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Liver TransplantationPhase 3NCT01888432

Efficacy and Safety of Everolimus in Liver Transplant Recipients of Living Donor Liver Transplants

A Phase 3 study testing Everolimus + reduced tacrolimus and Standard tacrolimus in people with Liver Transplantation, run by Novartis Pharmaceuticals at 42 sites in 13 countries.

Completed

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

Official record
Search all trials

Trial summary

The purpose of this trial was to demonstrate the efficacy and safety of everolimus in combination with reduced tacrolimus, compared to tacrolimus control, in living donor liver transplant recipients. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Liver Transplantation
What is being tested?
Everolimus + reduced tacrolimus and Standard tacrolimus
Could I receive a placebo?
No, everyone receives an active treatment
How many people
285 participants
Where
42 sitesin 13 countries
Study dates
25 Sep 2013to 21 Apr 2018
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

  • Written informed consent
  • Subject aged ≥18 years of a primary, orthotopic liver allograft, from a living donor
  • Subject negative for HIV
  • Incusion criteria at Randomization:
  • Subject was initated on tacrolimus-based immunosuppressive regimen with steroids and other immunosuppression
  • Written informed consent must be obtained before any extension specific assessment is performed.
  • Ability and willingness to adhere to study regimen.
  • Completed Month 24 visit of core study and continuously being treated with assigned regimen.

Who cannot join

  • Subjects transplanted for acute liver failure
  • HCV negativesubjects receiving a transplant from HCV positive donor
  • Subjects receiving multiple solid organ (including multiple liver lobes/segments) or islet cell tissue transplants, or have previously received an organ or tissue transplant.
  • Subjects receiving an ABO incompatible allograft.
  • MELD-score > 35 within 1 month prior to transplantation.
  • Use of immunosuppressive or antibody induction agents not specified in the protocol.
Show all 29Show fewer
  • History of malignancy of any organ system (except hepatocellular carcinoma or localized basal cell carcinoma of the skin)
  • Hepatocellular carcinoma with extrahepatic spread or macrovascular invasion
  • Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive hCG laboratory test.
  • Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using highly effective methods of contraception during dosing and for 2 weeks after the last dose of study medication
  • History of hypersensitivity to any of the study drugs or to drugs with similar chemical class, or to any of the excipients
  • Any post-transplant history of thrombosis, occlusion or stent placement in any major hepatic arteries, hepatic veins, portal vein or inferior vena cava at any time during the run-in period prior to randomization.
  • Subjects with a confirmed spot urine protein/creatinine ratio that indicates ≥ 1.0 g/24 hrs of proteinuria
  • Subjects who have severe hypercholesterolemia (>350 mg/dL; >9.1 mmol/L) or hypertriglyceridemia (>500 mg/dL; >5.6 mmol/L) at randomization.
  • Subjects with platelet count < 30,000/mm3.
  • Subjects with an absolute neutrophil count of < 1,000/mm³ or white blood cell count of < 2,000/mm³.
  • Subjects with systemic infection requiring active use of IV antibiotics.
  • Subjects requiring life support measures such as ventilation, dialysis, vasopressor agents.
  • Subjects who require renal replacement therapy within 7 days prior to randomization.
  • Subjects with detectable HBV DNA at time of randomization
  • Subjects meeting the following criteria for acute rejection during the run in period:
  • Any acute rejection in the week prior to randomization.
  • 2 treated acute rejections.
  • Any rejection requiring antibody treatment.
  • Any severe cellular (and/or any humoral) rejection.
  • Long term extension for patients in Japan:
  • Use of medication that is prohibited by the study protocol at Month 24.
  • Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive hCG laboratory test.
  • History of hypersensitivity to any of the study drugs or to drugs with similar chemical class, or to any of the excipients

Trial locations and contacts

42 sites in 13 countries.

42 sites in 13 countries

United States9 sites
  • Novartis Investigative Site

    Baltimore, Maryland, 21201

  • Novartis Investigative Site

    Boston, Massachusetts, 02114

  • Novartis Investigative Site

    Burlington, Massachusetts, 01805

  • Novartis Investigative Site

    Charlottesville, Virginia, 22908

  • Novartis Investigative Site

    Detroit, Michigan, 48202

  • Novartis Investigative Site

    Los Angeles, California, 90033

  • Novartis Investigative Site

    Minneapolis, Minnesota, 55455

  • Novartis Investigative Site

    New York, New York, 10032

  • Novartis Investigative Site

    San Francisco, California, 94143

Other trials in United States

Japan9 sites
  • Novartis Investigative Site

    Bunkyo Ku, Tokyo, 113 8655

  • Novartis Investigative Site

    Fukuoka, Fukuoka, 812-8582

  • Novartis Investigative Site

    Hiroshima, Hiroshima, 734-8551

  • Novartis Investigative Site

    Kumamoto, Kumamoto, 860-8556

  • Novartis Investigative Site

    Nagasaki, Nagasaki, 852-8501

  • Novartis Investigative Site

    Nagoya, Aichi-ken, 466 8560

  • Novartis Investigative Site

    Okayama, Okayama-ken, 700-8558

  • Novartis Investigative Site

    Sakyo Ku, Kyoto, 606 8507

  • Novartis Investigative Site

    Shinjuku-ku, Tokyo, 160-8582

Other trials in Japan

Germany4 sites
  • Novartis Investigative Site

    Berlin, 13353

  • Novartis Investigative Site

    Jena, 07740

  • Novartis Investigative Site

    Kiel, 24105

  • Novartis Investigative Site

    Regensburg, Bavaria, 93053

Other trials in Germany

India4 sites
  • Novartis Investigative Site

    Chennai, Tamil Nadu, 600006

  • Novartis Investigative Site

    Chennai, Tamil Nadu, 600100

  • Novartis Investigative Site

    Gurgaon, Haryana, 122 001

  • Novartis Investigative Site

    Kochi, Kerala, 682 026

Other trials in India

South Korea4 sites
  • Novartis Investigative Site

    Seoul, Gyeonggi-do, 03080

  • Novartis Investigative Site

    Seoul, Korea, 05505

  • Novartis Investigative Site

    Seoul, Korea, 06351

  • Novartis Investigative Site

    Seoul, 03722

Other trials in South Korea

Taiwan4 sites
  • Novartis Investigative Site

    Kaohsiung City, 83301

  • Novartis Investigative Site

    Taichung, 40447

  • Novartis Investigative Site

    Taipei, 11217

  • Novartis Investigative Site

    Taoyuan, 33305

Other trials in Taiwan

Turkey (Türkiye)2 sites
  • Novartis Investigative Site

    Malatya, 44280

  • Novartis Investigative Site

    Mecidiyekoy/Istanbul, 34394

Other trials in Turkey (Türkiye)

Canada1 site
  • Novartis Investigative Site

    Toronto, Ontario, M5G 2N2

Other trials in Canada

Egypt1 site
  • Novartis Investigative Site

    Cairo

Other trials in Egypt

Italy1 site
  • Novartis Investigative Site

    Milan, MI, 20162

Other trials in Italy

Russia1 site
  • Novartis Investigative Site

    Moscow, 123182

Other trials in Russia

Saudi Arabia1 site
  • Novartis Investigative Site

    Riyadh, 11211

Other trials in Saudi Arabia

Singapore1 site
  • Novartis Investigative Site

    Singapore, 119260

Other trials in Singapore

About this study

Official title: A 24 Month, Randomized, Controlled, Study to Evaluate the Efficacy and Safety of Concentration-controlled Everolimus Plus Reduced Tacrolimus Compared to Standard Tacrolimus in Recipients of Living Donor Liver Transplants and Long Term Extension to Evaluate the Efficacy and Safety of Concentration-controlled Everolimus Plus Reduced Tacrolimus Compared to Standard Tacrolimus in Recipients of Living Donor Liver Transplants in Japan

The purpose of this trial was to demonstrate the efficacy and safety of everolimus in combination with reduced tacrolimus, compared to tacrolimus control, in living donor liver transplant recipients.

Read the detailed description

This study was 24 month, multicenter study in 280 living donor liver transplant patients from Asia, Europe and Canada. The study has an long term extension in Japan and approximately 28 patients were to be included to evaluate the long-term efficacy and safety of concentration-controlled everolimus regimen plus reduced tacrolimus compared to standard tacrolimus in recipients of living donor liver transplants in Japan who participated in the CRAD001H2307 study.

Data reported here are the CRAD001H2307 core study results and its extension (CRAD001H2307E1).

Being tested
Everolimus + reduced tacrolimus, Standard tacrolimus
Keywords
liver transplantation, everolimus, tacrolimus, reduced calcineuron inhibitor, renal function, living donor, RAD001H2307, RAD001H

What participants receive

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

  • Everolimus + reduced tacrolimusDrug

    Everolimus was initiated at Week 4 post transplantation. The dose was adjusted to maintain the everolimus trough blood levels between 3-8 ng/mL for the duration of the study. Tacrolimus was reduced to 3-5 ng/mL.

  • Standard tacrolimusDrug

    Tacrolimus was initiated as soon as possible after transplantation according to approved labeling recommendations. The trough level should've been 5-15 ng/mL until randomization, 8-12 ng/mL from randomization until month 4 and after month 4 until end of study reduced to 6 -10 ng/mL.

Study groups in NCT01888432
Study groupRoleWhat they receive
Everolimus + reduced tacrolimusExperimentalEverolimus + reduced tacrolimus ± corticosteroids
Receives: Drug: Everolimus + reduced tacrolimus
Standard tacrolimusActive comparatorStandard tacrolimus ± corticosteroids
Receives: Drug: Standard tacrolimus

What is being measured

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

  1. Number of Participants With Composite Efficacy Failure of Treated Biopsy Proven Acute Rejection, Graft Loss or Death in Everolimus With Reduced Tacrolimus Group Compared to Standard Tacrolimus

    Rate of composite efficacy failure of treated biopsy proven acute rejection (tBPAR ≥ RAI score 3), graft loss (GL) or death (D) in everolimus with reduced tacrolimus group compared to standard tacrolimus at 12 months

    Measured: 12 months post transplantation

Secondary outcomes (15)
  1. Renal Function by Estimated Glomerular Filtration Rate (eGFR) From Randomization

    Renal function (change in estimated glomerular filtration rate (eGFR)) from randomization to Month 12 post transplantation with everolimus (EVR) in combination with reduced tacrolimus (rTAC) compared to standard exposure tacrolimus (TAC) in living donor liver transplant recipients.

    Measured: From randomization to month 12

  2. Compare Renal Function Over Time Assessed by the Change by eGFR, Post-randomization

    Change in renal function from randomization to month 24 assessed by the change in estimated GFR (MDRD-4). Rate of change of renal function.

    Measured: From randomziation to month 24

  3. Number of Participants With Composite of tBPAR, Graft Loss, and Death

    Compare between the treatment group EVR with rTAC vs standard TAC: incidence of a composite of tBPAR, graft loss, death

    Measured: Month 24 post transplantation

  4. Compare Incidence of tBPAR

    Compare between the treatment group EVR with rTAC vs standard TAC: Incidence of tBPAR

    Measured: Month 12 and Month 24 post transplantation

  5. Compare Incidence of BPAR

    Compare between the treatment group EVR with rTAC vs standard TAC: incidence of a composite of biopsy proven acute rejection (BPAR)

    Measured: Month 12 and Month 24 post transplantation

  6. Compare Incidence of Graft Loss

    Compare between the treatment group EVR with rTAC vs standard TAC: incidence of graft loss

    Measured: Month 12 and Month 24 post transplantation

  7. Compare Incidence of a Composite of Death or Graft Loss

    Compare between the treatment group EVR with rTAC vs standard TAC: Incidence of a composite of death or graft loss

    Measured: Month 12 and Month 24 post transplantation

  8. Compare Incidence of Death

    Compare between the treatment group EVR with rTAC vs standard TAC: incidence of death

    Measured: Month 12 and Month 24 post transplantation

  9. Compare Incidence of AR

    Compare between the treatment group EVR with rTAC vs standard TAC: incidence of acute rejection (AR)

    Measured: Month 12 and Month 24 post transplantation

  10. Compare Incidence of tAR

    Compare between the treatment group EVR with rTAC vs standard TAC: incidence of treated acute rejection (tAR).

    Measured: Month 12 and Month 24 post transplantation

  11. Number of Participants With Time to Recurrence of HCC in Subjects With a Diagnosis of HCC at the Time of Liver Transplantation

    Patients transplanted for HCC or with HCC diagnosed at time of transplantation were monitored for HCC recurrence according to local practice. For example routine laboratory monitoring/tests, tumor markers, hepatic ultrasound, computed tomography scans (CAT, CT) or MRI (especially Fe-MRI) on a regular basis per local practice.

    Measured: Month 12 and Month 24

  12. Number of Subjects Experiencing Adverse Events/Infections by SOC

    Measured: Month 24

  13. Compare Incidence of Notable Safety Events (SAEs, Infections and Serious Infections Leading to Premature Discontinuation)

    Notable events include death, Serious AE/infection,, and AE/infection leading to discontinuation of study medication.

    Measured: Month 24

  14. Composite Efficacy Failure of Treated Biopsy in Everolimus With Reduced Tacrolimus Group Compared to Standard Tacrolimus in Patients From Japan Only

    Rate of composite efficacy failure of treated biopsy in everolimus with reduced tacrolimus group compared to standard tacrolimus from randomization in core study up to 36 months in the extension study.

    Composite endpoint = treated BPAR, graft loss or death. AR = Acute rejection; tAR = treated AR; BPR = biopsy proven rejection; BPAR = biopsy proven acute rejection; tBPAR = treated BPAR

    Measured: randomization, 36 months post transplantion

  15. Renal Function by Estimated Glomerular Filtration Rate (All Extension Patients)

    Renal function (change in estimated glomerular filtration rate (eGFR)) from randomization to Month 36 post transplantation with everolimus (EVR) in combination with reduced tacrolimus (rTAC) compared to standard exposure tacrolimus (TAC) in living donor liver transplant recipients in Japan

    Measured: randomization, at 36 months post transplantation

Timeline

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

  1. First posted27 Jun 2013 (estimated)
  2. Study start25 Sep 2013
  3. Primary completion19 Oct 2016
  4. Study completion21 Apr 2018

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
Model description
This was a 24-month, multicenter, open-label, randomized, controlled study. It included the extension to the 24-month, randomized, controlled, open-label CRAD001H2307 study in recipients of living donor liver transplants in Japan.
Masking
Single blind
Who is masked
Care provider
Enrolment
285 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01888432
Sponsor's protocol ID
CRAD001H2307
Other IDs
2010-024527-25
Status last verified
Feb 2019
First submitted
15 Jun 2013
Last updated
18 Mar 2019
Data monitoring committee
Yes
FDA-regulated drug
Yes
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

  • Jeng LB, Lee SG, Soin AS, Lee WC, Suh KS, Joo DJ, Uemoto S, Joh J, Yoshizumi T, Yang HR, Song GW, Lopez P, Kochuparampil J, Sips C, Kaneko S, Levy G. Efficacy and safety of everolimus with reduced tacrolimus in living-donor liver transplant recipients: 12-month results of a randomized multicenter study. Am J Transplant. 2018 Jun;18(6):1435-1446. doi: 10.1111/ajt.14623. Epub 2018 Jan 25.

    PubMed 29237235

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Everolimus + reduced tacrolimus and Standard tacrolimus in people with Liver Transplantation, run by Novartis Pharmaceuticals at 42 sites in 13 countries.

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 8 inclusion and 29 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 18 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 42 sites in United States, Japan, Germany, India, South Korea and 8 more countries. 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 13 Nov 2018). 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 Composite Efficacy Failure of Treated Biopsy Proven Acute Rejection, Graft Loss or Death in Everolimus With Reduced Tacrolimus Group Compared to Standard Tacrolimus (time frame: 12 months post transplantation). 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 NCT01888432, which also lists 1 linked publication.

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 18 Mar 2019.

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