Cyclosporine A C-2h Monitoring Versus Tacrolimus C-0h Monitoring in de Novo Liver Transplant Recipients

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Novartis

Status and phase

Completed
Phase 4

Conditions

Liver Transplant

Treatments

Drug: Tacrolimus
Drug: Cyclosporine A
Drug: Prednisone
Drug: Basiliximab
Drug: Methylprednisolone

Study type

Interventional

Funder types

Industry

Identifiers

NCT00149994
COLO400ANL07

Details and patient eligibility

About

The purpose of this study is to determine whether cyclosporine A (in a micro emulsion formulation) monitored by sample taken 2 hour after oral dose (C-2h) will show equivalent or superior efficacy compared to tacrolimus monitored by pre-dose blood concentration (C-0h). In addition this study will assess the safety and tolerability of a cyclosporine A regimen based on C-2h monitoring in comparison to the standard tacrolimus regimen.

Enrollment

171 patients

Sex

All

Ages

18 to 75 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

About to undergo a primary liver transplant (including living donor, non-heart beating donor and split liver). Age between 18 and 75 years. Expected to be able to receive the first oral dose of CNI within the first 24 hours post-transplantation (Tx)

Exclusion criteria

This is a multi-organ transplant or if the patient has previously been transplanted with any other organ. Urine production is <200 ml within 12 hours after reperfusion of the graft Severe coexisting disease is present or if any unstable medical condition is present which could affect the study objectives. Other protocol-defined exclusion criteria applied

Trial design

Primary purpose

Prevention

Allocation

Randomized

Interventional model

Factorial Assignment

Masking

None (Open label)

171 participants in 2 patient groups

Cyclosporine A
Experimental group
Description:
Cyclosporine A was given in a twice-daily schedule at 12-hour intervals. It was administered within the first 4 hours post-operatively (study day 1), at an initial dose of 10-15mg/kg/day in two doses, as close as possible to 15mg/kg/day. After the first oral administration, the dose of Cyclosporine A was adjusted to bring the sample taken 2 hours after oral dose (C-2h) level into the target range by Days 3-5 post-transplantation. C-2h target ranges post-transplantation: 0-3 months: range of 800-1200 ng/ml with midpoint of 1000 ng/ml; 4-6 months: range of 700-900 ng/ml with midpoint of 800 ng/ml; > 6 months: range of 500-700 ng/ml with midpoint of 600 ng/ml is recommended. During the course of the study, the dose of Cyclosporine A was adjusted as necessary to achieve and maintain the C-2h blood Cyclosporine A (CsA) concentrations within the target ranges.
Treatment:
Drug: Methylprednisolone
Drug: Basiliximab
Drug: Prednisone
Drug: Cyclosporine A
Tacrolimus
Active Comparator group
Description:
Tacrolimus was given on a twice-daily schedule at 12-hour intervals which had to be maintained throughout the study period. Tacrolimus was administered within the first 24 hrs postoperatively (Study Day 1) at an initial dose of 0.1-0.15 mg/kg/day in two divided oral doses either by mouth or via an enteral feeding tube until the patient can swallow. The initial dosing level was determined by the patient's overall post-operative condition. During the course of the study, the dose of tacrolimus was adjusted as necessary to achieve and maintain the pre-dose blood concentration (C-0h) (trough) tacrolimus concentrations. C-0h target ranges post-transplantation: 0-3 months: 10-15 ng/ml; 4-6 months: 5-10 ng/ml; > 6 months: range of 5-10 ng/ml is recommended.
Treatment:
Drug: Methylprednisolone
Drug: Basiliximab
Drug: Prednisone
Drug: Tacrolimus

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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