Vincenti Flavio, Kim Jim, Gouveia Deborah, Pelle Gabrielle, Mayne Tracy J, Neylan John F
Department of Medicine and Surgery, University of California at San Francisco, San Francisco, CA.
Department of Surgery, Keck Medicine of the University of Southern California, Los Angeles, CA.
Kidney Int Rep. 2020 Nov 13;6(2):296-303. doi: 10.1016/j.ekir.2020.11.001. eCollection 2021 Feb.
One-third of kidney transplantation patients experience acute kidney injury (AKI) resulting in delayed graft function (DGF), associated with increased risk of graft failure and mortality. Preclinical and phase 2 data indicate that treatment with ANG-3777 (formerly BB3), a hepatocyte growth factor (HGF) mimetic, may improve long-term kidney function and reduce health care resource use and cost, but these data require validation in a phase 3 randomized controlled trial.
The Graft Improvement Following Transplant (GIFT) trial is a multicenter, double-blind randomized controlled trial, designed to determine the efficacy and safety of ANG-3777 in renal transplantation patients showing signs of DGF. Subjects are randomized 1:1 to ANG-3777 (2 mg/kg) administered intravenously once daily for 3 consecutive days starting within 30 hours after transplantation, or to placebo.
The primary endpoint is estimated glomerular filtration rate (eGFR) at 12 months. Secondary endpoints include proportion of subjects with eGFR >30 at days 30, 90, 180, and 360; proportion of subjects whose graft function is slow, delayed, or primary nonfunction; length of hospitalization; and duration of dialysis through day 30. Adverse events are assessed throughout the study.
GIFT will generate data that are important to advancing treatment of DGF in this medically complex population.
三分之一的肾移植患者会发生急性肾损伤(AKI),导致移植肾功能延迟恢复(DGF),这与移植失败和死亡风险增加相关。临床前和2期数据表明,用肝细胞生长因子(HGF)模拟物ANG-3777(原名BB3)进行治疗,可能会改善长期肾功能,并减少医疗资源的使用和成本,但这些数据需要在3期随机对照试验中进行验证。
移植后移植物改善(GIFT)试验是一项多中心、双盲随机对照试验,旨在确定ANG-3777对出现DGF迹象的肾移植患者的疗效和安全性。受试者按1:1随机分组,分别接受在移植后30小时内开始连续3天每天静脉注射一次ANG-3777(2 mg/kg),或接受安慰剂治疗。
主要终点是12个月时的估计肾小球滤过率(eGFR)。次要终点包括在第30、90、180和360天时eGFR>30的受试者比例;移植肾功能缓慢、延迟或原发性无功能的受试者比例;住院时间;以及到第30天的透析持续时间。在整个研究过程中评估不良事件。
GIFT试验将产生对于推进这一医学复杂人群中DGF治疗具有重要意义的数据。