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Multiple Doses of DM199 in Patients With Chronic Kidney Disease (REDUX)

Primary Purpose

Kidney Diseases

Status
Completed
Phase
Phase 2
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 Kidney Diseases

Eligibility Criteria

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

Inclusion Criteria:

Cohort I

  • African American
  • Hypertension as defined by the American Heart Association for Stage I hypertension where systolic blood pressure (BP) ≥130 mmHg or diastolic BP ≥ 80 mmHg or on medication for treatment of hypertension.

Cohort II

  • IgA nephropathy confirmed by medical history with biopsy

Cohort III

  • Diabetes Mellitus (Type 2) with hypertension where systolic blood pressure (BP) ≥130 mmHg or diastolic BP ≥ 80 mmHg or on medication for treatment of hypertension
  • Hemoglobin A1c ≥7% at screening

Both Cohorts

  • Participant is willing and able to provide informed consent for study participation
  • Participant male or female ≥ 18 years of age
  • Participant has CKD as defined by using CKD EPI for Stage II 60 to <90 mL/min/1.73 m2 or Stage III 30 to <60 mL/min/1.73 m2
  • UACR >150 mg/g and <5000 mg/g at screening
  • Participant is clinically stable with respect to underlying renal impairment as assessed by the Investigator's medical evaluation

Exclusion Criteria:

  • Participant has positive drug test for drugs of abuse and/or positive alcohol breath test at screening and Day 1
  • Participant has a current diagnosis and/or is taking medication or diet control for diabetes (cohort I and II only)
  • Participant has an A1c > 7% at screening (cohort I and II only)
  • Participant received corticosteroid therapy within last 3 months
  • Participant is unable or unwilling to comply with protocol requirements, including assessments, tests, and follow-up visits
  • Participant has a history of significant allergic diathesis such as urticaria, angioedema, or anaphylaxis
  • Participant has been previously diagnosed with kidney disease other than for hypertension, IgA or Diabetes Mellitus (Type II)
  • Participant has hypotension as defined by systolic blood pressure ≤ 90 mmHg and diastolic blood pressure ≤ 60 mmHg at screen
  • ACEi or GLP-1 medication prescribed for and taken by Participant (must not be taking for 5 half-lives prior to study drug administration and for 10 days post study drug administration)
  • Participant has a current malignancy or active malignancy ≤ 2 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 ≥ 6 months have elapsed since the procedure
  • Participant 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 with a completed therapy in the last 7 days prior to enrollment
  • Participant has known medical history of alpha 1-antitrypsin deficiency (α1-antitrypsin deficiency)
  • Participant is pregnant or nursing or is planning a pregnancy during the study period
  • Participant 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
  • Participant has received any investigational drug or device within 14 days (or 5 half lives, whichever is longer) prior to study drug administration starting on Day 1
  • Participant has renal artery stenosis as determined at screen with medical history
  • Participant received a kidney transplant
  • Participant does not have adequate venous access for blood sampling
  • Participant has any other medical condition which, in the opinion of the Investigator, will make participation medically unsafe or interfere with the study results
  • Participant has any other clinically significant abnormalities in laboratory test results at screening that would, in the opinion of the Investigator, increase the Participant's risk of participation, jeopardize complete participation in the study, or compromise interpretation of study data
  • Participant has any significant arrhythmia or conduction abnormality, which in the opinion of the Investigators and Medical Monitor may interfere with the safety of the Participant

Sites / Locations

  • Aventiv Research
  • Amcis Research Center
  • IMD Clinical Trials Inc
  • Amicis Reserch Center
  • Innovative Healthcare Institute
  • Elixia at Florida Kidney Physicians-SE
  • Pines Clinical Research-Hollywood
  • Elixia at Florida Kidney Physicians
  • Boise Kidney & Hypertension Institute
  • Research by Design LLC
  • New Orleans Center for Clinical Research, an AMR Company
  • Elixia At Clincal Renal Associates
  • Nephrotex Research Group, LLC
  • RDRI

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

2.0 µg/kg, multiple dose

5.0 µg/kg, multiple dose

Arm Description

n=45 with 15 Participants from cohort 1, 15 from cohort 2, and 15 from cohort 3

n=45 with 15 Participants from cohort 1, 15 from cohort 2 and 15 from cohort 3

Outcomes

Primary Outcome Measures

Incidence of treatment emergent adverse events
Incidence, severity, and causality of adverse events
Change in renal function
eGFR
Change in urine albumin to creatinine ratio
UACR change from baseline
Plasma measurements of DM199
Maximum plasma concentration of DM199

Secondary Outcome Measures

Tumor necrosis factor receptor 1 (TNF R1) concentration in plasma, change from baseline
TNF R1 change from baseline
C-reactive protein (CRP) concentration in plasma, change from baseline
CRP change from baseline
Matrix metalloproteainase-9 (MMP-9) concentration in plasma, change from baseline
MMP-9 change from baseline
Vascular endothelial growth factor (VEGF) concentration in plasma, change from baseline
VEGF change from baseline
Cystatin C concentration in plasma, change from baseline
Cystatin C change from baseline
Prostaglandin E2 concentration in plasma, change from baseline
Prostaglandin E2 change from baseline
Prostacyclin concentration in plasma, change from baseline
Prostacyclin change from baseline

Full Information

First Posted
October 8, 2019
Last Updated
March 16, 2022
Sponsor
DiaMedica Therapeutics Inc
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1. Study Identification

Unique Protocol Identification Number
NCT04123613
Brief Title
Multiple Doses of DM199 in Patients With Chronic Kidney Disease (REDUX)
Official Title
A Multi-Center Open-label Investigation to Assess the Safety and Efficacy of Multiple Doses of DM199 in Patients With Chronic Kidney Disease
Study Type
Interventional

2. Study Status

Record Verification Date
March 2022
Overall Recruitment Status
Completed
Study Start Date
December 17, 2019 (Actual)
Primary Completion Date
March 16, 2022 (Actual)
Study Completion Date
March 16, 2022 (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 II, multi-center study evaluating multiple doses of DM199 in participants with chronic kidney disease.
Detailed Description
This is an open-label, Phase II, multi-center study evaluating DM199 in approximately 90 Participants in three cohorts. Cohort I: African Americans with CKD (Stage II or III), hypertension and non-diabetic Cohort II: Participants with IgA nephropathy diagnosis and CKD (Stage II or III) Cohort III: Diabetes Mellitus (Type II) with CKD (Stage II or III) and hypertension Participants in each cohort will be enrolled in a parallel assignment to one of two doses: Dose 1: DM199 2.0 µg/kg SC 2x week for 95 days Dose 2: DM199 5.0 µg/kg SC 2x week for 95 days

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
79 (Actual)

8. Arms, Groups, and Interventions

Arm Title
2.0 µg/kg, multiple dose
Arm Type
Experimental
Arm Description
n=45 with 15 Participants from cohort 1, 15 from cohort 2, and 15 from cohort 3
Arm Title
5.0 µg/kg, multiple dose
Arm Type
Experimental
Arm Description
n=45 with 15 Participants from cohort 1, 15 from cohort 2 and 15 from cohort 3
Intervention Type
Drug
Intervention Name(s)
DM199
Intervention Description
A pharmaceutical formulation comprised of recombinant human tissue kallikrein-1 (rhKLK-1) that is being developed as an injectable protein drug
Primary Outcome Measure Information:
Title
Incidence of treatment emergent adverse events
Description
Incidence, severity, and causality of adverse events
Time Frame
12 weeks
Title
Change in renal function
Description
eGFR
Time Frame
12 weeks
Title
Change in urine albumin to creatinine ratio
Description
UACR change from baseline
Time Frame
12 weeks
Title
Plasma measurements of DM199
Description
Maximum plasma concentration of DM199
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Tumor necrosis factor receptor 1 (TNF R1) concentration in plasma, change from baseline
Description
TNF R1 change from baseline
Time Frame
12 weeks
Title
C-reactive protein (CRP) concentration in plasma, change from baseline
Description
CRP change from baseline
Time Frame
12 weeks
Title
Matrix metalloproteainase-9 (MMP-9) concentration in plasma, change from baseline
Description
MMP-9 change from baseline
Time Frame
12 weeks
Title
Vascular endothelial growth factor (VEGF) concentration in plasma, change from baseline
Description
VEGF change from baseline
Time Frame
12 weeks
Title
Cystatin C concentration in plasma, change from baseline
Description
Cystatin C change from baseline
Time Frame
12 weeks
Title
Prostaglandin E2 concentration in plasma, change from baseline
Description
Prostaglandin E2 change from baseline
Time Frame
12 weeks
Title
Prostacyclin concentration in plasma, change from baseline
Description
Prostacyclin change from baseline
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Cohort I African American Hypertension as defined by the American Heart Association for Stage I hypertension where systolic blood pressure (BP) ≥130 mmHg or diastolic BP ≥ 80 mmHg or on medication for treatment of hypertension. Cohort II IgA nephropathy confirmed by medical history with biopsy Cohort III Diabetes Mellitus (Type 2) with hypertension where systolic blood pressure (BP) ≥130 mmHg or diastolic BP ≥ 80 mmHg or on medication for treatment of hypertension Hemoglobin A1c ≥7% at screening Both Cohorts Participant is willing and able to provide informed consent for study participation Participant male or female ≥ 18 years of age Participant has CKD as defined by using CKD EPI for Stage II 60 to <90 mL/min/1.73 m2 or Stage III 30 to <60 mL/min/1.73 m2 UACR >150 mg/g and <5000 mg/g at screening Participant is clinically stable with respect to underlying renal impairment as assessed by the Investigator's medical evaluation Exclusion Criteria: Participant has positive drug test for drugs of abuse and/or positive alcohol breath test at screening and Day 1 Participant has a current diagnosis and/or is taking medication or diet control for diabetes (cohort I and II only) Participant has an A1c > 7% at screening (cohort I and II only) Participant received corticosteroid therapy within last 3 months Participant is unable or unwilling to comply with protocol requirements, including assessments, tests, and follow-up visits Participant has a history of significant allergic diathesis such as urticaria, angioedema, or anaphylaxis Participant has been previously diagnosed with kidney disease other than for hypertension, IgA or Diabetes Mellitus (Type II) Participant has hypotension as defined by systolic blood pressure ≤ 90 mmHg and diastolic blood pressure ≤ 60 mmHg at screen ACEi or GLP-1 medication prescribed for and taken by Participant (must not be taking for 5 half-lives prior to study drug administration and for 10 days post study drug administration) Participant has a current malignancy or active malignancy ≤ 2 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 ≥ 6 months have elapsed since the procedure Participant 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 with a completed therapy in the last 7 days prior to enrollment Participant has known medical history of alpha 1-antitrypsin deficiency (α1-antitrypsin deficiency) Participant is pregnant or nursing or is planning a pregnancy during the study period Participant 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 Participant has received any investigational drug or device within 14 days (or 5 half lives, whichever is longer) prior to study drug administration starting on Day 1 Participant has renal artery stenosis as determined at screen with medical history Participant received a kidney transplant Participant does not have adequate venous access for blood sampling Participant has any other medical condition which, in the opinion of the Investigator, will make participation medically unsafe or interfere with the study results Participant has any other clinically significant abnormalities in laboratory test results at screening that would, in the opinion of the Investigator, increase the Participant's risk of participation, jeopardize complete participation in the study, or compromise interpretation of study data Participant has any significant arrhythmia or conduction abnormality, which in the opinion of the Investigators and Medical Monitor may interfere with the safety of the Participant
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
Aventiv Research
City
Mesa
State/Province
Arizona
ZIP/Postal Code
85210
Country
United States
Facility Name
Amcis Research Center
City
Granada Hills
State/Province
California
ZIP/Postal Code
91334
Country
United States
Facility Name
IMD Clinical Trials Inc
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Facility Name
Amicis Reserch Center
City
Northridge
State/Province
California
ZIP/Postal Code
91324
Country
United States
Facility Name
Innovative Healthcare Institute
City
Coral Springs
State/Province
Florida
ZIP/Postal Code
33067
Country
United States
Facility Name
Elixia at Florida Kidney Physicians-SE
City
Fort Lauderdale
State/Province
Florida
ZIP/Postal Code
33308
Country
United States
Facility Name
Pines Clinical Research-Hollywood
City
Hollywood
State/Province
Florida
ZIP/Postal Code
33024
Country
United States
Facility Name
Elixia at Florida Kidney Physicians
City
Temple Terrace
State/Province
Florida
ZIP/Postal Code
33637
Country
United States
Facility Name
Boise Kidney & Hypertension Institute
City
Meridian
State/Province
Idaho
ZIP/Postal Code
83642
Country
United States
Facility Name
Research by Design LLC
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60643
Country
United States
Facility Name
New Orleans Center for Clinical Research, an AMR Company
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70119
Country
United States
Facility Name
Elixia At Clincal Renal Associates
City
Upland
State/Province
Pennsylvania
ZIP/Postal Code
19013
Country
United States
Facility Name
Nephrotex Research Group, LLC
City
Dallas
State/Province
Texas
ZIP/Postal Code
75231
Country
United States
Facility Name
RDRI
City
DeSoto
State/Province
Texas
ZIP/Postal Code
75115
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Multiple Doses of DM199 in Patients With Chronic Kidney Disease (REDUX)

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