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Study of ISA247 (Voclosporin) in De Novo Renal Transplantation (PROMISE)

Primary Purpose

Kidney Diseases

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Voclosporin
tacrolimus
Sponsored by
Aurinia Pharmaceuticals Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Kidney Diseases focused on measuring Randomized Controlled Trials, Immunosuppression, Adult, Kidney Transplantation, Treatment Outcome

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Males and females aged 18 - 65 years inclusive at the time of screening. Patients must be receiving a first cadaveric or living donor renal transplant. Patients must be able to receive oral medication at time of randomization. Females who are not pregnant or nursing or planning to become pregnant during the course of the study, or 3 months after last dose of study medication. Sexually-active women of child-bearing potential (including those who are < 1 year postmenopausal) and sexually-active men who are practicing a highly effective method of birth control. A highly effective method of birth control is defined as one that results in a low failure rate (i.e., less than 1% per year) when used consistently and correctly and will include implants, injectables, combined oral contraceptives, double-barrier method, sexual abstinence, or a sterile partner. Sexually-active men and women of child-bearing potential should continue to practice contraception as outlined above during treatment and for ≥ 3 months after the last dose of voclosporin. Able to give written informed consent prior to screening procedures. Able to keep study appointments and cooperate with all study requirements, in the opinion of the investigator. Exclusion Criteria: Receiving a HLA (human leukocyte antigen)identical living related transplant. Cold ischemic time > 24 hours. Peak PRA (panel reactive antibodies) > 30% Cadaveric donors who are over age 60, non-heart beating donors, or any cadaveric donors positive for HIV, hepatitis B virus (HBV) or hepatitis C virus (HCV). Transplantation of multiple grafts (e.g. kidney and pancreas). Systemic infections requiring continued therapy at the time of entry into this study. (Prophylaxis against cytomegalovirus [CMV] and/or pneumocystis carinii pneumonia (PCP) infection will be permitted). Serologic evidence or known latent human immunodeficiency virus (HIV), hepatitis B (HBV) or hepatitis C (HCV) virus. Known negative serology prior to study entry may be used. A current malignancy or history of malignancy within 5 years or a history of lymphoma at any time. Subjects can be enrolled with a history of squamous or basal cell carcinoma that has been surgically excised or removed with curettage and electrodesiccation. Requires prohibited medications or treatment during the study. Alanine transaminase (ALT), aspartate transaminase (AST), or gamma-glutamyl transferase (GGT) ≥ 3x upper limit of normal (ULN) at time of transplantation. White blood cell count ≤ 2.8 x 10^9/L. Triglycerides ≥ 3x ULN. Pregnant women or nursing mothers. Has used any investigational drug or device within 28 days or 5 half lives (whichever is longer) prior to enrollment. Previous exposure to voclosporin. A history of active alcoholism or drug addiction within 1 year prior to study entry. Weighs < 45 kg (99 lbs) or > 140 kg (308 lbs). A history of disease, including mental/emotional disorder that would interfere with the subject's participation in the study, or that might cause the administration of voclosporin to pose a significant risk to the subject, in the opinion of the investigator. Allergy to iodine.

Sites / Locations

  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site
  • Isotechnika Investigational Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Arm Label

Low Dose Voclosporin

Mid Dose Voclosporin

High Dose Voclosporin

Tacrolimus

Arm Description

Low dose voclosporin

Mid Dose Voclosporin

High Dose Voclosporin

Standard Dose Tacrolimus

Outcomes

Primary Outcome Measures

Biopsy Proven Acute Rejection (BPAR)
The primary objective of the PROMISE trial was to demonstrate noninferiority of biopsy proven acute rejection (BPAR) rate in de novo renal transplant patients at 6 months in at least one VCS treatment group.

Secondary Outcome Measures

To Demonstrate a 5% Improvement in Renal Function as Measured by Iothalamate Glomerular Filtration Rate (GFR)
ANOVAs to test for differences in GFR at Month 6.
The Pharmacokinetic-pharmacodynamic Relationship Between Voclosporin and Calcineurin Inhibition (CNi), or Tacrolimus and Calcineurin Inhibition
A sparse sampling protocol of whole blood samples obtained on Day 180 at time points immediately prior to drug administration and at 1, 2, and 4 hours post-dose were utilized. Standard non-compartmental analysis (NCA) was performed on whole blood concentration data for voclosporin and its metabolites, tacrolimus, MPA (mycophenolic acid) and MPAG (mycophenolic acid glucuronide). Tmax and Cmax were obtained directly from the concentration-time profiles without interpolation. AUC(0-4)[area under the curve] was calculated using log-linear trapezoidal rule. Cmax, AUC(0-4), C0 and C2 were summarized using descriptive statistics.
Patient Survival
Graft Survival
Hypertension, Hyperlipidemia, or Hyperglycemia
A Composite of Biopsy-proven Chronic Rejection Graft Loss, Death, or Lost to Follow up.

Full Information

First Posted
December 23, 2005
Last Updated
February 11, 2013
Sponsor
Aurinia Pharmaceuticals Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00270634
Brief Title
Study of ISA247 (Voclosporin) in De Novo Renal Transplantation
Acronym
PROMISE
Official Title
A Phase IIb, Randomized, Multicenter, Open-Label, Concentration Controlled, Safety Study of ISA247 (Voclosporin) and Tacrolimus (Prograf®) in De Novo Renal Transplant Patients
Study Type
Interventional

2. Study Status

Record Verification Date
February 2013
Overall Recruitment Status
Completed
Study Start Date
January 2006 (undefined)
Primary Completion Date
July 2009 (Actual)
Study Completion Date
July 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Aurinia Pharmaceuticals Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study will see if voclosporin is safe and effective in preventing kidney transplant rejection.
Detailed Description
Prograf® (tacrolimus) is associated with numerous side effects, including neurotoxicity, nephrotoxicity, polyoma nephropathy, QT prolongation, and New Onset Diabetes Mellitus After Transplant (NODAT). Voclosporin is a novel calcineurin inhibitor intended for use in the prevention of organ graft rejection. Comparison(s): Voclosporin at 3 dose levels (0.4, 0.6, and 0.8 mg/kg twice a day) compared to tacrolimus

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Kidney Diseases
Keywords
Randomized Controlled Trials, Immunosuppression, Adult, Kidney Transplantation, Treatment Outcome

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
334 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Low Dose Voclosporin
Arm Type
Active Comparator
Arm Description
Low dose voclosporin
Arm Title
Mid Dose Voclosporin
Arm Type
Active Comparator
Arm Description
Mid Dose Voclosporin
Arm Title
High Dose Voclosporin
Arm Type
Active Comparator
Arm Description
High Dose Voclosporin
Arm Title
Tacrolimus
Arm Type
Active Comparator
Arm Description
Standard Dose Tacrolimus
Intervention Type
Drug
Intervention Name(s)
Voclosporin
Other Intervention Name(s)
ISA247
Intervention Description
voclosporin 0.4, 0.6, 0.8 mg/kg po BID
Intervention Type
Drug
Intervention Name(s)
tacrolimus
Intervention Description
tacrolimus 0.05 mg/kg po BID
Primary Outcome Measure Information:
Title
Biopsy Proven Acute Rejection (BPAR)
Description
The primary objective of the PROMISE trial was to demonstrate noninferiority of biopsy proven acute rejection (BPAR) rate in de novo renal transplant patients at 6 months in at least one VCS treatment group.
Time Frame
Six months
Secondary Outcome Measure Information:
Title
To Demonstrate a 5% Improvement in Renal Function as Measured by Iothalamate Glomerular Filtration Rate (GFR)
Description
ANOVAs to test for differences in GFR at Month 6.
Time Frame
Six months
Title
The Pharmacokinetic-pharmacodynamic Relationship Between Voclosporin and Calcineurin Inhibition (CNi), or Tacrolimus and Calcineurin Inhibition
Description
A sparse sampling protocol of whole blood samples obtained on Day 180 at time points immediately prior to drug administration and at 1, 2, and 4 hours post-dose were utilized. Standard non-compartmental analysis (NCA) was performed on whole blood concentration data for voclosporin and its metabolites, tacrolimus, MPA (mycophenolic acid) and MPAG (mycophenolic acid glucuronide). Tmax and Cmax were obtained directly from the concentration-time profiles without interpolation. AUC(0-4)[area under the curve] was calculated using log-linear trapezoidal rule. Cmax, AUC(0-4), C0 and C2 were summarized using descriptive statistics.
Time Frame
Six months
Title
Patient Survival
Time Frame
Six months
Title
Graft Survival
Time Frame
Six months
Title
Hypertension, Hyperlipidemia, or Hyperglycemia
Time Frame
Six months
Title
A Composite of Biopsy-proven Chronic Rejection Graft Loss, Death, or Lost to Follow up.
Time Frame
Six months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males and females aged 18 - 65 years inclusive at the time of screening. Patients must be receiving a first cadaveric or living donor renal transplant. Patients must be able to receive oral medication at time of randomization. Females who are not pregnant or nursing or planning to become pregnant during the course of the study, or 3 months after last dose of study medication. Sexually-active women of child-bearing potential (including those who are < 1 year postmenopausal) and sexually-active men who are practicing a highly effective method of birth control. A highly effective method of birth control is defined as one that results in a low failure rate (i.e., less than 1% per year) when used consistently and correctly and will include implants, injectables, combined oral contraceptives, double-barrier method, sexual abstinence, or a sterile partner. Sexually-active men and women of child-bearing potential should continue to practice contraception as outlined above during treatment and for ≥ 3 months after the last dose of voclosporin. Able to give written informed consent prior to screening procedures. Able to keep study appointments and cooperate with all study requirements, in the opinion of the investigator. Exclusion Criteria: Receiving a HLA (human leukocyte antigen)identical living related transplant. Cold ischemic time > 24 hours. Peak PRA (panel reactive antibodies) > 30% Cadaveric donors who are over age 60, non-heart beating donors, or any cadaveric donors positive for HIV, hepatitis B virus (HBV) or hepatitis C virus (HCV). Transplantation of multiple grafts (e.g. kidney and pancreas). Systemic infections requiring continued therapy at the time of entry into this study. (Prophylaxis against cytomegalovirus [CMV] and/or pneumocystis carinii pneumonia (PCP) infection will be permitted). Serologic evidence or known latent human immunodeficiency virus (HIV), hepatitis B (HBV) or hepatitis C (HCV) virus. Known negative serology prior to study entry may be used. A current malignancy or history of malignancy within 5 years or a history of lymphoma at any time. Subjects can be enrolled with a history of squamous or basal cell carcinoma that has been surgically excised or removed with curettage and electrodesiccation. Requires prohibited medications or treatment during the study. Alanine transaminase (ALT), aspartate transaminase (AST), or gamma-glutamyl transferase (GGT) ≥ 3x upper limit of normal (ULN) at time of transplantation. White blood cell count ≤ 2.8 x 10^9/L. Triglycerides ≥ 3x ULN. Pregnant women or nursing mothers. Has used any investigational drug or device within 28 days or 5 half lives (whichever is longer) prior to enrollment. Previous exposure to voclosporin. A history of active alcoholism or drug addiction within 1 year prior to study entry. Weighs < 45 kg (99 lbs) or > 140 kg (308 lbs). A history of disease, including mental/emotional disorder that would interfere with the subject's participation in the study, or that might cause the administration of voclosporin to pose a significant risk to the subject, in the opinion of the investigator. Allergy to iodine.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Daniel Abramowicz, MD, PhD
Organizational Affiliation
Erasme hospital
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Philip Belitsky, MD
Organizational Affiliation
No Affiliation
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Arthur Matas, MD
Organizational Affiliation
University of Minnesota
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Mark Pescovitz, MD
Organizational Affiliation
Indiana University
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
A. Osama Gaber, MD
Organizational Affiliation
The Methodist Hospital Research Institute
Official's Role
Study Director
Facility Information:
Facility Name
Isotechnika Investigational Site
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35924
Country
United States
Facility Name
Isotechnika Investigational Site
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Facility Name
Isotechnika Investigational Site
City
Los Angeles
State/Province
California
ZIP/Postal Code
90057
Country
United States
Facility Name
Isotechnika Investigational Site
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095-7306
Country
United States
Facility Name
Isotechnika Investigational Site
City
Orange
State/Province
California
ZIP/Postal Code
92868
Country
United States
Facility Name
Isotechnika Investigational Site
City
Palo Alto
State/Province
California
ZIP/Postal Code
94304-1510
Country
United States
Facility Name
Isotechnika Investigational Site
City
San Diego
State/Province
California
ZIP/Postal Code
92123
Country
United States
Facility Name
Isotechnika Investigational Site
City
San Francisco
State/Province
California
ZIP/Postal Code
94143-0116
Country
United States
Facility Name
Isotechnika Investigational Site
City
Denver
State/Province
Colorado
ZIP/Postal Code
80262
Country
United States
Facility Name
Isotechnika Investigational Site
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32610
Country
United States
Facility Name
Isotechnika Investigational Site
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Facility Name
Isotechnika Investigational Site
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Isotechnika Investigational Site
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
Isotechnika Investigational Site
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40536
Country
United States
Facility Name
Isotechnika Investigational Site
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70112
Country
United States
Facility Name
Isotechnika Investigational Site
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70121
Country
United States
Facility Name
Isotechnika Investigational Site
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States
Facility Name
Isotechnika Investigational Site
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Isotechnika Investigational Site
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109-9623
Country
United States
Facility Name
Isotechnika Investigational Site
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48202
Country
United States
Facility Name
Isotechnika Investigational Site
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Isotechnika Investigational Site
City
Livingston
State/Province
New Jersey
ZIP/Postal Code
07039
Country
United States
Facility Name
Isotechnika Investigational Site
City
Buffalo
State/Province
New York
ZIP/Postal Code
14203
Country
United States
Facility Name
Isotechnika Investigational Site
City
Hawthorne
State/Province
New York
ZIP/Postal Code
10532
Country
United States
Facility Name
Isotechnika Investigational Site
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Isotechnika Investigational Site
City
Rochester
State/Province
New York
ZIP/Postal Code
14642-8410
Country
United States
Facility Name
Isotechnika Investigational Site
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27705
Country
United States
Facility Name
Isotechnika Investigational Site
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Name
Isotechnika Investigational Site
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45219
Country
United States
Facility Name
Isotechnika Investigational Site
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45267-0585
Country
United States
Facility Name
Isotechnika Investigational Site
City
Portland
State/Province
Oregon
ZIP/Postal Code
97210
Country
United States
Facility Name
Isotechnika Investigational Site
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239-2940
Country
United States
Facility Name
Isotechnika Investigational Site
City
Portland
State/Province
Oregon
ZIP/Postal Code
97329-2940
Country
United States
Facility Name
Isotechnika Investigational Site
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19102
Country
United States
Facility Name
Isotechnika Investigational Site
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Isotechnika Investigational Site
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Facility Name
Isotechnika Investigational Site
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38104
Country
United States
Facility Name
Isotechnika Investigational Site
City
Dallas
State/Province
Texas
ZIP/Postal Code
75246
Country
United States
Facility Name
Isotechnika Investigational Site
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Isotechnika Investigational Site
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23298
Country
United States
Facility Name
Isotechnika Investigational Site
City
Edmonton
State/Province
Alberta
ZIP/Postal Code
T6G 2G3
Country
Canada
Facility Name
Isotechnika Investigational Site
City
London
State/Province
Ontario
ZIP/Postal Code
N6A 5A5
Country
Canada
Facility Name
Isotechnika Investigational Site
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5C 2T2
Country
Canada
Facility Name
Isotechnika Investigational Site
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H3A 1A1
Country
Canada
Facility Name
Isotechnika Investigational Site
City
Saskatoon
State/Province
Saskatchewan
ZIP/Postal Code
S7M 0Z9
Country
Canada

12. IPD Sharing Statement

Citations:
PubMed Identifier
15371668
Citation
Gregory CR, Kyles AE, Bernsteen L, Wagner GS, Tarantal AF, Christe KL, Brignolo L, Spinner A, Griffey SM, Paniagua RT, Hubble RW, Borie DC, Morris RE. Compared with cyclosporine, ISATX247 significantly prolongs renal-allograft survival in a nonhuman primate model. Transplantation. 2004 Sep 15;78(5):681-5. doi: 10.1097/01.tp.0000131950.75697.71.
Results Reference
background
PubMed Identifier
14672749
Citation
Stalder M, Birsan T, Hubble RW, Paniagua RT, Morris RE. In vivo evaluation of the novel calcineurin inhibitor ISATX247 in non-human primates. J Heart Lung Transplant. 2003 Dec;22(12):1343-52. doi: 10.1016/s1053-2498(03)00033-0.
Results Reference
background
PubMed Identifier
11250240
Citation
Abel MD, Aspeslet LJ, Freitag DG, Naicker S, Trepanier DJ, Kneteman NM, Foster RT, Yatscoff RW. ISATX247: a novel calcineurin inhibitor. J Heart Lung Transplant. 2001 Feb;20(2):161. doi: 10.1016/s1053-2498(00)00290-4. No abstract available.
Results Reference
background
PubMed Identifier
21943027
Citation
Busque S, Cantarovich M, Mulgaonkar S, Gaston R, Gaber AO, Mayo PR, Ling S, Huizinga RB, Meier-Kriesche HU; PROMISE Investigators. The PROMISE study: a phase 2b multicenter study of voclosporin (ISA247) versus tacrolimus in de novo kidney transplantation. Am J Transplant. 2011 Dec;11(12):2675-84. doi: 10.1111/j.1600-6143.2011.03763.x. Epub 2011 Sep 22.
Results Reference
result
PubMed Identifier
24243422
Citation
Mayo PR, Ling SY, Huizinga RB, Freitag DG, Aspeslet LJ, Foster RT. Population PKPD of voclosporin in renal allograft patients. J Clin Pharmacol. 2014 May;54(5):537-45. doi: 10.1002/jcph.237. Epub 2013 Nov 30.
Results Reference
derived

Learn more about this trial

Study of ISA247 (Voclosporin) in De Novo Renal Transplantation

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