Envarsus XR Compared to Immediate Release Tacrolimus (SIMPLE)

Mayo Clinic

Status and phase

Active, not recruiting

Phase 4

Conditions

Kidney Transplant Recipients

Treatments

Drug: Tacrolimus twice daily

Drug: Envarsus XR

Study type

Interventional

Funder types

Other

Industry

Identifiers

NCT03979365

19-002678

Details and patient eligibility

About

The purpose of this study is to compare once-daily tacrolimus extended-release (Envarsus XR®) to twice-daily immediate release tacrolimus to find out if people taking tacrolimus extended release (Envarsus XR®) report fewer side effects, increased medication compliance and higher scores on quality of life assessments compared to people taking twice daily tacrolimus immediate release.

Full description

Despite improvement in short-term graft outcomes in organ transplant, transplant patients still have to take on complex medication regimens to achieve current results. Adherence to these complex medications is an important problem in light of the potential risk of acute and chronic rejection and the associated burden of increased hospitalization, cost, and diminished quality of life that results from missed doses and poor overall drug taking. Part of the diminished quality of life is also tied to the bothersome symptoms patient feel after transplant. Most patients experience symptoms that relate to either the overall transplant immunosuppression or medication specific side effects. In the BENEFIT and BENEFIT-EXT trials, >60% of patients reported tiredness and lack of energy as an issue. Sleep problems, mood swings, restlessness, anxiety, depression, and concentration and memory difficulties appeared in approximately 50-60% of patients. In addition to these symptoms, >38% patients also reported numerous others side effects that have been strongly associated with calcineurin-inhibitors such as tacrolimus that include dizziness, muscle cramps, trembling hands, tingling in hands and feet, and headache.

The investigators hypothesize that the use of once-daily Envarsus XR® could decrease some transplant- and tacrolimus-related adverse symptoms and potentially lead to improvement in quality of life and medication adherence when compared to twice-daily tacrolimus. In order to assess this hypothesis, a prospective, multi-center, randomized, open-label, pilot study to investigate medication adherence and patient reported symptom occurrence and interference with daily life comparing once-daily Envarsus XR® and twice-daily immediate release tacrolimus in adult renal transplant recipients (SIMPLE) is being proposed.

Enrollment

240 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Patient is an adult (18 years of age or older).
Patient is a recipient of a deceased or living donor kidney transplant.
Patient is able to comply with study procedures for the entire length of the study.
Patient has been informed about the study survey and has signed an informed consent form.

Exclusion criteria

Patient is unable or unwilling to complete study patient reported outcome questionnaires.
Patient is currently receiving azathioprine
Patient is currently receiving an mTOR inhibitor (sirolimus, everolimus)
Patient is currently receiving an belatacept
Patient has received investigational immunosuppression 1 month prior to transplant or post-transplant
Patient is in a setting where a professional care taker is responsible for dispensing subject's medication.