Certican® (Everolimus) Against Cytomegalovirus Disease in Renal Transplant Patients (Certi-CMV)

This study is currently recruiting participants. (see Contacts and Locations)
Verified August 2012 by Medical University of Vienna
Sponsor:
Information provided by (Responsible Party):
Marcus Saemann, Medical University of Vienna
ClinicalTrials.gov Identifier:
NCT00828503
First received: January 23, 2009
Last updated: August 30, 2012
Last verified: August 2012
  Purpose

A prospective, randomized safety and efficacy study of Certican® as add-on therapy against CMV disease in renal transplant recipients

OBJECTIVES:

Primary Objective:

To demonstrate efficacy of Certican® as add-on therapy against CMV disease in comparison to either valcyte® (valganciclovir) or cymevene® (ganciclovir) alone, evaluated by quantitative measurement of CMV-DNA with PCR from the blood (qCMV-PCR)

Secondary Objectives:

To assess safety and tolerability of Certican® in patients with CMV- disease To study the effects of Certican® treatment on quality of life


Condition Intervention Phase
Cytomegalovirus Disease
Drug: Certican (everolimus) + valganciclovir
Drug: Valganciclovir
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Certican® (Everolimus) Against Cytomegalovirus Disease in Renal Transplant Patients

Resource links provided by NLM:


Further study details as provided by Medical University of Vienna:

Primary Outcome Measures:
  • relative changes in CMV-load (copies/mL), as determined by qCMV-PCR from whole blood throughout the observational period [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • CMV-load (copies/mL) after 1-8 weeks, in months 3, 4, 6 and 12; Time (in weeks) until the CMV-load reaches ≤600 copies/mL [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 40
Study Start Date: December 2008
Estimated Study Completion Date: June 2014
Estimated Primary Completion Date: December 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: 1 Certican + Valganciclovir
Valganciclovir will be administered and Certican (everolimus) will be added as immunosuppression
Drug: Certican (everolimus) + valganciclovir

Oral MED 1: Certican® initial dose: 1,5-3 mg day target trough level: 3-8 ng/mL (first levels will be performed after 3 days and then adjusted until - according to the judgement of the clinical investigator - a stable degree of immunosuppression is reached; thereafter Certican® trough levels will be performed at the scheduled appointments)

MED 2: Valganciclovir (or ganciclovir) will be administered in addition to Certican (valganciclovir: 450 mg twice daily, ganciclovir 5 mg/kg i.v. twice daily)

Active Comparator: 2 Valganciclovir alone
Valganciclovir will be added alone.
Drug: Valganciclovir
Valganciclovir (or ganciclovir) will be administered alone (valganciclovir: 450 mg twice daily, ganciclovir 5 mg/kg i.v. twice daily)

Detailed Description:

DESIGN / PHASE Prospective, single-center, randomized, parallel group, controlled, phase II study.

PATIENTS / GROUPS 40 patients in 2 groups 20 patients per group Randomization ratio 1:1, no stratification

INVESTIGATIONAL DRUG Oral MED 1: Certican® initial dose: 1,5-3 mg day target trough level: 3-8 ng/mL (first levels will be performed after 3 days and then adjusted until - according to the judgment of the clinical investigator - a stable degree of immunosuppression is reached; thereafter Certican® trough levels will be performed at the scheduled appointments)

COMPARATIVE DRUG No therapy (add-on design

CONCOMITANT MEDICATION Allowed The concomitant immunosuppressive medication will be adjusted to the additional administration of Certican®. For example, if the patient already receives cyclosporine A or tacrolimus, this will be adjusted, according to the current recommendations4 at the judgment of the clinical investigator

TOLERABILITY / SAFETY ENDPOINTS:

Rejection Hematocrit Platelet count WBC count Wound healing disorders Blood lipids (cholesterol, triglycerides) Infections (other than CMV)

PHARMACOKINETIC / PHARMACODYNAMIC ENDPOINTS Certican® (everolimus) trough levels

STATISTICAL METHODOLOGY Primary Endpoint: CMV-load (copies/mL)

Null and alternative hypotheses:

H0 Treatment with Certican® (everolimus) in combination with valcyte® (valganciclovir) or cymevene® (ganciclovir) is equal to valcyte® (valganciclovir) or cymevene® (ganciclovir) alone in reducing the CMV-load in renal transplant patients with CMV-disease H1: Treatment with Certican® (everolimus) in combination with valcyte® (valganciclovir) or cymevene® (ganciclovir) is superior to valcyte® (valganciclovir) or cymevene® (ganciclovir) in reducing CMV load (copies/mL) in renal transplant patients with CMV-disease Type-I and -II errors - power. α=0.05 ß=0.2 (power 0.8) Statistical methodology ANOVA of repeated measures (CMV-copies/mL), one-sided t-test of CMV load at distinct time-points, one-sided t-test of the time (in weeks) until CMV-load reaches ≤600 copies/mL Sample size calculation Based on a one-sided testing and a σ of 0.2 in relative changes of CMV-copies, an α=0.05 And a ß=0.2 a sample size of 20 patients per group was determined. Main analysis set Per-protocol (efficacy) and intention to treat (ITT) for safety Other endpoints Bonferroni corrected t-tests will be performed for CMV-copies/mL at each time point of the follow-up period. The time to copies ≤ 600 will also be analyzed by a t-test. All other secondary endpoints and subgroup analysis will be performed in explorative intention (descriptive statistics).

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • CMV-disease after renal transplantation, i.e.,(1.) CMV present in the blood, and (2.) one of the following symptoms (for viral syndrome, from the American Society of Transplantation recommendations for use in clinical trials1):

    • body temperature ≥ 38°C
    • new or increased significant malaise
    • leucopenia (< 3500/mL)
    • atypical lymphocytosis ≥ 5%
    • thrombocytopenia (platelets < 100.000/mL)
  • no other cause of symptoms/signs identified
  • informed consent of the patient

Exclusion Criteria:

  • patients with a known hypersensitivity to everolimus, sirolimus or any of the excipients
  • administration of strong CYP3A4 Inhibitors (e.g. ketoconazole, itraconazole, voriconazole, clarithromycin, telithromycin) and inducers (rifampicin), unless the benefit outweighs the risk, according to the judgment of the clinical investigator
  • acute rejection episodes in the first 3 months after renal transplantation
  • active hepatitis in the previous month
  • Significant proteinuria (> 0.8g/24h Urine)
  • hepatic impairment, according to the criteria defined by Bénichou et al.2: a singular elevation of GPT or conjugated bilirubin to a value twice above the normal level, or a combined elevation of GOT, AP, and total bilirubin, given that at least one parameter is twice above the normal level
  • hematocrit < 25%
  • any significant wound healing disorder (anamnestic)
  • blood white blood cell (WBC) count < 3000/mL
  • platelets < 50.000/mL
  • severe dyslipidemia (cholesterol >300mg/dL, triglycerides > 350mg/dL)
  • uncontrolled hypertension (continuous episodes of hypertension above 140/90 (WHO classification and American Society of Transplantation recommendations 3) despite adequate hypertensive therapy)
  • uncontrolled hyperuricemia (uric acid > 8mg/dL)
  • pregnancy
  • any immunosuppressive protocol which does not allow the addition of Certican®, according to the judgment of the clinical investigator
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00828503

Contacts
Contact: Marcus D Säemann, MD +431404005593 marcus.saemann@meduniwien.ac.at
Contact: Manfred Hecking, MD +431404005593 manfred.hecking@meduniwien.ac.at

Locations
Austria
Medical University of Vienna Recruiting
Vienna, Austria, 1090
Sub-Investigator: Manfred Hecking, MD         
Sponsors and Collaborators
Marcus Saemann
Investigators
Study Chair: Sabine Schmaldienst, MD Medical University of Vienna
  More Information

Publications:
Responsible Party: Marcus Saemann, Ass. Prof. Dr. Marcus Säemann, Medical University of Vienna
ClinicalTrials.gov Identifier: NCT00828503     History of Changes
Other Study ID Numbers: EudraCT: 2008-004745-28
Study First Received: January 23, 2009
Last Updated: August 30, 2012
Health Authority: Austria: Österreichische Agentur für Gesundheit und Ernährungssicherheit GmbH Spargelfeldstraße 191 1220 Vienna Austria

Keywords provided by Medical University of Vienna:
Certi-CMV
immunosuppressive switch (to Certican)
renal transplant

Additional relevant MeSH terms:
Cytomegalovirus Infections
Herpesviridae Infections
DNA Virus Infections
Virus Diseases
Everolimus
Sirolimus
Valganciclovir
Ganciclovir
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Pharmacologic Actions
Antibiotics, Antineoplastic
Antineoplastic Agents
Therapeutic Uses
Antifungal Agents
Anti-Infective Agents
Anti-Bacterial Agents
Antiviral Agents

ClinicalTrials.gov processed this record on July 29, 2014