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Simulect

Phase 4FDA approved 1998

Renal Transplantation | Small molecule | Nephrology |Novartis AG|Trials Updated: Apr 2, 2020

Simulect development status

FDA approval May 12, 1998
Approval holderNovartis
ApplicationBLA103764
Highest phase Phase 4 (NCT00343226)
Phase scored for NVSPhase 2
Registered trials 35 across 11 sponsors since Aug 2001

Label indication Simulect ® (basiliximab) is indicated for the prophylaxis of acute organ rejection in patients receiving renal transplantation when used as part of an immunosuppressive regimen that includes cyclosporine, USP (MODIFIED), and corticosteroids. The efficacy of Simulect for the prophylaxis of acute rejection in recipients of other solid organ allografts has not been demonstrated. FDA label

Simulect target and mechanism

ModalitySmall molecule

Also known as Basiliximab, Basiliximab (Simulect)

Success Probability

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Market & Valuation

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Trial Design

RandomizedACTIVE_CONTROLLEDDMC
Total Trials5
Total Enrollment1,351

FDA Designations

No designations recorded

Simulect clinical trials

Simulect · 5 trials · 6 indications

Phase 3 3Phase 2 2
NCT00149890Efficacy and Safety of Basiliximab, Cyclosporine/Cyclosporine Microemulsion, and Steroids in Pediatric de Novo Liver Transplant Recipients Avoiding Intraoperative SteroidsLiver Transplantation
COMPLETED77 Analytics
NCT00238901Efficacy and Safety of Basiliximab in Hepatitis C Virus Positive Patients Undergoing Liver TransplantationLiver Transplant
COMPLETED194 Analytics
NCT00228020Study of Safety and Efficacy of a Basiliximab, Mycophenolate Mofetil, Cyclosporine Microemulsion and Prednisone Combination Treatment Regimen in Pediatric Renal Allograft RecipientsPediatric Kidney Transplantation
COMPLETED212 Analytics
PHASE3COMPLETED
Efficacy and Safety of Basiliximab, Cyclosporine/Cyclosporine Microemulsion, and Steroids in Pediatric de Novo Liver Transplant Recipients Avoiding Intraoperative Steroids
Liver TransplantationUnlock trial analytics
PHASE3COMPLETED
Efficacy and Safety of Basiliximab in Hepatitis C Virus Positive Patients Undergoing Liver Transplantation
Liver TransplantUnlock trial analytics
PHASE3COMPLETED
Study of Safety and Efficacy of a Basiliximab, Mycophenolate Mofetil, Cyclosporine Microemulsion and Prednisone Combination Treatment Regimen in Pediatric Renal Allograft Recipients
Pediatric Kidney TransplantationUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Participants With at Least One Biopsy Proven Acute Rejection (BPAR) Episode, Graft Loss or Death Within the First Three Months Post-transplantation
3 months after treatment

Graft loss is defined as being listed for a re-transplantation. The analysis was based on the locally performed biopsy assessments. Generally, patients not experiencing a relevant event (i.e., acute rejection, graft loss or death) were censored with the last visit date.

12-month cumulative incidence of post-surgical graft loss and death
Time to first BPAR episode or treatment failure
6 months

Treatment failure is defined as: graft loss, death, or initiation of anti-rejection therapy without prior biopsy-proven rejection (in case of medical contraindication for a biopsy).

Area Under the Curve (AUC) of CD25 Saturation by Basiliximab From Day 0 to Day 84
Day 84 (Week 12) after transplantation

CD25 saturation is the percentage of T cells expressing CD25. Mean AUC of CD25 was calculated only for patients who received two Simulect® injections.

Saturation Rate of CD25 Antigen Saturation by Basiliximab
Day 0, Day 1, Day 4, Day 6, Day 14, Day 21, Day 28, Day 42, Day 56 and Day 84 (Week 12) post-transplantation

CD25 saturation is the percentage of T cells expressing CD25

Number of Participants With Biopsy-proven Acute Rejection at 6-months After Randomization to Induction Therapy
6 months post-transplantation

Occurence of biopsy-proven acute rejection events at 6-months after transplantation during Period 1 (randomization to induction therapy (Campath-1H and Tacrolimus, or Basiliximab and Tacrolimus))

Graft Function (at 18-months After Randomization to Maintenance Therapy)
2 years post-transplantation

Estimated glomerular filtration rate (estimated using MDRD formula) at 18-months after maintenance therapy randomization to either Sirolimus or Tacrolimus.

Secondary Endpoints

Number of Participants With Biopsy Proven Acute Rejection (BPAR) Episodes Within the First Three Months
3 months
Number of Participants With Steroid Resistant Rejection Episodes Within Three and Six Months
3 and 6 months
Percentage of Participants Experiencing Death or Graft Loss Within Three and Six Months After Transplantation
3 months and 6 months
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Study Design & Arms

AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposePREVENTION

Treatment Arms

ArmTypeDescription
With Intraoperative SteroidsEXPERIMENTALIntraoperative steroids were administered during transplantation and Basiliximab was administered on Day 0 and 4 (10 mg if the body weight was \<35 kg; 20 mg if body weight was ≥35 kg) in combination with cyclosporine/cyclosporine microemulsion and steroids. Basiliximab was administered as an intravenous bolus injection within 8 hours after reperfusion of the graft.
Without Intraoperative SteroidsACTIVE_COMPARATORNo intraoperative steroids were administered during transplantation and Basiliximab was administered on Day 0 and 4 (10 mg if the body weight was \<35 kg; 20 mg if body weight was ≥35 kg) in combination with cyclosporine/cyclosporine microemulsion and steroids. Basiliximab and the first dose of steroids had to be administered within 8 hours after reperfusion of the graft and basiliximab was given as an intravenous bolus injection.
BasiliximabEXPERIMENTALPatients will be on a regimen of Basiliximab, MMF, cyclosporine and steroids
Basiliximab-freeACTIVE_COMPARATORPatients will be on a regimen of MMF, cyclosporine and steroids.
Simulect 40mg + Neoral + Myfortic + steroidsACTIVE_COMPARATORA cumulative dose of 40 mg of Simulect® (20mg at Day 0 (D0) and 20mg at Day 4 (D4)+ Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Neoral + Myfortic + steroidsEXPERIMENTALA cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Neoral® + Myfortic® + corticosteroids
Simulect 80mg + Certican + Myfortic + steroidsEXPERIMENTALA cumulative dose of 80 mg of Simulect® (40mg at D0 and 40mg at D4) + Certican® + Myfortic® + corticosteroids
Alemtuzumab/SirolimusEXPERIMENTALInduction therapy allocation: Alemtuzumab (Campath-1H). Maintenance therapy allocation (at 6-months post-transplant): Sirolimus
Alemtuzumab/TacrolimusEXPERIMENTALInduction therapy allocation: Alemtuzumab (Campath-1H). Maintenance therapy allocation (at 6-months post-transplant): Tacrolimus
Basiliximab/TacrolimusACTIVE_COMPARATORInduction therapy allocation: Basiliximab. Maintenance therapy allocation (at 6-months post-transplant): Tacrolimus
Basiliximab/SirolimusACTIVE_COMPARATORInduction therapy allocation: Basiliximab. Maintenance therapy allocation (at 6-months post-transplant): Sirolimus

Interventions

NameTypeDescription
BasiliximabDRUGBasiliximab (10 mg) was supplied as a lyophilisate in vials with ampoules of sterile water for injection (5 mL) and had to be given of 10 mg (body weight \<35 kg) or 20 mg (body weight ≥35 kg) strength.
Cyclosporine/cyclosporine microemulsionDRUGCyclosporine/cyclosporine microemulsion had to be started with 100 mg/m²/day intravenous (i.v) (2x4h) for 7 days and was to be continued i.v. or orally from day 8 onwards as per center practice. During the 6 months treatment period Cyclosporine doses had to be adjusted according to Cyclosporine A (CsA)-trough levels.
SteroidDRUGIntravenous prednisolone (loading dose: 300 mg/m2, maximum 500 mg) had to be administered intraoperatively only in treatment arm 1 (day 0). The first dose of steroids in treatment arm 2 (day 0) had to be administered within 8 hours after reperfusion of the graft. Beginning from day 1 to day 6 doses of 15 mg/m2/day had to be given intravenously (i.v.) in both treatment arms. Then, the steroid doses (oral prednisone or its equivalent) were to be decreased from 10 mg/m²/day orally (day 7-13), to 7.5 mg/m²/day orally (day 14-30), to 4 mg/m²/day orally (until end of month 2), to 2.5 mg/m²/day orally (until end of month 3) and to 1 mg/m²/day orally (until end of month 6).
basiliximab, MMF(mycophenolate mofetil), cyclosporine, prednisone (or equivalent)DRUG -
MMF, cyclosporine, steroidsDRUG -
Simulect®DRUGSimulect® was provided to the study center in its commercial package containing a powder vial with 20 mg of active product and sterile water for injection. The solution should be used immediately after reconstitution. The infusion was prepared by adding at least 50 mL of physiologic or 5% glucose solution to the reconstituted solution (at least 100 mL for 40 mg of Simulect®). Simulect® was transported and kept in a cold environment (2-8°C) as recommended in the summary of product characteristics (SPC).
Neoral®DRUGNeoral® was provided to the study center in its commercial package as 10, 25, 50 or 100 mg soft capsules in thermoformed blister packs.
Certican®DRUGCertican® was provided to the study center in its commercial package as 0.75, 0.5 and 0.25 mg tablets in thermoformed blister packs.
Myfortic®DRUGMyfortic® was administered orally b.i.d. with a 12-hour interval. Tablets could be taken either with or outside meals but consistently throughout the study. To maintain the integrity of the enteric coating, tablets were not to be crushed. Myfortic® treatment was initiated either preoperatively or within 24 hours post transplantation according to local practice in each center. Starting dose was to be 2160 mg/day (1080 mg b.i.d.) for at least 2 weeks and for at most 4 weeks. Patients were then to receive 1440 mg/day (720 mg b.i.d.) until the end of the study. Myfortic® was administered as concomitant treatment to all patients, using the same regimen for all 3 study groups. It was provided to the study center in its commercial package as 180 and 360 mg gastro-resistant tablets.
CorticosteroidsDRUGCorticosteroid i.v. therapy could be administered peri or per operatively according to local practice in each center with the same scheme for each patient in the center. Oral corticotherapy was to be initiated rapidly, within one week following transplantation, with a minimal dose of 20 mg/day. Thereafter, the dose was to be decreased according to local practice but oral corticosteroids were to be continued throughout the study with a minimal dose of 5 mg/day.
AlemtuzumabDRUGAlemtuzumab 30 mg intravenously or subcutaneously, two doses 24 hours apart
SirolimusDRUGSirolimus: target trough levels 6-12 ng/mL for first 6-months after maintenance therapy randomization, then 5-10 ng/mL
TacrolimusDRUGTacrolimus: target trough levels 5-7 ng/mL after maintenance therapy randomization.
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Eligibility Criteria

Age RangeN/A to 16 Years
SexALL
Healthy VolunteersNo
Study Sites1

Inclusion Criteria: * Pediatric patients undergoing primary orthotopic liver transplantation (whole organ or split liver or reduced size) * Cadaveric or living donor (related or unrelated) Exclusion Criteria: * Patients who are recipients of multiple solid organ transplants and/or who have previo...

Countries:GermanyFranceUnited Kingdom
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Frequently asked questions about Simulect

What is Simulect used for?

Simulect is used in renal transplantation. It is studied in adult low risk de novo renal transplant recipients, where it is given in combination with ciclosporine microemulsion or everolimus. Its therapeutic area is nephrology, and the recorded development stage is Phase 2.

Who makes Simulect?

Simulect is developed by Novartis AG, which trades under the ticker NVS. The company is the sponsor associated with the clinical development of the drug in renal transplantation.

What phase is Simulect in?

Simulect is in Phase 2 development. It is an investigational agent in the recorded clinical program rather than a marketed product, and the single listed trial has been completed. No active trials are currently recorded for it.

What clinical trials is Simulect in?

Simulect has been studied in one recorded clinical trial, NCT01596062, also called the IDEALE Study. It was a Phase 2, randomized, active controlled trial of basiliximab 40 or 80 mg with ciclosporine microemulsion or everolimus in adult low risk de novo renal transplant recipients in France, and it enrolled 16 participants.

Is Simulect the same as basiliximab?

Yes, Simulect is the brand name for basiliximab, and it is also written as Simulect®. Searches for either name refer to the same agent, which is being studied in renal transplantation in combination with ciclosporine microemulsion or everolimus.