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Safety and Effectiveness of Propagermanium in Focal Segmental Glomerulosclerosis Participants Receiving Irbesartan (ACTION)

Primary Purpose

Focal Segmental Glomerulosclerosis

Status
Completed
Phase
Phase 2
Locations
Australia
Study Type
Interventional
Intervention
Propagermanium
Placebo
Sponsored by
Dimerix Bioscience Pty Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Focal Segmental Glomerulosclerosis

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Aged 18 to 80 (inclusive) at screening;
  2. A diagnosis of primary FSGS confirmed by renal biopsy;
  3. Must be receiving a stable dose of 300 mg daily dose of irbesartan (in any marketed formulation) for at least 3 months prior to screening, and have no plan to change treatment regime throughout the study;
  4. Patients can be on stable doses of angiotensin converting enzyme inhibitors, aldosterone inhibitors, direct renin inhibitor and/or sodium-glucose co-transporter- 2 inhibitors. However, the dose and regimen must be stable for 3 months prior to screening and must have no plan to change treatment regime throughout the study.
  5. If taking immunosuppressive medications (except for rituximab or cyclophosphamide), must have a stable treatment regime for 3 months prior to screening and do not have plans to alter the regimen except to maintain therapeutic immunosuppression or in the event of adverse events. Patients who have received rituximab or cyclophosphamide must have ceased treatment for at least 6 months prior to screening;
  6. Mean of two protein/creatinine ratio values (screening and baseline) of ≥ 1326 mg/g (150 mg/mmol), and within ± 30% of the screening value at the baseline assessment;
  7. Estimated glomerular filtration rate ≥ 25 mL/min/1.73 m^2 using chronic kidney disease epidemiology collaboration (CKD-EPI) formula at screening;
  8. Serum potassium levels (screening and baseline) < 5.5 mmol/L. If either value is 5.5 or above, the patient may receive dietary advice and be retested 1 week later;
  9. A female patient is eligible to participate if she is not pregnant, not breastfeeding, and at least 1 of the following conditions applies:

    • Not of childbearing potential, defined as surgically sterile (documented hysterectomy, bilateral salpingectomy or bilateral oophorectomy) or postmenopausal (no menses for 12 months without an alternative medical cause. A high follicle stimulating hormone [FSH] level in the postmenopausal range may be used to confirm a postmenopausal state in women not using hormonal contraception or hormonal replacement therapy; however, in the absence of 12 months of amenorrhea, a single FSH measurement is insufficient.);
    • Of childbearing potential and agrees to use a highly effective method of contraception consistently during the treatment period and for at least 60 days after the last dose of investigational product;
  10. A male patient with a female partner of childbearing potential is eligible to participate if he agrees to use acceptable contraception during the treatment period and for at least 60 days after the last dose of investigational product and refrains from donating sperm during this period;
  11. Have given written informed consent prior to any study procedures being performed.

Exclusion Criteria:

  1. Has FSGS secondary to another condition;
  2. A history of type 1 diabetes mellitus, diagnosis of type 2 diabetes mellitus prior to FSGS positive renal biopsy, or non-fasting blood glucose > 180 mg/dL (10 mmol/L) at screening;
  3. A prior kidney organ or stem cell transplant;
  4. A major adverse cardiac event within 6 months before screening;
  5. Lymphoma, leukaemia, or any malignancy within the past 5 years except for basal cell or squamous cell carcinomas of the skin or cervical carcinoma in situ that have been resected with no evidence of metastatic disease for 3 years;
  6. Jaundice, active hepatitis, or known hepatobiliary disease (except asymptomatic cholelithiasis);
  7. Alanine aminotransferase and/or aspartate aminotransferase more than two times the upper limit of normal at screening;
  8. Participation in any clinical study with an experimental medication or device within 90 days or 5 half-lives (whichever is longer) of screening or have previously participated in a study involving propagermanium;
  9. Positive screening assessment for viral hepatitis B surface antigen or hepatitis C virus (HCV) antibody AND positive HCV RNA or human immunodeficiency virus (HIV), or a history of illicit drug injecting;
  10. Seated blood pressure of ≥ 160/100 mmHg at screening;
  11. Body mass index ≥ 35 kg/m^2 at screening;
  12. Past hospitalisation for a major depressive episode;
  13. Is breast feeding or pregnant;
  14. Unable to comply with the study procedures and assessments, including the ability swallow capsules;
  15. Any other disease, physical or psychological condition that the investigator or sponsor believes may contraindicate the use of the investigational medicinal product or affect the interpretation of study results or render the patient at high risk from treatment complications;
  16. Are investigator site personnel directly affiliated with this study and their immediate families. Immediate family is defined as a spouse, parent, child or sibling, whether biological or legally adopted.

Sites / Locations

  • Renal Research
  • Liverpool Hospital
  • Royal North Shore Hospital
  • Westmead
  • Sunshine Coast University Hospital
  • Princess Alexandra Hospital
  • Box Hill Hospital
  • Austion Hospital
  • Sunshine Hospital
  • Melbourne Renal Research Group
  • Epworth Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Propagermanium then Placebo

Placebo then Propagermanium

Arm Description

Propagermanium one capsule orally twice daily for 16 weeks. Compliance will be measured by drug accountability and completion of a participant diary. Participants will receive 16 weeks propagermanium and 16 weeks placebo separated by a 6 week washout period.

Propagermanium one capsule orally twice daily for 16 weeks. Compliance will be measured by drug accountability and completion of a participant diary. Participants will receive 16 weeks placebo and 16 weeks propagermanium separated by a 6 week washout period.

Outcomes

Primary Outcome Measures

The Number of Adverse Events with the Adjunct use of Propagermanium Compared to Placebo in Participants with FSGS who are Receiving Irbesartan
Assessed by monitoring of adverse events

Secondary Outcome Measures

The Frequency of Proteinuria-Based Responses to Treatment Compared to Placebo
Assessed by testing a 24-hour urine sample.

Full Information

First Posted
August 7, 2018
Last Updated
July 28, 2022
Sponsor
Dimerix Bioscience Pty Ltd
Collaborators
Iqvia Pty Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT03649152
Brief Title
Safety and Effectiveness of Propagermanium in Focal Segmental Glomerulosclerosis Participants Receiving Irbesartan
Acronym
ACTION
Official Title
A Phase 2a, Double-Blind, Randomized, Placebo-Controlled, Crossover Study Evaluating the Safety and Efficacy of Propagermanium in Patients With Primary Focal Segmental Glomerulosclerosis (FSGS) Who Are Receiving Irbesartan
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Completed
Study Start Date
November 8, 2018 (Actual)
Primary Completion Date
June 16, 2020 (Actual)
Study Completion Date
July 13, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Dimerix Bioscience Pty Ltd
Collaborators
Iqvia Pty Ltd

4. Oversight

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

5. Study Description

Brief Summary
This study will be evaluating the safety and efficacy of propagermanium for the treatment of participants with FSGS who are already taking irbesartan by: monitoring symptoms that participants may experience while on the study, measuring levels of protein in participant's urine and kidney function during the course of the study, measuring the levels of propagermanium and irbesartan that enters into participant's urine and blood, and comparing the propagermanium outcomes to participants' pre-study and placebo outcomes. Eligible participants will randomly be assigned to one of two arms to receive both the propagermanium and placebo in different orders as follows, either: Treatment Period 1 taking a propagermanium capsule twice a day for 16 weeks, followed by a six week washout period followed by Treatment Period 2 taking a placebo capsule twice a day for 16 weeks. OR Treatment Period 1 taking a placebo capsule twice a day for 16 weeks, followed by a six week washout period followed by Treatment Period 2 taking a propagermanium capsule twice a day for 16 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Focal Segmental Glomerulosclerosis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Model Description
Double-blind, Randomised, Placebo-Controlled, Crossover Study
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
8 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Propagermanium then Placebo
Arm Type
Experimental
Arm Description
Propagermanium one capsule orally twice daily for 16 weeks. Compliance will be measured by drug accountability and completion of a participant diary. Participants will receive 16 weeks propagermanium and 16 weeks placebo separated by a 6 week washout period.
Arm Title
Placebo then Propagermanium
Arm Type
Experimental
Arm Description
Propagermanium one capsule orally twice daily for 16 weeks. Compliance will be measured by drug accountability and completion of a participant diary. Participants will receive 16 weeks placebo and 16 weeks propagermanium separated by a 6 week washout period.
Intervention Type
Drug
Intervention Name(s)
Propagermanium
Other Intervention Name(s)
PPG, repagermanium, DMX-200
Intervention Description
Immediate release capsule
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo capsule
Primary Outcome Measure Information:
Title
The Number of Adverse Events with the Adjunct use of Propagermanium Compared to Placebo in Participants with FSGS who are Receiving Irbesartan
Description
Assessed by monitoring of adverse events
Time Frame
Sixteen weeks
Secondary Outcome Measure Information:
Title
The Frequency of Proteinuria-Based Responses to Treatment Compared to Placebo
Description
Assessed by testing a 24-hour urine sample.
Time Frame
Sixteen weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Aged 18 to 80 (inclusive) at screening; A diagnosis of primary FSGS confirmed by renal biopsy; Must be receiving a stable dose of 300 mg daily dose of irbesartan (in any marketed formulation) for at least 3 months prior to screening, and have no plan to change treatment regime throughout the study; Patients can be on stable doses of angiotensin converting enzyme inhibitors, aldosterone inhibitors, direct renin inhibitor and/or sodium-glucose co-transporter- 2 inhibitors. However, the dose and regimen must be stable for 3 months prior to screening and must have no plan to change treatment regime throughout the study. If taking immunosuppressive medications (except for rituximab or cyclophosphamide), must have a stable treatment regime for 3 months prior to screening and do not have plans to alter the regimen except to maintain therapeutic immunosuppression or in the event of adverse events. Patients who have received rituximab or cyclophosphamide must have ceased treatment for at least 6 months prior to screening; Mean of two protein/creatinine ratio values (screening and baseline) of ≥ 1326 mg/g (150 mg/mmol), and within ± 30% of the screening value at the baseline assessment; Estimated glomerular filtration rate ≥ 25 mL/min/1.73 m^2 using chronic kidney disease epidemiology collaboration (CKD-EPI) formula at screening; Serum potassium levels (screening and baseline) < 5.5 mmol/L. If either value is 5.5 or above, the patient may receive dietary advice and be retested 1 week later; A female patient is eligible to participate if she is not pregnant, not breastfeeding, and at least 1 of the following conditions applies: Not of childbearing potential, defined as surgically sterile (documented hysterectomy, bilateral salpingectomy or bilateral oophorectomy) or postmenopausal (no menses for 12 months without an alternative medical cause. A high follicle stimulating hormone [FSH] level in the postmenopausal range may be used to confirm a postmenopausal state in women not using hormonal contraception or hormonal replacement therapy; however, in the absence of 12 months of amenorrhea, a single FSH measurement is insufficient.); Of childbearing potential and agrees to use a highly effective method of contraception consistently during the treatment period and for at least 60 days after the last dose of investigational product; A male patient with a female partner of childbearing potential is eligible to participate if he agrees to use acceptable contraception during the treatment period and for at least 60 days after the last dose of investigational product and refrains from donating sperm during this period; Have given written informed consent prior to any study procedures being performed. Exclusion Criteria: Has FSGS secondary to another condition; A history of type 1 diabetes mellitus, diagnosis of type 2 diabetes mellitus prior to FSGS positive renal biopsy, or non-fasting blood glucose > 180 mg/dL (10 mmol/L) at screening; A prior kidney organ or stem cell transplant; A major adverse cardiac event within 6 months before screening; Lymphoma, leukaemia, or any malignancy within the past 5 years except for basal cell or squamous cell carcinomas of the skin or cervical carcinoma in situ that have been resected with no evidence of metastatic disease for 3 years; Jaundice, active hepatitis, or known hepatobiliary disease (except asymptomatic cholelithiasis); Alanine aminotransferase and/or aspartate aminotransferase more than two times the upper limit of normal at screening; Participation in any clinical study with an experimental medication or device within 90 days or 5 half-lives (whichever is longer) of screening or have previously participated in a study involving propagermanium; Positive screening assessment for viral hepatitis B surface antigen or hepatitis C virus (HCV) antibody AND positive HCV RNA or human immunodeficiency virus (HIV), or a history of illicit drug injecting; Seated blood pressure of ≥ 160/100 mmHg at screening; Body mass index ≥ 35 kg/m^2 at screening; Past hospitalisation for a major depressive episode; Is breast feeding or pregnant; Unable to comply with the study procedures and assessments, including the ability swallow capsules; Any other disease, physical or psychological condition that the investigator or sponsor believes may contraindicate the use of the investigational medicinal product or affect the interpretation of study results or render the patient at high risk from treatment complications; Are investigator site personnel directly affiliated with this study and their immediate families. Immediate family is defined as a spouse, parent, child or sibling, whether biological or legally adopted.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Simon Roger, MD
Organizational Affiliation
Renal Research
Official's Role
Principal Investigator
Facility Information:
Facility Name
Renal Research
City
Gosford
State/Province
New South Wales
ZIP/Postal Code
2250
Country
Australia
Facility Name
Liverpool Hospital
City
Liverpool
State/Province
New South Wales
ZIP/Postal Code
2170
Country
Australia
Facility Name
Royal North Shore Hospital
City
St Leonards
State/Province
New South Wales
ZIP/Postal Code
2065
Country
Australia
Facility Name
Westmead
City
Westmead
State/Province
New South Wales
ZIP/Postal Code
2145
Country
Australia
Facility Name
Sunshine Coast University Hospital
City
Birtinya
State/Province
Queensland
ZIP/Postal Code
4575
Country
Australia
Facility Name
Princess Alexandra Hospital
City
Woolloongabba
State/Province
Queensland
ZIP/Postal Code
4102
Country
Australia
Facility Name
Box Hill Hospital
City
Box Hill
State/Province
Victoria
ZIP/Postal Code
3128
Country
Australia
Facility Name
Austion Hospital
City
Heidelberg
State/Province
Victoria
ZIP/Postal Code
3084
Country
Australia
Facility Name
Sunshine Hospital
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3021
Country
Australia
Facility Name
Melbourne Renal Research Group
City
Melbourne
State/Province
Victoria
Country
Australia
Facility Name
Epworth Hospital
City
Richmond
State/Province
Victoria
ZIP/Postal Code
3121
Country
Australia

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
35224732
Citation
Hodson EM, Sinha A, Cooper TE. Interventions for focal segmental glomerulosclerosis in adults. Cochrane Database Syst Rev. 2022 Feb 28;2(2):CD003233. doi: 10.1002/14651858.CD003233.pub3.
Results Reference
derived

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Safety and Effectiveness of Propagermanium in Focal Segmental Glomerulosclerosis Participants Receiving Irbesartan

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