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Treatment of Renal Sarcoidosis by Methylprednisolone Bolus (CORTICOIDOSE)

Primary Purpose

Renal Sarcoidosis

Status
Terminated
Phase
Not Applicable
Locations
France
Study Type
Interventional
Intervention
methylprednisolone bolus IV 15 mg/kg/d for 3 days.
Sponsored by
Assistance Publique - Hôpitaux de Paris
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Renal Sarcoidosis focused on measuring Methylprednisolone, prednisone, renal sarcoidosis treatment

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age ≥ 18 years
  • Acute kidney injury with estimated glomerular filtration rate (eGFR) < 60 mL/min/1,73 m2, defined by an increase of initial value > 25% or an increase of > 30 µmol/l, since at least 3 months.
  • Sarcoidosis diagnostic criteria according to ATS/ERS/WASOG (Am J Respir Crit Care Med 1999)
  • Renal biopsy compatible with renal sarcoidosis :
  • Granulomatosis tubulo-interstitial nephropathy and extra-renal damage of histologically proved or suggestive sarcoidosis Or
  • Tubulo-interstitial nephropathy without granuloma and extra-renal damage of histologically proved sarcoidosis
  • Informed consent
  • Patients with social security

Exclusion Criteria:

  • Corticosteroids greater than 0,25 mg/kg/j prednisone equivalent
  • Introduction of an immunosuppressant in the month before inclusion
  • Another cause of renal granulomatosis or tubulo-interstitial nephropathy
  • Isolated renal damage without extra-renal past or present damage for a sarcoidosis
  • Chronic renal failure, prior sarcoidosis with eGFR < 30 mL/min/1,73 m2
  • Acute renal failure from other causes. If hypercalcaemia is greater than 3 mmol/L, the correction of any dehydration will systematically salt intake, followed of renal function control before inclusion.
  • Pregnancy, nursing
  • Tuberculosis
  • Uncontrolled sepsis
  • Uncontrolled psychotic state
  • Hypersensibility to methylprednisolone hemisuccinate
  • Drugs prescription causing wave burst arrhythmia and/or long QT on ECG

Sites / Locations

  • Service de Néphrologie et Dialyses, Hôpital Tenon

Arms of the Study

Arm 1

Arm 2

Arm Type

No Intervention

Experimental

Arm Label

oral prednisone

methylprednisolone bolus

Arm Description

Oral prednisone 1 mg/kg/d for 30 days and progressive tapering of steroids, to get 0,5 mg/kg/d at M3 and 0,25 mg/kg/d at M6 and 5-10 mg at M12.

methylprednisolone bolus 15 mg/kg/d for 3 days before oral prednisone 1 mg/kg/d for 30 days and progressive tapering of steroids, to get 0,5 mg/kg/d at M3 and 0,25 mg/kg/d at M6 and 5-10 mg at M12.

Outcomes

Primary Outcome Measures

Percentage of patients with a positive response defined by eGRF better than 100% compared to eGRF prior treatment or a normalization of renal function.

Secondary Outcome Measures

Efficacy (eGFR, percentage of patients with a eGRF < 60 ml/min/1.73m²)
Extra-renal manifestations
incidence of arrhythmias and cardiac conduction disease
fragility fracture
neuro-psychiatric troubles and infections
number of renal and extra-renal relapses.
Characterization of vitamin and calcium deficiencies by blood and urinary dosages

Full Information

First Posted
May 16, 2012
Last Updated
February 24, 2016
Sponsor
Assistance Publique - Hôpitaux de Paris
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1. Study Identification

Unique Protocol Identification Number
NCT01652417
Brief Title
Treatment of Renal Sarcoidosis by Methylprednisolone Bolus
Acronym
CORTICOIDOSE
Official Title
Randomized, Multicentric Study Evaluating the Efficacy and the Safety of Methylprednisolone Bolus in the Treatment of Renal Sarcoidosis
Study Type
Interventional

2. Study Status

Record Verification Date
October 2015
Overall Recruitment Status
Terminated
Why Stopped
insufficient recruitment
Study Start Date
October 2012 (undefined)
Primary Completion Date
November 2015 (Actual)
Study Completion Date
November 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Assistance Publique - Hôpitaux de Paris

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Renal sarcoidosis treatment is based on steroids, but the dose and duration are unknown. Despite this treatment, most patients will have chronic kidney disease. From our previous studies, the investigators believe that high dose steroids by methylprednisolone bolus will improve patient outcome and renal function.
Detailed Description
In a multicentric, randomized, open trial, the investigators will assess the efficacy of methylprednisolone bolus at 15mg/kg/d for 3 days before oral steroids on renal function improvement in renal sarcoidosis patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Renal Sarcoidosis
Keywords
Methylprednisolone, prednisone, renal sarcoidosis treatment

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
40 (Actual)

8. Arms, Groups, and Interventions

Arm Title
oral prednisone
Arm Type
No Intervention
Arm Description
Oral prednisone 1 mg/kg/d for 30 days and progressive tapering of steroids, to get 0,5 mg/kg/d at M3 and 0,25 mg/kg/d at M6 and 5-10 mg at M12.
Arm Title
methylprednisolone bolus
Arm Type
Experimental
Arm Description
methylprednisolone bolus 15 mg/kg/d for 3 days before oral prednisone 1 mg/kg/d for 30 days and progressive tapering of steroids, to get 0,5 mg/kg/d at M3 and 0,25 mg/kg/d at M6 and 5-10 mg at M12.
Intervention Type
Drug
Intervention Name(s)
methylprednisolone bolus IV 15 mg/kg/d for 3 days.
Other Intervention Name(s)
Methylprenisolone Mylan
Intervention Description
methylprednisolone bolus IV 15 mg/kg/d for 3 days.
Primary Outcome Measure Information:
Title
Percentage of patients with a positive response defined by eGRF better than 100% compared to eGRF prior treatment or a normalization of renal function.
Time Frame
3 months after the beginning of the treatment
Secondary Outcome Measure Information:
Title
Efficacy (eGFR, percentage of patients with a eGRF < 60 ml/min/1.73m²)
Time Frame
1, 3, 6 and 12 months after the beginning of the treatment
Title
Extra-renal manifestations
Time Frame
1, 3, 6 and 12 months after the beginning of the treatment
Title
incidence of arrhythmias and cardiac conduction disease
Time Frame
1, 3, 6 and 12 months after the beginning of the treatment
Title
fragility fracture
Time Frame
1, 3, 6 and 12 months after the beginning of the treatment
Title
neuro-psychiatric troubles and infections
Time Frame
1, 3, 6 and 12 months after the beginning of the treatment
Title
number of renal and extra-renal relapses.
Time Frame
1, 3, 6 and 12 months after the beginning of the treatment
Title
Characterization of vitamin and calcium deficiencies by blood and urinary dosages
Time Frame
1, 3, 6 and 12 months after the beginning of the treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years Acute kidney injury with estimated glomerular filtration rate (eGFR) < 60 mL/min/1,73 m2, defined by an increase of initial value > 25% or an increase of > 30 µmol/l, since at least 3 months. Sarcoidosis diagnostic criteria according to ATS/ERS/WASOG (Am J Respir Crit Care Med 1999) Renal biopsy compatible with renal sarcoidosis : Granulomatosis tubulo-interstitial nephropathy and extra-renal damage of histologically proved or suggestive sarcoidosis Or Tubulo-interstitial nephropathy without granuloma and extra-renal damage of histologically proved sarcoidosis Informed consent Patients with social security Exclusion Criteria: Corticosteroids greater than 0,25 mg/kg/j prednisone equivalent Introduction of an immunosuppressant in the month before inclusion Another cause of renal granulomatosis or tubulo-interstitial nephropathy Isolated renal damage without extra-renal past or present damage for a sarcoidosis Chronic renal failure, prior sarcoidosis with eGFR < 30 mL/min/1,73 m2 Acute renal failure from other causes. If hypercalcaemia is greater than 3 mmol/L, the correction of any dehydration will systematically salt intake, followed of renal function control before inclusion. Pregnancy, nursing Tuberculosis Uncontrolled sepsis Uncontrolled psychotic state Hypersensibility to methylprednisolone hemisuccinate Drugs prescription causing wave burst arrhythmia and/or long QT on ECG
Facility Information:
Facility Name
Service de Néphrologie et Dialyses, Hôpital Tenon
City
Paris
Country
France

12. IPD Sharing Statement

Citations:
PubMed Identifier
36066903
Citation
Mahevas M, Audard V, Rousseau A, Cez A, Guerrot D, Verhelst D, Delahousse M, Hanrotel C, Pillebout E, Daugas E, Krastinova E, Valeyre D, Boffa JJ; GSF French Sarcoidosis Group. Efficacy and safety of methylprednisolone pulse followed by oral prednisone vs. oral prednisone alone in sarcoidosis tubulointerstitial nephritis: a randomized, open-label, controlled clinical trial. Nephrol Dial Transplant. 2023 Mar 31;38(4):961-968. doi: 10.1093/ndt/gfac227.
Results Reference
derived

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Treatment of Renal Sarcoidosis by Methylprednisolone Bolus

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