Acute Antibody-Mediated Rejection (AMR)
Conditions
Brief summary
The main purpose of the study is to evaluate the efficacy of CINRYZE administered with plasmapheresis, plasma exchange, or immune adsorption treatments and sucrose-free immunoglobulin (IVIg) for the treatment of acute antibody-mediated rejection (AMR) of renal allograft in kidney transplant recipients as measured by the proportion of participants with new or worsening transplant glomerulopathy (TG) at 6 months after treatment initiation.
Interventions
BIOLOGICALCinryze®
Participants will receive 5000 Units of CINRYZE (50 millilitre \[mL\] of CINRYZE/ 50 mL of normal saline) on Day 1 and 2500 Units of CINRYZE (25 mL of CINRYZE/ 75 mL of normal saline) on Day 3, 5, 7, 9, 11, and 13 respectively.
DRUGPlacebo
Participants will receive 7 doses of matched placebo over 13 days of treatment.
Sponsors
Shire
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
1. Be greater than or equal to (\>=) 18 and less than or equal to (\<=) 70 years of age. 2. Weigh \>= 45 kg with a body mass index (BMI) less than (\<) 35 kilogram (kg)/meter (m)\^2 at screening. 3. Have human leukocyte antigen (HLA) donor-specific antibody (DSA) identified at the time of diagnosis of AMR. If it is anticipated that the local DSA results will not be available within the screening period, previously obtained local DSA results can be used to assess eligibility, if obtained after kidney transplant and within 30 days prior to the qualifying AMR episode. In any instance, a local DSA test should still be performed at the time of AMR diagnosis. 4. Have a first qualifying episode of AMR in the participant's current renal allograft between 72 hours (h) and 12 months after transplant defined by a renal allograft biopsy demonstrating neutrophil and/or monocyte infiltration in the peritubular capillaries (PTC) and/or glomeruli with or without evidence of 4th complement protein degradation product (C4d) deposition by immunohistopathology according to 2013 Banff criteria. 5. Have achieved adequate renal function defined as: Pre-AMR baseline estimated glomerular filtration rate calculated by the Modification of Diet in Renal Disease (eGFRMDRD) \>=20 millilitre (mL)/minute (min) /1.73m\^2 for a qualifying AMR episode occurring \<=21 days after transplant or pre-AMR baseline eGFRMDRD \>=30 mL/min/1.7m\^2 for a qualifying AMR episode occurring greater than (\>) 21 days after transplant. The pre-AMR baseline is the highest eGFRMDRD value obtained following the kidney transplant and within 30 days prior to the qualifying AMR episode. If more than 1 eGFRMDRD value is available, a mean of the 2 highest values (at least 1 day apart and both prior to the AMR episode) will be used as the pre-AMR baseline value. If no eGFRMDRD was obtained within 30 days prior to biopsy, it can be evaluated within a 60 day period. 6. Receive first dose of investigational product after 7 days after the kidney transplant procedure and within 7 days after the qualifying renal allograft biopsy procedure that was positive for AMR. 7. Be informed of the nature of the study and provide written informed consent before any study-specific procedures are performed. 8. If female and of child-bearing potential, must have a negative urine pregnancy test confirmed by a negative serum beta human chorionic gonadotropin (beta-HCG) pregnancy test at the Screening Visit and must have a negative urine pregnancy test at the Day 1 visit. 9. Agree to comply with any applicable contraceptive requirements of the protocol.
Exclusion criteria
1. Have received pediatric en bloc kidney transplant. 2. Have primary Focal Segmental Glomerulosclerosis, rapidly progressive glomerulonephritis, membrano-proliferative glomerulonephritis type 1 (including C3 glomerulopathy), dense deposit disease, or thrombotic microangiopathy as the cause of native kidney failure. 3. Have prior or concurrent non-renal solid organ transplant or hematopoietic stem cell transplant (HSCT) or have more than 2 completed kidney transplant procedures (note: 1 double kidney transplant procedure is considered to be 1 procedure). 4. Have a known neoplastic lesion in the transplanted allograft 5. Have, any ongoing infection that causes hemodynamic compromise or as determined by the investigator, any surgical or medical condition that could interfere with the administration of investigational product, interpretation of study results, or could compromise participant safety, including (as determined by the transplanting surgeon and documented in the operative report) any major technical complications of the renal artery, renal vein, or ureteral anastomosis 6. Have ongoing treatment for hepatitis C virus (HCV) infection. 7. Have had a recent myocardial infarction (MI) within the past 6 months and/or at the time of screening are treated with anticoagulants and/or antiplatelet agents (excluding aspirin) for a previous myocardial infarction. 8. Have a history of: abnormal bleeding, clotting events or disorders (excluding a history of clotted hemodialysis access or superficial thrombophlebitis in the absence of medically confirmed coagulopathy), any coagulopathy (documented or clinically suspected) For example, participants should be excluded if they have a history of renal allograft arterial or venous thrombosis, deep vein thrombosis, pulmonary embolism, ischemic cerebrovascular accident (stroke) or transient ischemic attack (TIA), any large vessel thrombosis. 9. Have a history of allergic reaction to CINRYZE or other blood products. 10. Have had any change in androgen therapy (example, danazol, oxandrolone, stanozolol, testosterone), tranexamic acid, epsilon-aminocaproic acid, or other fibrinolytics within 3 months before the first dose of investigational product. 11. Have participated in the active dosing phase of any other investigational drug study within 30 days prior to dosing with investigational product. 12. Have any of the following local laboratory values reported prior to dosing with investigational product: Within 24 h prior to participant dosing, white blood cell (WBC) count \<0.5×109/litre (L) or \>20×109/L (the value of \>20×109/L should be excluded if obtained during steroid treatment), Within 24 h prior to participant dosing platelet count \<25×109/L or \>600×109/L 13. Be pregnant or breastfeeding. 14. Have received any of the following agents within 1 month prior to the first dose of investigational product: Sucrose-containing intravenous immunoglobulin (IVIg), Any C1 inhibitor (C1 INH) (plasma-derived \[example, CINRYZE®, Berinert®, Cetor®\] or recombinant \[example, Rhucin®\]), Eculizumab (Soliris®), Ecallantide (Kalbitor®).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With New or Worsening Transplant Glomerulopathy (TG) at Month 6 Post-Treatment | Month 6 | New or worsening TG at month 6 by the standard score was defined as an increase in one or more between qualifying biopsy and 6-month biopsy. New or worsening TG was measured by Banff 2013 criteria (standard score) using allograft glomerulopathy (Cg0-Cg3): Cg0- No GBM double contours by light microscopy (LM) or electron microscopy (EM); Cg1- no GBM double contours by LM but GBM double contours in at least 3 glomerular capillaries by EM; Cg2- Double contours affecting 26 to 50% of peripheral capillary loops in the most affected of nonsclerotic glomeruli; Cg3- Double contours affecting more than 50% of peripheral capillary loops in the most affected of nonsclerotic glomeruli with a score range of 0 (no allograft glomerulopathy) and 3 (severe glomerulopathy). Percentage of participants with new or worsening TG at Month 6 post-treatment was reported. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline in Renal Function up to Month 48 | Baseline, up to Month 48 | Renal function was measured as glomerular filtration rate calculated by the modification of diet in renal disease (eGFRMDRD). |
| Change From Baseline With Pre-Antibody-Mediated Rejection (AMR) in Renal Function up to Month 48 | Pre-AMR Baseline, up to Month 48 | Renal function was measured as glomerular filtration rate calculated by the modification of diet in renal disease (eGFRMDRD). Pre-AMR baseline was the highest eGFRMDRD value obtained following the kidney transplant and within 30 days prior to the qualifying AMR episode. |
| Number of Participants With Proteinuria Levels at Month 48 | Month 48 | Proteinuria included spot urine protein, urine creatinine, and urine protein/urine creatinine ratio. |
| Change From Pre-Antibody-Mediated Rejection (AMR) Baseline in Histopathology Per Banff Criteria at Month 6 | Pre-AMR Baseline, Month 6 | Histopathological diagnosis of acute rejection was measured by Banff 2013 criteria: Glomerulitis score (g0-g3), allograft glomerulopathy (Cg0-cg3), Tubulitis score (T0-T3), Intimal arteritis score (V0-V3), peritubular capillaritis (PTC) (ptc0-ptc3) and Interstitial Inflammation score (i0-i3). The histopathology was a composite of the sub-scores. Each of the sub-scores or histopathology score ranges from 0 ( no histopathology) to 3 (more severe histopathology). |
| Number of Participants With All-Cause Graft Failure at Month 6 | Month 6 | Graft failure was determined by the presence of one or more of the following criteria: institution of permanent dialysis (defined as dialysis treatment more than \[\>\] 30 days), current transplant nephrectomy, and/or a clinical determination of cessation of kidney graft function and estimated glomerular filtration rate (eGFR) less than or equal to (\<=) 15 milliliter (mL)/minute (min)/1.73 meter (m)\^2. |
| Number of Participants With Graft Failure Due to Antibody-Mediated Rejection (AMR) Episodes at Month 48 | Month 48 | Graft failure was determined by the presence of one or more of the following criteria: institution of permanent dialysis (defined as dialysis treatment more than \[\>\] 30 days), current transplant nephrectomy, and/or a clinical determination of cessation of kidney graft function and estimated glomerular filtration rate (eGFR) less than or equal to (\<=) 15 milliliter (mL)/minute (min)/1.73 meter (m)\^2. |
| Number of Participants With All-Cause Graft Failure at Month 48 | Month 48 | Graft failure was determined as the presence of one or more of the following criteria: institution of permanent dialysis (defined as dialysis treatment more than \[\>\] 30 days), current transplant nephrectomy, and/or a clinical determination of cessation of kidney graft function and estimated glomerular filtration rate (eGFR) less than or equal to (\<=) 15 milliliter (mL)/minute (min)/1.73 meter (m)\^2. |
| Time to Graft Failure Due to Antibody-Mediated Rejection (AMR) Episodes up to Month 48 | Up to Month 48 | Graft failure was determined by the presence of one or more of the following criteria: institution of permanent dialysis (defined as dialysis treatment \> 30 days), current transplant nephrectomy, and/or a clinical determination of cessation of kidney graft function and eGFR \<=15 mL/ min/1.73m\^2. Time to graft failure due to AMR episodes in months was calculated as (Date of graft failure due to AMR - Date of first dose + 1)/30.25. |
| Number of Participants With Resolution of the Qualifying Antibody-Mediated Rejection (AMR) Episodes at Month 48 | Month 48 | Number of participants with resolution of the qualifying AMR episodes at Month 48. |
| Time to Resolution of Qualifying Antibody-Mediated Rejection (AMR) Episodes up to Month 48 | Up to Month 48 | Time to resolution of qualifying AMR episodes was calculated as (Date of qualifying AMR resolution - Date of first dose + 1)/30.25. Participants who didn't had resolution of qualifying AMR episodes and still on-study were censored at the date of last visit; Participants who had completed the study without resolution of qualifying AMR were censored at the date of study completion; participants who discontinued from the study without resolution of qualifying AMR were censored at the date of early discontinuation. |
| Number of Participants Who Were Alive at Month 36 | Month 36 | Number of participants who were alive at Month 36 (study terminated instead of Month 48) were reported. |
| Time to All-Cause Mortality up to Month 48 | Up to Month 48 | Time to all-cause mortality was calculated as (Date of discontinuation due to death - Date of first dose + 1)/30.25. Participants who are alive and still on-study were censored at the date of last visit; Participants who had completed the study were censored at the date of study completion; Participants who discontinued from the study but not due to death were censored at the date of early discontinuation. |
| Number of Participants With Treatment-emergent Adverse Events (TEAEs) | From start of study drug administration up to study termination (Month 36) | An adverse event (AE) was any untoward, undesired, unplanned clinical event in the form of signs, symptoms, disease, or laboratory or physiological observations occurred in a participant participating in a clinical study with the sponsor's product, regardless of causal relationship. TEAEs were defined as events that started or worsened on or after the date of the first dose of investigational product, but no later than 30 days following the last dose of investigational product, within a treatment period. |
| Time to All-Cause Graft Failure up to Month 48 | Up to Month 48 | Graft failure was determined by the presence of one or more of the following criteria: institution of permanent dialysis (defined as dialysis treatment more than \[\>\] 30 days), current transplant nephrectomy, and/or a clinical determination of cessation of kidney graft function and estimated glomerular filtration rate (eGFR) less than or equal to (\<=) 15 milliliter (mL)/minute (min)/1.73 meter (m)\^2. Time to all-cause graft failure in months was calculated as (Date of graft failure - Date of first dose + 1)/30.25. |
Countries
Canada, France, Germany, Netherlands, Spain, United States
Participant flow
Recruitment details
The study was conducted at 49 sites between 20 May 2016 (first participant first visit) and 31 May 2019 (last participant last visit).
Pre-assignment details
A total of 39 participants were randomized and received treatment.
Participants by arm
| Arm | Count |
|---|---|
| Placebo Participants received a total of seven doses with an initial 100 mL intravenous (IV) infusion containing 5000 units of placebo (100 mL 0.9% sodium chloride) on day 1 followed by 2500 units of placebo (100 mL 0.9% sodium chloride) on Days 3, 5, 7, 9, 11, and 13. | 19 |
| CINRYZE Participants received a total of seven doses with an initial 100 mL intravenous (IV) infusion containing 5000 units of CINRYZE on Day 1 followed by 2500 units of CINRYZE in 100 mL of IV infusion on Day 3, 5, 7, 9, 11, and 13. | 20 |
| Total | 39 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Study terminated by sponsor | 18 | 20 |
| Overall Study | Withdrawal by Subject | 1 | 0 |
Baseline characteristics
| Characteristic | CINRYZE | Total | Placebo |
|---|---|---|---|
| Age, Continuous | 49.2 Years STANDARD_DEVIATION 13.45 | 50.5 Years STANDARD_DEVIATION 12.9 | 51.9 Years STANDARD_DEVIATION 12.49 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 6 Participants | 9 Participants | 3 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 10 Participants | 23 Participants | 13 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 4 Participants | 7 Participants | 3 Participants |
| Race/Ethnicity, Customized American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race/Ethnicity, Customized Asian/Japanese | 0 Participants | 0 Participants | 0 Participants |
| Race/Ethnicity, Customized Asian/Non-Japanese | 1 Participants | 6 Participants | 5 Participants |
| Race/Ethnicity, Customized Black or African American | 2 Participants | 4 Participants | 2 Participants |
| Race/Ethnicity, Customized Latino | 1 Participants | 1 Participants | 0 Participants |
| Race/Ethnicity, Customized Native Hawaiian or Other Pacific Islander | 2 Participants | 2 Participants | 0 Participants |
| Race/Ethnicity, Customized Unknown | 1 Participants | 1 Participants | 0 Participants |
| Race/Ethnicity, Customized White | 13 Participants | 25 Participants | 12 Participants |
| Sex: Female, Male Female | 5 Participants | 14 Participants | 9 Participants |
| Sex: Female, Male Male | 15 Participants | 25 Participants | 10 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 19 | 0 / 20 |
| other Total, other adverse events | 15 / 19 | 16 / 20 |
| serious Total, serious adverse events | 6 / 19 | 3 / 20 |
Outcome results
Primary
Percentage of Participants With New or Worsening Transplant Glomerulopathy (TG) at Month 6 Post-Treatment
New or worsening TG at month 6 by the standard score was defined as an increase in one or more between qualifying biopsy and 6-month biopsy. New or worsening TG was measured by Banff 2013 criteria (standard score) using allograft glomerulopathy (Cg0-Cg3): Cg0- No GBM double contours by light microscopy (LM) or electron microscopy (EM); Cg1- no GBM double contours by LM but GBM double contours in at least 3 glomerular capillaries by EM; Cg2- Double contours affecting 26 to 50% of peripheral capillary loops in the most affected of nonsclerotic glomeruli; Cg3- Double contours affecting more than 50% of peripheral capillary loops in the most affected of nonsclerotic glomeruli with a score range of 0 (no allograft glomerulopathy) and 3 (severe glomerulopathy). Percentage of participants with new or worsening TG at Month 6 post-treatment was reported.
Time frame: Month 6
Population: FAS consisted of all participants who had taken at least 1 dose of investigational product.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Placebo | Percentage of Participants With New or Worsening Transplant Glomerulopathy (TG) at Month 6 Post-Treatment | 47.4 Percentage of participants |
| CINRYZE | Percentage of Participants With New or Worsening Transplant Glomerulopathy (TG) at Month 6 Post-Treatment | 50.0 Percentage of participants |
p-value: 0.685795% CI: [-29.4, 34.5]Fisher Exact
Secondary
Change From Baseline in Renal Function up to Month 48
Renal function was measured as glomerular filtration rate calculated by the modification of diet in renal disease (eGFRMDRD).
Time frame: Baseline, up to Month 48
Population: This study was prematurely terminated at Month 36 due to futility issue. This outcome measure was planned to analyze at Month 48. Hence, data for this outcome measure was not collected as planned, analyzed and reported.
Secondary
Change From Baseline With Pre-Antibody-Mediated Rejection (AMR) in Renal Function up to Month 48
Renal function was measured as glomerular filtration rate calculated by the modification of diet in renal disease (eGFRMDRD). Pre-AMR baseline was the highest eGFRMDRD value obtained following the kidney transplant and within 30 days prior to the qualifying AMR episode.
Time frame: Pre-AMR Baseline, up to Month 48
Population: This study was prematurely terminated at Month 36 due to futility issue. This outcome measure was planned to analyze at Month 48. Hence, data for this outcome measure was not collected as planned, analyzed and reported.
Secondary
Change From Pre-Antibody-Mediated Rejection (AMR) Baseline in Histopathology Per Banff Criteria at Month 6
Histopathological diagnosis of acute rejection was measured by Banff 2013 criteria: Glomerulitis score (g0-g3), allograft glomerulopathy (Cg0-cg3), Tubulitis score (T0-T3), Intimal arteritis score (V0-V3), peritubular capillaritis (PTC) (ptc0-ptc3) and Interstitial Inflammation score (i0-i3). The histopathology was a composite of the sub-scores. Each of the sub-scores or histopathology score ranges from 0 ( no histopathology) to 3 (more severe histopathology).
Time frame: Pre-AMR Baseline, Month 6
Population: This study was prematurely terminated at Month 36 due to futility issues. The data of this secondary outcome measure was not collected as planned and the secondary analysis was not performed, due to early study termination.
Secondary
Number of Participants Who Were Alive at Month 36
Number of participants who were alive at Month 36 (study terminated instead of Month 48) were reported.
Time frame: Month 36
Population: Safety analysis set consisted of all participants who had taken at least 1 dose of investigational product. This study was prematurely terminated at Month 36 due to futility issue. This outcome measure was planned to analyze at Month 48.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Placebo | Number of Participants Who Were Alive at Month 36 | 19 Participants |
| CINRYZE | Number of Participants Who Were Alive at Month 36 | 20 Participants |
Secondary
Number of Participants With All-Cause Graft Failure at Month 48
Graft failure was determined as the presence of one or more of the following criteria: institution of permanent dialysis (defined as dialysis treatment more than \[\>\] 30 days), current transplant nephrectomy, and/or a clinical determination of cessation of kidney graft function and estimated glomerular filtration rate (eGFR) less than or equal to (\<=) 15 milliliter (mL)/minute (min)/1.73 meter (m)\^2.
Time frame: Month 48
Population: This study was prematurely terminated at Month 36 due to futility issue. This outcome measure was planned to analyze at Month 48. Hence, data for this outcome measure was not collected as planned, analyzed and reported.
Secondary
Number of Participants With All-Cause Graft Failure at Month 6
Graft failure was determined by the presence of one or more of the following criteria: institution of permanent dialysis (defined as dialysis treatment more than \[\>\] 30 days), current transplant nephrectomy, and/or a clinical determination of cessation of kidney graft function and estimated glomerular filtration rate (eGFR) less than or equal to (\<=) 15 milliliter (mL)/minute (min)/1.73 meter (m)\^2.
Time frame: Month 6
Population: This study was prematurely terminated at Month 36 due to futility issues. The data of this secondary outcome measure was not collected as planned and the secondary analysis was not performed, due to early study termination.
Secondary
Number of Participants With Graft Failure Due to Antibody-Mediated Rejection (AMR) Episodes at Month 48
Graft failure was determined by the presence of one or more of the following criteria: institution of permanent dialysis (defined as dialysis treatment more than \[\>\] 30 days), current transplant nephrectomy, and/or a clinical determination of cessation of kidney graft function and estimated glomerular filtration rate (eGFR) less than or equal to (\<=) 15 milliliter (mL)/minute (min)/1.73 meter (m)\^2.
Time frame: Month 48
Population: This study was prematurely terminated at Month 36 due to futility issue. This outcome measure was planned to analyze at Month 48. Hence, data for this outcome measure was not collected as planned, analyzed and reported.
Secondary
Number of Participants With Proteinuria Levels at Month 48
Proteinuria included spot urine protein, urine creatinine, and urine protein/urine creatinine ratio.
Time frame: Month 48
Population: This study was prematurely terminated at Month 36 due to futility issue. This outcome measure was planned to analyze at Month 48. Hence, data for this outcome measure was not collected as planned, analyzed and reported.
Secondary
Number of Participants With Resolution of the Qualifying Antibody-Mediated Rejection (AMR) Episodes at Month 48
Number of participants with resolution of the qualifying AMR episodes at Month 48.
Time frame: Month 48
Population: This study was prematurely terminated at Month 36 due to futility issue. This outcome measure was planned to analyze at Month 48. Hence, data for this outcome measure was not collected as planned, analyzed and reported.
Secondary
Number of Participants With Treatment-emergent Adverse Events (TEAEs)
An adverse event (AE) was any untoward, undesired, unplanned clinical event in the form of signs, symptoms, disease, or laboratory or physiological observations occurred in a participant participating in a clinical study with the sponsor's product, regardless of causal relationship. TEAEs were defined as events that started or worsened on or after the date of the first dose of investigational product, but no later than 30 days following the last dose of investigational product, within a treatment period.
Time frame: From start of study drug administration up to study termination (Month 36)
Population: Safety analysis set consisted of all participants who had taken at least 1 dose of investigational product.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Placebo | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | 16 Participants |
| CINRYZE | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | 16 Participants |
Secondary
Time to All-Cause Graft Failure up to Month 48
Graft failure was determined by the presence of one or more of the following criteria: institution of permanent dialysis (defined as dialysis treatment more than \[\>\] 30 days), current transplant nephrectomy, and/or a clinical determination of cessation of kidney graft function and estimated glomerular filtration rate (eGFR) less than or equal to (\<=) 15 milliliter (mL)/minute (min)/1.73 meter (m)\^2. Time to all-cause graft failure in months was calculated as (Date of graft failure - Date of first dose + 1)/30.25.
Time frame: Up to Month 48
Population: This study was prematurely terminated at Month 36 due to futility issue. This outcome measure was planned to analyze at Month 48. Hence, data for this outcome measure was not collected as planned, analyzed and reported.
Secondary
Time to All-Cause Mortality up to Month 48
Time to all-cause mortality was calculated as (Date of discontinuation due to death - Date of first dose + 1)/30.25. Participants who are alive and still on-study were censored at the date of last visit; Participants who had completed the study were censored at the date of study completion; Participants who discontinued from the study but not due to death were censored at the date of early discontinuation.
Time frame: Up to Month 48
Population: This study was prematurely terminated at Month 36 due to futility issue. This outcome measure was planned to analyze at Month 48. Hence, data for this outcome measure was not collected as planned, analyzed and reported.
Secondary
Time to Graft Failure Due to Antibody-Mediated Rejection (AMR) Episodes up to Month 48
Graft failure was determined by the presence of one or more of the following criteria: institution of permanent dialysis (defined as dialysis treatment \> 30 days), current transplant nephrectomy, and/or a clinical determination of cessation of kidney graft function and eGFR \<=15 mL/ min/1.73m\^2. Time to graft failure due to AMR episodes in months was calculated as (Date of graft failure due to AMR - Date of first dose + 1)/30.25.
Time frame: Up to Month 48
Population: This study was prematurely terminated at Month 36 due to futility issue. This outcome measure was planned to analyze at Month 48. Hence, data for this outcome measure was not collected as planned, analyzed and reported.
Secondary
Time to Resolution of Qualifying Antibody-Mediated Rejection (AMR) Episodes up to Month 48
Time to resolution of qualifying AMR episodes was calculated as (Date of qualifying AMR resolution - Date of first dose + 1)/30.25. Participants who didn't had resolution of qualifying AMR episodes and still on-study were censored at the date of last visit; Participants who had completed the study without resolution of qualifying AMR were censored at the date of study completion; participants who discontinued from the study without resolution of qualifying AMR were censored at the date of early discontinuation.
Time frame: Up to Month 48
Population: This study was prematurely terminated at Month 36 due to futility issue. This outcome measure was planned to analyze at Month 48. Hence, data for this outcome measure was not collected as planned, analyzed and reported.