 26 and 52 |
22; 16; 33; 29 | — |
| SECONDARY Number of Patients With Treatment Failure and Crossover for Treatment Failure |
6; 11; 2; 8 | — |
| SECONDARY Changes in Circulating Markers of Inflammation and Oxidation: F2 Isoprostanes (Pediatric Population) |
106.06; 104.68; 69.71; 66.48; -38.31; -30.07 | — |
| SECONDARY Changes in Circulating Markers of Inflammation and Oxidation: Nitrotyrosine (Pediatric Population) |
233.08; 12701.21; 5462.99; 41147.62; 5148.42; 21514.62 | — |
| SECONDARY Changes in Circulating Markers of Inflammation and Oxidation: hsCRP (Pediatric Population) |
30.46; 12.08; 26.31; 2.43; -7.85; -13.94 | — |
| SECONDARY Changes in Circulating Markers of Inflammation and Oxidation: Cystatin-C (Pediatric Population) |
0.86; 0.77; 0.87; 0.84; -0.11; -0.01 | — |
| SECONDARY Number of Acute Rejection Episodes by International Society of Heart and Lung Transplantation (ISHLT) Criteria (Pediatric Population) |
3; 3; 3; 3; 0; 0 | — |
| SECONDARY Time to First Acute Rejection Episode Following de Novo Cardiac Transplant (Pediatric Population) |
56.3; 49.0 | — |
| SECONDARY Number of Patients Requiring Antilymphocyte Antibodies or Steroids for Treatment of Severe Acute Rejection (Pediatric Population) |
0; 0 | — |
| SECONDARY Number of Cardiac Rejection Episodes Requiring Treatment (Pediatric Population) |
3; 3 | — |
| SECONDARY Mean Cases of Acute Rejection (MCAR) Per Patient (Pediatric Population) |
0.60; 0.50 | 0.8373 |
| SECONDARY Number of Patients With Successful Steroid Taper or Withdrawal at Weeks 26 and 52 (Pediatric Population) |
2; 3; 1; 1 | — |
| SECONDARY Number of Patients With Treatment Failure and Crossover for Treatment Failure (Pediatric Population) |
1; 3; 0; 3 | — |
Summary
The purpose of this study is to assess the safety and efficacy of tacrolimus in de novo heart transplantation.
Eligibility Criteria
Inclusion Criteria
- Patients (or their legal guardians) who are capable of understanding, and who have been fully informed of the purpose of the study and the risks of participation.
- Patients (or their legal guardians) who have signed and dated the Informed Consent form and are willing and able to follow the study protocol.
- Patients who are primary cadaveric heart transplant recipients.
- Males or females from birth.
- Female patients of child-bearing potential who have a current negative pregnancy test and agree to practice effective birth control, as judged by the investigator, while participating in the study. Prepubescent pediatric patients will not require pregnancy testing.
- Patients able to tolerate oral medication and who do not have a gastrointestinal condition likely to affect the absorption kinetics or metabolism of the oral study medications.
Exclusion Criteria
- Previous organ transplant recipients.
- Multi-organ transplant recipients.
- Recipients of a heart from a donor with incompatible ABO blood type.
- Patients with significant graft dysfunction and/or significant de novo infection(s) at time of randomization
- Patients with known hypersensitivity to tacrolimus, cyclosporine, mycophenolate mofetil (MMF), daclizumab, prednisone, cremophor, polysorbate 80 and/or polyoxyl 60 hydrogenated castor oil (HCO-60).
- Patients who are pregnant or lactating or planning to become pregnant prior to completion of the study.
- Patients who have consumed an investigational product in the 30 days prior to transplantation or at any time during post-transplantation follow-up.
- Patients receiving cholestyramine or colestipol.
- Patients having any one of the following at enrolment:
- History of malignancy, not chart-documented as cured or active malignancy (with exception of eradicable non-metastatic in-situ basal cell or squamous cell carcinoma).
- Leukopenia (white cell count 230 umol/l.
- Continual elevation of AST and/or ALT to >= 3X the upper limit of normal.
- Body mass index (weight in kg/height in m2) > 30.
- Undiagnosed diabetes mellitus as determined by 2 hour (2h) oral glucose tolerance test (OGTT) or fasting glucose test or uncontrolled diabetes mellitus at screening. In either case, the patient may be declared as no longer excluded by this criterion upon establishment of control of the diabetes through appropriate medical management.
- Blood glucose >= 11.1 mmol/L at pre-operative assessment.
- Patients having a significant disease, substance dependency, or disability that may prevent adherence to, or understanding of, the protocol and/or the investigator's instructions.
Data sourced from ClinicalTrials.gov (NCT00157014). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.