Safety & Efficacy of Eculizumab to Prevent AMR in Living Donor Kidney Transplant Recipients Requiring Desensitization

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01399593
Recruitment Status : Terminated (Did not achieve statistical significance for primary endpoint)
First Posted : July 22, 2011
Results First Posted : April 19, 2017
Last Update Posted : October 3, 2017
Information provided by (Responsible Party):
Alexion Pharmaceuticals

Brief Summary:
The purpose of this trial was to determine the safety and efficacy of eculizumab in the prevention of antibody-mediated rejection (AMR) in sensitized recipients of a living donor kidney transplant requiring desensitization therapy.

Condition or disease Intervention/treatment Phase
Antibody Mediated Rejection Drug: Eculizumab Phase 2

Detailed Description:

The main objective of this study was to evaluate the safety and efficacy of eculizumab to prevent AMR in sensitized recipients of living donor kidney transplants requiring desensitization therapy prior to transplantation. The primary endpoint focused on acute AMR during the first 9 weeks post-transplantation.

Patients were to be vaccinated against N. meningitidis at least 14 days prior to study drug initiation and revaccinated 30 days later. If not vaccinated 14 days prior, prophylactic antibiotics were to be administered. Pre-transplant infectious disease assessment was to be performed as part of the screening assessment.

Patients were to undergo desensitization therapy according to the practice of the local transplant center prior to transplantation, and this desensitization practice was to be uniformly applied for all patients at that center throughout the study. The actual length of desensitization for an individual patient was based on the clinical judgment of the Transplant Center team. Rituximab was prohibited in all patients as part of the pre-transplantation desensitization therapy due to potential pharmacodynamic interactions.

The control group was designed to test eculizumab against the best available care (referred to as standard of care, or SOC) consisting of plasmapheresis (PP) and/or intravenous immunoglobulin (IVIg). The best available care consisting of PP and IVIg was chosen because these modalities combined represented the most prevalent therapy reported in the literature and were the best available therapies at the time of this protocol's inception as per the transplant community.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 102 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Randomized, Open-label, Multicenter Trial to Determine Safety and Efficacy of Eculizumab in the Prevention of Antibody Mediated Rejection (AMR) in Living Donor Kidney Transplant Recipients Requiring Desensitization Therapy
Actual Study Start Date : November 2, 2011
Actual Primary Completion Date : May 13, 2014
Actual Study Completion Date : November 13, 2015

Resource links provided by the National Library of Medicine

Drug Information available for: Eculizumab

Arm Intervention/treatment
Experimental: Eculizumab
Patients were to receive eculizumab 1200 mg prior to allograft transplantation (Day 0, starting approximately one hour prior to kidney allograft reperfusion), eculizumab 900 mg (Days 1, 7, 14, 21, and 28), and eculizumab 1200 mg (Weeks 5, 7 and 9). All doses of eculizumab were administered intravenously: the median infusion time was 39 minutes.
Drug: Eculizumab
Other Name: Soliris

No Intervention: Standard of Care
Patients received standard of care (SOC) prophylactic therapy for acute AMR according to the SOC choice at each participating investigative site, which could have included any combination of plasmapheresis (PP) and intravenous immunoglobulin (IVIg). Patients randomized to SOC who were diagnosed with AMR could have received eculizumab for the treatment of AMR after initially receiving PP and/or IVIg.

Primary Outcome Measures :
  1. Treatment Failure Rate [ Time Frame: 9 weeks post-transplantation ]
    The primary efficacy variable was a binary outcome variable where patients meeting the composite endpoint of the occurrence of 1) biopsy-proven acute AMR, 2) graft loss, 3) patient death, or 4) loss to follow-up definition at Week 9 post-transplantation were considered treatment failures and all others were considered treatment successes.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Male or female patients ≥18 years old
  2. Patients with Stage IV or Stage V chronic kidney disease who will receive a kidney transplant from a living donor to whom they are sensitized and require desensitization prior to transplantation

Exclusion Criteria:

  1. ABO incompatible with living donor
  2. Any medical condition that, in the opinion of the Investigator, might interfere with the patient's participation in the study, poses an added risk for the patient, or confounds the assessment of the patient

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01399593

  Hide Study Locations
United States, Alabama
Birmingham, Alabama, United States, 35294
United States, California
La Jolla, California, United States, 92037
Los Angeles, California, United States, 90095
San Francisco, California, United States, 94143
United States, District of Columbia
Washington, D.C., District of Columbia, United States, 20007
United States, Georgia
Atlanta, Georgia, United States, 30309
United States, Illinois
Chicago, Illinois, United States, 60612
United States, Maryland
Baltimore, Maryland, United States, 21205
United States, Massachusetts
Boston, Massachusetts, United States, 02115
United States, Minnesota
Rochester, Minnesota, United States, 55905
United States, Missouri
Saint Louis, Missouri, United States, 63110
United States, New Jersey
Livingston, New Jersey, United States, 07039
United States, New York
New York, New York, United States, 10032
United States, North Carolina
Chapel Hill, North Carolina, United States, 27599
United States, Ohio
Cincinnati, Ohio, United States, 45267
United States, Oklahoma
Oklahoma City, Oklahoma, United States, 73112
United States, Texas
Houston, Texas, United States, 77030
Australia, South Australia
North Terrace, South Australia, Australia, 5000
Camperdown, Australia, 2050
Clayton VIC, Australia, 3168
Parkville VIC, Australia, 3050
Paris, France, 75010
Paris, France, 75743
Toulouse Cedex, France, 31059
Tours Cedex, France, 37044
Dresden, Germany, 01307
Heidelberg, Germany, 69120
Milan, Italy, 20162
Padova, Italy, 35128
Rotterdam, Netherlands, 3015 CE
Oslo, Norway, N-0027
Barcelona, Spain, 8036
Göteborg, Sweden, 413 45
Huddinge, Sweden, SE 141 86
Uppsala, Sweden, S 751 85
United Kingdom
London, England, United Kingdom, SE1 9RT
London, England, United Kingdom, W12 0HS
Oxford, England, United Kingdom, OX3 7LJ
Birmingham, United Kingdom, B15 2TH
Cambridge, United Kingdom, CB2 2QQ
Coventry, United Kingdom, CV2 2DX
Sponsors and Collaborators
Alexion Pharmaceuticals
Study Director: Masayo Ogawa, MD Alexion Pharmaceuticals

Responsible Party: Alexion Pharmaceuticals Identifier: NCT01399593     History of Changes
Other Study ID Numbers: C10-001
2010-019630-28 ( EudraCT Number )
BB-IND: 100,003 ( Other Identifier: FDA IND: 100,003 )
First Posted: July 22, 2011    Key Record Dates
Results First Posted: April 19, 2017
Last Update Posted: October 3, 2017
Last Verified: September 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Alexion Pharmaceuticals:
Antibody Mediated Rejection
Acute Humoral Rejection
Living Donor
Kidney Transplant