Targeting Inflammation and Alloimmunity in Lung Transplant Recipients With Tocilizumab (CTOT-45)
National Institute of Allergy and Infectious Diseases (NIAID)
Summary
This is a trial in which 350 primary lung transplant recipients will be randomized (1:1) to receive either Tocilizumab (six doses over 20 weeks) plus standard triple maintenance immunosuppression or placebo (sterile normal saline) plus standard triple maintenance immunosuppression (Tacrolimus, Mycophenolate Mofetil, corticosteroids). The primary objective is to test the hypothesis that treatment with triple maintenance immunosuppression plus Tocilizumab (TCZ) is superior to triple maintenance immunosuppression plus placebo (saline) as defined by a composite endpoint of a) CLAD, b) listed for re-transplantation, and c) death
Eligibility
- Age range
- 12–75 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: Study Entry: 1. Subject and/or parent guardian must be able to understand the purpose of the study and willing to participate and sign informed consent/assent 2. Greater than or equal to 30 kg body weight 3. Listed or received for a primary lung transplant 4. No previous or planned desensitization therapy prior to transplant 5. Serum Immunoglobulin G (IgG) level greater than 400 mg/dL. Patients treated with intravenous immune globulin (IVIG) for hypogammaglobulinemia are eligible for enrollment if their serum IgG level is greater than 400 mg/dL 14 or more days after the m…
Interventions
- DrugTocilizumab
The initial dose of tocilizumab will be administered in the operating room before reperfusion of the first lung during the lung transplant surgery. 6 doses will be given once every four weeks over a 20-week period. The dose is approved for pediatric patients who weigh 30 kg or more
- DrugPlacebo for Tocilizumab
Placebo 0.9% Sodium Chloride Injection USP (Normal Saline) Placebo will be given as a single intravenous dose, volume matched to tocilizumab. Placebo will be administered over a period of approximately 60 minutes; once every four weeks over a 20-week period. The first placebo dose will be during the transplant surgery before reperfusion of the first lung allograft, with 5 subsequent monthly doses
Locations (21)
- St. Joseph's Hospital and Medical Center (Site #: 71192)Phoenix, Arizona
- Cedars Sinai Medical Center (Site #: 71146)Beverly Hills, California
- David Geffen School of Medicine at UCLA (Site #: 71123)Los Angeles, California
- University of Florida Shands Hospital (Site #: 71131)Gainesville, Florida
- Emory University (Site #: 71103)Atlanta, Georgia
- University of Maryland Medical Center (Site #: 71138)Baltimore, Maryland