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Study to Assess PK, Safety and Tolerability in Patients With DM and CKD

Primary Purpose

Chronic Kidney Disease, Chronic Kidney Disease, Stage 3 (Moderate), Chronic Kidney Disease, Stage 4 (Severe)

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
DM199
Sponsored by
DiaMedica Therapeutics Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Kidney Disease focused on measuring Diabetes, Chronic Kidney Disease

Eligibility Criteria

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

Inclusion Criteria:

  • Subject is willing and able to provide informed consent for study participation.
  • Subject is ≥ 18 years of age.
  • Subject has an established diagnosis of T1D or T2D as determined by medical evaluation at screen.
  • Subjects A1c <9.8%
  • Subject is clinically stable with respect to underlying renal impairment and diabetes, as assessed by the Investigator's medical evaluation.
  • Subject has been diagnosed with Stage 3 CKD as defined by eGFR (MDRD) between 30 - <60 or Stage 4 as defined by eGFR <30 (not on dialysis) at screening.
  • Subject has a body mass index (BMI) between 18 to 45 kg/m2 (inclusive).

Exclusion Criteria:

  • Subject has positive drug test for drugs of abuse and/or positive alcohol breath test at screening and Day 0.
  • Subject is unable or unwilling to comply with protocol requirements, including assessments, tests, and follow-up visits.
  • Subject has a history of significant allergic diathesis such as urticaria, angioedema, or anaphylaxis.
  • Subject has had any live vaccination ≤ 3 months prior to enrollment or will require vaccination during the study.
  • Subject must not be taking an ACEi medication for 5 half-lives prior to study drug administration and for 5 days post study drug administration.
  • Subject is unwilling or unable to limit smoking to ≤ 10 cigarettes per day (or other products that contain nicotine limited to < 200 mg of nicotine/day) during the study participation period.
  • Subject has a current malignancy or active malignancy ≤ 3 years prior to enrollment except basal cell or squamous cell carcinoma of the skin or in situ cervical cancer that has undergone potentially curative therapy and ≥ six months have elapsed since the procedure.
  • Subject has an active infection at the time of enrollment, and/or a history of clinically significant acute bacterial, viral, or fungal systemic infections that required systemic treatment in the last four weeks prior to enrollment.
  • Subject has known medical history of alpha 1-antitrypsin deficiency (α1-antitrypsin deficiency).
  • Subject has serological evidence of human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), or anti-hepatitis C virus (Anti-HCV) at screen.
  • Subject is pregnant or nursing or is planning a pregnancy during the study period.
  • Subject is male or female of childbearing potential, is participating in sexual activity that could lead to pregnancy and is unable or unwilling to practice medically effective contraception during the study.
  • Subject has received any investigational drug or device within 14 days (or 5 half lives, whichever is longer) prior to study drug administration on Day 1
  • Subject has renal artery stenosis as determine at screen with medical history.
  • Subject has hypotension as defined by systolic blood pressure ≤ 90 and diastolic blood pressure ≤ 60 mmHg.
  • Subject has Proteinuria: PCR>2000mg/gm (spot testing).
  • Subject does not have adequate venous access for blood sampling.
  • Subject has any other medical condition which, in the opinion of the Investigator, will make participation medically unsafe or interfere with the study results.
  • Subject has any other clinically significant abnormalities in laboratory test results at screening that would, in the opinion of the Investigator, increase the subject's risk of participation, jeopardize complete participation in the study, or compromise interpretation of study data.
  • Subject has any of the following conditions as determined by ECG or medical record:

    • Any significant arrhythmia or conduction abnormality, which, in the opinion of the Investigators and Medical Monitor, may interfere with the safety of the subject.
  • Subject is taking Cimetidine, St. John's Wort, or any other herbal or probiotic supplement.

Sites / Locations

  • Clinical Pharmacology of Miami
  • Orlando Clinical Research Center Inc
  • Prism Research

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

3.0 µg/kg SC, single dose

5.0 µg/kg SC, single dose

8.0 µg/kg SC, single dose

Arm Description

n=8, study group of T1D or T2D with stage 3 CKD. separate n=8 of study group with T1D or T2D with CKD stage 4).

n=8, study group of T1D or T2D with stage 3 CKD.

n=8, study group of T1D or T2D with stage 3 CKD.

Outcomes

Primary Outcome Measures

Safety as assessed by incidence, severity, and causality of adverse events
Tolerability as assessed by incidence and severity of AEs
plasma measurements of DM199
as measured in the three different dosing groups; 3.0 ug/kg, 5.0 ug/kg, and 8.0 ug/kg.
DM199 urine concentrations of KLK1
urine KLK1 will be measured pre and post study drug administration.

Secondary Outcome Measures

C Reactive protein (CRP)
Matrix Metalloproteinase-9 (MMP-9)
Vascular Endothelial Growth Factor (VEGF)
Nitric Oxide (NO)
Serum creatinine
Cystatin C
neutrophil gelatinase-associated prostaglandin E2
Urine Kidney Injury Molecule-1 (Kim1)

Full Information

First Posted
January 3, 2019
Last Updated
September 3, 2021
Sponsor
DiaMedica Therapeutics Inc
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1. Study Identification

Unique Protocol Identification Number
NCT03795389
Brief Title
Study to Assess PK, Safety and Tolerability in Patients With DM and CKD
Official Title
A Multi-Center Open-label Investigation to Assess the Pharmacokinetics, Safety and Tolerability of DM199 in Patients With Diabetes Mellitus and Chronic Kidney Disease
Study Type
Interventional

2. Study Status

Record Verification Date
July 2019
Overall Recruitment Status
Completed
Study Start Date
February 12, 2019 (Actual)
Primary Completion Date
July 21, 2019 (Actual)
Study Completion Date
July 21, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
DiaMedica Therapeutics Inc

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
An open-label, phase IB, multi-center study evaluating DM199 in subjects with Type 1 Diabetes or Type 2 Diabetes and Stage 3 or 4 Chronic Kidney Disease. The primary objectives of this study are to evaluate safety, tolerability, and PK profile of DM199 in these subjects.
Detailed Description
The study evaluates the safety, tolerability, and PK profile of DM199 in subjects with T1D or T2D and with Stage 3 or Stage 4 CKD. Additionally, this study evaluates urine concentrations of KLK1 pre and post dose. Cohort 1: Subjects with T1D or T2D and Stage 3 CKD will be administered one of three DM199 doses: 3.0 ug/kg or 5.0 ug/kg or 8.0 ug/kg single SC dose. Cohort 2: Subjects with T1D or T2D and Stage 4 CKD will be administered a single 3.0 µg/kg single SC dose. Secondary and exploratory study objectives include collection and analysis of vital signs, biomarkers, eGFR, blood glucose, and ECG's.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Kidney Disease, Chronic Kidney Disease, Stage 3 (Moderate), Chronic Kidney Disease, Stage 4 (Severe), Diabetes
Keywords
Diabetes, Chronic Kidney Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
33 (Actual)

8. Arms, Groups, and Interventions

Arm Title
3.0 µg/kg SC, single dose
Arm Type
Experimental
Arm Description
n=8, study group of T1D or T2D with stage 3 CKD. separate n=8 of study group with T1D or T2D with CKD stage 4).
Arm Title
5.0 µg/kg SC, single dose
Arm Type
Experimental
Arm Description
n=8, study group of T1D or T2D with stage 3 CKD.
Arm Title
8.0 µg/kg SC, single dose
Arm Type
Experimental
Arm Description
n=8, study group of T1D or T2D with stage 3 CKD.
Intervention Type
Drug
Intervention Name(s)
DM199
Intervention Description
Single SC dose
Primary Outcome Measure Information:
Title
Safety as assessed by incidence, severity, and causality of adverse events
Time Frame
11 days
Title
Tolerability as assessed by incidence and severity of AEs
Time Frame
11 days
Title
plasma measurements of DM199
Description
as measured in the three different dosing groups; 3.0 ug/kg, 5.0 ug/kg, and 8.0 ug/kg.
Time Frame
11 days
Title
DM199 urine concentrations of KLK1
Description
urine KLK1 will be measured pre and post study drug administration.
Time Frame
11 days
Secondary Outcome Measure Information:
Title
C Reactive protein (CRP)
Time Frame
11 days
Title
Matrix Metalloproteinase-9 (MMP-9)
Time Frame
11 days
Title
Vascular Endothelial Growth Factor (VEGF)
Time Frame
11 days
Title
Nitric Oxide (NO)
Time Frame
11 days
Title
Serum creatinine
Time Frame
11 days
Title
Cystatin C
Time Frame
11 days
Title
neutrophil gelatinase-associated prostaglandin E2
Time Frame
11 days
Title
Urine Kidney Injury Molecule-1 (Kim1)
Time Frame
11 days
Other Pre-specified Outcome Measures:
Title
serum creatinine
Time Frame
11 days
Title
Blood glucose
Time Frame
11 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is willing and able to provide informed consent for study participation. Subject is ≥ 18 years of age. Subject has an established diagnosis of T1D or T2D as determined by medical evaluation at screen. Subjects A1c <9.8% Subject is clinically stable with respect to underlying renal impairment and diabetes, as assessed by the Investigator's medical evaluation. Subject has been diagnosed with Stage 3 CKD as defined by eGFR (MDRD) between 30 - <60 or Stage 4 as defined by eGFR <30 (not on dialysis) at screening. Subject has a body mass index (BMI) between 18 to 45 kg/m2 (inclusive). Exclusion Criteria: Subject has positive drug test for drugs of abuse and/or positive alcohol breath test at screening and Day 0. Subject is unable or unwilling to comply with protocol requirements, including assessments, tests, and follow-up visits. Subject has a history of significant allergic diathesis such as urticaria, angioedema, or anaphylaxis. Subject has had any live vaccination ≤ 3 months prior to enrollment or will require vaccination during the study. Subject must not be taking an ACEi medication for 5 half-lives prior to study drug administration and for 5 days post study drug administration. Subject is unwilling or unable to limit smoking to ≤ 10 cigarettes per day (or other products that contain nicotine limited to < 200 mg of nicotine/day) during the study participation period. Subject has a current malignancy or active malignancy ≤ 3 years prior to enrollment except basal cell or squamous cell carcinoma of the skin or in situ cervical cancer that has undergone potentially curative therapy and ≥ six months have elapsed since the procedure. Subject has an active infection at the time of enrollment, and/or a history of clinically significant acute bacterial, viral, or fungal systemic infections that required systemic treatment in the last four weeks prior to enrollment. Subject has known medical history of alpha 1-antitrypsin deficiency (α1-antitrypsin deficiency). Subject has serological evidence of human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), or anti-hepatitis C virus (Anti-HCV) at screen. Subject is pregnant or nursing or is planning a pregnancy during the study period. Subject is male or female of childbearing potential, is participating in sexual activity that could lead to pregnancy and is unable or unwilling to practice medically effective contraception during the study. Subject has received any investigational drug or device within 14 days (or 5 half lives, whichever is longer) prior to study drug administration on Day 1 Subject has renal artery stenosis as determine at screen with medical history. Subject has hypotension as defined by systolic blood pressure ≤ 90 and diastolic blood pressure ≤ 60 mmHg. Subject has Proteinuria: PCR>2000mg/gm (spot testing). Subject does not have adequate venous access for blood sampling. Subject has any other medical condition which, in the opinion of the Investigator, will make participation medically unsafe or interfere with the study results. Subject has any other clinically significant abnormalities in laboratory test results at screening that would, in the opinion of the Investigator, increase the subject's risk of participation, jeopardize complete participation in the study, or compromise interpretation of study data. Subject has any of the following conditions as determined by ECG or medical record: Any significant arrhythmia or conduction abnormality, which, in the opinion of the Investigators and Medical Monitor, may interfere with the safety of the subject. Subject is taking Cimetidine, St. John's Wort, or any other herbal or probiotic supplement.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Harry Alcorn, Pharm.D.
Organizational Affiliation
DiaMedica Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Clinical Pharmacology of Miami
City
Hialeah
State/Province
Florida
ZIP/Postal Code
33014
Country
United States
Facility Name
Orlando Clinical Research Center Inc
City
Orlando
State/Province
Florida
ZIP/Postal Code
32803
Country
United States
Facility Name
Prism Research
City
Saint Paul
State/Province
Minnesota
ZIP/Postal Code
55114
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Study to Assess PK, Safety and Tolerability in Patients With DM and CKD

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