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NCT01399593

Safety & Efficacy of Eculizumab to Prevent AMR in Living Donor Kidney Transplant Recipients Requiring Desensitization

Terminated Phase 2 Results posted Last updated 3 October 2017
What this trial tests

Phase 2 trial testing Eculizumab in Antibody Mediated Rejection in 102 participants. Terminated before completion.

Timeline
2 November 2011
Primary endpoint
13 May 2014
13 November 2015

Quick facts

Lead sponsorAlexion Pharmaceuticals, Inc.
PhasePhase 2
StatusTerminated
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingnone
Primary purposetreatment
Enrollment102
Start date2 November 2011
Primary completion13 May 2014
Estimated completion13 November 2015
Sites41 locations across France, Italy, Netherlands, Sweden, United Kingdom, Germany, Norway, Australia

Drugs / interventions tested

Conditions studied

Sponsor

Alexion Pharmaceuticals, Inc. — full company profile →

Who can join

18 and older, any sex, with Antibody Mediated Rejection. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Treatment Failure Rate Primary · 9 weeks post-transplantation

The primary efficacy variable was a binary outcome variable where patients meeting the composite endpoint of the occurrence of 1) biopsy-proven acute AMR, 2) graft loss, 3) patient death, or 4) loss to follow-up definition at Week 9 post-transplantation were considered treatment failures and all others were considered treatment successes.

GroupValue95% CI
Eculizumab5
Standard of Care7

Adverse events — posted to ClinicalTrials.gov

Time frame: Adverse events were collected throughout the 3-year study period.. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Eculizumab
Serious: 43/51 (84%)
Deaths: 1/51
Standard of Care
Serious: 48/51 (94%)
Deaths: 1/51

Serious adverse events (165 terms)

ReactionSystemEculizumabStandard of Care
Kidney transplant rejectionImmune system disorders
DiarrhoeaGastrointestinal disorders
Urinary tract infectionInfections and infestations
Escherichia urinary tract infectionInfections and infestations
LymphoceleVascular disorders
GastroenteritisInfections and infestations
PneumoniaInfections and infestations
PyelonephritisInfections and infestations
UrosepsisInfections and infestations
BronchitisInfections and infestations
Post procedural haemorrhageInjury, poisoning and procedural complications
Blood creatinine increasedInvestigations
Acute kidney injuryRenal and urinary disorders
HydronephrosisRenal and urinary disorders
AnaemiaBlood and lymphatic system disorders
Cardiac failureCardiac disorders
Pancreatitis acuteGastrointestinal disorders
Chest painGeneral disorders
Oedema peripheralGeneral disorders
CellulitisInfections and infestations
Gastroenteritis viralInfections and infestations
Lower respiratory tract infectionInfections and infestations
Urinary tract infection bacterialInfections and infestations
Urinary tract infection enterococcalInfections and infestations
Delayed graft functionInjury, poisoning and procedural complications
Other adverse events (113 terms — click to expand)

ReactionSystemEculizumabStandard of Care
AnaemiaBlood and lymphatic system disorders
Urinary tract infectionInfections and infestations
DiarrhoeaGastrointestinal disorders
NauseaGastrointestinal disorders
LeukopeniaBlood and lymphatic system disorders
Oedema peripheralGeneral disorders
Kidney transplant rejectionImmune system disorders
PyrexiaGeneral disorders
HyperglycaemiaMetabolism and nutrition disorders
HypophosphataemiaMetabolism and nutrition disorders
ConstipationGastrointestinal disorders
HyperkalaemiaMetabolism and nutrition disorders
HypertensionVascular disorders
HypocalcaemiaMetabolism and nutrition disorders
HeadacheNervous system disorders
TremorNervous system disorders
Abdominal painGastrointestinal disorders
VomitingGastrointestinal disorders
Upper respiratory tract infectionInfections and infestations
HypomagnesaemiaMetabolism and nutrition disorders
ThrombocytopeniaBlood and lymphatic system disorders
BK virus infectionInfections and infestations
Blood creatinine increasedInvestigations
Metabolic acidosisMetabolism and nutrition disorders
HypokalaemiaMetabolism and nutrition disorders
Musculoskeletal painMusculoskeletal and connective tissue disorders
InsomniaPsychiatric disorders
HypotensionVascular disorders
TachycardiaCardiac disorders
AstheniaGeneral disorders
Back painMusculoskeletal and connective tissue disorders
HaematuriaRenal and urinary disorders
Diabetes mellitusMetabolism and nutrition disorders
ProteinuriaRenal and urinary disorders
AlopeciaSkin and subcutaneous tissue disorders
PruritusSkin and subcutaneous tissue disorders
NasopharyngitisInfections and infestations
Incision site painInjury, poisoning and procedural complications
Procedural painInjury, poisoning and procedural complications
Vitamin D deficiencyMetabolism and nutrition disorders

Most-reported serious reactions: Kidney transplant rejection, Diarrhoea, Urinary tract infection, Escherichia urinary tract infection, Lymphocele, Gastroenteritis, Pneumonia, Pyelonephritis.

Data from ClinicalTrials.gov NCT01399593 adverse events section.

Sponsor's own description

The purpose of this trial was to determine the safety and efficacy of eculizumab in the prevention of antibody-mediated rejection (AMR) in sensitized recipients of a living donor kidney transplant requiring desensitization therapy.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. New insights into the immune functions of complement.
    Reis ES, Mastellos DC, Hajishengallis G, Lambris JD. · · 2019 · cited 357× · PMID 31048789 · DOI 10.1038/s41577-019-0168-x
  2. The renaissance of complement therapeutics.
    Ricklin D, Mastellos DC, Reis ES, Lambris JD. · · 2018 · cited 305× · PMID 29199277 · DOI 10.1038/nrneph.2017.156
  3. Clinical promise of next-generation complement therapeutics.
    Mastellos DC, Ricklin D, Lambris JD. · · 2019 · cited 255× · PMID 31324874 · DOI 10.1038/s41573-019-0031-6
  4. Ischemia and Reperfusion Injury in Kidney Transplantation: Relevant Mechanisms in Injury and Repair.
    Nieuwenhuijs-Moeke GJ, Pischke SE, Berger SP, Sanders JSF, et al · · 2020 · cited 234× · PMID 31963521 · DOI 10.3390/jcm9010253
  5. Safety and efficacy of eculizumab in the prevention of antibody-mediated rejection in living-donor kidney transplant recipients requiring desensitization therapy: A randomized trial.
    Marks WH, Mamode N, Montgomery RA, Stegall MD, et al · · 2019 · cited 109× · PMID 30887675 · DOI 10.1111/ajt.15364
  6. Complement-Activating Anti-HLA Antibodies in Kidney Transplantation: Allograft Gene Expression Profiling and Response to Treatment.
    Lefaucheur C, Viglietti D, Hidalgo LG, Ratner LE, et al · · 2018 · cited 83× · PMID 29042454 · DOI 10.1681/asn.2017050589
  7. Complement-activating donor-specific anti-HLA antibodies and solid organ transplant survival: A systematic review and meta-analysis.
    Bouquegneau A, Loheac C, Aubert O, Bouatou Y, et al · · 2018 · cited 70× · PMID 29799874 · DOI 10.1371/journal.pmed.1002572
  8. Tolerogenic therapies in transplantation.
    Page EK, Dar WA, Knechtle SJ. · · 2012 · cited 42× · PMID 22826708 · DOI 10.3389/fimmu.2012.00198

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