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Antiproteinuric Effects of Liraglutide Treatment (LIRALBU)

Primary Purpose

Diabetic Kidney Disease

Status
Completed
Phase
Phase 4
Locations
Denmark
Study Type
Interventional
Intervention
Liraglutide
placebo
Sponsored by
Steno Diabetes Center Copenhagen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetic Kidney Disease

Eligibility Criteria

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

Inclusion Criteria:

  1. Must give written informed consent before participation. Patient information and consent form must be approved by the Danish Medicines Agency and the Regional Scientific Ethical Committee
  2. Male or female patients >18 years with type 2 diabetes (WHO criteria).
  3. HbA1c ≥ 48 mmol/mol (6.5 %)
  4. eGFR ≥ 30 ml/min/1.73 m2 (estimated by MDRD formula)
  5. Fertile female patients must use chemical, hormonal or mechanical contraceptives or be in menopause (i.e. must not have had regular menstrual bleeding for at least one year) or have undergone bilateral oophorectomi or have been surgically sterilized or hysterectomised at least six months prior to screening
  6. Patients must be on stable RAAS-blocking treatment (unchanged dose 4 weeks before inclusion)
  7. Geometic mean urine albumin-to-creatinine ratio (UACR) above 30 mg/g at screening (measured in at least two of three consecutive morning spot urine samples)
  8. Systolic blood pressure (SBP) must be lower than 180 mm Hg at screening.
  9. Patients must be on stable glucose lowering medication for at least two weeks before the first visit.
  10. Must be able to communicate with the investigator.

Exclusion Criteria:

  1. SBP > 180 mm Hg at screening
  2. Type 1 diabetes mellitus
  3. Chronic pancreatitis / previous acute pancreatitis
  4. Known or suspected hypersensitivity to trial product(s) or related products.
  5. Treatment with oral glucocorticoids, calcineurin inhibitors, dipeptidyl peptidase 4 (DPP4) inhibitors, glucagon like peptide-1 agonists and sodium-glucose co-transporter 2 (SGLT-2) inhibitors, which in the investigator's opinion could interfere with glucose or lipid metabolism 90 days prior to screening
  6. Cancer (except basal cell skin cancer or squamous cell skin cancer) or any other clinically significant disorder, except for conditions associated with type 2 diabetes history, which in the investigators opinion could interfere with the results of the trial
  7. Inflammatory bowel disease
  8. Cardiac disease defined as: Decompensated heart failure (NYHA class III-IV) and/or diagnosis of unstable angina pectoris and/or myocardial infarction within the last 6 months
  9. Previous bowel resection
  10. Body mass index <18.5 kg/m2
  11. Females of childbearing potential who are pregnant, breast-feeding, intending to become pregnant or not using adequate contraceptive methods
  12. Clinical signs of diabetic gastroparesis
  13. Impaired liver function (transaminases > two times upper reference levels)
  14. The receipt of any investigational product 90 days prior to this trial
  15. Known or suspected abuse of alcohol or narcotics
  16. Subjects with personal or family history of medullary thyroid carcinoma or a personal history of multiple endocrine neoplasia type 2

Sites / Locations

  • Peter Rossing

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Liraglutide

Placebo

Arm Description

Liraglutide s.c. up-escalated to 1.8 mg/day for 12 weeks.

Placebo s.c. for 12 weeks.

Outcomes

Primary Outcome Measures

Change in albuminuria
24h urinary albumin excretion rate (UAER mg/24h)

Secondary Outcome Measures

Change in renin-angiotensin system hormones
renin (activity and concentration), angiotensin 1+2, aldosteron (concentrations)
Change in kidney function
Cr-EDTA-GFR (ml/min/1.73m2)
Change in 24h blood pressure
24 h systolic and diastolic blood presure (mmHg)
Change in markers of inflammation
TNF-alfa, mcp (concentration)
24h heart rate
puls in BPM

Full Information

First Posted
April 13, 2015
Last Updated
August 9, 2016
Sponsor
Steno Diabetes Center Copenhagen
Collaborators
Novo Nordisk A/S
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1. Study Identification

Unique Protocol Identification Number
NCT02545738
Brief Title
Antiproteinuric Effects of Liraglutide Treatment
Acronym
LIRALBU
Official Title
Antiproteinuric Effects of Liraglutide Treatment in Patients With Type 2 Diabetes and Albuminuria: A Randomised, Placebo-Controlled Trial
Study Type
Interventional

2. Study Status

Record Verification Date
August 2016
Overall Recruitment Status
Completed
Study Start Date
April 2015 (undefined)
Primary Completion Date
May 2016 (Actual)
Study Completion Date
May 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Steno Diabetes Center Copenhagen
Collaborators
Novo Nordisk A/S

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of the study is to determine the effect of Liraglutide on albuminuria in type 2 diabetes.
Detailed Description
Initial findings point to a clinically significant antiproteinuric effect of liraglutide treatment, possibly independent from blood pressure reduction. The mechanism behind is unclear and the magnitude of albuminuria reduction needs to be verified. Antiproteinuric effects are usually renoprotective and potentially also cardioprotective and may suggest an additional benefit from liraglutide treatment. The aim of this study is to evaluate the magnitude of the antiproteinuric effect of short-term liraglutide treatment (12 weeks) in patients with type 2 diabetes and albuminuria. In addition, possible mechanisms causing the antiproteinuric effect will be explored.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetic Kidney Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
32 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Liraglutide
Arm Type
Experimental
Arm Description
Liraglutide s.c. up-escalated to 1.8 mg/day for 12 weeks.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo s.c. for 12 weeks.
Intervention Type
Drug
Intervention Name(s)
Liraglutide
Other Intervention Name(s)
Victoza
Intervention Description
active treatment
Intervention Type
Drug
Intervention Name(s)
placebo
Intervention Description
placebo
Primary Outcome Measure Information:
Title
Change in albuminuria
Description
24h urinary albumin excretion rate (UAER mg/24h)
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Change in renin-angiotensin system hormones
Description
renin (activity and concentration), angiotensin 1+2, aldosteron (concentrations)
Time Frame
24 weeks
Title
Change in kidney function
Description
Cr-EDTA-GFR (ml/min/1.73m2)
Time Frame
24 weeks
Title
Change in 24h blood pressure
Description
24 h systolic and diastolic blood presure (mmHg)
Time Frame
24 weeks
Title
Change in markers of inflammation
Description
TNF-alfa, mcp (concentration)
Time Frame
24 weeks
Title
24h heart rate
Description
puls in BPM
Time Frame
24 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Must give written informed consent before participation. Patient information and consent form must be approved by the Danish Medicines Agency and the Regional Scientific Ethical Committee Male or female patients >18 years with type 2 diabetes (WHO criteria). HbA1c ≥ 48 mmol/mol (6.5 %) eGFR ≥ 30 ml/min/1.73 m2 (estimated by MDRD formula) Fertile female patients must use chemical, hormonal or mechanical contraceptives or be in menopause (i.e. must not have had regular menstrual bleeding for at least one year) or have undergone bilateral oophorectomi or have been surgically sterilized or hysterectomised at least six months prior to screening Patients must be on stable RAAS-blocking treatment (unchanged dose 4 weeks before inclusion) Geometic mean urine albumin-to-creatinine ratio (UACR) above 30 mg/g at screening (measured in at least two of three consecutive morning spot urine samples) Systolic blood pressure (SBP) must be lower than 180 mm Hg at screening. Patients must be on stable glucose lowering medication for at least two weeks before the first visit. Must be able to communicate with the investigator. Exclusion Criteria: SBP > 180 mm Hg at screening Type 1 diabetes mellitus Chronic pancreatitis / previous acute pancreatitis Known or suspected hypersensitivity to trial product(s) or related products. Treatment with oral glucocorticoids, calcineurin inhibitors, dipeptidyl peptidase 4 (DPP4) inhibitors, glucagon like peptide-1 agonists and sodium-glucose co-transporter 2 (SGLT-2) inhibitors, which in the investigator's opinion could interfere with glucose or lipid metabolism 90 days prior to screening Cancer (except basal cell skin cancer or squamous cell skin cancer) or any other clinically significant disorder, except for conditions associated with type 2 diabetes history, which in the investigators opinion could interfere with the results of the trial Inflammatory bowel disease Cardiac disease defined as: Decompensated heart failure (NYHA class III-IV) and/or diagnosis of unstable angina pectoris and/or myocardial infarction within the last 6 months Previous bowel resection Body mass index <18.5 kg/m2 Females of childbearing potential who are pregnant, breast-feeding, intending to become pregnant or not using adequate contraceptive methods Clinical signs of diabetic gastroparesis Impaired liver function (transaminases > two times upper reference levels) The receipt of any investigational product 90 days prior to this trial Known or suspected abuse of alcohol or narcotics Subjects with personal or family history of medullary thyroid carcinoma or a personal history of multiple endocrine neoplasia type 2
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Peter Rossing, MD
Organizational Affiliation
Steno Diabetes Center Copenhagen
Official's Role
Principal Investigator
Facility Information:
Facility Name
Peter Rossing
City
Gentofte
ZIP/Postal Code
2820
Country
Denmark

12. IPD Sharing Statement

Citations:
PubMed Identifier
27753201
Citation
von Scholten BJ, Persson F, Rosenlund S, Hovind P, Faber J, Hansen TW, Rossing P. The effect of liraglutide on renal function: A randomized clinical trial. Diabetes Obes Metab. 2017 Feb;19(2):239-247. doi: 10.1111/dom.12808. Epub 2016 Nov 21.
Results Reference
derived

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Antiproteinuric Effects of Liraglutide Treatment

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