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Randomized, Double-blind, Placebo-controlled, Crossover Study of Atrasentan in Subjects With IgA Nephropathy (ASSIST)

Primary Purpose

IgA Nephropathy, Immunoglobulin A Nephropathy

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Atrasentan
Atrasentan
Placebo
Sponsored by
Chinook Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for IgA Nephropathy focused on measuring Kidney Diseases, Kidney Disease, Chronic, Urologic Diseases, Glomerulonephritis, Glomerular Disease, Glomerulonephritis, IGA, Glomerulopathy, Immunoglobulin Disease

Eligibility Criteria

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

Inclusion Criteria: Subjects aged 18 and older at the time of signing the informed consent form (ICF) prior to initiation of any study specific activities/procedures. Biopsy-proven IgA nephropathy. Receiving a maximally tolerated and stable dose of RAS inhibitor therapy (ACEi or ARB) for at least 12 weeks prior to screening. Investigator discretion should be used in determining maximally tolerated and stable dose. eGFR of at least 30 mL/min/1.73 m2 at screening based on the CKD-EPI equation. Willing to agree to highly effective forms of contraception, as specified in the protocol, throughout the study and for up to 1 month afterward. In WOCBP, use of hormonal contraceptive agents must have been started at least 1 month prior to baseline. Willing and able to provide informed consent and comply with all study requirements. Inclusion Criteria for SGLT2i stable subjects Receiving a stable dose of an SGLT2i for at least 8 weeks prior to screening Must have a 24-hour urine protein of >0.5 grams/day. Inclusion Criteria for Run-In Subjects Must have a 24-hour total urine protein of >0.85 grams/day at screening Willing to participate in an 8-week run-in period with an SGLT2i (per Investigator choice) Additional Inclusion Criteria for Run-in Subjects at the end of Run-In Must have completed the 8-week run-in period on a stable and well tolerated dose of an SGLT2i Must have a 24-hour total urine protein of >0.5 grams/day confirmed at the Week -1 Visit Must have an eGFR of ≥ 30 mL/min/1.73 m2 based on the CKD-EPI equation at the Week -1 Visit Receiving treatment with SGLT2i at a stable dose for at least 8 weeks prior to screening. Exclusion Criteria: Current diagnosis with another chronic kidney disease, including diabetic kidney disease. History of kidney transplantation or other organ transplantation. Use of systemic immunosuppressant medications, such as steroids, for more than 2 weeks in the past 3 months. Blood pressure above 150 mmHg systolic or 95 mmHg diastolic as evaluated by the Investigator. Known history of heart failure or a previous hospital admission for fluid overload. Clinically significant history of liver disease as assessed by the Investigator. Hemoglobin below 9 g/dL as measured by the Investigator or prior history of blood transfusion for anemia within the past 3 months. Malignancy within the past 5 years. Exceptions to this criteria include nonmelanoma skin cancer and curatively treated cervical carcinoma in situ. For women, pregnancy, breast feeding, or intent to become pregnant during the study. and at least 1 month afterward. For men, intent to father a child or donate sperm during the study. Have received any investigational agent or approved treatment for IgAN (other than a RAS inhibitor) including SGLT2i (except for subjects in the SGLT2i stable stratum) within 1 month (or 5 half-lives of the agent, whichever is longer) prior to Screening. If the investigational agent is a cytotoxic or immunosuppressive agent then this washout period is 6 months.

Sites / Locations

  • University of North Carolina at Chapel Hill - Nephrology and HypertensionRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Sequence AB

Sequence BA

Arm Description

Once daily oral administration of 0.75 mg atrasentan for 12 weeks (Period A) followed by once daily oral administration of placebo for 24 weeks (Period B)

Once daily oral administration of placebo for 12 weeks (Period B) followed by once daily oral administration of 0.75 mg atrasentan for 24 weeks (Period A)

Outcomes

Primary Outcome Measures

Change in proteinuria
The change in urine protein: creatinine ratio (UPCR) from baseline to Week 12

Secondary Outcome Measures

Change in proteinuria at 24 weeks of treatment
The change in UPCR from baseline to Week 24

Full Information

First Posted
April 18, 2023
Last Updated
August 17, 2023
Sponsor
Chinook Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05834738
Brief Title
Randomized, Double-blind, Placebo-controlled, Crossover Study of Atrasentan in Subjects With IgA Nephropathy
Acronym
ASSIST
Official Title
A Randomized, Double-blind, Placebo-controlled, Crossover Study of Atrasentan in Subjects With IgA Nephropathy on Sodium-glucose Cotransporter-2 Inhibitors (SGLT2i)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 20, 2023 (Actual)
Primary Completion Date
October 1, 2025 (Anticipated)
Study Completion Date
October 1, 2025 (Anticipated)

3. Sponsor/Collaborators

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

4. Oversight

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

5. Study Description

Brief Summary
The ASSIST study is a phase 2, double-blind, placebo-controlled crossover study to evaluate the safety and efficacy of atrasentan vs. placebo in subjects with IgA nephropathy (IgAN) while on background standard of care therapy and an SGLT2 inhibitor (SGLT2i).
Detailed Description
Approximately 52 patients with biopsy-proven IgAN on a background SGLT2i and a maximally tolerated and stable dose of a renin-angiotensin system (RAS) inhibitor [such as angiotensin converting enzyme inhibitor (ACEi) or angiotensin-receptor antagonist (ARB)] as part of standard of care, will be randomized to either sequence AB or sequence BA in which they will receive 0.75 mg atrasentan once daily during one period (period A), complete a 12-week washout period, and then receive matching placebo during the other period (period B) as determined by the randomization schema. Subjects who are not on background SGLT2i therapy must be willing to undergo a run-in period of 8 weeks with an SGLT2i. The primary objective of the study is to evaluate the efficacy of atrasentan vs. placebo while on background therapy with SGLT2i. Subjects will have safety and efficacy assessments for 1 year (52 weeks).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
IgA Nephropathy, Immunoglobulin A Nephropathy
Keywords
Kidney Diseases, Kidney Disease, Chronic, Urologic Diseases, Glomerulonephritis, Glomerular Disease, Glomerulonephritis, IGA, Glomerulopathy, Immunoglobulin Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigator
Masking Description
Double-blind
Allocation
Randomized
Enrollment
52 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Sequence AB
Arm Type
Experimental
Arm Description
Once daily oral administration of 0.75 mg atrasentan for 12 weeks (Period A) followed by once daily oral administration of placebo for 24 weeks (Period B)
Arm Title
Sequence BA
Arm Type
Experimental
Arm Description
Once daily oral administration of placebo for 12 weeks (Period B) followed by once daily oral administration of 0.75 mg atrasentan for 24 weeks (Period A)
Intervention Type
Drug
Intervention Name(s)
Atrasentan
Other Intervention Name(s)
CHK-01, Atrasentan Hydrochloride, ABT-627
Intervention Description
Period A (12 Weeks) - Film-coated tablet, Washout Period: 12 weeks, Period B (24 Weeks) - Placebo
Intervention Type
Drug
Intervention Name(s)
Atrasentan
Other Intervention Name(s)
CHK-01, Atrasentan Hydrochloride, ABT-627
Intervention Description
Period B (12 Weeks) - Placebo, Washout Period: 12 weeks, Period A (24 Weeks) - Film-coated tablet
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo
Primary Outcome Measure Information:
Title
Change in proteinuria
Description
The change in urine protein: creatinine ratio (UPCR) from baseline to Week 12
Time Frame
Up to 12 weeks or approximately 3 months
Secondary Outcome Measure Information:
Title
Change in proteinuria at 24 weeks of treatment
Description
The change in UPCR from baseline to Week 24
Time Frame
24 weeks or approximately 6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects aged 18 and older at the time of signing the informed consent form (ICF) prior to initiation of any study specific activities/procedures. Biopsy-proven IgA nephropathy. Receiving a maximally tolerated and stable dose of RAS inhibitor therapy (ACEi or ARB) for at least 12 weeks prior to screening. Investigator discretion should be used in determining maximally tolerated and stable dose. eGFR of at least 30 mL/min/1.73 m2 at screening based on the CKD-EPI equation. Willing to agree to highly effective forms of contraception, as specified in the protocol, throughout the study and for up to 1 month afterward. In WOCBP, use of hormonal contraceptive agents must have been started at least 1 month prior to baseline. Willing and able to provide informed consent and comply with all study requirements. Inclusion Criteria for SGLT2i stable subjects Receiving a stable dose of an SGLT2i for at least 8 weeks prior to screening Must have a 24-hour urine protein of >0.5 grams/day. Inclusion Criteria for Run-In Subjects Must have a 24-hour total urine protein of >0.85 grams/day at screening Willing to participate in an 8-week run-in period with an SGLT2i (per Investigator choice) Additional Inclusion Criteria for Run-in Subjects at the end of Run-In Must have completed the 8-week run-in period on a stable and well tolerated dose of an SGLT2i Must have a 24-hour total urine protein of >0.5 grams/day confirmed at the Week -1 Visit Must have an eGFR of ≥ 30 mL/min/1.73 m2 based on the CKD-EPI equation at the Week -1 Visit Receiving treatment with SGLT2i at a stable dose for at least 8 weeks prior to screening. Exclusion Criteria: Current diagnosis with another chronic kidney disease, including diabetic kidney disease. History of kidney transplantation or other organ transplantation. Use of systemic immunosuppressant medications, such as steroids, for more than 2 weeks in the past 3 months. Blood pressure above 150 mmHg systolic or 95 mmHg diastolic as evaluated by the Investigator. Known history of heart failure or a previous hospital admission for fluid overload. Clinically significant history of liver disease as assessed by the Investigator. Hemoglobin below 9 g/dL as measured by the Investigator or prior history of blood transfusion for anemia within the past 3 months. Malignancy within the past 5 years. Exceptions to this criteria include nonmelanoma skin cancer and curatively treated cervical carcinoma in situ. For women, pregnancy, breast feeding, or intent to become pregnant during the study. and at least 1 month afterward. For men, intent to father a child or donate sperm during the study. Have received any investigational agent or approved treatment for IgAN (other than a RAS inhibitor) including SGLT2i (except for subjects in the SGLT2i stable stratum) within 1 month (or 5 half-lives of the agent, whichever is longer) prior to Screening. If the investigational agent is a cytotoxic or immunosuppressive agent then this washout period is 6 months.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Chinook Therapeutics
Phone
2064857051
Email
clinicaltrials@chinooktx.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Charlotte Jones-Burton, MD, MS
Organizational Affiliation
SVP, Product Development & Strategy
Official's Role
Study Director
Facility Information:
Facility Name
University of North Carolina at Chapel Hill - Nephrology and Hypertension
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Anne Froment
Phone
919-966-4131
Email
anne_froment@med.unc.edu
First Name & Middle Initial & Last Name & Degree
Amy Mottl

12. IPD Sharing Statement

Learn more about this trial

Randomized, Double-blind, Placebo-controlled, Crossover Study of Atrasentan in Subjects With IgA Nephropathy

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