Imlifidase Prior to Kidney Transplant in Highly Sensitised Children

Launched by HANSA BIOPHARMA AB · Feb 23, 2023

Keywords

ClinConnect Summary

This clinical trial is studying a medication called imlifidase to see if it can help highly sensitized children (ages 1 to 17) who need a kidney transplant. Highly sensitized patients have a lot of antibodies that make it difficult to find a compatible donor kidney. The trial aims to determine if imlifidase can change the way the body reacts to a donor kidney, making it possible for these children to receive a transplant. The researchers will also monitor how well the transplanted kidney functions after the procedure.

To be part of this trial, participants need to meet certain criteria, such as being highly sensitized with specific antibodies and having end-stage renal disease, which means their kidneys are not working properly. They must also be eligible for a transplant from either a living or deceased donor. If chosen, participants will spend time in the hospital, where they will receive medications to prevent their bodies from rejecting the new kidney. It's important to note that this trial is looking for patients who have not had success with previous desensitization treatments. Parents or guardians will need to give consent for their child's participation, and the study is currently recruiting eligible participants.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Signed Informed Consent obtained from patient/parent/legal guardian/independent witness (depending on patient's age) before any trial-related procedures
• • 2. Highly sensitised patient with panel reactive antibodies (PRA) ≥80%
• • 3. Male or female patient between the age of 1 to 17 years (up to the day before the 18th birthday) at the time of screening
• • 4. Patient with end-stage renal disease (ESRD) and waiting for a renal transplant from a living or deceased donor
• • 5. Patient must be transplantable (including size mismatch) at the time of obtaining informed consent for trial participation
• • 6. Patients who have previously undergone desensitisation unsuccessfully with plasmapheresis/IVIg/anti-CD20 or have an anti-HLA antibody status deemed too difficult to make a successful desensitisation (judgement based on physicians' previous experience with similar patients)
• • 7. Positive crossmatch (XM) test determined by flow cytometry crossmatch (FCXM) and/or complement-dependent cytotoxicity crossmatch (CDCXM) tests against the donor. For the DD patients, if physical XM tests are not practically possible due to lack of time, patients may be included on a virtual crossmatch (vXM) predictive of a positive XM test.
• • 8. Willingness and ability to comply with the protocol as judged by the investigator
• Exclusion Criteria:
• • 1. Previous treatment with imlifidase
• • 2. IVIg treatment within 28 days prior to imlifidase treatment
• • 3. Desensitisation treatment(s) within 1 month prior to the current transplantation
• • 4. Hypersensitivity to the active substance (imlifidase) or to any of the excipients and to other immunosuppressive drugs specified in the protocol
• • 5. Ongoing serious infections
• • 6. Present, or history of, thrombotic thrombocytopenic purpura (TTP), or known familial history of TTP
• • 7. At the time of transplantation: severe other condition requiring treatment and close monitoring e.g. cardiac failure ≥ grade 4 (New York Heart Association), unstable coronary disease, active peripheral vascular disease, proven hypercoagulable conditions/events or oxygen dependent respiratory disease
• • 8. Malignancy within 3 years prior to transplantation
• • 9. ABO blood group incompatible transplantations (A2 and A2B kidneys will not be accepted for B recipients)
• • 10. Any other reason that, in the view of the investigator, precludes transplantation
• • 11. Breast feeding or pregnancy, if applicable
• • 12. Woman of fertile age and sexually active without adequate contraceptive measures to avoid pregnancy during the interventional trial period (i.e. up to 6 months after transplantation)
• • 13. Suspicion of Covid-19 infection or positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test
• • 14. Positive serology for human immunodeficiency virus (HIV)
• • 15. Clinical signs of hepatitis B virus (HBV), hepatitis C virus (HCV), cytomegalovirus (CMV), or Epstein Barr virus (EBV) infection
• • 16. Donor with positive serology for HIV, HBV, HCV, CMV or EBV to a patient with negative serology (mismatch serology)
• • 17. Clinically relevant active infection(s) as judged by the investigator
• • 18. Tuberculosis or history of tuberculosis
• • 19. Use of other investigational agents within 5 terminal elimination half-lives prior to the transplantation
• • 20. Contemporaneous participation in medical device studies
• • 21. Known mental incapacity or language barriers precluding patients'/parents'/legal guardians' adequate understanding of the informed consent information and the trial activities
• • 22. Inability by the judgement of the investigator to participate in the trial for any other reason