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Vascular Impact of Dapagliflozin in CKD Patients (DAPAVASC) (DAPAVASC)

Primary Purpose

Renal Insufficiency, Chronic

Status
Unknown status
Phase
Phase 2
Locations
France
Study Type
Interventional
Intervention
Dapagliflozin 10Mg Tab
Placebo
impedance cardiography
Applanation tonometry
post-ischemic hyperemia of forearm
haemodynamics parameters
Sponsored by
University Hospital, Rouen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Renal Insufficiency, Chronic

Eligibility Criteria

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

Inclusion Criteria:

  • Chronic kidney disease (eGFR ≥25 and ≤60 mL/min/1.73m² by CKD-EPI)
  • Age ≥ 18 years
  • Receiving a stable dose of an ACE inhibitor or ARB for at least 12 weeks before screening or patients who were documented to be intolerant to ACE inhibitors or ARBs

Exclusion Criteria:

  • Type 1 and type 2 diabetes (fasting glycemia≥126 mg/dL or use of oral hypoglycemic agents or insulin)
  • Recessive or autosomal dominant polycystic kidney disease
  • Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis
  • Lupus nephritis
  • Receiving cytotoxic therapy, immunosuppressive therapy or other immunotherapy for primary or secondary renal disease within 6 months prior to enrolment
  • History of organ transplantation
  • Body weight > 35 kg/m²
  • Receiving therapy with a sodium glucose co-transporter 2 (SGLT2) inhibitor within 8 weeks prior to enrolment or previous intolerance of an SGLT2 inhibitor
  • Patients with NYHA class IV congestive heart failure at the time of enrolment
  • Myocardial infarction, unstable angina, stroke or transient ischemic attack (TIA) within 12 weeks prior to enrolment
  • Coronary revascularization (percutaneous coronary intervention or coronary artery bypass grafting) or valvular repair/replacement within 12 weeks prior to enrolment or is planned to undergo any of these procedures after randomization
  • Active malignancy requiring treatment at the time of enrolment or is planned to undergo any treatment after randomization
  • Severe hepatic impairment (Child-Pugh class C)
  • History of frequent genital mycotic infections (>2)
  • Current pregnancy OR women of child-bearing potential (ie, those who are not chemically or surgically sterilized or who are not post-menopausal) who are not willing to use a medically accepted method of contraception that is considered reliable in the judgment of the investigator OR women who have a positive pregnancy test at enrolment or exploration visits OR women who are breast-feeding
  • Contraindications to use glyceryl trinitrate (in particular allergy to nitrates or concomitant use of vasodilators)
  • Participation in another clinical study with an investigational product during the last month prior to enrolment
  • Inability of the patient, in the opinion of the investigator, to understand and/or comply with procedures and/or follow-up OR any conditions that, in the opinion of the investigator, may render the patient unable to complete the study.

Sites / Locations

  • Department of Nephrology
  • Department of Pharmacology

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Dapagliflozin 10Mg Tab

Placebo

Arm Description

Dapagliflozin 10 mg film-coated tablets

Identical film-coated tablets without dapagliflozin

Outcomes

Primary Outcome Measures

Change from baseline of brachial artery endothelial function using echography
Change in brachial artery flow-mediated dilatation in response to post-ischemia hyperemia using difference of brachial artery diameter

Secondary Outcome Measures

Change from baseline of arterial stiffness using applanation tonometry
Change in carotid-to-femoral pulse wave velocity
Change from baseline of carotid artery geometry using echography (1)
Change in carotid diastolic diameter
Change from baseline of carotid artery geometry using echography (2)
Change in carotid intima-media thickness using echography
Change from baseline of cardiac function by impedance cardiography (1)
Change in cardiac output
Change from baseline of cardiac function by impedance cardiography (2)
Change in stroke volume
Change from baseline of cardiac function by impedance cardiography (3)
Change in ejection fraction
Change from baseline of cardiac function by impedance cardiography (4)
Change in end-diastolic volume
Change from baseline of cardiac function by impedance cardiography (5)
Change in total peripheral resistance,
Change from baseline of cardiac function by impedance cardiography (6)
Change in left ventricular end-systolic elastance
Change from baseline of epoxyeicosatrienoic acid bioavailability
Change in epoxyeicosatroenoic acid bioavailibility during heating
Change from baseline of plasma NO bioavailability
Change in plasma nitrite bioavailibility during heating

Full Information

First Posted
June 3, 2021
Last Updated
October 19, 2021
Sponsor
University Hospital, Rouen
Collaborators
AstraZeneca
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1. Study Identification

Unique Protocol Identification Number
NCT04930549
Brief Title
Vascular Impact of Dapagliflozin in CKD Patients (DAPAVASC)
Acronym
DAPAVASC
Official Title
Impact of Dapagliflozin on Vascular Function in Chronic Kidney Disease Patients
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Unknown status
Study Start Date
December 2021 (Anticipated)
Primary Completion Date
December 31, 2022 (Anticipated)
Study Completion Date
March 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Hospital, Rouen
Collaborators
AstraZeneca

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study aims to determine whether dapaglfiflozin 12-week administration is associated with a beneficial impact on the vasculature of patients with chronic kidney disease.
Detailed Description
A prospective, randomized, double-blind studies evaluating the impact of once-daily dapagliflozin 10 mg versus placebo for 12 weeks on endothelial function, as primary endpoint, will be conducted in 56 patients with chronic kidney disease (eGFR ≥25 and ≤60 mL/min/1.73m2 by CKD-EPI) and without diabetes (fasting glycemia≥1.26 mg/dL, oral hypoglycemic agents or insulin) on top of standard treatment (n=27 per group). Indexes of arterial stiffness, cardiovascular coupling, cardiac function and plasma concentrations of endothelial, inflammatory and oxidative stress biomarkers will be assessed as secondary endpoints. Patients will be recruited in the Departments of Cardiology and Nephrology of Rouen University Hospital. The study will include an inclusion visit (V1), 2 exploration visits performed before (V2) and 12 weeks (V3) after treatment initiation, and 1 output study (V4).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Renal Insufficiency, Chronic

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
54 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Dapagliflozin 10Mg Tab
Arm Type
Experimental
Arm Description
Dapagliflozin 10 mg film-coated tablets
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Identical film-coated tablets without dapagliflozin
Intervention Type
Drug
Intervention Name(s)
Dapagliflozin 10Mg Tab
Intervention Description
Patients receive dapagliflozin 10mg tablets once a day during 12 weeks
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Patients receive placebo tablets once a day during 12 weeks
Intervention Type
Procedure
Intervention Name(s)
impedance cardiography
Intervention Description
impedance cardiography (PhysioFlow® PF-05 Lab1TM, Manatec Biomedical) is done for evaluation of cardiac function
Intervention Type
Procedure
Intervention Name(s)
Applanation tonometry
Intervention Description
Applanation tonometry will be done using SphygmoCor®, Hogimed) is done for evaluation of arterial stiffness
Intervention Type
Procedure
Intervention Name(s)
post-ischemic hyperemia of forearm
Intervention Description
An arterial occlusion cuff will be placed on the forearm, and will be deflated to allow post-ischemic hyperemia with the continuous measurements of brachial artery diameter and blood flow velocity by high-resolution echotracking coupled to a Doppler system (ArtLab system®)
Intervention Type
Procedure
Intervention Name(s)
haemodynamics parameters
Intervention Description
haemodynamics parameters will be evaluated using automatic oscillometric recorder
Primary Outcome Measure Information:
Title
Change from baseline of brachial artery endothelial function using echography
Description
Change in brachial artery flow-mediated dilatation in response to post-ischemia hyperemia using difference of brachial artery diameter
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Change from baseline of arterial stiffness using applanation tonometry
Description
Change in carotid-to-femoral pulse wave velocity
Time Frame
12 weeks
Title
Change from baseline of carotid artery geometry using echography (1)
Description
Change in carotid diastolic diameter
Time Frame
12 weeks
Title
Change from baseline of carotid artery geometry using echography (2)
Description
Change in carotid intima-media thickness using echography
Time Frame
12 weeks
Title
Change from baseline of cardiac function by impedance cardiography (1)
Description
Change in cardiac output
Time Frame
12 weeks
Title
Change from baseline of cardiac function by impedance cardiography (2)
Description
Change in stroke volume
Time Frame
12 weeks
Title
Change from baseline of cardiac function by impedance cardiography (3)
Description
Change in ejection fraction
Time Frame
12 weeks
Title
Change from baseline of cardiac function by impedance cardiography (4)
Description
Change in end-diastolic volume
Time Frame
12 weeks
Title
Change from baseline of cardiac function by impedance cardiography (5)
Description
Change in total peripheral resistance,
Time Frame
12 weeks
Title
Change from baseline of cardiac function by impedance cardiography (6)
Description
Change in left ventricular end-systolic elastance
Time Frame
12 weeks
Title
Change from baseline of epoxyeicosatrienoic acid bioavailability
Description
Change in epoxyeicosatroenoic acid bioavailibility during heating
Time Frame
12 weeks
Title
Change from baseline of plasma NO bioavailability
Description
Change in plasma nitrite bioavailibility during heating
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Chronic kidney disease (eGFR ≥25 and ≤60 mL/min/1.73m² by CKD-EPI) Age ≥ 18 years Receiving a stable dose of an ACE inhibitor or ARB for at least 12 weeks before screening or patients who were documented to be intolerant to ACE inhibitors or ARBs Exclusion Criteria: Type 1 and type 2 diabetes (fasting glycemia≥126 mg/dL or use of oral hypoglycemic agents or insulin) Recessive or autosomal dominant polycystic kidney disease Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis Lupus nephritis Receiving cytotoxic therapy, immunosuppressive therapy or other immunotherapy for primary or secondary renal disease within 6 months prior to enrolment History of organ transplantation Body weight > 35 kg/m² Receiving therapy with a sodium glucose co-transporter 2 (SGLT2) inhibitor within 8 weeks prior to enrolment or previous intolerance of an SGLT2 inhibitor Patients with NYHA class IV congestive heart failure at the time of enrolment Myocardial infarction, unstable angina, stroke or transient ischemic attack (TIA) within 12 weeks prior to enrolment Coronary revascularization (percutaneous coronary intervention or coronary artery bypass grafting) or valvular repair/replacement within 12 weeks prior to enrolment or is planned to undergo any of these procedures after randomization Active malignancy requiring treatment at the time of enrolment or is planned to undergo any treatment after randomization Severe hepatic impairment (Child-Pugh class C) History of frequent genital mycotic infections (>2) Current pregnancy OR women of child-bearing potential (ie, those who are not chemically or surgically sterilized or who are not post-menopausal) who are not willing to use a medically accepted method of contraception that is considered reliable in the judgment of the investigator OR women who have a positive pregnancy test at enrolment or exploration visits OR women who are breast-feeding Contraindications to use glyceryl trinitrate (in particular allergy to nitrates or concomitant use of vasodilators) Participation in another clinical study with an investigational product during the last month prior to enrolment Inability of the patient, in the opinion of the investigator, to understand and/or comply with procedures and/or follow-up OR any conditions that, in the opinion of the investigator, may render the patient unable to complete the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Julien Blot
Phone
+33232884035
Email
julien.blot@chu-rouen.fr
First Name & Middle Initial & Last Name or Official Title & Degree
Jeremy Bellien, MD, PhD
Phone
+33232881428
Email
jeremy.bellien@chu-rouen.fr
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dominique Guerrot, MD, PhD
Organizational Affiliation
University Hospital, Rouen
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jeremy Bellien, PharmD, PhD
Organizational Affiliation
University Hospital, Rouen
Official's Role
Study Director
Facility Information:
Facility Name
Department of Nephrology
City
Bois-Guillaume
ZIP/Postal Code
76230
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dominique Guerrot, MD,PhD
Phone
+33232885446
Email
dominique.guerrot@chu-rouen.fr
Facility Name
Department of Pharmacology
City
Rouen
ZIP/Postal Code
76031
Country
France
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jeremy Bellien, PHarmD, PhD
Phone
+33232881428
Email
jeremy.bellien@chu-rouen.fr

12. IPD Sharing Statement

Plan to Share IPD
No

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Vascular Impact of Dapagliflozin in CKD Patients (DAPAVASC)

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