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Sitaxsentan in Proteinuric Chronic Kidney Disease

Primary Purpose

Chronic Kidney Disease, Proteinuria, Blood Pressure

Status
Unknown status
Phase
Phase 2
Locations
United Kingdom
Study Type
Interventional
Intervention
Sitaxsentan
Nifedipine
Placebo tablet
Sponsored by
University of Edinburgh
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Kidney Disease focused on measuring Chronic kidney disease, Proteinuria, Blood pressure, Arterial stiffness, Endothelin antagonist, Sitaxsentan

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Has Stage 1-5 chronic kidney disease (CKD) as defined by the Kidney Disease Outcomes Quality Initiative (using the Cockcroft and Gault equation for calculation of glomerular filtration rate) with proteinuria, including any of the following aetiologies: immunoglobulin A (IgA) nephropathy, polycystic kidney disease (PCKD), congenital abnormalities, reflux nephropathy, focal segmental glomerulosclerosis, minimal change nephropathy, and membranous nephropathy.
  2. Is between 18 and 70 years of age, inclusive.
  3. Has a body mass index (BMI) between 18 and 35 kg/m2, inclusive.
  4. Is willing and able to adhere to the protocol requirements.
  5. Provides written informed consent before any study procedure is performed.

Exclusion Criteria:

  1. Requires peritoneal dialysis or haemodialysis.
  2. Has kidney disease due to diabetes mellitus, vasculitis, systemic lupus erythematosus, or known renovascular disease; antiglomerular basement membrane disease; or is on immunosuppressive medication.
  3. Has a serum albumin in the nephrotic range (< 30 g/L) during Screening.
  4. Has a sustained sitting systolic blood pressure (BP) > 160 mmHg or sustained sitting diastolic BP > 100 mmHg during Screening.
  5. Has postural hypotension during Screening, which is defined as a decrease in systolic BP ≥ 20 mmHg and/or a decrease in diastolic BP ≥ 10 mmHg, comparing sitting and standing measurements.
  6. Has a history and/or evidence of ischaemic heart disease.
  7. Has or had a malignancy, with the exception of adequately-treated basal cell or squamous cell carcinoma of the skin, that required significant medical intervention within the past 3 months and/or is likely to result in death within the next 2 years.
  8. Has a history of allergies or hypersensitivity to sitaxsentan or nifedipine or the excipients of either drug.
  9. Has a clinically significant psychiatric, addictive, neurological disease or any other condition that, in the Investigator's opinion, would compromise his/her ability to give informed consent, participate fully in this study, prevent adherence to the requirements of the study protocol, or would compromise the interpretation of the data obtained from this study.
  10. Uses a prohibited medication or plans to use a prohibited medication during the study.

    • Prohibited medications include cyclosporine A, alternative endothelin (ET) receptor antagonists, phosphodiesterase inhibitors, and/or vitamin K antagonists (e.g., warfarin). The intermittent use of phosphodiesterase inhibitors (e.g., sildenafil) "as needed" for erectile dysfunction is acceptable, however, as long as the subject is not dosed within 24 hours of an efficacy assessment.
  11. Received treatment with an investigational drug or device within 30 days prior to study entry.
  12. Has a history of organ transplantation.
  13. Has atrial fibrillation requiring anticoagulation or a history (in the preceding 6 months) of any intermittent cardiac dysrhythmia that may require anticoagulation therapy.
  14. Has an alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) level > 1.5 × the upper limit of the normal range (ULN) at Screening and/or serum total bilirubin > ULN.
  15. Has a haemoglobin concentration < 8.0 mg/dL at Screening.
  16. Has positive serological results for hepatitis B and/or hepatitis C.
  17. Is a woman of childbearing potential who is unwilling to use 2 forms of contraceptive therapy, including at least 1 barrier method, throughout the study. (Women who are surgically sterile or who are post-menopausal for at least 2 years are not considered to be of childbearing potential.)
  18. Is pregnant, lactating, or breastfeeding.
  19. Has, in the opinion of the Investigator, a dependence on alcohol.
  20. Has, in the opinion of the Investigator, a dependence on illicit drugs.

Sites / Locations

  • Clinical Research Centre, Western General Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Placebo Comparator

Active Comparator

Arm Label

Sitaxsentan

Placebo

Nifedipine

Arm Description

Once daily oral sitaxsentan 100mg given over a period of 6 weeks. 24hr proteinuria, 24hr blood pressure and arterial stiffness measured at day 1, week 3 and week 6 of treatment

Once daily oral placebo tablet given over a period of 6 weeks. 24hr proteinuria, 24hr blood pressure and arterial stiffness measured at day 1, week 3 and week 6 of treatment

Open labeled active comparator Once daily oral nifedipine 30mg given over a period of 6 weeks. 24hr proteinuria, 24hr blood pressure and arterial stiffness measured at day 1, week 3 and week 6 of treatment

Outcomes

Primary Outcome Measures

The principal objective of this study is to evaluate whether sitaxsentan reduces proteinuria in people with chronic kidney disease.

Secondary Outcome Measures

Secondary objective of this study is to evaluate whether sitaxsentan reduces systemic blood pressure in people with chronic kidney disease.
Secondary objective is to determine whether sitaxsentan improves indices of arterial stiffness in people with chronic kidney disease
Secondary objectives is to determine the safety of sitaxsentan in chronic kidney disease

Full Information

First Posted
January 5, 2009
Last Updated
January 5, 2009
Sponsor
University of Edinburgh
Collaborators
Encysive Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT00817037
Brief Title
Sitaxsentan in Proteinuric Chronic Kidney Disease
Official Title
The Effect of Sitaxsentan Once Daily Dosing on Proteinuria, 24-Hour Systemic Blood Pressure, and Arterial Stiffness in Subjects With Chronic Kidney Disease
Study Type
Interventional

2. Study Status

Record Verification Date
January 2009
Overall Recruitment Status
Unknown status
Study Start Date
May 2007 (undefined)
Primary Completion Date
March 2009 (Anticipated)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
University of Edinburgh
Collaborators
Encysive Pharmaceuticals

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Patients with chronic kidney disease (CKD) have higher blood pressures than the general population. They also tend to have protein leaking into the urine (proteinuria). CKD, high blood pressure and proteinuria independently and together increase the risk of developing atherosclerosis (hardening) of the arteries that leads to diseases such as heart attack and stroke. Although there are a number of drugs available that lower blood pressure, these are not always fully effective. Furthermore, there are even fewer drugs that simultaneously lower blood pressure, reduce proteinuria, and slow down kidney damage in CKD. Recent research has shown that drugs like sitaxsentan not only lower blood pressure but also reduce proteinuria and potentially slow down the progression of CKD [1,2]. Before sitaxsentan can become freely available to individuals with CKD it is important to look at the effects this drug could have on proteinuria and blood pressure. Goddard J, Johnston NR, Hand MF, et al. Endothelin-A receptor antagonism reduces blood pressure and increases renal blood flow in hypertensive patients with chronic renal failure: a comparison of selective and combined endothelin receptor blockade. Circulation 2004;109:1186-1193. Krum H, Viskoper RJ, Lacourciere Y et al. The effect of an endothelin receptor antagonist, bosentan, on blood pressure in patients with essential hypertension. New Engl J Med 1998;338:784-790.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Kidney Disease, Proteinuria, Blood Pressure
Keywords
Chronic kidney disease, Proteinuria, Blood pressure, Arterial stiffness, Endothelin antagonist, Sitaxsentan

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
27 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Sitaxsentan
Arm Type
Experimental
Arm Description
Once daily oral sitaxsentan 100mg given over a period of 6 weeks. 24hr proteinuria, 24hr blood pressure and arterial stiffness measured at day 1, week 3 and week 6 of treatment
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Once daily oral placebo tablet given over a period of 6 weeks. 24hr proteinuria, 24hr blood pressure and arterial stiffness measured at day 1, week 3 and week 6 of treatment
Arm Title
Nifedipine
Arm Type
Active Comparator
Arm Description
Open labeled active comparator Once daily oral nifedipine 30mg given over a period of 6 weeks. 24hr proteinuria, 24hr blood pressure and arterial stiffness measured at day 1, week 3 and week 6 of treatment
Intervention Type
Drug
Intervention Name(s)
Sitaxsentan
Other Intervention Name(s)
Thelin
Intervention Description
Sitaxsentan 100mg once daily oral dosing for 6 weeks
Intervention Type
Drug
Intervention Name(s)
Nifedipine
Other Intervention Name(s)
Adalat LA
Intervention Description
Nifedipine 30mg once daily oral dosing for 6 weeks
Intervention Type
Drug
Intervention Name(s)
Placebo tablet
Intervention Description
Placebo tablet once daily oral dosing for 6 weeks
Primary Outcome Measure Information:
Title
The principal objective of this study is to evaluate whether sitaxsentan reduces proteinuria in people with chronic kidney disease.
Time Frame
6 Weeks
Secondary Outcome Measure Information:
Title
Secondary objective of this study is to evaluate whether sitaxsentan reduces systemic blood pressure in people with chronic kidney disease.
Time Frame
6 weeks
Title
Secondary objective is to determine whether sitaxsentan improves indices of arterial stiffness in people with chronic kidney disease
Time Frame
6 weeks
Title
Secondary objectives is to determine the safety of sitaxsentan in chronic kidney disease
Time Frame
6 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Has Stage 1-5 chronic kidney disease (CKD) as defined by the Kidney Disease Outcomes Quality Initiative (using the Cockcroft and Gault equation for calculation of glomerular filtration rate) with proteinuria, including any of the following aetiologies: immunoglobulin A (IgA) nephropathy, polycystic kidney disease (PCKD), congenital abnormalities, reflux nephropathy, focal segmental glomerulosclerosis, minimal change nephropathy, and membranous nephropathy. Is between 18 and 70 years of age, inclusive. Has a body mass index (BMI) between 18 and 35 kg/m2, inclusive. Is willing and able to adhere to the protocol requirements. Provides written informed consent before any study procedure is performed. Exclusion Criteria: Requires peritoneal dialysis or haemodialysis. Has kidney disease due to diabetes mellitus, vasculitis, systemic lupus erythematosus, or known renovascular disease; antiglomerular basement membrane disease; or is on immunosuppressive medication. Has a serum albumin in the nephrotic range (< 30 g/L) during Screening. Has a sustained sitting systolic blood pressure (BP) > 160 mmHg or sustained sitting diastolic BP > 100 mmHg during Screening. Has postural hypotension during Screening, which is defined as a decrease in systolic BP ≥ 20 mmHg and/or a decrease in diastolic BP ≥ 10 mmHg, comparing sitting and standing measurements. Has a history and/or evidence of ischaemic heart disease. Has or had a malignancy, with the exception of adequately-treated basal cell or squamous cell carcinoma of the skin, that required significant medical intervention within the past 3 months and/or is likely to result in death within the next 2 years. Has a history of allergies or hypersensitivity to sitaxsentan or nifedipine or the excipients of either drug. Has a clinically significant psychiatric, addictive, neurological disease or any other condition that, in the Investigator's opinion, would compromise his/her ability to give informed consent, participate fully in this study, prevent adherence to the requirements of the study protocol, or would compromise the interpretation of the data obtained from this study. Uses a prohibited medication or plans to use a prohibited medication during the study. Prohibited medications include cyclosporine A, alternative endothelin (ET) receptor antagonists, phosphodiesterase inhibitors, and/or vitamin K antagonists (e.g., warfarin). The intermittent use of phosphodiesterase inhibitors (e.g., sildenafil) "as needed" for erectile dysfunction is acceptable, however, as long as the subject is not dosed within 24 hours of an efficacy assessment. Received treatment with an investigational drug or device within 30 days prior to study entry. Has a history of organ transplantation. Has atrial fibrillation requiring anticoagulation or a history (in the preceding 6 months) of any intermittent cardiac dysrhythmia that may require anticoagulation therapy. Has an alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) level > 1.5 × the upper limit of the normal range (ULN) at Screening and/or serum total bilirubin > ULN. Has a haemoglobin concentration < 8.0 mg/dL at Screening. Has positive serological results for hepatitis B and/or hepatitis C. Is a woman of childbearing potential who is unwilling to use 2 forms of contraceptive therapy, including at least 1 barrier method, throughout the study. (Women who are surgically sterile or who are post-menopausal for at least 2 years are not considered to be of childbearing potential.) Is pregnant, lactating, or breastfeeding. Has, in the opinion of the Investigator, a dependence on alcohol. Has, in the opinion of the Investigator, a dependence on illicit drugs.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Webb, MD DSc FRCP FRSE FMedSci
Organizational Affiliation
University of Edinburgh
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Neeraj Dhaun, MBChB
Organizational Affiliation
University of Edinburgh
Official's Role
Principal Investigator
Facility Information:
Facility Name
Clinical Research Centre, Western General Hospital
City
Edinburgh
State/Province
Scotland
ZIP/Postal Code
EH4 2XU
Country
United Kingdom

12. IPD Sharing Statement

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Sitaxsentan in Proteinuric Chronic Kidney Disease

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