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Efficacy and Safety of Paricalcitol in the Reduction of Secondary Hyperparathyroidism After Kidney Transplantation. (PARIDOINAL)

Primary Purpose

Secondary Hyperparathyroidism Due to Renal Causes

Status
Completed
Phase
Phase 4
Locations
Spain
Study Type
Interventional
Intervention
Paricalcitol
Calcifediol
Sponsored by
Fundación Senefro
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Secondary Hyperparathyroidism Due to Renal Causes focused on measuring Hyperparathyroidism, Hyperparathyroidism Secondary, Paricalcitol, Calcifediol, Parathyroid hormone, Renal transplantation

Eligibility Criteria

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

Inclusion Criteria:

  • Patient that have willingly signed and dated the ICD (Informed Consent Document) approved by the EC (Ethics Committee) before any study procedure and after they have been explained the study, they have read the ICD and have had the opportunity to make questions about it.
  • Patients of both genders and older than 18 years candidates to an immediately renal transplantation from living or deceased donor.
  • 24 hours previous to the transplantation, patient must have a significant grade of secondary hyperparathyroidism, defined as iPTH (Intact parathyroid hormone) levels between 110 and 600 pg/mL as per central laboratory results.
  • Patients with a preformed antibody panel <20% 24 hours before the transplantation or that are considered by the investigator of low immunological risk (PRA determination is being done on local laboratory, not central).
  • Serum calcium (corrected by albumin) < 10 mg/dL 24 hour previous to the transplantation as per central laboratory results.
  • Patients that are to be treated with immunosuppression based on tacrolimus, mofetil mycofenolate or mycophenolic acid and with steroids and that are not going to be treated with mTOR (mammalian target of rapamycin) inhibitors. Tacrolimus and steroids must not be removed on the 6 month post-transplantation.
  • Patients that are able to take oral capsules on the first week post-transplantation.

Exclusion Criteria:

  • Third or subsequent renal transplantation.
  • Positive cross-match assay or ABO (A-B-0) incompatibility
  • Patients that have been or are going to be recipients of other organs other than the kidney or a double kidney transplantation.
  • Patients with history of allergic reaction or sensibility to paricalcitol, calcifediol or similar study drugs (related with vitamin D).
  • Patients with chronic gastrointestinal disease, that, based on investigators criteria, can cause significant gastrointestinal malabsorption.
  • Patient with hypo or hyperthyroidism not controlled based on investigators criteria.
  • Patient with uncontrolled hypertension based on investigators criteria.
  • Patients that, 48 hours previous to transplantation, have been receiving calcimimetics.
  • Patients with VIH (human immunodeficiency virus)infection of positive serology for HBV (hepatitis B virus) and/or HCV (hepatitis C virus)
  • Patients on treatment with drugs contraindicated with paricalcitol and calcifediol (based on SMPC)
  • Patients that are participating on other clinical trial with investigational drugs.
  • Women of childbearing potential (defined as those whose last menstruation was <2 years ago and that are not surgically sterilized) that are not willing to use correct contraception during study treatment.
  • Patient with other diseases or conditions that based on investigators criteria are not suitable for the study.
  • Treatment will not be started if the Calcium-Phosphorus product (CAxP)is >55 mg2/dL2 or in case of hyperphosphatemia considered significant as per investigator criteria

Sites / Locations

  • Hospital Universitari Germans Trias I Pujol de Badalona
  • Hospital Universitari de Bellvitge
  • Hospital Universitario Marqués de Valdecilla
  • Hospital Del Mar
  • Fundació Puigvert-Iuna
  • Hospital Universitari Vall D'Hebron
  • Hospital Puerta Del Mar
  • Hospital Reina Sofía
  • Complexo Hospitalario Universitario A Coruna
  • Complejo Hospitalario Universitario de Canarias
  • Hospital Ramón Y Cajal
  • Hospital Universitario 12 de Octubre
  • Complejo Hospitalario Regional de Málaga
  • Hospital Virgen Del Rocío
  • Hospital Universitari I Politècnic La Fe
  • Hospital Universitario Miguel Servet

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Paricalcitol

Calcifediol

Arm Description

Paricalcitol oral capsules.

Calcifediol oral drops.

Outcomes

Primary Outcome Measures

Percentage of Patients With iPTH Serum Concentration >110 pg/mL.
Percentage of patients with iPTH serum concentration >110 pg/mL 6 month after transplant.

Secondary Outcome Measures

Change on iPTH Serum Concentration. Intention to Treat Analysis.
Change on iPTH serum concentration on each treatment group 6 month post transplantation.
Percentage of Patients That Reach at Least a 30% iPTH Reduction at the End of the Study.
Percentage of Patients With iPTH Levels Between 70-110 pg/mL at the End of the Study. ITT.
Percentage of Patient With Presence of Calcifications on Protocol Renal Biopsies at 6 Months After Treatment in Each Treatment Group.
Patients That Suffered the Following Events: Acute Rejection, Acute Rejection Confirmed With Biopsy and/or Subclinic Rejection and/or Chronic Damage.
Patients with at least one of the following events: acute rejection, acute rejection confirmed with biopsy and/or subclinic rejection and/or chronic damage.
Change on Concentration of Bone Markers (Osteocalcin) at 6 Months After Transplantation on Each Treatment Group.
Percentage of Patients With Acute Rejection at 6 Months After Transplantation and Treatment on Each Treatment Group.
Percentage of Patients With Microalbuminuria on Months 1, 3 and 6 Post Transplantation.
Percentage of Patients on Each Stage of Renal Function on Months 1, 3 and 6 Post Transplantation.
Evolution of Speed of Pulse Wave From Month 1 to Month 6 Post Transplantation.
Baseline speed of pulse wave was performed between 1 week and 1 month post transplant; next measure of speed of pulse wave performed at month 6 post transplant.
Percentage of Patients With Hypercalcemia on Each Treatment Group at 6 Months Post Transplantation.
Percentage of patients with hypercalcemia (defined as serum calcium levels > 10,3 mg/dl) on each treatment group at 6 months post transplantation.
Evolution of Anti-HLA Antibodies (PRA) From Basal to Month 6 Post-transplantation.
HLAs corresponding to MHC (major histocompatibility complex) class I (A, B, and C) present peptides from inside the cell. HLAs corresponding to MHC class II (DP, DM, DO, DQ, and DR) present antigens from outside of the cell to T-lymphocytes.
Frequency of Adverse Events or Serious Adverse Events That Occurs During the Study on Each Treatment Group.
Change on Concentration of Bone Markers (Alkaline Phosphatase) at 6 Months After Transplantation on Each Treatment Group.
Change on Concentration of Bone Markers (FGF-23) at 6 Months After Transplantation on Each Treatment Group

Full Information

First Posted
August 28, 2013
Last Updated
May 18, 2018
Sponsor
Fundación Senefro
Collaborators
AbbVie, Effice Servicios Para la Investigacion S.L.
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1. Study Identification

Unique Protocol Identification Number
NCT01939977
Brief Title
Efficacy and Safety of Paricalcitol in the Reduction of Secondary Hyperparathyroidism After Kidney Transplantation.
Acronym
PARIDOINAL
Official Title
Efficacy and Safety of Paricalcitol in the Reduction of Secondary Hyperparathyroidism After Renal Transplantation.
Study Type
Interventional

2. Study Status

Record Verification Date
May 2018
Overall Recruitment Status
Completed
Study Start Date
January 2014 (undefined)
Primary Completion Date
September 2015 (Actual)
Study Completion Date
December 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Fundación Senefro
Collaborators
AbbVie, Effice Servicios Para la Investigacion S.L.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
To demonstrate the superiority of paricalcitol treatment at early renal post-transplantation (M6) in the control of iPTH (Intact parathyroid hormone) compared to the use of vitamin D nutritional supplements (calcifediol) in patients with renal transplantation.
Detailed Description
The purpose of this study is to demonstrate the superiority of paricalcitol treatment at early renal post-transplantation (M6) in the control of iPTH (Intact parathyroid hormone) compared to the use of vitamin D nutritional supplements (calcifediol) in patients with renal transplantation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Secondary Hyperparathyroidism Due to Renal Causes
Keywords
Hyperparathyroidism, Hyperparathyroidism Secondary, Paricalcitol, Calcifediol, Parathyroid hormone, Renal transplantation

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
148 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Paricalcitol
Arm Type
Experimental
Arm Description
Paricalcitol oral capsules.
Arm Title
Calcifediol
Arm Type
Active Comparator
Arm Description
Calcifediol oral drops.
Intervention Type
Drug
Intervention Name(s)
Paricalcitol
Other Intervention Name(s)
Zemplar
Intervention Description
1 capsule/day for 6 months. On Month 1 and Month 3 it can be increased up to 2 capsules/day or decreased down to 1 capsule/48 hours.
Intervention Type
Drug
Intervention Name(s)
Calcifediol
Other Intervention Name(s)
Hidroferol
Intervention Description
5 drops/day during 6 months. On Month 1 it can be increased up to 7 drops/day. If this occurs then, on Month 3, it can decreased to 5 drops/day or continue 7 drops/day until end of treatment.
Primary Outcome Measure Information:
Title
Percentage of Patients With iPTH Serum Concentration >110 pg/mL.
Description
Percentage of patients with iPTH serum concentration >110 pg/mL 6 month after transplant.
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Change on iPTH Serum Concentration. Intention to Treat Analysis.
Description
Change on iPTH serum concentration on each treatment group 6 month post transplantation.
Time Frame
6 months
Title
Percentage of Patients That Reach at Least a 30% iPTH Reduction at the End of the Study.
Time Frame
6 months
Title
Percentage of Patients With iPTH Levels Between 70-110 pg/mL at the End of the Study. ITT.
Time Frame
6 month
Title
Percentage of Patient With Presence of Calcifications on Protocol Renal Biopsies at 6 Months After Treatment in Each Treatment Group.
Time Frame
6 months
Title
Patients That Suffered the Following Events: Acute Rejection, Acute Rejection Confirmed With Biopsy and/or Subclinic Rejection and/or Chronic Damage.
Description
Patients with at least one of the following events: acute rejection, acute rejection confirmed with biopsy and/or subclinic rejection and/or chronic damage.
Time Frame
6 months
Title
Change on Concentration of Bone Markers (Osteocalcin) at 6 Months After Transplantation on Each Treatment Group.
Time Frame
6 months
Title
Percentage of Patients With Acute Rejection at 6 Months After Transplantation and Treatment on Each Treatment Group.
Time Frame
6 months
Title
Percentage of Patients With Microalbuminuria on Months 1, 3 and 6 Post Transplantation.
Time Frame
Months 1, 3 and 6
Title
Percentage of Patients on Each Stage of Renal Function on Months 1, 3 and 6 Post Transplantation.
Time Frame
Months 1, 3 and 6
Title
Evolution of Speed of Pulse Wave From Month 1 to Month 6 Post Transplantation.
Description
Baseline speed of pulse wave was performed between 1 week and 1 month post transplant; next measure of speed of pulse wave performed at month 6 post transplant.
Time Frame
6 months.
Title
Percentage of Patients With Hypercalcemia on Each Treatment Group at 6 Months Post Transplantation.
Description
Percentage of patients with hypercalcemia (defined as serum calcium levels > 10,3 mg/dl) on each treatment group at 6 months post transplantation.
Time Frame
6 months
Title
Evolution of Anti-HLA Antibodies (PRA) From Basal to Month 6 Post-transplantation.
Description
HLAs corresponding to MHC (major histocompatibility complex) class I (A, B, and C) present peptides from inside the cell. HLAs corresponding to MHC class II (DP, DM, DO, DQ, and DR) present antigens from outside of the cell to T-lymphocytes.
Time Frame
6 months
Title
Frequency of Adverse Events or Serious Adverse Events That Occurs During the Study on Each Treatment Group.
Time Frame
6 months
Title
Change on Concentration of Bone Markers (Alkaline Phosphatase) at 6 Months After Transplantation on Each Treatment Group.
Time Frame
6 months
Title
Change on Concentration of Bone Markers (FGF-23) at 6 Months After Transplantation on Each Treatment Group
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient that have willingly signed and dated the ICD (Informed Consent Document) approved by the EC (Ethics Committee) before any study procedure and after they have been explained the study, they have read the ICD and have had the opportunity to make questions about it. Patients of both genders and older than 18 years candidates to an immediately renal transplantation from living or deceased donor. 24 hours previous to the transplantation, patient must have a significant grade of secondary hyperparathyroidism, defined as iPTH (Intact parathyroid hormone) levels between 110 and 600 pg/mL as per central laboratory results. Patients with a preformed antibody panel <20% 24 hours before the transplantation or that are considered by the investigator of low immunological risk (PRA determination is being done on local laboratory, not central). Serum calcium (corrected by albumin) < 10 mg/dL 24 hour previous to the transplantation as per central laboratory results. Patients that are to be treated with immunosuppression based on tacrolimus, mofetil mycofenolate or mycophenolic acid and with steroids and that are not going to be treated with mTOR (mammalian target of rapamycin) inhibitors. Tacrolimus and steroids must not be removed on the 6 month post-transplantation. Patients that are able to take oral capsules on the first week post-transplantation. Exclusion Criteria: Third or subsequent renal transplantation. Positive cross-match assay or ABO (A-B-0) incompatibility Patients that have been or are going to be recipients of other organs other than the kidney or a double kidney transplantation. Patients with history of allergic reaction or sensibility to paricalcitol, calcifediol or similar study drugs (related with vitamin D). Patients with chronic gastrointestinal disease, that, based on investigators criteria, can cause significant gastrointestinal malabsorption. Patient with hypo or hyperthyroidism not controlled based on investigators criteria. Patient with uncontrolled hypertension based on investigators criteria. Patients that, 48 hours previous to transplantation, have been receiving calcimimetics. Patients with VIH (human immunodeficiency virus)infection of positive serology for HBV (hepatitis B virus) and/or HCV (hepatitis C virus) Patients on treatment with drugs contraindicated with paricalcitol and calcifediol (based on SMPC) Patients that are participating on other clinical trial with investigational drugs. Women of childbearing potential (defined as those whose last menstruation was <2 years ago and that are not surgically sterilized) that are not willing to use correct contraception during study treatment. Patient with other diseases or conditions that based on investigators criteria are not suitable for the study. Treatment will not be started if the Calcium-Phosphorus product (CAxP)is >55 mg2/dL2 or in case of hyperphosphatemia considered significant as per investigator criteria
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Josep M Cruzado, Dr
Organizational Affiliation
Fundación SENEFRO - Hospital Universitario de Bellvitge - Barcelona.
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hospital Universitari Germans Trias I Pujol de Badalona
City
Badalona
State/Province
Barcelona
ZIP/Postal Code
08916
Country
Spain
Facility Name
Hospital Universitari de Bellvitge
City
L'Hospitalet de Llobregat
State/Province
Barcelona
ZIP/Postal Code
08907
Country
Spain
Facility Name
Hospital Universitario Marqués de Valdecilla
City
Santander
State/Province
Cantabria
ZIP/Postal Code
39008
Country
Spain
Facility Name
Hospital Del Mar
City
Barcelona
ZIP/Postal Code
08003
Country
Spain
Facility Name
Fundació Puigvert-Iuna
City
Barcelona
ZIP/Postal Code
08025
Country
Spain
Facility Name
Hospital Universitari Vall D'Hebron
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
Facility Name
Hospital Puerta Del Mar
City
Cádiz
ZIP/Postal Code
11009
Country
Spain
Facility Name
Hospital Reina Sofía
City
Córdoba
ZIP/Postal Code
14004
Country
Spain
Facility Name
Complexo Hospitalario Universitario A Coruna
City
La Coruna
ZIP/Postal Code
15006
Country
Spain
Facility Name
Complejo Hospitalario Universitario de Canarias
City
Las Palmas De Gran Canaria
ZIP/Postal Code
38320
Country
Spain
Facility Name
Hospital Ramón Y Cajal
City
Madrid
ZIP/Postal Code
28034
Country
Spain
Facility Name
Hospital Universitario 12 de Octubre
City
Madrid
ZIP/Postal Code
28041
Country
Spain
Facility Name
Complejo Hospitalario Regional de Málaga
City
Málaga
ZIP/Postal Code
29010
Country
Spain
Facility Name
Hospital Virgen Del Rocío
City
Sevilla
ZIP/Postal Code
41013
Country
Spain
Facility Name
Hospital Universitari I Politècnic La Fe
City
Valencia
ZIP/Postal Code
46026
Country
Spain
Facility Name
Hospital Universitario Miguel Servet
City
Zaragoza
ZIP/Postal Code
50009
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
No

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Efficacy and Safety of Paricalcitol in the Reduction of Secondary Hyperparathyroidism After Kidney Transplantation.

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