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Trial registered on ANZCTR
Registration number
ACTRN12611000316909
Ethics application status
Not yet submitted
Date submitted
24/03/2011
Date registered
24/03/2011
Date last updated
24/03/2011
Type of registration
Prospectively registered
Titles & IDs
Public title
The effect of proton pump inhibitor on mycophenolic acid absorption in kidney and liver transplant recipients
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Scientific title
A prospective, double-blind placebo-controlled multicentre trial to assess mycophenolic acid area under curve following Mycophenolate Mofetil and Enteric-coated Mycophenolic Acid in the presence and absence of the proton-pump inhibitor Pantoprazole in kidney and liver transplant recipients
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Secondary ID [1]
259847
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Nil
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Universal Trial Number (UTN)
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Trial acronym
Interaction of the Proton Pump Inhibitor (PPI) Pantoprazole on MycoPhenolic ACid (MPA) exposure In Kidney And Liver Transplant Recipients (IMPACT Study)
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Drug interaction
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Condition category
Condition code
Renal and Urogenital
265593
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0
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Kidney disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Pantoprazole 40mg oral tablet once daily for 7 days. There will be a 1-week washout period between treatments.
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Intervention code [1]
264266
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Treatment: Drugs
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Comparator / control treatment
Placebo (identical in taste and appearance with no active ingredient) 1 tablet once daily for 7 days. There will be a 1-week washout period between treatments.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Dose normalised area under the curve (AUC) for mycophenolic acid (MPA) and MPA-ether glucuronide (MPA-Ge) will be determined using validated assay
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Assessment method [1]
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Timepoint [1]
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Days 7 and 21
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Secondary outcome [1]
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Transplant graft outcomes (clinical assessments, blood and urine test)
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Assessment method [1]
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Timepoint [1]
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Days 7 and 21
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Secondary outcome [2]
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Plasma calcineurin-inhibitor levels (blood test)
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Assessment method [2]
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Timepoint [2]
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Days 7 and 21
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Secondary outcome [3]
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Plasma pantoprazole levels (blood test)
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Assessment method [3]
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Timepoint [3]
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Days 7 and 21
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Eligibility
Key inclusion criteria
Inclusion Criteria:
1. Males and females >18 years.
2. Kidney and liver transplant recipients of deceased-donor organs or for renal only, living donor organs. Recipients must be at least 6 months post-transplant.
3. Recipients who are willing to change to pantoprazole (from other proton-pump inhibitor or H2-antagonist) or willing to start pantoprazole if not already on this drug.
4. Maintained on either cyclosporine or tacrolimus.
5. Capable of giving written informed consent and adhering to the study schedule.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion Criteria:
1. Recipients who are unwilling to change to pantoprazole (from other proton-pump inhibitor or H2-antagonist) or unwilling to start pantoprazole if not already on this.
2. Patients maintained on everolimus, sirolimus or other non-calcineurin inhibitor except corticosteroids.
3. Recent change (<2 weeks) in dose of mycophenolate mofetil or enteric coated-mycophenolic sodium (EC-MPS).
4. Recent substantial change (>50% change in dosage within 2 weeks prior to inclusion) in dose of calcineurin-inhibitor (CNI).
5. Recent acute rejection requiring methylprednisolone within 1 month prior to inclusion.
6. Change in dose of corticosteroids (prednisolone) within 2 weeks prior to inclusion.
7. MDRD derived estimated glomerular filtration rate (eGFR) <30mL/min or alanine amino-transaminase (ALT) >3x upper limit of normal (ULN) or aspartate amino-transferase (AST) >3xULN or bilirubin >2xULN.
8. Plan change in dosing of MMF or EC-MPS or CNI during study period.
9. Significant peptic ulcer disease or ulcerative oesophagitis where withdrawal of current acid suppression therapy is not clinically appropriate.
10. Concurrent use of magnesium and aluminium antacid or cholestyramine.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
The authorized person(s) and/or research staff will receive a set of treatment allocation cards (separate cards for kidney and liver transplant recipients) with sequential randomization numbers on which the treatment group information is covered by a label or sealed within an envelope. Each number will correspond to 2 packets of study medications clearly labelled as ‘Packet 1’ or ‘Packet 2’.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation by coin-tossing
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Pharmacokinetics
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/06/2011
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
42
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
3872
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6009
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Novartis Pharmaceuticals Australia Pty Limited
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Address [1]
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54 Waterloo Road
North Ryde NSW 2113
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Country [1]
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Australia
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Primary sponsor type
Government body
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Name
Health Department of Western Australia
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Address
Department of Health
189 Royal Street
East Perth WA 6004
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Other collaborator category [1]
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Government body
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Name [1]
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Royal Adelaide Hospital
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Address [1]
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PO Box 287
Rundle Mall
South Australia 5000
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Country [1]
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Australia
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
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Sir Charles Gairdner Hospital Group
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Ethics committee address [1]
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Hospital Avenue, NEDLANDS WA 6009
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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01/02/2011
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Approval date [1]
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Ethics approval number [1]
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2011-004
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Ethics committee name [2]
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Royal Adelaide Hospital
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Ethics committee address [2]
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PO Box 287 Rundle Mall South Australia 5000
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Ethics committee country [2]
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Australia
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Date submitted for ethics approval [2]
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23/03/2011
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Approval date [2]
266711
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Ethics approval number [2]
266711
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Summary
Brief summary
To determine the effect of gastric acid suppression (using the proton pump inhibitor [PPI] pantoprazole) on the pharmacokinetics of mycophenolic acid (MPA) in kidney and liver transplant recipients maintained on either mycophenolate mofetil [MMF] or enteric-coated mycophenolate sodium [EC-MPS]. The following outcomes will be assessed: a. MPA area under curve (AUC). b. Clinical outcomes including rejection, graft function and proteinuria.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr Wai Lim
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Address
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Department of Renal Medicine
Sir Charles Gairdner Hospital
Hospital Avenue,
NEDLANDS WA 6009
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Country
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Australia
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Phone
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+61 8 93462799
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Fax
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+61 8 93463942
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Wai Lim
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Address
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Department of Renal Medicine
Sir Charles Gairdner Hospital
Hospital Avenue,
NEDLANDS WA 6009
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Country
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Australia
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Phone
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+61 8 93462799
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Fax
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+61 8 93463942
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Effect of the proton-pump Inhibitor pantoprazole on MycoPhenolic ACid exposure in kidney and liver transplant recipienTs (IMPACT study): A randomized trial.
2020
https://dx.doi.org/10.1093/ndt/gfaa111
N.B. These documents automatically identified may not have been verified by the study sponsor.
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