Once Daily Immunosuppression Regimen
Study Details
Study Description
Brief Summary
The purpose of this research study is to determine whether an immunosuppressive maintenance regimen of Envarsus/azathioprine compared to a tacrolimus/ mycophenolic acid regimen is associated with better compliance, tolerability, and lower biopsy proven rejection.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
|
Phase 4 |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Active Comparator: Once daily regimen Once daily medication regimen (Envarsus and azathioprine) |
Drug: Once daily immunosuppression regimen
Intervention focuses on the type of regimen, in this case the intervention arm will receive a once daily regimen for immunosuppression compared to the twice daily regimen.
|
Active Comparator: Twice daily regimen Twice daily medication regimen (Tacrolimus and mycophenolic acid) |
Drug: Twice daily immunosuppression regimen
This is the arm which we are designating the standard, which will be the comparison to the active drug arm.
|
Outcome Measures
Primary Outcome Measures
- Change in Compliance and tolerability of medication regimen at 3 and 12 months [3 months and 12 months post transplant]
BAASIS Survey
Secondary Outcome Measures
- Change in Self-recorded Compliance and tolerability of medication regimen at 3 and 12 months [3 months and 12 months post transplant]
Pill Manager (personal medication record keeping for those who participants who choose to use this method of recording their self-administered medication)
- Composite endpoint measurement [12 months]
Incidence of Biopsy proven Acute Rejection, graft loss, death, Lost to follow-up at 12 months.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Age >/= 18 years old
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Kidney transplant recipient
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Thymoglobulin induction
Exclusion Criteria:
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Non-renal organ transplant
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Combined organ transplant
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Inability to receive Envarsus after transplant
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Discharged to acute care facility after transplant
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | Washington University | Saint Louis | Missouri | United States | 63110 |
Sponsors and Collaborators
- Washington University School of Medicine
- Veloxis Pharmaceuticals
Investigators
- Principal Investigator: Rowena Delos Santos, Washington University School of Medicine
Study Documents (Full-Text)
None provided.More Information
Publications
- Budde K, Bunnapradist S, Grinyo JM, Ciechanowski K, Denny JE, Silva HT, Rostaing L; Envarsus study group. Novel once-daily extended-release tacrolimus (LCPT) versus twice-daily tacrolimus in de novo kidney transplants: one-year results of Phase III, double-blind, randomized trial. Am J Transplant. 2014 Dec;14(12):2796-806. doi: 10.1111/ajt.12955. Epub 2014 Oct 2.
- Bunnapradist S, Ciechanowski K, West-Thielke P, Mulgaonkar S, Rostaing L, Vasudev B, Budde K; MELT investigators. Conversion from twice-daily tacrolimus to once-daily extended release tacrolimus (LCPT): the phase III randomized MELT trial. Am J Transplant. 2013 Mar;13(3):760-9. doi: 10.1111/ajt.12035. Epub 2012 Dec 21.
- Jamieson NJ, Hanson CS, Josephson MA, Gordon EJ, Craig JC, Halleck F, Budde K, Tong A. Motivations, Challenges, and Attitudes to Self-management in Kidney Transplant Recipients: A Systematic Review of Qualitative Studies. Am J Kidney Dis. 2016 Mar;67(3):461-78. doi: 10.1053/j.ajkd.2015.07.030. Epub 2015 Sep 11. Review.
- Laliberté F, Nelson WW, Lefebvre P, Schein JR, Rondeau-Leclaire J, Duh MS. Impact of daily dosing frequency on adherence to chronic medications among nonvalvular atrial fibrillation patients. Adv Ther. 2012 Aug;29(8):675-90. doi: 10.1007/s12325-012-0040-x. Epub 2012 Aug 15.
- Rostaing L, Bunnapradist S, Grinyó JM, Ciechanowski K, Denny JE, Silva HT Jr, Budde K; Envarsus Study Group. Novel Once-Daily Extended-Release Tacrolimus Versus Twice-Daily Tacrolimus in De Novo Kidney Transplant Recipients: Two-Year Results of Phase 3, Double-Blind, Randomized Trial. Am J Kidney Dis. 2016 Apr;67(4):648-59. doi: 10.1053/j.ajkd.2015.10.024. Epub 2015 Dec 22.
- Vrijens B, Heidbuchel H. Non-vitamin K antagonist oral anticoagulants: considerations on once- vs. twice-daily regimens and their potential impact on medication adherence. Europace. 2015 Apr;17(4):514-23. doi: 10.1093/europace/euu311. Epub 2015 Feb 17. Review.
- 201803162