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Phase 4 N=89 Randomized Treatment

Multicenter, Randomized, Open-label Study to Assess Whether Treatment With Mycophenolate Sodium (MPS) Allows Higher Dose Optimization Versus Mycophenolate Mofetil (MMF) Leading to a Dose Reduction of Tacrolimus. Maximiza Study.

Prophilaxis of Acute Rejection in Patients Receiving a Renal Allograft

Enrolled (actual)
89
Serious AEs
7.0%
Results posted
Dec 2014
Primary outcome: Primary: Number of Participants Achieving at Least Two Mycophenolic Acid (MPA) Dose Steps Higher and Reducing Tacrolimus Dose at the End of the Study — 0; 0; 43; 38 number of participants

Study Design & Population

Study type
Interventional
Phase
Phase 4
Interventions
1 (Drug); 2 (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Novartis Pharmaceuticals
Primary completion
Apr 2013

Outcome Measures

OutcomeResultp-value
PRIMARY
Number of Participants Achieving at Least Two Mycophenolic Acid (MPA) Dose Steps Higher and Reducing Tacrolimus Dose at the End of the Study
0; 0; 43; 38
PRIMARY
Number of Participants That Achieved One Dose Step Higher With Mycophenolic Acid (MPA) or Mycophenolate Mofetil (MMF), According to the Treatment Group Assigned at the End of the Study (Final Visit) Compared to Baseline Dose
37; 30; 6; 8
PRIMARY
Participants With Reduction in Tacrolimus or Tacrolimus Extended Release Levels at the End of the Study (Final Visit) Compared to Baseline Dose.
27; 18; 16; 20
PRIMARY
Mean Mycophenolic Acid (MPA) Doses at the End of the Study (Final Visit) Compared to Baseline Dose.
1173.10; 1195.20
SECONDARY
Change in Renal Function Measured Using Cockcroft-Gault Creatinine Clearance (CrCl)
83.01; 83.44; 81.55; 83.04; 81.59; 82.88
SECONDARY
Glomerular Filtration Rate (GFR) Using Abbreviated MDRD
64.83; 61.08; 62.68; 59.78; 62.71; 60.84
SECONDARY
Gastrointestinal Symptom Rating Scale (GSRS) Item Score
1.64; 1.70; 1.29; 1.54; 1.40; 1.41
SECONDARY
Gastrointestinal Symptom Rating Scale (GSRS) Subscale Score
1.95; 2.14; 1.58; 1.79; 1.59; 1.75
SECONDARY
Health-related Quality of Life (HRQoL): Impact of Gastrointestinal Symptoms on Quality Of Life (SIGIT)-QoL Questionnaire. Total Score.
79.20; 76.00; 78.79; 76.34; 77.88; 74.53
SECONDARY
Change in Gastrointestinal Symptom Rating Scale (GSRS) Score From Baseline to Visit 2 Stratified on the Basis of the Presence or Absence of Single-nucleotide Polymorphisms (SNPs) in the UGT1A9 Gene for the ITT Population
1.67; 0.00; -0.72; 1.52
SECONDARY
Change in Gastrointestinal Symptom Rating Scale (GSRS) Score From Baseline to Visit 4 Stratified on the Basis of the Presence or Absence of Single-nucleotide Polymorphisms (SNPs) in the UGT1A9 Gene for the ITT Population
6.25; 0.67; 1.42; 2.96
SECONDARY
Change in Gastrointestinal Symptom Rating Scale (GSRS) Score From Baseline to Visit 5 Stratified on the Basis of the Presence or Absence of Single-nucleotide Polymorphisms (SNPs) in the UGT1A9 Gene for the ITT Population
8.00; 4.00; 1.10; -0.48
SECONDARY
Change in Gastrointestinal Symptom Rating Scale (GSRS) Score From Baseline to Visit 2 Stratified on the Basis of the Presence or Absence of Single-nucleotide Polymorphisms (SNPs) in the MRP2 Gene for the ITT Population
1.78; 0.79; -2.00; 1.93
SECONDARY
Change in Gastrointestinal Symptom Rating Scale (GSRS) Score From Baseline to Visit 4 Stratified on the Basis of the Presence or Absence of Single-nucleotide Polymorphisms (SNPs) in the MRP2 Gene for the ITT Population
5.67; 3.71; 0.07; 1.71
SECONDARY
Change in Gastrointestinal Symptom Rating Scale (GSRS) Score From Baseline to Visit 5 Stratified on the Basis of the Presence or Absence of Single-nucleotide Polymorphisms (SNPs) in the MRP2 Gene for the ITT Population
3.67; 1.92; 0.93; -1.57
SECONDARY
Change in SIGIT-QoL Score From Baseline to Visit 2 Stratified on the Basis of the Presence or Absence of SNP in the UGT1A9 Gene for the ITT Population
-5.50; 0.33; -0.44; -0.46
SECONDARY
Change in SIGIT-QoL Score From Baseline to Visit 4 Stratified on the Basis of the Presence or Absence of SNP in the UGT1A9 Gene for the ITT Population
-5.75; -1.67; -2.00; -2.63
SECONDARY
Change in SIGIT-QoL Score From Baseline to Visit 5 Stratified on the Basis of the Presence or Absence of SNP in the UGT1A9 Gene for the ITT Population
-1.33; -3.67; -0.55; -0.65
SECONDARY
Change in SIGIT-QoL Score From Baseline to Visit 2 Stratified on the Basis of the Presence or Absence of SNP in the MRP2 Gene for the ITT Population
-0.89; 0.56; -1.69; -1.40
SECONDARY
Change in SIGIT-QoL Score From Baseline to Visit 4 Stratified on the Basis of the Presence or Absence of SNP in the MRP2 Gene for the ITT Population
-2.67; -1.73; -2.64; -3.33
SECONDARY
Change in SIGIT-QoL Score From Baseline to Visit 5 Stratified on the Basis of the Presence or Absence of SNP in the MRP2 Gene for the ITT Population
-1.11; -0.50; -0.36; -1.40
SECONDARY
Duration of Exposure to the Study Medicinal Product, Mycophenolate Sodium Descriptive Statistics. Safety Population Per Treatment Group
201.91
SECONDARY
Dose of the Study Medicinal Product Mycophenolate Sodium (MPS)
579.13; 856.28; 1080.00; 1228.50
SECONDARY
Dose of the Study Medicinal Product Mycophenolate Mofetil (MMF)
806.25; 1250.00; 1578.57; 1757.14

Summary

Multicenter, Randomized, Open-label Study to Assess Whether Treatment With Mycophenolate sodium (MPS) Allows Higher Dose Optimization Versus Mycophenolate mofetil (MMF) Leading to a Dose Reduction of Tacrolimus. Maximiza Study.

Eligibility Criteria

Inclusion criteria

  • Renal transplant recipients ≥ 1 year and ≤ 5 years prior1 to inclusion in the study.
  • Patients who were receiving an immunosuppressive regimen including MMF ≤1000 mg/day and ≥ 250 mg/day 4 and Prograf®1 or Advagraf®6 (levels ≥7 ng/ml).
  • Patients who had been receiving the current maintenance immunosuppressive regimen with stable doses of MMF for at least the past 3 months.2
  • Patients included must have had Prograf® or Advagraf® levels ≥ 7ng/ml4 for at least one month prior to inclusion in the trial.2
  • Patients with low immunological risk, in the investigator's opinion.
  • Patients with an estimated glomerular filtration rate based on the MDRD formula of > 30 ml/min x 1.73 m2.1
  • Patients over 18 years of age.1
  • Patients who were able to understand the study information and give written informed consent.
  • Patients who were able to meet all study requirements, including completing questionnaires and attending study visits.

Exclusion criteria

  • Patients with GI symptoms known or assumed not to be caused by mycophenolic acid (MPA) treatment (e.g. oral bisphosphonate-induced infectious diarrhoea).
  • Patients with chronic inflammatory bowel disease.
  • Diabetic patients.
  • Acute rejection < 1 month prior to inclusion in the study.
  • Patients with leukopenia (< 3500 cells/mm3) or thrombocytopenia (< 100,000 cells/mm3).
  • Women of childbearing potential who were planning to become pregnant, were pregnant and/or breastfeeding, or who did not wish to use effective contraception [hormonal contraceptives (implantation, patches, oral) and double-barrier methods (any double combination of: IUD, male or female condoms with spermicidal gel, diaphragm, contraceptive sponge, cervical cap)].
  • Presence of psychiatric illness (such as schizophrenia, major depression) that, in the investigator's opinion, could interfere with study requirements.
  • Patients who were undergoing surgery for an acute condition or who were hospitalised.
  • Any other medical condition that, in the investigator's opinion based on blood counts or chart review, could interfere with completion of the study, including but not limited to visual problems or cognitive impairment.
  • Patients who were receiving or had received any investigational medicinal product during the 30 days prior to inclusion in the study.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01056822). 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.

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