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Graft RejectionPhase 2NCT00035555

Study Comparing the Safety and Efficacy of Belatacept With That of Cyclosporine in Patients With a Transplanted Kidney

A Phase 2 study testing Belatacept, Cyclosporine and Mycophenolate mofetil (MMF) in people with Graft Rejection and Kidney Transplantation, run by Bristol-Myers Squibb at 12 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to determine whether treatment with Belatacept (BMS-224818) is as efficacious as treatment with cyclosporine at preventing acute rejection and with a superior safety/tolerability profile (better kidney function and blood pressure, fewer lipid problems, less diabetes mellitus). Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Belatacept, Cyclosporine and Mycophenolate mofetil (MMF)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
230 participants
Where
12 sitesUnited States
Study dates
Mar 2001to Jul 2012
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Recipients of first kidney transplant

Who cannot join

  • Those at high risk for acute allograft rejection, including those who receive a second or more renal transplant, those with a history of panel reactive antibody levels >20%, and those considered by investigators to be at relatively higher risk for acute rejection
  • Human leukocyte antigen-identical donor-recipient pairs
  • Cold ischemia time >36 hours (donor kidney)
  • Participants who are positive for hepatitis C antibody, on polymerase chain reaction, for hepatitis B surface antigen, and for human immunodeficiency virus
  • A positive purified protein derivative tuberculosis test (test performed within 1 year of enrollment), unless previously vaccinated with Bacille-Calmette-Guérin or those who had a history of adequate chemoprophylaxis
  • Any active infection that would normally exclude transplantation
Show all 19Show fewer
  • Recipients of multiple organ transplants
  • Donor age >60 or <6 years or donors whose hearts were not beating
  • Recipients with underlying renal disease of (due to risk of rapid disease recurrence in the allograft): focal segmental glomerulosclerosis, Type I or II membranoproliferative glomerulonephritis, or hemolytic uremic syndrome/ thrombotic thrombocytopenic purpura
  • A positive T-cell lymphocytoxic crossmatch using donor lymphocytes and recipient serum
  • A history of true allergy to intravenous iodinated roentgenographic contrast agents
  • Participants with life expectancy severely limited by disease state or other underlying medical condition
  • A history of cancer (other than nonmelanoma skin cell cancers cured by local resection) within the last 5 years
  • Mammogram film with any clinically significant abnormality requiring further investigation or biopsies
  • History of substance abuse (drug or alcohol) or psychotic disorders that were not compatible with adequate study follow-up
  • A currently functioning, nonrenal transplant
  • Previous treatment with basiliximab for any reason
  • Active peptic ulcer disease, chronic diarrhea, or gastrointestinal malabsorption
  • Those who had used any investigational drug within 30 days before the Day 1 visit.

Trial locations and contacts

12 sites in 1 country.

12 sites in 1 country

United States12 sites
  • Emory Univ. School of Medicine

    Atlanta, Georgia, 30322

  • Johns Hopkins University

    Baltimore, Maryland, 21205

  • Massachusetts General Hospital

    Boston, Massachusetts, 02114

  • Medical Univ. of South Carolina

    Charleston, South Carolina, 29425

  • Baylor Univ. Medical Center

    Dallas, Texas, 75246

  • Saint Barnabas Medical Center

    Livingston, New Jersey, 07039

  • Univ. of Wisconsin

    Madison, Wisconsin, 53792-7375

  • Mount Sinai Medical Center

    New York, New York, 10029-6574

  • Univ. of Nebraska Medical Center

    Omaha, Nebraska, 68198-1002

  • Univ. of Pennsylvania

    Philadelphia, Pennsylvania, 19104

  • Mayo Clinic

    Rochester, Minnesota, 55905

  • Univ. of Calif. - San Francisco

    San Francisco, California, 94143-0001

Other trials in United States

About this study

Official title: Phase II/III, Open-Label, Randomized, Controlled, Multiple-Dose Study of Efficacy and Safety of BMS-224818 (Belatacept) as Part of a Quadruple Drug Regimen in First Renal Transplant Recipients

The purpose of this study is to determine whether treatment with Belatacept (BMS-224818) is as efficacious as treatment with cyclosporine at preventing acute rejection and with a superior safety/tolerability profile (better kidney function and blood pressure, fewer lipid problems, less diabetes mellitus).

Being tested
Belatacept, Cyclosporine, Mycophenolate mofetil (MMF), Corticosteroids
Keywords
kidney, transplant, rejection
Medical subject headings
Rejection, Psychology

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • BelataceptDrug

    Also called LEA29Y, BMS-224818

    Solution, intravenous

  • CyclosporineDrug

    Also called The cyclosporine used in this study will be in the modified formulation with enhanced bioavailability.

    Oral, capsule

  • Mycophenolate mofetil (MMF)Drug

    Oral, capsule

  • CorticosteroidsDrug

    Corticosteroids given daily, orally or intravenously (IV). Day of transplant (Day 1): methylprednisolone, 500 mg, given IV on arrival in operating room; Day 2: methylprednisolone, 250 mg, given IV once daily; Day 3: prednisone, 100 mg, given orally once daily; Day 4: prednisone, 50 mg, given orally once daily; Days 5 through 30: prednisone, 25 mg, given orally once daily; Days 31-44: prednisone, 22.5 mg, given orally once daily; Days 45-58: prednisone, 20 mg, given orally once daily

Study groups in NCT00035555
Study groupRoleWhat they receive
Belatacept: More intensive (MI) regimenExperimentalThe MI regimen was designed to achieve projected serum trough concentrations of belatacept of approximately 20 μg/mL through Day 99, and approximately 5 μg/mL through Day 183 (10 mg/kg on Days 1, 5, 15, 29, 43, 57, 71, 85, 113, 141, and 169). After Day 169, patients were reallocated and dosed to achieve projected trough serum concentrations of approximately 2 or 0.25 μg/mL (5 mg/kg every 4 or 8 weeks starting on Day 197). Those patients who received belatacept every 8 weeks received placebo infusions on scheduled treatment dates between infusions of active drug to maintain the blind between treatment regimens. Patients initially received mycophenolate mofetil (MMF), 2 g/d orally, unless the investigator chose to administer ≥1 doses intravenously The first MMF dose was administered preoperatively; subsequent doses were administered in 2 or 3 divided doses, every 8-12 hours, beginning as soon as the patient was able to tolerate medications by mouth. Corticosteroids given daily.
Receives: Drug: Belatacept; Drug: Mycophenolate mofetil (MMF); Drug: Corticosteroids
Belatacept: Less intensive (LI) regimenExperimentalThe LI regimen was designed to achieve projected trough serum concentrations of belatacept of approximately 20 μg/mL through Day 29, and approximately 5 μg/mL through Day 99 (10 mg/kg on Days 1, 15, 29, 57 and 85). After Day 85, these subjects were reallocated and dosed to achieve projected trough serum concentrations of either approximately 2 or 0.25 μg/mL (5 mg/kg every 4 or 8 weeks starting on Day 113). Participants initially received mycophenolate mofetil (MMF), 2 g/d orally, unless the investigator chose to administer ≥1 doses intravenously The first MMF dose was administered preoperatively; subsequent doses were administered in 2 or 3 divided doses, every 8-12 hours, beginning as soon as the participant was able to tolerate medications by mouth. Corticosteroids given daily.
Receives: Drug: Belatacept; Drug: Mycophenolate mofetil (MMF); Drug: Corticosteroids
Cyclosporine regimenExperimentalThe initial daily dose was 7±3 mg/kg. Subsequent doses were adjusted to maintain a predefined range of serum concentrations: 1st month, target level 150-400 ng/mL; after 1st month, target level of 150-300 ng/mL. Participants initially received mycophenolate mofetil (MMF), 2 g/d orally, unless the investigator chose to administer ≥1 doses intravenously The first MMF dose was administered preoperatively; subsequent doses were administered in 2 or 3 divided doses, every 8-12 hours, beginning as soon as the participant was able to tolerate medications by mouth. Corticosteroids given daily.
Receives: Drug: Cyclosporine; Drug: Mycophenolate mofetil (MMF); Drug: Corticosteroids

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With an Episode of Clinically-suspected and Biopsy-proven Acute Rejection (CSPAR)

    No participant was to receive treatment for acute rejection without a biopsy to confirm the diagnosis. CSPAR=Clinically-suspected rejection, defined as an increase in serum creatinine ≥0.5 mg/dL compared with the baseline value in the absence of other factors known to adversely affect renal function, and biopsy-proven rejection, which includes all cases in which a biopsy was read by the central pathologist as demonstrating acute rejection regardless of the reason why the biopsy was performed.

    Measured: By Month 6 posttransplant (From Day 1 to Month 6)

Secondary outcomes (9)
  1. Percentage of Participants With Biopsy-proven Acute Rejection (BPAR) Through Months 6 and 12

    BPAR includes all cases in which a biopsy read by the central pathologist demonstrates acute rejection, regardless of the reason that the biopsy was performed.

    Measured: Through Months 6 and 12 posttransplant (From Day 1 to Months 6 and 12)

  2. Percentage of Participants With Biopsy-proven Acute Rejection (BPAR) or Who Received Treatment for Acute Rejection

    BPAR includes all cases in which a biopsy read by the central pathologist demonstrates acute rejection, regardless of the reason that the biopsy was performed. A participant was reported as having had an episode of treated acute rejection if he or she received antirejection therapy during an episode of rejection (clinically-suspected or biopsy-proven rejection).

    Measured: By Months 3, 6, and 12 posttransplant (Day 1 to Months 3, 6, and 12)

  3. Percentage of Participants With Acute Rejection or Presumed Acute Rejection (PAR)

    Throughout this study, acute rejection=clinically-suspected and biopsy-proven acute rejection (BPAR). Clinically-suspected rejection is defined as an increase in serum creatinine ≥0.5 mg/dL compared with the baseline value in the absence of other factors known to adversely affect renal function. BPAR includes all cases in which a biopsy was read by the central pathologist as demonstrating acute rejection regardless of the reason why the biopsy was performed. PAR is defined as an elevation in SCr ≥0.5 mg/dL compared with the baseline value in the absence of other factors known to adversely affect renal function that led the investigator to suspect that the participant had experienced acute rejection, and in whom either the biopsy did not confirm acute rejection and the participant received treatment for acute rejection or the participant received treatment for acute rejection without a biopsy to confirm the diagnosis.

    Measured: By Months 6 and 12 posttransplant (Day 1 to Months 6 and 12)

  4. Percentage of Participants Who Had Chronic Allograft Nephropathy

    Based on postbaseline biopsies

    Measured: By Months 6 and 12 posttransplant (Day 1 to Months 6 and 12)

  5. Mean Iohexol Clearance

    Iohexol, a true glomerular filtration marker, is used to measure glomerular filtration rate.

    Measured: By Months 1, 6, and 12 posttransplant (Day 1 to Months 1, 6, and 12)

  6. Percentage of Participants Who Used Antihypertensive Medication

    Hypertension is defined as diastolic blood pressure ≥90 mm Hg and/or systolic blood pressure ≥140 mm Hg

    Measured: By Months 6 and 12 posttransplant (Day 1 to Months 6 and 12)

  7. Number of Participants With Hypertension

    Hypertension is defined as diastolic blood pressure ≥90 mm Hg and/or systolic blood pressure ≥140 mm Hg or, the use of any antihypertensive medication.

    Measured: By Months 6 and 12 posttransplant (Day 1 to Months 6 and 12)

  8. Mean LDL Cholesterol, HDL Cholesterol, Total Cholesterol, Triglyceride, and Non-HDL Levels

    LDL=low-density lipoprotein; HDL=high-density lipoprotein. Total cholesterol=LDL + HDL + very low-density (VLDL) cholesterol. VLDL=triglycerides divided by 5. Non-HDL cholesterol=Total cholesterol minus HDL cholesterol.

    Measured: By Months 1, 6, and 12 posttransplant (Day 1 to Months 1, 6, and 12)

  9. Number of Participants With Posttransplant Diabetes Mellitus

    Posttransplant diabetes mellitus is defined as the need for treatment of hyperglycemia with either an oral agent or insulin for a total of >4 weeks or hemoglobin A1c (HbA1c) >7% in a participant not known to be diabetic prior to transplantation

    Measured: By Months 1, 3, 6, 9, and 12 posttransplant (Day 1 to Months 1, 3, 6, 9, and 12 )

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 May 2002 (estimated)
  2. Study startMar 2001
  3. Primary completionJan 2004
  4. Study completionJul 2012

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
230 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00035555
Sponsor's protocol ID
IM103-100
Status last verified
Nov 2013
First submitted
3 May 2002
Last updated
13 Jan 2014

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Belatacept, Cyclosporine and Mycophenolate mofetil (MMF) in people with Graft Rejection and Kidney Transplantation, run by Bristol-Myers Squibb at 12 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 13 Jan 2014. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 13 Jan 2014). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants With an Episode of Clinically-suspected and Biopsy-proven Acute Rejection (CSPAR) (time frame: By Month 6 posttransplant (From Day 1 to Month 6)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Jan 2014.

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