Title

Pharmacokinetics of LCP-Tacro in Stable Kidney Transplant Patients
A Phase II, Open-Label, Multi-Center Prospective, Conversion Study in Stable Kidney Transplant Patients to Compare the Pharmacokinetics of LCP-Tacro Tablets Once-A-Day to Prograf® Capsules Twice-A-Day
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Intervention/Treatment

    tacrolimus ...
  • Study Participants

    60
A three sequence, open-label, multi-center, prospective, study in stable kidney transplant patients to assess and compare the pharmacokinetics (Cmax, C24, and AUC), and safety of LCP-Tacro (tacrolimus) tablets versus Prograf (tacrolimus) capsules.
A three sequence, open-label, multi-center, prospective, study in stable kidney transplant patients to assess and compare the pharmacokinetics (Cmax, C24, and AUC), and safety of LCP-Tacro (tacrolimus) tablets versus Prograf (tacrolimus) capsules.

Stable kidney transplant patients who fulfill all I/E criteria will be enrolled and kept on Prograf for 7 days. Following a 24-hour PK study on Day 7 to determine pharmacokinetics for Prograf, all patients will be converted to once daily LCP-Tacro for 7 days with no dose changes allowed. On Day 14 and Day 21 a 24-hour LCP-Tacro PK study will be performed. On Day 22 patients will be converted back to their original twice daily dose of Prograf for a safety follow-up period of 30 days ending with a safety assessment on day 53.
Study Started
Jul 31
2007
Primary Completion
Mar 31
2008
Study Completion
Mar 31
2008
Results Posted
Jul 23
2015
Estimate
Last Update
Jul 23
2015
Estimate

Drug LCP Tacro (tacrolimus)

Prograf will be administrated twice a day, per product labeling, with an interval of 12 ± 1 hours between the morning and evening doses. Patients will continue on the same dose on Day0 through Day 7 to maintain target trough levels of 7-12 ng/mL. On the morning of Day 8, following the final blood draw for the PK assessment, patient will be converted to LCP-Tacro using the conversion Ratio 0.66-0.8. LCP-Tacro tablets will be administered orally once daily in the morning, with an interval of 24 ± 1 hours between doses. Other Names: Tacrolimus modified-release LCP-Tacro tablets were provided in 3 strengths: 1 mg, 2 mg, and 5 mg oral tablets.

  • Other names: tacrolimus

Drug Prograf

Prograf will be administrated twice a day, per product labeling, with an interval of 12 ± 1 hours between the morning and evening doses. Patients will continue on the same dose on Day0 through Day 7 to maintain target trough levels of 7-12 ng/mL. On the morning of Day 8, following the final blood draw for the PK assessment, patient will be converted to LCP-Tacro using the conversion Ratio 0.66-0.8. LCP-Tacro tablets will be administered orally once daily in the morning, with an interval of 24 ± 1 hours between doses. Other Names: Tacrolimus modified-release LCP-Tacro tablets were provided in 3 strengths: 1 mg, 2 mg, and 5 mg oral tablets.

  • Other names: Tacrolimus

LCP-Tacro (tacrolimus) Active Comparator

Experimental: LCP Tacro; investigational product LCP-Tacro tablets were provided in 3 strengths: 1 mg, 2 mg, and 5 mg oral tablets.

Criteria

Inclusion Criteria:

Men and women 18-65 years of age who are recipients of a renal transplant at least 6 months prior to enrollment
Patients on oral Prograf therapy as part of their maintenance immunosuppression therapy, with stable doses and trough levels of tacrolimus of 7-12 ng/mL for at least two weeks prior to enrollment.
Patients maintained on concurrent immunosuppression with mycophenolate mofetil (MMF, CellCept) or mycophenolic acid delayed-release tablets (Myfortic), with stable doses for at least two weeks prior to enrollment
Patients with serum creatinine < 2.0mg/dL prior to enrollment
Able to swallow study medication
Patients capable of understanding the purposes and risks of the study, who can give written informed consent and who are willing to participate in and comply with the study
Women of childbearing potential must have a negative serum pregnancy test within seven days prior to receiving study medication
Patients who successfully pass a drug screen

Exclusion Criteria:

Recipients of any transplanted organ other than a kidney
White blood cell count < 2.8 x 10^9 /L
Patients who are receiving a total dose of Prograf for 24 hours < 3mg
Patients unable or unwilling to provide informed consent
Pregnant or nursing women
Patients with reproductive potential who are unwilling/unable to use a double barrier method of contraception
Administration of other investigational agent in the three months prior to enrollment
Patient receiving any drug interfering with tacrolimus metabolism
Patients who have taken sirolimus within the past three months prior to screening
Patient with an episode of acute cellular requiring antibody therapy within the 6 months prior to enrollment
Patient treated for acute cellular rejection within the 30 days prior to enrollment
Patient who is HCV negative and has received an HCV positive (HCV RNA by PCR or HCV antibody) donor kidney
Patient has a current malignancy or a history of malignancy (within the past 5 years), except basal or non-metastatic squamous cell carcinoma of the skin that has been treated successfully
Patient has uncontrolled concomitant infection, a systemic infection requiring treatment, or any other unstable medical condition that could interfere with the study objectives
Patient has severe diarrhea, vomiting, active peptic ulcer or gastrointestinal disorder that may affect the absorption of tacrolimus
Patient will require therapy with any immunosuppressive agent other than those prescribed in the study
Patient has a known hypersensitivity to corticosteroids, mycophenolate mofetil, mycophenolic acid or tacrolimus
Patient has any form of current substance abuse, psychiatric disorder or a condition that, in the opinion of the Investigator, may invalidate communication with the Investigator

Summary

LCP-Tacro

Prograf

All Events

Event Type Organ System Event Term LCP-Tacro Prograf

Evaluation of Steady State Tacrolimus Trough Levels (C24).

Patients had a baseline trough level (C24) measured at day 7 before conversion to LCP-Tacro.

Prograf

7.0
ng/mL (Mean)
Standard Deviation: 1.54

Evaluation of Steady State Tacrolimus Exposure (AUC 0-24).

Patients had a baseline AUC measured (0 to 24 hours) at day 7 before conversion to LCP-Tacro.

Prograf

218.82
ng*hr/mL (Mean)
Standard Deviation: 55.99

Evaluation of Steady State Tacrolimus Exposure Trough Levels (C24).

Patients were converted from Prograf to LCP-Tacro on day 7. On day 21, a trough level (C24) was measured.

LCP-Tacro

6.94
ng/mL (Mean)
Standard Deviation: 2.20

Evaluation of Steady State Tacrolimus Exposure (AUC 0-24).

Patients were converted from Prograf to LCP-Tacro on day 7. On day 21, AUC was measured (0 to 24 hours).

LCP-Tacro

218.03
ng*hr/mL (Mean)
Standard Deviation: 68.23

Tacrolimus Pharmacokinetics (Tmax) Was Measured at Day 7.

Tmax was measured at baseline day 7 (Cmin was measured as part of the primary outcome).

Prograf

1.82
hour (Mean)
Full Range: 0.5 to 24.0

Tacrolimus Pharmacokinetics (Fluctuation and Swing) Was Measured at Day 7.

Degree og fluctuation and degree of swing was measured as baseline at day 7 (Cmin was measured as part of the primary outcome).

Prograf

Fluctuation

127.41
percentage (Mean)
Standard Deviation: 57.28

Swing

174.55
percentage (Mean)
Standard Deviation: 93.72

Tacrolimus Pharmacokinetics (Cmax and Cavg) Was Measured at Day 21.

Cmax and Cavg was measured at day 21 (Cmin was measured as part of the primary outcome).

LCP-Tacro

Cavg

9.08
ng/mL (Mean)
Standard Deviation: 2.84

Cmax

13.94
ng/mL (Mean)
Standard Deviation: 5.84

Safety Evaluation

A combination of deaths, graft failure and biopsy proven acute rejections (BPAR) was used to evaluate the safety.

LCP-Tacro

BPAR

Death

Graft failure

Tacrolimus Pharmacokinetics (Tmax) Was Measured at Day 21.

Tmax was measured at day 21 (Cmin was measured as part of the primary outcome).

LCP-Tacro

6.0
hour (Mean)
Full Range: 1.5 to 16.0

Tacrolimus Pharmacokinetics (Fluctuation and Swing) Was Measured at Day 21.

Degree og fluctuation and degree of swing was measured at day 21 (Cmin was measured as part of the primary outcome).

LCP-Tacro

Fluctuation

77.04
percentage (Mean)
Standard Deviation: 50.59

Swing

110.07
percentage (Mean)
Standard Deviation: 89.23

Tacrolimus Pharmacokinetics (Cmax and Cavg) Was Measured at Day 7.

Cmax and Cavg was measured at baseline day 7 (Cmin was measured as part of the primary outcome).

Prograf

Cavg

9.12
ng/mL (Mean)
Standard Deviation: 2.33

Cmax

19.14
ng/mL (Mean)
Standard Deviation: 8.15

Age, Continuous

45.6
years (Mean)
Standard Deviation: 12.08

Region of Enrollment

Sex: Female, Male

Overall Study

LCP-Tacro

Drop/Withdrawal Reasons

LCP-Tacro