An Open-Label, Study to Treat Patients With Renal Allograft and Polyoma BK Viruria
Primary Purpose
Viruria, Viremia
Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Leflunomide and orotic acid
Sponsored by
About this trial
This is an interventional prevention trial for Viruria focused on measuring leflunomide, orotic acid, Polyoma BK Viruria, Polyoma BK Viremia, Polyoma BK Nephropathy, Renal Allograft Rejection
Eligibility Criteria
Inclusion Criteria:
- Patients, 75 years of age or less, with the diagnosis of renal allograft Polyoma BK viruria of 10 million or more copies/mL in their urine confirmed by PCR at the central laboratory.
- No viremia (viremia is defined as greater than 1,000 copies/ml plasma on two consecutive tests two weeks or more apart as measured at the designated central laboratory),
- Serum creatinine <2.0 mg/dL
- Hct > 30%
- WBC > 3,500 x 103/L
- Platelet count > 150,000 x 103/L
- Normal values for ALT, AST and bilirubin; Alk Phos < 2 X upper limits of normal
- No symptomatic cardiac, pulmonary, GI, hepatic or neurologic disease
- No other active infections
- Receiving CyA or Tacrolimus, Mycophenolate/Azathioprine + prednisone.
- Is not pregnant as verified by a pregnancy test
Exclusion Criteria:
- Is not able to comply with study procedures and dosing.
- Has psychiatric instability.
- Has an active systemic infection including Hepatitis B or C, HIV, or on anti-viral therapy within seven days of entering the study. Note however, that the subjects may be taking ganciclovir, valaciclovir, acyclovir and valganciclovir and therefore these are not exclusionary antiviral medications.
- Has BK viremia (viremia is defined as greater than 1,000 copies/ml plasma on two consecutive tests two weeks or more apart as measured at the designated central laboratory), or has had a single episode of BK viremia. (viremia is defined as greater than 1,000 copies/ml plasma on two consecutive tests two weeks or more apart as measured at the designated central laboratory or the local laboratory),
- Has a cancer diagnosis within past five years with potential for recurrence.
- Has received experimental drug within past 3 months.
- Is receiving immune suppressive drug other than those listed above calcineurin inhibitor, mycophenolate/azathioprine and +/- corticosteroid)
- Is a woman of child bearing potential or is a male with female partner of child bearing potential who is unwilling to use reliable contraception.
- Has any neurologic abnormalities including peripheral neuropathy.
- Is receiving concomitant therapy with drug known to have hepatotoxic risk.
- Has known or suspected liver disease or current alcohol abuse.
Sites / Locations
- University of Alabama, Birmingham
- Tampa General Hospital
- Rush Univeristy
- University of Illinois, Chicago
- The University of Chicago Transplant Center
- IU Health
- University of Lousiville
- Beth Israel Deaconess Hospital
- Methodist University Hospital
Arms of the Study
Arm 1
Arm 2
Arm Type
No Intervention
Experimental
Arm Label
Control Group
Treatment Group
Arm Description
Patients receive standard of care.
Dose adjusted leflunomide plus 600 mg orotic acid.
Outcomes
Primary Outcome Measures
Clearance of viruria
Viral load of Polyoma BK virus in urine reduced from greater than or equal to 10 million copies/mL to less than 500,000 copies/mL or a 2 log reduction in copies/mL.
Secondary Outcome Measures
Absence of viremia
No more that 1000 copies of Polyoma BK Virus in the blood on two consecutive tests 2 weeks or more apart
Absence of Polyoma BK Nephropathy
Absence of Polyoma BK Nephropathy
No rejection of the renal allograft
No rejection of the renal allograft
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01620268
Brief Title
An Open-Label, Study to Treat Patients With Renal Allograft and Polyoma BK Viruria
Official Title
An Open-Label, Phase 2 Study to Treat Patients With Renal Allograft and Polyoma BK Viruria to Prevent Polyoma BK Viremia, Polyoma BK Nephropathy and Renal Allograft Rejection
Study Type
Interventional
2. Study Status
Record Verification Date
December 2018
Overall Recruitment Status
Terminated
Why Stopped
Lack of recruitment
Study Start Date
July 2012 (Actual)
Primary Completion Date
June 2018 (Actual)
Study Completion Date
June 2018 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Changzheng-Cinkate
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This study will evaluate the clinical efficacy and safety of a combination of leflunomide and orotic acid in kidney transplant patients with high levels of Polyoma BK viruria for the purpose of preventing Polyoma BK viremia and Nephropathy that could lead to kidney transplant loss from viral damage, acute rejection or both.
Detailed Description
This is a multicenter, randomized trial that will evaluate the effect of a combination of leflunomide and orotic acid for the treatment of Polyoma BK viruria. In this multicenter trial, renal allograft patients with the diagnosis of Polyoma BK viruria as determined by a viral level in the urine of 25 million or more copies/mL, and no detectable viremia, will complete a screening visit (V1) to determine eligibility for the study based on inclusion/exclusion criteria. Patients that meet the entrance criteria for this study will be randomly assigned to one of two treatment groups at Visit (2) and enter a 4 month dosing period.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Viruria, Viremia
Keywords
leflunomide, orotic acid, Polyoma BK Viruria, Polyoma BK Viremia, Polyoma BK Nephropathy, Renal Allograft Rejection
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
24 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Control Group
Arm Type
No Intervention
Arm Description
Patients receive standard of care.
Arm Title
Treatment Group
Arm Type
Experimental
Arm Description
Dose adjusted leflunomide plus 600 mg orotic acid.
Intervention Type
Drug
Intervention Name(s)
Leflunomide and orotic acid
Intervention Description
Daily dose of leflunomide adjusted to target steady state blood levels of 50 ug/mL to 100 ug/mL of the active metabolite plus 600 mg orotic acid
Primary Outcome Measure Information:
Title
Clearance of viruria
Description
Viral load of Polyoma BK virus in urine reduced from greater than or equal to 10 million copies/mL to less than 500,000 copies/mL or a 2 log reduction in copies/mL.
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Absence of viremia
Description
No more that 1000 copies of Polyoma BK Virus in the blood on two consecutive tests 2 weeks or more apart
Time Frame
12 weeks
Title
Absence of Polyoma BK Nephropathy
Description
Absence of Polyoma BK Nephropathy
Time Frame
12 weeks
Title
No rejection of the renal allograft
Description
No rejection of the renal allograft
Time Frame
12 weeks
10. Eligibility
Sex
All
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients, 75 years of age or less, with the diagnosis of renal allograft Polyoma BK viruria of 10 million or more copies/mL in their urine confirmed by PCR at the central laboratory.
No viremia (viremia is defined as greater than 1,000 copies/ml plasma on two consecutive tests two weeks or more apart as measured at the designated central laboratory),
Serum creatinine <2.0 mg/dL
Hct > 30%
WBC > 3,500 x 103/L
Platelet count > 150,000 x 103/L
Normal values for ALT, AST and bilirubin; Alk Phos < 2 X upper limits of normal
No symptomatic cardiac, pulmonary, GI, hepatic or neurologic disease
No other active infections
Receiving CyA or Tacrolimus, Mycophenolate/Azathioprine + prednisone.
Is not pregnant as verified by a pregnancy test
Exclusion Criteria:
Is not able to comply with study procedures and dosing.
Has psychiatric instability.
Has an active systemic infection including Hepatitis B or C, HIV, or on anti-viral therapy within seven days of entering the study. Note however, that the subjects may be taking ganciclovir, valaciclovir, acyclovir and valganciclovir and therefore these are not exclusionary antiviral medications.
Has BK viremia (viremia is defined as greater than 1,000 copies/ml plasma on two consecutive tests two weeks or more apart as measured at the designated central laboratory), or has had a single episode of BK viremia. (viremia is defined as greater than 1,000 copies/ml plasma on two consecutive tests two weeks or more apart as measured at the designated central laboratory or the local laboratory),
Has a cancer diagnosis within past five years with potential for recurrence.
Has received experimental drug within past 3 months.
Is receiving immune suppressive drug other than those listed above calcineurin inhibitor, mycophenolate/azathioprine and +/- corticosteroid)
Is a woman of child bearing potential or is a male with female partner of child bearing potential who is unwilling to use reliable contraception.
Has any neurologic abnormalities including peripheral neuropathy.
Is receiving concomitant therapy with drug known to have hepatotoxic risk.
Has known or suspected liver disease or current alcohol abuse.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James W Williams, MD
Organizational Affiliation
Cinkate Corp
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Alabama, Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
Facility Name
Tampa General Hospital
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Facility Name
Rush Univeristy
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
University of Illinois, Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
The University of Chicago Transplant Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
IU Health
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
University of Lousiville
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202
Country
United States
Facility Name
Beth Israel Deaconess Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Methodist University Hospital
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38104
Country
United States
12. IPD Sharing Statement
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An Open-Label, Study to Treat Patients With Renal Allograft and Polyoma BK Viruria
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