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Belatacept in Renal Transplantation With Intermediate Risk Maryland Aggregate Pathology Index (MAPI) Scores

Information source: University of Maryland
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: End-Stage Renal Disease

Intervention: Belatacept (Drug)

Phase: N/A

Status: Recruiting

Sponsored by: University of Maryland

Official(s) and/or principal investigator(s):
Rolf N Barth, MD, Principal Investigator, Affiliation: University of Maryland

Overall contact:
Rolf N Barth, MD, Phone: 4438412222, Email: rbarth@smail.umaryland.edu

Summary

This will be a pilot study to investigate the use of belatacept (BMS) therapy in kidney transplant patients who have a MAPI score of greater than or equal to 8. The MAPI (Maryland Aggregate Pathology Index) score is a preimplantation donor scoring system which has five histopathological parameters that impact long-term kidney outcomes. Many kidney transplant recipients use calcineurin inhibitors (CNIs) as one of their anti-rejection medi cations. Kidney function may be affected by anti-rejection medications known as calcineurin inhibitors (CNIs). Sometimes CNIs can lead to toxicities and eventually loss of the kidney or episodes of chronic allograft nephropathy (CAN). Avoiding CNI immunosuppression and using belatacept therapy (BMS) instead, may be associated with improved kidney transplant outcomes.

Clinical Details

Official title: A 12 Month, Single-center, Non-randomized, Open-label Study of Outcomes of Intermediate Risk Maryland Aggregate Pathology Index (MAPI) Scores in de Novo Renal Transplant Recipients

Study design: Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Primary outcome: Renal Function

Secondary outcome:

Rejection rate

Graft survival

MAPI biopsy score

Patient survival

Eligibility

Minimum age: 18 Years. Maximum age: 70 Years. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Male or female renal recipients 18-70 years of age undergoing primary kidney

transplantation.

- Recipients of deceased donor (including expanded criteria donor organs and deceased

donor organs after cardiac death) with MAPI score ≥ 8.

- Cold ischemic time less than 40 hours at time of reperfusion.

- Negative serum pregnancy test for female patients.

- Patients who can understand the purposes and risks of the study, provide informed

consent, and can comply with the treatment and follow-up requirements. Exclusion Criteria:

- Cold ischemic time (CIT) > 40 hours

- Patients who are sensitized with current PRA>40%, ABO incompatible transplants, or T,

or B cell crossmatch positive transplant.

- Patients without antibody to EBV

- Patients receiving multiple organ transplants.

- Patients unable to take oral medication at time of randomization

- Patient with a history of malignancy of any organ system, treated or untreated,

within the past 2 years whether or not there is evidence of local recurrence or metastases, with the exception of carcinoma in situ

- Patients who tested positive for HIV, Hepatitis C or Hepatitis B surface antigen.

- Recipients of organs from donors who test positive for HIV, Hepatitis C or Hepatitis

B surface antigen

- Patients with a clinically significant systemic infection within 30 days prior to

transplant

- Patients who have cardiac failure at time of screening or any other severe cardiac

disease as determined by the investigator

- Patients with abnormal laboratory findings of clinical significance within 2 weeks of

randomization which would interfere with the objectives of the study.

- Females, pregnant or lactating, or are of childbearing potential unwilling to use an

effective means of contraception or are planning to become pregnant.

- Patient with active tuberculosis infection

Locations and Contacts

Rolf N Barth, MD, Phone: 4438412222, Email: rbarth@smail.umaryland.edu

University of Maryland, Baltimore, Maryland 21201, United States; Recruiting
Rolf Barth, MD, Phone: 410-328-6020, Email: rbarth@smail.umaryland.edu
Rolf Barth, MD, Principal Investigator

University of Maryland, Baltimore, Maryland 21201, United States; Recruiting
Rolf Barth, MD, Phone: 410-328-6020, Email: rbarth@smail.umaryland.edu
Onumara Opara, Phone: 410-328-0303, Email: OOpara@smail.umaryland.edu
Rolf Barth, MD, Principal Investigator

Additional Information

University of Maryland Division of Transplantation

Related publications:

Vincenti F, Blancho G, Durrbach A, Friend P, Grinyo J, Halloran PF, Klempnauer J, Lang P, Larsen CP, Mühlbacher F, Nashan B, Soulillou JP, Vanrenterghem Y, Wekerle T, Agarwal M, Gujrathi S, Shen J, Shi R, Townsend R, Charpentier B. Five-year safety and efficacy of belatacept in renal transplantation. J Am Soc Nephrol. 2010 Sep;21(9):1587-96. doi: 10.1681/ASN.2009111109. Epub 2010 Jul 15.

Vincenti F, Larsen C, Durrbach A, Wekerle T, Nashan B, Blancho G, Lang P, Grinyo J, Halloran PF, Solez K, Hagerty D, Levy E, Zhou W, Natarajan K, Charpentier B; Belatacept Study Group. Costimulation blockade with belatacept in renal transplantation. N Engl J Med. 2005 Aug 25;353(8):770-81.

Vincenti F, Charpentier B, Vanrenterghem Y, Rostaing L, Bresnahan B, Darji P, Massari P, Mondragon-Ramirez GA, Agarwal M, Di Russo G, Lin CS, Garg P, Larsen CP. A phase III study of belatacept-based immunosuppression regimens versus cyclosporine in renal transplant recipients (BENEFIT study). Am J Transplant. 2010 Mar;10(3):535-46. doi: 10.1111/j.1600-6143.2009.03005.x.

Larsen CP, Grinyó J, Medina-Pestana J, Vanrenterghem Y, Vincenti F, Breshahan B, Campistol JM, Florman S, Rial Mdel C, Kamar N, Block A, Di Russo G, Lin CS, Garg P, Charpentier B. Belatacept-based regimens versus a cyclosporine A-based regimen in kidney transplant recipients: 2-year results from the BENEFIT and BENEFIT-EXT studies. Transplantation. 2010 Dec 27;90(12):1528-35. doi: 10.1097/TP.0b013e3181ff87cd.

Starting date: March 2012
Last updated: January 27, 2015

Page last updated: August 23, 2015

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