MK-8228 (Letermovir) in the Prevention of Human Cytomegalovirus (CMV) Infection and Disease in Adult Japanese Kidney Transplant Recipients (MK-8228-042)
Primary Purpose
Cytomegalovirus Infection, Cytomegalovirus Disease
Status
Completed
Phase
Phase 3
Locations
Japan
Study Type
Interventional
Intervention
Letermovir tablet
Letermovir IV
Sponsored by
About this trial
This is an interventional prevention trial for Cytomegalovirus Infection
Eligibility Criteria
Inclusion Criteria:
- Meets recipient and/or donor CMV Immunoglobulin G (IgG) serostatus.
- Anticipates receiving a primary or secondary allograft kidney at the time of screening and have received a primary or secondary allograft kidney at the time of allocation.
- Is within 0 (i.e., day of transplantation) to 7 days (inclusive) post-kidney transplant at the time of allocation.
- Is a Japanese male or female from 18 years to any years of age inclusive, at the time of signing the informed consent.
- Female is not pregnant or breastfeeding, and is not a woman of childbearing potential (WOCBP); but if a WOCBP, she is using an acceptable contraceptive method, or is abstinent from heterosexual intercourse, and must have a negative highly sensitive pregnancy test within 72 hours before the first dose of study intervention.
Exclusion Criteria:
- Has received a previous solid organ transplant or hematopoietic stem cell transplant (HSCT).
- Is a multi-organ transplant recipient (e.g., kidney-pancreas).
- Has a history of CMV disease or suspected CMV disease within 6 months prior to allocation.
- Has positive results on CMV assay and/or CMV antigen test at any time between the completion of the transplant surgery and time of allocation.
- Has suspected or known hypersensitivity to active or inactive ingredients of LET formulations.
- Is on dialysis (for the purposes of this protocol dialysis includes hemofiltration) or plasmapheresis at the time of allocation.
- Has Child-Pugh Class C severe hepatic insufficiency at screening.
- Has post-transplant renal function of creatinine clearance (CrCl) ≤10 mL/min at allocation (measured locally).
- Has both moderate hepatic insufficiency AND moderate-to-severe renal insufficiency at screening.
- Has any uncontrolled infection on the day of allocation.
- Has documented positive results for human immunodeficiency virus antibody (HIV-Ab) test at any time prior to allocation, or for hepatitis C virus antibody (HCV-Ab) and with detectable HCV RNA within 90 days prior to allocation or hepatitis B surface antigen (HBsAg) within 90 days prior to allocation.
- Requires mechanical ventilation, or is hemodynamically unstable, at the time of allocation.
- Has a history of malignancy ≤5 years prior to signing informed consent.
- Has received within 30 days prior to allocation or plans to receive during the study any of the following: CMV immune globulin; any investigational CMV antiviral agent/biologic therapy.
- Has received any dose of LET prior to allocation.
- Has received within 7 days prior to allocation or plans to receive during the study any anti-CMV drug therapy.
- Is a user of recreational or illicit drugs or has had a recent history (within the last year) of drug or alcohol abuse or dependence.
- Is taking or plans to take any of the prohibited medications listed in the protocol.
- Is currently participating or has participated in a study with an unapproved investigational compound or device within 28 days, or 5× half-life of the investigational compound.
- Has previously participated in this study or any other study involving LET.
- Has previously participated or is currently participating in any study involving administration of a CMV vaccine or another CMV investigational agent, or is planning to participate in a study of a CMV vaccine or another CMV investigational agent during the course of this study.
- Is pregnant or expecting to conceive, is breastfeeding, or plans to breastfeed from the time of consent through at least 28 days following cessation of study therapy.
- Is expecting to donate eggs starting from the time of consent through at least 28 days following cessation of study therapy.
Sites / Locations
- Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital ( Site 0002)
- Sapporo City General Hospital ( Site 0004)
- Osaka University Hospital ( Site 0003)
- Tokyo Women's Medical University Hospital ( Site 0001)
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Letermovir
Arm Description
Letermovir oral or intravenous (IV) formulation will be administered once daily for up to 28 weeks, beginning up to 7 days post-transplant. The dose will be 240 mg once daily for participants receiving concomitant cyclosporin A (CsA) and 480 mg once daily for participants not receiving CsA. IV infusion will be administered only to participants who are unable to swallow tablets or who have a condition that may interfere with absorption of the tablets.
Outcomes
Primary Outcome Measures
Percentage of participants with Adverse Events (AEs)
Percentage of participants with one or more adverse events (AEs)
Percentage of participants who discontinued from study drug
Percentage of participants who discontinued from study drug due to an AE
Secondary Outcome Measures
Percentage of participants with adjudicated CMV disease or undergone anti-CMV treatment
Percentage of participants with adjudicated CMV disease or undergone anti-CMV treatment
Percentage of participants with adjudicated CMV disease
Percentage of participants with adjudicated CMV disease
Percentage of participants with quantifiable CMV DNAemia
Percentage of participants with quantifiable CMV DNAemia
Area under the concentration-time curve (AUC) of plasma Letermovir - oral treatment
Area under the concentration-time curve to the end of the dosing period (AUCtau) of plasma LET - oral treatment
Trough concentration (Ctrough) of plasma Letermovir - oral treatment
Trough concentration (Ctrough) of plasma LET - oral treatment
Maximum concentration (Cmax) of plasma Letermovir - oral treatment
Maximum concentration (Cmax) of plasma LET - oral treatment
Time to Cmax (Tmax) of plasma Letermovir - oral treatment
Time to Cmax (Tmax) of plasma LET - oral treatment
Apparent clearance at steady state (CLss/F) of plasma Letermovir - oral treatment
Apparent clearance at steady state (CLss/F) of plasma LET - oral treatment
Area under the concentration-time curve (AUC) of plasma Letermovir - IV treatment
Area under the concentration-time curve to the end of the dosing period (AUCtau) of plasma LET - IV treatment
Trough concentration (Ctrough) of plasma Letermovir - IV treatment
Trough concentration (Ctrough) of plasma LET - IV treatment
Concentration at the end of infusion (Ceoi) of plasma Letermovir - IV treatment
Concentration at the end of infusion (Ceoi) of plasma LET - IV treatment
Clearance at steady state (CLss) of plasma Letermovir - IV treatment
Clearance at steady state (CLss) of plasma LET - IV treatment
Full Information
NCT ID
NCT04129398
First Posted
October 15, 2019
Last Updated
October 21, 2022
Sponsor
Merck Sharp & Dohme LLC
1. Study Identification
Unique Protocol Identification Number
NCT04129398
Brief Title
MK-8228 (Letermovir) in the Prevention of Human Cytomegalovirus (CMV) Infection and Disease in Adult Japanese Kidney Transplant Recipients (MK-8228-042)
Official Title
A Phase 3, Open-Label, Single-Arm Clinical Study to Evaluate the Safety, Efficacy and Pharmacokinetics of MK-8228 (Letermovir) for the Prevention of Human Cytomegalovirus (CMV) Infection and Disease in Adult Japanese Kidney Transplant Recipients
Study Type
Interventional
2. Study Status
Record Verification Date
October 2022
Overall Recruitment Status
Completed
Study Start Date
December 27, 2019 (Actual)
Primary Completion Date
October 6, 2022 (Actual)
Study Completion Date
October 6, 2022 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Merck Sharp & Dohme LLC
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This study aims to evaluate the safety, efficacy and pharmacokinetics (PK) of Letermovir (LET) administered as prevention of cytomegalovirus (CMV) infection and disease in adult Japanese kidney transplant recipients.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cytomegalovirus Infection, Cytomegalovirus Disease
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
22 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Letermovir
Arm Type
Experimental
Arm Description
Letermovir oral or intravenous (IV) formulation will be administered once daily for up to 28 weeks, beginning up to 7 days post-transplant. The dose will be 240 mg once daily for participants receiving concomitant cyclosporin A (CsA) and 480 mg once daily for participants not receiving CsA. IV infusion will be administered only to participants who are unable to swallow tablets or who have a condition that may interfere with absorption of the tablets.
Intervention Type
Drug
Intervention Name(s)
Letermovir tablet
Other Intervention Name(s)
MK-8228, PREVYMIS™
Intervention Description
A single 240 mg tablet or two 240 mg tablets letermovir administered orally, once daily for 28 weeks
Intervention Type
Drug
Intervention Name(s)
Letermovir IV
Other Intervention Name(s)
MK-8228, PREVYMIS™
Intervention Description
IV solution of 240 mg (one vial) or 480 mg (2 vials) letermovir in 250 mL infused over 60 minutes, once daily for 28 weeks
Primary Outcome Measure Information:
Title
Percentage of participants with Adverse Events (AEs)
Description
Percentage of participants with one or more adverse events (AEs)
Time Frame
Up to week 52 post-transplant
Title
Percentage of participants who discontinued from study drug
Description
Percentage of participants who discontinued from study drug due to an AE
Time Frame
Up to week 28 post-transplant
Secondary Outcome Measure Information:
Title
Percentage of participants with adjudicated CMV disease or undergone anti-CMV treatment
Description
Percentage of participants with adjudicated CMV disease or undergone anti-CMV treatment
Time Frame
Up to Week 52 post-transplant
Title
Percentage of participants with adjudicated CMV disease
Description
Percentage of participants with adjudicated CMV disease
Time Frame
Up to Week 52 post-transplant
Title
Percentage of participants with quantifiable CMV DNAemia
Description
Percentage of participants with quantifiable CMV DNAemia
Time Frame
Up to Week 52 post-transplant
Title
Area under the concentration-time curve (AUC) of plasma Letermovir - oral treatment
Description
Area under the concentration-time curve to the end of the dosing period (AUCtau) of plasma LET - oral treatment
Time Frame
Any day between Days 6-10: pre-dose, 1, 2.5, 5, 8 and 24 hrs post-dose
Title
Trough concentration (Ctrough) of plasma Letermovir - oral treatment
Description
Trough concentration (Ctrough) of plasma LET - oral treatment
Time Frame
Pre-dose on Weeks 1, 2,4, 6, 8, 10, 12, 16, 20, 24 and 28
Title
Maximum concentration (Cmax) of plasma Letermovir - oral treatment
Description
Maximum concentration (Cmax) of plasma LET - oral treatment
Time Frame
Any day between Days 6-10: pre-dose, 1, 2.5, 5, 8 and 24 hrs post-dose
Title
Time to Cmax (Tmax) of plasma Letermovir - oral treatment
Description
Time to Cmax (Tmax) of plasma LET - oral treatment
Time Frame
Any day between Days 6-10: pre-dose, 1, 2.5, 5, 8 and 24 hrs post-dose
Title
Apparent clearance at steady state (CLss/F) of plasma Letermovir - oral treatment
Description
Apparent clearance at steady state (CLss/F) of plasma LET - oral treatment
Time Frame
Any day between Days 6-10: pre-dose, 1, 2.5, 5, 8 and 24 hrs post-dose
Title
Area under the concentration-time curve (AUC) of plasma Letermovir - IV treatment
Description
Area under the concentration-time curve to the end of the dosing period (AUCtau) of plasma LET - IV treatment
Time Frame
Any day between Days 6-10: pre-dose, 1, 2.5, 5, 8 and 24 hrs post-dose
Title
Trough concentration (Ctrough) of plasma Letermovir - IV treatment
Description
Trough concentration (Ctrough) of plasma LET - IV treatment
Time Frame
Pre-dose on Weeks 2,4, 6, 8, 10, 12, 16, 20, 24 and 28
Title
Concentration at the end of infusion (Ceoi) of plasma Letermovir - IV treatment
Description
Concentration at the end of infusion (Ceoi) of plasma LET - IV treatment
Time Frame
Any day between Days 6-10: at end of infusion (up to 1 hour)
Title
Clearance at steady state (CLss) of plasma Letermovir - IV treatment
Description
Clearance at steady state (CLss) of plasma LET - IV treatment
Time Frame
Any day between Days 6-10: pre-dose, 1, 2.5, 5, 8 and 24 hrs post-dose
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Meets recipient and/or donor CMV Immunoglobulin G (IgG) serostatus.
Anticipates receiving a primary or secondary allograft kidney at the time of screening and have received a primary or secondary allograft kidney at the time of allocation.
Is within 0 (i.e., day of transplantation) to 7 days (inclusive) post-kidney transplant at the time of allocation.
Is a Japanese male or female from 18 years to any years of age inclusive, at the time of signing the informed consent.
Female is not pregnant or breastfeeding, and is not a woman of childbearing potential (WOCBP); but if a WOCBP, she is using an acceptable contraceptive method, or is abstinent from heterosexual intercourse, and must have a negative highly sensitive pregnancy test within 72 hours before the first dose of study intervention.
Exclusion Criteria:
Has received a previous solid organ transplant or hematopoietic stem cell transplant (HSCT).
Is a multi-organ transplant recipient (e.g., kidney-pancreas).
Has a history of CMV disease or suspected CMV disease within 6 months prior to allocation.
Has positive results on CMV assay and/or CMV antigen test at any time between the completion of the transplant surgery and time of allocation.
Has suspected or known hypersensitivity to active or inactive ingredients of LET formulations.
Is on dialysis (for the purposes of this protocol dialysis includes hemofiltration) or plasmapheresis at the time of allocation.
Has Child-Pugh Class C severe hepatic insufficiency at screening.
Has post-transplant renal function of creatinine clearance (CrCl) ≤10 mL/min at allocation (measured locally).
Has both moderate hepatic insufficiency AND moderate-to-severe renal insufficiency at screening.
Has any uncontrolled infection on the day of allocation.
Has documented positive results for human immunodeficiency virus antibody (HIV-Ab) test at any time prior to allocation, or for hepatitis C virus antibody (HCV-Ab) and with detectable HCV RNA within 90 days prior to allocation or hepatitis B surface antigen (HBsAg) within 90 days prior to allocation.
Requires mechanical ventilation, or is hemodynamically unstable, at the time of allocation.
Has a history of malignancy ≤5 years prior to signing informed consent.
Has received within 30 days prior to allocation or plans to receive during the study any of the following: CMV immune globulin; any investigational CMV antiviral agent/biologic therapy.
Has received any dose of LET prior to allocation.
Has received within 7 days prior to allocation or plans to receive during the study any anti-CMV drug therapy.
Is a user of recreational or illicit drugs or has had a recent history (within the last year) of drug or alcohol abuse or dependence.
Is taking or plans to take any of the prohibited medications listed in the protocol.
Is currently participating or has participated in a study with an unapproved investigational compound or device within 28 days, or 5× half-life of the investigational compound.
Has previously participated in this study or any other study involving LET.
Has previously participated or is currently participating in any study involving administration of a CMV vaccine or another CMV investigational agent, or is planning to participate in a study of a CMV vaccine or another CMV investigational agent during the course of this study.
Is pregnant or expecting to conceive, is breastfeeding, or plans to breastfeed from the time of consent through at least 28 days following cessation of study therapy.
Is expecting to donate eggs starting from the time of consent through at least 28 days following cessation of study therapy.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Director
Organizational Affiliation
Merck Sharp & Dohme LLC
Official's Role
Study Director
Facility Information:
Facility Name
Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital ( Site 0002)
City
Nagoya
State/Province
Aichi
ZIP/Postal Code
466-8650
Country
Japan
Facility Name
Sapporo City General Hospital ( Site 0004)
City
Sapporo
State/Province
Hokkaido
ZIP/Postal Code
060-8604
Country
Japan
Facility Name
Osaka University Hospital ( Site 0003)
City
Suita
State/Province
Osaka
ZIP/Postal Code
565-0871
Country
Japan
Facility Name
Tokyo Women's Medical University Hospital ( Site 0001)
City
Tokyo
ZIP/Postal Code
162-8666
Country
Japan
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
IPD Sharing URL
http://engagezone.msd.com/ds_documentation.php
Learn more about this trial
MK-8228 (Letermovir) in the Prevention of Human Cytomegalovirus (CMV) Infection and Disease in Adult Japanese Kidney Transplant Recipients (MK-8228-042)
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