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Lung TransplantationPhase 34EVERLUNGNCT01404325

Efficacy Regarding Renal Function of Everolimus in Combination With Specific Standard Immunosuppressive Regimen Lung Transplant Recipients

A Phase 3 study testing standard therapy and Everolimus in people with Lung Transplantation, run by Novartis Pharmaceuticals at 9 sites in Germany.

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

This trial evaluated the efficacy of an everolimus-based quadruple low immunosuppressive regimen versus a standard immunosuppressive regimen concerning kidney function in lung transplant recipients. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Lung Transplantation
What is being tested?
standard therapy and Everolimus
Could I receive a placebo?
No, everyone receives an active treatment
How many people
130 participants
Where
9 sitesGermany
Study dates
1 Feb 2012to 5 Jan 2017
Phase
Phase 3
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

  • Adult recipients of de novo cadaveric lung transplants 3-18 months prior to enrollment

Who cannot join

  • Patients with thrombocytopenia (platelets <100,000/mm³), with an absolute neutrophil count of <1,500/mm³ or leucopenia (leucocytes <3000/mm³), with anemia with Hb < 8g/dl at time of screening
  • Patients with uncontrolled hypercholesterolemia (> 350 mg/dL; > 9.1 mmol/L) or hypertriglyceridemia (> 750 mg/dL; > 8.5 mmol/L) at time of screening
  • Patients with a history of malignancy of any organ system, treated or untreated, during the last five years, whether or not there is evidence of local recurrence or metastases, except squamous or basal cell carcinoma of the skin Other protocol-defined inclusion/exclusion criteria may apply

Trial locations and contacts

9 sites in 1 country.

9 sites in 1 country

Germany9 sites
  • Novartis Investigative Site

    Berlin, 10117

  • Novartis Investigative Site

    Berlin, 13353

  • Novartis Investigative Site

    Essen, 45147

  • Novartis Investigative Site

    Freiburg im Breisgau, 79106

  • Novartis Investigative Site

    Hamburg, 20246

  • Novartis Investigative Site

    Hanover, 30625

  • Novartis Investigative Site

    Homburg, 66421

  • Novartis Investigative Site

    Leipzig, 04103

  • Novartis Investigative Site

    München, 81377

Other trials in Germany

About this study

Official title: A 2-arm, Prospective, Randomized, Controlled, Open-label, 12 Month Phase III Trial to Evaluate the Efficacy Regarding Renal Function of Everolimus in Combination With a Centre Specific Standard Immunosuppressive Regimen Consisting of CNI, Purinantagonists and Steroids Versus a Standard Triple Immunosuppressive Regimen in Lung Transplant Recipients.

This trial evaluated the efficacy of an everolimus-based quadruple low immunosuppressive regimen versus a standard immunosuppressive regimen concerning kidney function in lung transplant recipients.

Being tested
standard therapy, Everolimus
Keywords
Lung transplantation, everolimus, kidney function, renal function

What participants receive

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

  • standard therapyDrug

    centre specific CNI-based triple drug immunosuppression

  • EverolimusDrug

    Also called RAD001

    quadruple immunosuppressive regimen consisting of everolimus, CNI, MPA and steroids

Study groups in NCT01404325
Study groupRoleWhat they receive
Quadruple low level IS regimenExperimentalquadruple immunosuppressive (IS) regimen consisting of everolimus, CNI, MPA and steroids
Receives: Drug: Everolimus
Centre specific triple IS regimenExperimentalcentre specific CNI-based triple drug immunosuppression (IS)
Receives: Drug: standard therapy

What is being measured

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

  1. Calculated Glomerular Filtration Rate (cGFR) According to Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) at 12 Months

    Calculated Glomerular Filtration Rate (cGFR) according to Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) at 12 months The CKD-EPI equation, expressed as a single equation, is GFR = 141 × min(Scr/κ, 1)α × max(Scr/κ, 1)^-1.209 × 0.993Age × 1.018 (if female) × 1.159 (if black), where Scr is serum creatinine, κ is 0.7 for females and 0.9 for males, α is -0.329 for females and -0.411 for males, min indicates the minimum of Scr/ĸ or 1, and max indicates the maximum of Scr/κ or 1

    Measured: Month 12

Secondary outcomes (26)
  1. Calculated Glomerular Filtration Rate (cGFR) According to Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) at Month 1, 3, 6, 9, 12

    Calculated Glomerular Filtration Rate (cGFR) according to Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) at Month 1, 3, 6, 9 and 12. The CKD-EPI equation, expressed as a single equation, is GFR = 141 × min(Scr/κ, 1)α × max(Scr/κ, 1)^-1.209 × 0.993Age × 1.018 (if female) × 1.159 (if black), where Scr is serum creatinine, κ is 0.7 for females and 0.9 for males, α is -0.329 for females and -0.411 for males, min indicates the minimum of Scr/ĸ or 1, and max indicates the maximum of Scr/κ or 1

    Measured: Month 1, 3, 6, 9, 12

  2. Calculated Glomerular Filtration Rate (cGFR) According to Cystatin C-based Hoek's Formula at Month 1, 3, 6, 9, 12

    Calculated Glomerular Filtration Rate (cGFR) according to Cystatin C-based Hoek's formula at Month 1, 3, 6, 9, 12

    Measured: Month 1, 3, 6, 9, 12

  3. Calculated Glomerular Filtration Rate (cGFR) Using Modification of Diet in Renal Disease (MDRD) Formula at Month 1, 3, 6, 9, 12

    Calculated Glomerular Filtration Rate (cGFR) Using Modification of Diet in Renal Disease (MDRD) Formula at Month 1, 3, 6, 9, 12 cGFR (in mL/min/1.73 m2) = 186.3*(C-1.154)*(A-0.203)*G*R where C = the serum concentration of creatinine (mg/dL), A = age (years), G = 0.742 when gender is female, otherwise G = 1, R = 1.21 when race is black, otherwise R = 1.

    Measured: Month 1, 3, 6, 9, 12

  4. Calculated Glomerular Filtration Rate (cGFR) According to Cockcroft-Gault at Month 1, 3, 6, 9, 12

    Calculated Glomerular Filtration Rate (cGFR) according to Cockcroft-Gault at Month 1, 3, 6, 9, 12 For men: GFR=(140-Age) x Body weight (kg) / 72 x Serum Creatinine (mg/dl) For women: GFR=0.85 (140 -Age) x Body weight(kg)/ 72 x Serum Creatinine (mg/dl)

    Measured: Month 1, 3, 6, 9, 12

  5. Incidence of Patients Experiencing a Decline in GFR of < 10, 10-15, 15-20, 20-25 and > 25 mL/Min From Baseline to Month 6 and 12.

    Incidence of patients experiencing a decline in GFR of < 10, 10-15, 15-20, 20-25 and > 25 mL/min from Baseline to Month 6 and 12calculated by the CKD-EPI method. Participants are counted in each decline level observed for that participant; this means participants may be counted in more than 1 decline level.

    Measured: Baseline, Month 6, Month 12

  6. Incidence of Renal Replacement Therapy at Month 6 and Month 12

    Incidence of renal replacement therapy at Month 6 and Month 12: There were no incidences in either group where renal replacement therapy was required

    Measured: Month 6, Month 12

  7. Time to Renal Replacement Therapy at Month 6 and Month 12

    Time to renal replacement therapy at Month 6 and Month 12: There were no incidences in either group where renal replacement therapy was required

    Measured: Month 6, Month 12

  8. Incidence of Acute Rejection Episodes at Month 6 and Month 12

    Incidence of acute rejection episodes at Month 6 and Month 12. This table counts multiple occurrences of rejection in the same patient as different incidents. Every incident is associated with both an A and a B classification.

    Classification A: Acute Rejection Grade 0 - none, Grade 1-minimal, Grade 2- mild, Grade 3-moderate, Grade 4-Severe; Classification B: Airway Inflammation-Grade 0-none, Grade 1R-low grade, Grade 2R-high grade, Grade X-ungradeable

    Measured: Month 6, Month 12

  9. Incidence of Graft Loss/Re-transplantation at Month 6 and Month 12

    Incidence of graft loss/re-transplantation at Month 6 and Month 12

    Measured: Month 6, Month 12

  10. Incidence of Bronchiolitis Obliterans Syndrome (BOS) at Month 6 and Month 12

    Incidence of Bronchiolitis obliterans syndrome (BOS) at Month 6 and Month 12 BOS 0 is FEV1 > 90% of baseline and FEF25-75% > 75% of baseline; BOS 0-p is FEV1 81-90% of baseline and/or FEF25-75% ≤ 75% of baseline; BOS 1 is FEV1 66-80% of baseline; BOS 2 is FEV1 51-65% of baseline; BOS 3 is FEV1 ≤ 50% of baseline

    Measured: Month 6, Month 12

  11. Incidence of Death at Month 6 and Month 12

    Incidence of death at Month 6 and Month 12

    Measured: Month 6, Month 12

  12. Quality of Life (QoL, SF36) at Month 6 and Month 12

    Quality of Life (QoL, SF36) at Month 6 and Month 12 Scores can range from a minimum of 0 (maximum disability) to a maximum of 100 (no disability).

    Measured: Month 6, Month 12

  13. Exercise Capacity 6-Minute Walk Test(6MWT) at Month 6 and Month 12

    Exercise capacity (6MWT) at Month 6 and Month 12 Measured by the Borg Scale. THE BORG SCALE 0 is Nothing at all, 0.5 is Very, very slight (just noticeable); 1 is Very slight, 2 is Slight (light); 3 is Moderate; 4 is Somewhat severe; 5 is Severe (heavy), 7 is Very severe, 10 is Very, very severe (maximal)The higher the Borg score implies increased shortness of breath and/or increased fatigue.

    Measured: Month 6, Month 12

  14. Incidence of Treated Arterial Hypertension up to Month 12

    Incidence of treated of arterial hypertension up to Month 12

    Measured: up to Month 12

  15. Incidence of Diabetes Mellitus up to Month 12

    Incidence of Diabetes Mellitus up to Month 12

    Measured: up to Month 12

  16. Trough Levels of Everolimus at Month 1, 3, 6, 9, 12

    Trough levels of everolimus at Month 1, 3, 6, 9, 12

    Measured: Month 1, 3, 6, 9, 12

  17. Adherence to Target Ranges of Everolimus at Month 1, 3, 6, 9, 12

    Adherence to target ranges of everolimus at Month 1, 3, 6, 9, 12

    Measured: Month 1, 3, 6, 9, 12

  18. Trough Levels of Cyclosporine A (CsA) at Month 1, 3, 6, 9, 12

    Trough levels of Cyclosporine A (CsA) at Month 1, 3, 6, 9, 12

    Measured: Month 1, 3, 6, 9, 12

  19. Adherence to Target Ranges of Cyclosporine A (CsA) at Month 1, 3, 6, 9, 12

    Adherence to target ranges of Cyclosporine A (CsA) at Month 1, 3, 6, 9, 12

    Measured: Month 1, 3, 6, 9, 12

  20. Trough Levels of Tacrolimus at Month 1, 3, 6, 9, 12

    Trough levels of Tacrolimus at Month 1, 3, 6, 9, 12

    Measured: Month 1, 3, 6, 9, 12

  21. Adherence to Target Ranges of Tacrolimus at Month 1, 3, 6, 9, 12

    Adherence to target ranges of Tacrolimus at Month 1, 3, 6, 9, 12

    Measured: Month 1, 3, 6, 9, 12

  22. Incidence of Bacterial, Viral, and Fungal Infections at Month 12

    Incidence of bacterial, viral, and fungal infections at Month 12

    Measured: Month 12

  23. Triglyceride Levels at Month 1, 3, 6, 9, 12

    Triglyceride levels at Month 1, 3, 6, 9, 12

    Measured: Month 1, 3, 6, 9, 12

  24. Total Cholesterol Levels at Month 1, 3, 6, 9, 12

    Total Cholesterol levels at Month 1, 3, 6, 9, 12

    Measured: Month 1, 3, 6, 9, 12

  25. Low-Density Lipoprotein (LDL)Cholesterol Levels at Month 1, 3, 6, 9, 12

    LDL Cholesterol levels at Month 1, 3, 6, 9, 12

    Measured: Month 1, 3, 6, 9, 12

  26. High-Density Lipoprotein (HDL)Cholesterol Levels at Month 1, 3, 6, 9, 12

    HDL Cholesterol levels at Month 1, 3, 6, 9, 12

    Measured: Month 1, 3, 6, 9, 12

Timeline

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

  1. First posted28 Jul 2011 (estimated)
  2. Study start1 Feb 2012
  3. Primary completion5 Jan 2017
  4. Study completion5 Jan 2017

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
130 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01404325
Sponsor's protocol ID
CRAD001ADE36
Other IDs
2011-001539-21
Acronym
4EVERLUNG
Status last verified
Nov 2018
First submitted
13 Jul 2011
Last updated
14 Mar 2019
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com.

Publications

  • Kneidinger N, Valtin C, Hettich I, Frye BC, Wald A, Wilkens H, Bessa V, Gottlieb J. Five-year Outcome of an Early Everolimus-based Quadruple Immunosuppression in Lung Transplant Recipients: Follow-up of the 4EVERLUNG Study. Transplantation. 2022 Sep 1;106(9):1867-1874. doi: 10.1097/TP.0000000000004095. Epub 2022 Mar 8.

    PubMed 35283454
  • Gottlieb J, Neurohr C, Muller-Quernheim J, Wirtz H, Sill B, Wilkens H, Bessa V, Knosalla C, Porstner M, Capusan C, Struber M. A randomized trial of everolimus-based quadruple therapy vs standard triple therapy early after lung transplantation. Am J Transplant. 2019 Jun;19(6):1759-1769. doi: 10.1111/ajt.15251. Epub 2019 Feb 5.

    PubMed 30615259

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing standard therapy and Everolimus in people with Lung Transplantation, run by Novartis Pharmaceuticals at 9 sites in Germany.

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 3 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 14 Mar 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in Germany. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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 14 Mar 2019). 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?

Calculated Glomerular Filtration Rate (cGFR) According to Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) at 12 Months (time frame: Month 12). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01404325, which also lists 2 linked publications.

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 14 Mar 2019.

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