Clinical trial • Phase IV • Nephrology

TACROLIMUS for Chronic kidney disease | Kidney transplant (pre-transplant)

Phase IV trial of TACROLIMUS for Chronic kidney disease | Kidney transplant (pre-transplant).

Overview

Trial Therapeutic Area
Nephrology
Trial Disease
Chronic kidney disease | Kidney transplant (pre-transplant)
Trial Stage
Phase IV
Drug Modality
Small molecule
Paediatric Trial
Yes

Key dates

Initial CTIS Submission Date
05-11-2024
First CTIS Authorization Date
17-01-2025

Trial design

Randomised, control arm: tacrolimus standard of care as determined by the healthcare provider. intervention arm: tacrolimus dose prescribed according to the most recent clinical pharmacogenetic guideline treatment/dosing recommendations for the participant's genetic profile., adaptive Phase IV trial across 6 sites in Spain.

Randomised
Yes
Comparator
Control arm: tacrolimus standard of care as determined by the healthcare provider. Intervention arm: tacrolimus dose prescribed according to the most recent clinical pharmacogenetic guideline treatment/dosing recommendations for the participant's genetic profile.
Adaptive
True, adaptive clinical trial design (described as adaptive in protocol; further details and rationale referenced in the iPHARMGx master protocol).
Biomarker Stratified
True, CYP3A5 genotype (genotype-guided dosing according to clinical pharmacogenetic guideline).
Target Sample Size
114

Eligibility

Recruits 114 paediatric patients.

Vulnerable Population
Minors are included (there are specific consent documents for legal guardians and an assent form for mature minors). Written informed consent is required from participants prior to any study procedures; where applicable the legally authorised representative (tutor) may sign. Specific subject information and informed consent forms exist for adults, for tutors/legal guardians, and an assent form for mature minors.

Inclusion criteria

  • {"criterion_text":"- Participants must be willing and able to provide written informed consent prior the initiation of any study procedures.\n- Subject or their legally authorized representative has voluntarily signed the informed consent document.\n- Participant is on the waiting list for a kidney transplant.\n- Subject is able and willing to take part and be followed-up for the majority of the study duration, and adhere to the procedures specified in this protocol.\n- Subjects must be naïve to any genotyping test of the following genes: CYP3A5."}

Exclusion criteria

  • {"criterion_text":"- Known hypersensitivity/allergy reaction to tacrolimus or any of the excipients.\n- History of renal, heart, and/or liver transplant.\n- History or clinical evidence of any disease and/or existence of any surgical or medical condition, which might interfere in a relevant manner with the absorption, distribution, metabolism, or excretion of the study treatment, except for renal disease.\n- Any condition or situation precluding or interfering the compliance with the protocol.\n- Any condition at medical discretion for which renal transplantation and/or study treatment should not be received."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Tacrolimus concentrations levels at day 4 (+/-1d) will be the effectiveness surrogate outcome. It will be considered therapeutic range levels between 7-10 ng/ml.","definition_or_measurement_approach":"Tacrolimus concentrations measured at day 4 (+/-1 day); therapeutic range defined as 7-10 ng/ml."}

Secondary endpoints

  • {"endpoint_text":"- Ratio that divides the differences in costs between both treatments by the difference in effectiveness between both treatments.","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Number and percentage of patients achieving tacrolimus target plasma concentrations.","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Number and percentage of patients with transplant rejection. Transplant rejection will be considered if there is histological confirmation and/or the patient initiates any type of therapy aimed at treating rejection (e.g. corticosteroids).","definition_or_measurement_approach":"Transplant rejection defined by histological confirmation and/or initiation of therapy aimed at treating rejection (for example corticosteroids)."}
  • {"endpoint_text":"- Rate of adverse events associated to treatment.","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Healthcare expenditure related to predefined events of interest: Any costs made as a result of an adverse event.","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Incidence of discontinuation or treatment modification due to lack of effective related to the drug of inclusion.","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Identification of new actionable genes/relevant polymorphisms within the predefined population subsets.","definition_or_measurement_approach":""}
  • {"endpoint_text":"- Novel prognostic and predictive genetic biomarkers of tacrolimus safety and effectiveness will be assessed trough techniques only available at Nation Centre of Oncological Investigations (CNIO) and genome-wide association studies when applicable.","definition_or_measurement_approach":"Assessment using techniques available at CNIO and genome-wide association studies when applicable."}

Recruitment

Planned Sample Size
114
Recruitment Window Months
24
Consent Approach
Written informed consent is required prior to any study procedures. The subject or their legally authorised representative must voluntarily sign the informed consent document. Specific subject information and consent documents are provided for adults, for tutors/legal guardians (consent by tutor), and an assent form exists for mature minors. The protocol states participants must be willing and able to provide written informed consent and/or have consent provided by a legally authorised representative where applicable.

Geography

Total Number Of Sites
6
Total Number Of Participants
114

Spain

Earliest CTIS Part Ii Submission Date
18-12-2024
Latest Decision Or Authorization Date
24-04-2026
Processing Time Days
492
Number Of Sites
6
Number Of Participants
114

Sites

Site Name
Hospital Universitario De Canarias
Department Name
Nephrology
Contact Person Name
Juan Fernandez Solis
Contact Person Email
juanfdezsolis@outlook.com
Site Name
Hospital General Universitario Gregorio Maranon
Department Name
Nephrology
Contact Person Name
Nicolás Macías Carmona
Site Name
Hospital Universitario Regional De Malaga
Department Name
Nephrology
Contact Person Name
Verónica López Jiménez
Site Name
Hospital Germans Trias I Pujol
Department Name
Nephrology
Contact Person Name
María Molina Gómez
Site Name
Hospital Universitario La Paz
Department Name
Nephrology
Contact Person Name
Carlos Jiménez
Contact Person Email
cjmartin@salud.madrid.org
Site Name
Hospital Universitario Marques De Valdecilla
Department Name
Nephrology
Contact Person Name
Rosalía Valero San Cecilio
Contact Person Email
rosalia.valero@scsalud.es

Sponsor

Primary sponsor

Full Name
Fundacion Para La Investigacion Biomedica Del Hospital Universitario La Paz
Organisation Type
Patient organisation/association
Country Of Registered Address
Spain

Investigational products

Investigational Product Name
Tacrolimus STADA 0,5 mg cápsulas duras EFG
Active Substance
TACROLIMUS
Modality
Small molecule
Routes Of Administration
ORAL
Route
ORAL
Authorisation Status
Authorised/marketed
Investigational Product Name
Advagraf 0.5 mg prolonged-release hard capsules
Active Substance
TACROLIMUS
Modality
Small molecule
Routes Of Administration
ORAL
Route
ORAL
Authorisation Status
Authorised/marketed
Investigational Product Name
Conferoport 0,5 mg cápsulas duras de liberación prolongada EFG
Active Substance
TACROLIMUS
Modality
Small molecule
Routes Of Administration
ORAL
Route
ORAL
Authorisation Status
Authorised/marketed
Investigational Product Name
Adoport 0,5 mg cápsulas duras EFG
Active Substance
TACROLIMUS
Modality
Small molecule
Routes Of Administration
ORAL
Route
ORAL
Authorisation Status
Authorised/marketed
Investigational Product Name
Prograf 0,5 mg Cápsulas duras
Active Substance
TACROLIMUS
Modality
Small molecule
Routes Of Administration
ORAL
Route
ORAL
Authorisation Status
Authorised/marketed
Investigational Product Name
Modigraf 0.2 mg oral granules, suspension
Active Substance
TACROLIMUS
Modality
Small molecule
Routes Of Administration
ORAL
Route
ORAL
Authorisation Status
Authorised/marketed
Investigational Product Name
Envarsus 0.75 mg prolonged-release tablets
Active Substance
TACROLIMUS
Modality
Small molecule
Routes Of Administration
ORAL
Route
ORAL
Authorisation Status
Authorised/marketed

Related trials

Other published trials that may interest you.