E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Kidney allograft rejection following living-donor renal transplantation. |
rigetto di trapianto renale conseguente a trapianto da donatore vivente |
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E.1.1.1 | Medical condition in easily understood language |
Kidney graft rejection in patients receiving a kidney transplant from a living organ donor. |
rigetto del trapianto renale in pazienti che ricevono un trapianto di rene da donatore vivente |
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E.1.1.2 | Therapeutic area | Body processes [G] - Immune system processes [G12] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 16.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10051366 |
E.1.2 | Term | Kidney graft dysfunction |
E.1.2 | System Organ Class | 100000004863 |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 16.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10049581 |
E.1.2 | Term | Graft rejection episode |
E.1.2 | System Organ Class | 100000004870 |
|
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 16.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10050436 |
E.1.2 | Term | Prophylaxis against renal transplant rejection |
E.1.2 | System Organ Class | 100000004865 |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 16.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10069030 |
E.1.2 | Term | Graft failure |
E.1.2 | System Organ Class | 100000004863 |
|
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 16.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10038297 |
E.1.2 | Term | Rejection acute renal |
E.1.2 | System Organ Class | 100000004870 |
|
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 16.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10021510 |
E.1.2 | Term | Immunosuppression NOS |
E.1.2 | System Organ Class | 100000004870 |
|
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 16.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10038299 |
E.1.2 | Term | Rejection chronic renal |
E.1.2 | System Organ Class | 100000004863 |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 16.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10066543 |
E.1.2 | Term | Acute allograft rejection |
E.1.2 | System Organ Class | 100000004870 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To confirm the rate of acute kidney graft rejection in the study population under standard immunosuppressive therapy in order to corroborate historical renal transplantation statistics and generate reference ranges for future clinical research within The ONE Study.
The Reference Group Trial is the first clinical trial planned within the context of The ONE Study, an international, non-commercial research project that ultimately aims in subsequent trials to test several alternative GMP cell products as adjunct immunosuppressive treatments in kidney transplantation. Future trials will assess whether immunoregulatory cell infusion could allow for a reduction in the use of pharmacological maintenance therapy in transplant recipients and alleviate the drawbacks associated with traditional immunosuppressive agents. |
confermare il tasso di rigetto acuto del trapianto renale studiando la popolazione in trattamento con terapia standard immunosoppressiva, al fine di supportare le statistiche esistenti di trapianto renale e creare linee guida per la futura ricerca clinica nell'ambito dello studio ONE.
Lo studio sul “Gruppo di Riferimento” è il primo trial clinico previsto nell'ambito dello studio ONE, un progetto di ricerca internazionale, non commerciale
che mira, in ultima analisi, nel corso degli studi successivi a testare diversi
prodotti alternativi cellulari (GMP) come coadiuvante dei trattamenti immunosoppressivi nel trapianto di rene. Studi futuri valuteranno se
infusioni di cellule immunomodulanti potrebbero consentire una riduzione nell'uso della terapia farmacologica di mantenimento nei pazienti trapiantati e
alleviare gli inconvenienti legati ai tradizionali agenti immunosoppressivi
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E.2.2 | Secondary objectives of the trial |
The Reference Group Trial will also measure various clinical, immunological and health-economic parameters to generate reference ranges for future cell therapy studies within The ONE Study project.
An Immune Monitoring Subpr. will use scientific lab. assays to investigate the progression of the immunological response in trial patients by measuring functional and molecular correlates of immune reactivity. Results will be used as a reference data set for the future study "The ONE Study cell therapy" |
Lo studio del “Gruppo di Riferimento” misurerà anche i diversi parametri clinici, immunologici e salute-economici di riferimento per generare range per futuri studi di terapia cellulare all'interno dello studio THE ONE.
Un sottoprogetto di Monitoraggio Immunitario utilizzerà test di lab. scient. per indagare la progressione della risposta immunologica dei pazienti in studio misurando la funzionalità e le correlazioni molecolari della reattività immunitaria.
I risultati saranno utilizzati per il futuro studio “THE ONE- terapia cellulare” . |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
The main inclusion criteria for trial patients (organ recipients) are:
• Chronic renal insufficiency necessitating kidney transplantation and approved to receive a primary kidney allograft from a living donor
• Aged at least 18 years
• Signed and dated written informed consent. |
•insufficienza renale cronica che richiede il trapianto di rene e che sia
approvato per ricevere un trapianto di rene da un donatore vivente
•Età maggiore di 18 anni
•Consenso informato datato e firmato
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E.4 | Principal exclusion criteria |
The main exclusion criteria for trial patients (organ recipients) are:
• Patient has previously received, or is scheduled to receive, any tissue or organ transplant other than the planned kidney graft
• Known sensitivity to tacrolimus, mycophenolate or corticosteroids
• Genetically identical to the prospective organ donor at the HLA loci
• PRA grade > 40% within 6 months prior to enrolment
• Previous treatment with any desensitisation procedure (with or without IVIg)
• Concomitant malignancy or history of malignancy within 5 years prior to planned study entry (excluding successfully-treated non-metastatic basal/squamous cell carcinoma of the skin)
• Evidence of significant local or systemic infection
• HIV-positive, EBV-negative or suffering chronic viral hepatitis
• Significant liver disease (persistently elevated AST and/or ALT levels > 2 x ULN)
• Known primary haematological disorders. |
•Pazienti che abbiano ricevuto, o siano in attesa di ricevere trapianto di qualsiasi organo o tessuto, oltre al già programmato trapianto di rene
•Intolleranza nota verso tacrolimus, micofenolato e corticosteroidi.
°Prospettico dei loci HLA geneticamente identico al donatore.
•Pra > 40% nei sei mesi precedenti l’arruolamento
•Precedenti trattamenti con procedure di desensibilizzazione ( con o senza IVIg)
•Neoplasie concomitanti o storia di neoplasia nei 5 anni precedenti l’arruolamento ( escludendo: i carcinomi della pelle non metastatici trattati con successo)
•Infezioni locali o sistemiche documentate
•Soggetti HIV positivi, EBV negativi o affetti da epatiti virali croniche
•Significativi problemi epatici ( persistenza di valori elevati di AST o ALT > 2 x ULN)
•Patologie ematologiche maligne o pre-maligne note
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint is the incidence of biopsy-confirmed acute rejection (BCAR). |
L’ end point primario consiste nella valutazione dell’ incidenza dei rigetti acuti, confermati con biopsia. (BCAR). |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
Incidences of BCAR occurring within 60 weeks following kidney transplantation will be evaluated in the final analysis. |
nell’analisi finale verrà valutata l’incidenza di BCAR avvenuti nelle 60 settimane successive al trapianto di rene |
|
E.5.2 | Secondary end point(s) |
Secondary endpoints include:
• Time to first acute rejection episode
• Severity of acute rejection episodes (based on response to treatment and histological scoring)
• Total immunosuppressive burden at 60 weeks post-transplantation
• Incidence of chronic graft dysfunction
• Incidence of graft loss through rejection (acute/chronic)
• Incidence of adverse drug reactions
• Incidence of major infections
• Incidence of neoplasia. |
•valutazione del tempo del primo episodio di rigetto acuto
•valutazione del grado di severità dell’episodio di rigetto acuto ( sulla base della risposta al trattamento e ai punteggi istologici)
•valutazione totale delle risposte immunosoppressive a 60 settimane post trapianto
•valutazione dell’ incidenza di disfunzioni croniche di organo
•valutazione di perdita dell’organo in seguito a reazione ( acuta/cronica)
•valutazione dell’ incidenze di reazioni avverse ai farmaci
•valutazione dell’incidenze di infezioni
•valutazione dell’incidenza di neoplasie |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
Secondary endpoints occurring within 60 weeks following kidney transplantation will be evaluated in the final analysis. |
nell’ analisi finale verranno valutati gli end point secondari avvenuti entro 60 settimane dal trapianto di rene. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | Yes |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Establishment of immunological reference ranges in renal transplant patients treated with conventional immunosuppression. |
Istituzione di range immunologici di riferimento nel trapianto renale per pazienti trattati con terapia immunosoppressiva convenzionale |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | Information not present in EudraCT |
E.8.1.2 | Open | Information not present in EudraCT |
E.8.1.3 | Single blind | Information not present in EudraCT |
E.8.1.4 | Double blind | Information not present in EudraCT |
E.8.1.5 | Parallel group | Information not present in EudraCT |
E.8.1.6 | Cross over | Information not present in EudraCT |
E.8.1.7 | Other | Information not present in EudraCT |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 6 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
France |
Germany |
Italy |
United Kingdom |
United States |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 3 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 3 |
E.8.9.2 | In all countries concerned by the trial days | 0 |