Efficacy and Safety of Using MPC-5971 in Subjects Undergoing Shock Wave Lithotripsy
A Multi-Site Placebo-Controlled Randomized Double-Blind Study to Evaluate the Efficacy and Safety of Using MPC-5971 as Adjuvant Therapy in Subjects Undergoing Shock Wave Lithotripsy
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
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Idaho
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Meridian, Idaho, United States, 83642
- Idaho Urologic Institute
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Ohio
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Columbus, Ohio, United States, 43220
- Columbus Urology Research
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Texas
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Dallas, Texas, United States, 75231
- Urology Clinics Of North Texas, Pa
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion criteria:
- Male or female subject aged > or equal to 18 to < or equal to 70.
- Subject has undergone a computerized tomography (CT) scan within 30 days of the screening visit.
- Subject has been diagnosed with single unilateral renal calculus (target treatment stone).
- Target treatment stone, is presumed to be of calcium composition and/or uric acid composition.
- Target treatment stone is between > or equal to 5 and < or equal to 15 mm in diameter.
- Contra lateral kidney may hold a clinically inconsequential size calculus that does not require concurrent SWL treatment.
- Both kidneys are anatomically normal.
- An appropriate candidate for SWL, determined by treating physician.
- Female subjects with a negative pregnancy test, hysterectomy, tubal ligation or non-child bearing potential (post-menopausal).
- Female subjects of child bearing potential with a negative pregnancy test and taking appropriate birth control for the duration of the study.
- Urine is pyuria negative and nitrite negative on dipstick and/or negative upon microscopic evaluation.
- Subject must voluntarily consent to participate in this study and provide his/her written informed consent prior to start of any study-specific procedures.
Exclusion Criteria:
- Current or past history of cystine stones or infection stones.
- Renal insufficiency, defined as serum creatinine value outside of the normal reference range.
- Currently has or had hyperkalemia within the past six months, defined as serum potassium outside of the normal reference range.
- Currently has or had hypermagnesemia within the past six months, defined as serum magnesium outside of the normal reference range.
- Active urinary tract infection.
- Renal calculi in an anatomically abnormal kidney; horseshoe shape, ureteropelvic junction obstruction or calyceal diverticulum.
- Altered urinary tract anatomy such as a transplant kidney, urinary reconstruction or congenital anomaly.
- Blood coagulopathies and or taking anticoagulants (warfarin, coumarin, heparin).
- Taking salicylate (aspirin), including low dose aspirin for cardio-prophylaxis or other NSAID (OTC) that may increase bleeding time, within the past 7 days.
- History of complications with previous SWL; pyelonephritis, perinephric hematoma.
- Unsuccessful SWL treatments for previous stone within the past six months.
- Currently has or previously had ulcers of the esophagus, stomach and/or small intestines.
- Chronic diarrhea or has a history of diarrhea.
- Bowel disease such as Crohn's disease, Celiac disease, fat malabsorption or Sprue.
- Undergone any bariatric surgery procedures.
- Obese, defined as BMI >30.
- Uncontrolled hypertension defined as subjects taking medication specific for hypertension or subject not on medication with systolic blood pressure above 140 and diastolic above 90.
- Adrenal insufficiency (i.e., Addison's disease), adrenal tumors, and/or subjects on adrenal hormone replacement therapy.
- Taking potassium-sparing diuretics (triamterene, amiloride, spironolactone, Midamor®, Aldactone®, Dyrenium®, Eplerenone®).
- Taking potassium supplements (Rx or OTC) within the past 15 days.
- Taking magnesium supplements (Rx or OTC) within the past 15 days.
- Taken potassium citrate supplements (Rx or OTC) within the past 30 days.
- Subject taking anticholinergic medications at entry (dicyclomine, atropine, scopolamine, oxybutynin, tolerodine, Cogentin®, Sinemet®, Robinal®, Kenadrin®, Artane®, Enablex®, Detrol®, Vesicare®, Sanctura®, Ditropan®, Oxytrol®, Bentyl®, Byclomine®, Dibent®, Di-Spaz®, or Dilomine®). (Subjects may be prescribed anticholinergics as standard of care with use of stents post entry.)
- Subject is has taken gastrointestinal enzyme replacement therapy or proton pump inhibitors within past 30 days (Ultrase®, Creon®, Viokase®, Pancrease® MT, pancrelipase agents, Aciphex®, Nexium®, Prevacid®, Protonix®, Zegerid® Prilosec OTC®, Kapidex®, rabeprazole, esomeprazole, lansoprazole, pantoprazole, omeprazole, dexlansoprazole).
- Women who are pregnant or lactating.
- Subjects with a known hypersensitivity to potassium, magnesium, citrate or any excipients in the drug formulation
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: 1
MPC-5971
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After SWL treatment subjects will be randomized to receive either MPC-5971 or placebo.
Two tablets of MPC-5971 or placebo will be taken orally twice a day (bid).
This will give a daily dosage equal to 40 mEq of potassium, 20 mEq of magnesium and 60 mEq of citrate.
MPC-5971 or placebo will be taken bid for 90 days beginning immediately after SWL treatment.
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Placebo Comparator: 2
placebo identical in appearance to study drug
|
After SWL treatment subjects will be randomized to receive either MPC-5971 or placebo.
Two tablets of MPC-5971 or placebo will be taken orally twice a day (bid).
This will give a daily dosage equal to 40 mEq of potassium, 20 mEq of magnesium and 60 mEq of citrate.
MPC-5971 or placebo will be taken bid for 90 days beginning immediately after SWL treatment.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
stone free rate after SWL treatment
Time Frame: 12 weeks
|
12 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
increase in urine inhibitors
Time Frame: 4 week and 12 week
|
4 week and 12 week
|
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Reduced need for secondary procedures such as URS to clear obstructive fragments
Time Frame: 12 weeks
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12 weeks
|
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reduced stone/fragment area (mm2),percent change from the treatment stone area (mm2)
Time Frame: 12 weeks
|
12 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Koenig K, Padalino P, Alexandrides G, Pak CY. Bioavailability of potassium and magnesium, and citraturic response from potassium-magnesium citrate. J Urol. 1991 Feb;145(2):330-4. doi: 10.1016/s0022-5347(17)38330-1.
- Odvina CV, Mason RP, Pak CY. Prevention of thiazide-induced hypokalemia without magnesium depletion by potassium-magnesium-citrate. Am J Ther. 2006 Mar-Apr;13(2):101-8. doi: 10.1097/01.mjt.0000149922.16098.c0.
- Ruml LA, Pak CY. Effect of potassium magnesium citrate on thiazide-induced hypokalemia and magnesium loss. Am J Kidney Dis. 1999 Jul;34(1):107-13. doi: 10.1016/s0272-6386(99)70115-0.
- Pak CY, Koenig K, Khan R, Haynes S, Padalino P. Physicochemical action of potassium-magnesium citrate in nephrolithiasis. J Bone Miner Res. 1992 Mar;7(3):281-5. doi: 10.1002/jbmr.5650070306.
- Ettinger B, Pak CY, Citron JT, Thomas C, Adams-Huet B, Vangessel A. Potassium-magnesium citrate is an effective prophylaxis against recurrent calcium oxalate nephrolithiasis. J Urol. 1997 Dec;158(6):2069-73. doi: 10.1016/s0022-5347(01)68155-2.
- Gonzalez GB, Pak CY, Adams-Huet B, Taylor R, Bilhartz LE. Effect of potassium-magnesium citrate on upper gastrointestinal mucosa. Aliment Pharmacol Ther. 1998 Jan;12(1):105-10. doi: 10.1046/j.1365-2036.1998.00280.x.
- Ruml LA, Wuermser LA, Poindexter J, Pak CY. The effect of varying molar ratios of potassium-magnesium citrate on thiazide-induced hypokalemia and magnesium loss. J Clin Pharmacol. 1998 Nov;38(11):1035-41. doi: 10.1177/009127009803801108.
- Ruml LA, Gonzalez G, Taylor R, Wuermser LA, Pak CY. Effect of varying doses of potassium-magnesium citrate on thiazide-induced hypokalemia and magnesium loss. Am J Ther. 1999 Jan;6(1):45-50. doi: 10.1097/00045391-199901000-00007.
- Wuermser LA, Reilly C, Poindexter JR, Sakhaee K, Pak CY. Potassium-magnesium citrate versus potassium chloride in thiazide-induced hypokalemia. Kidney Int. 2000 Feb;57(2):607-12. doi: 10.1046/j.1523-1755.2000.00881.x.
- Jaipakdee S, Prasongwatana V, Premgamone A, Reungjui S, Tosukhowong P, Tungsanga K, Suwantrai S, Noppawinyoowong C, Maskasame S, Sriboonlue P. The effects of potassium and magnesium supplementations on urinary risk factors of renal stone patients. J Med Assoc Thai. 2004 Mar;87(3):255-63.
- Tosukhowong P, Tungsanga K, Phongudom S, Sriboonlue P. Effects of potassium-magnesium citrate supplementation on cytosolic ATP citrate lyase and mitochondrial aconitase activity in leukocytes: a window on renal citrate metabolism. Int J Urol. 2005 Feb;12(2):140-4. doi: 10.1111/j.1442-2042.2005.01001.x.
- Sriboonlue P, Jaipakdee S, Jirakulsomchok D, Mairiang E, Tosukhowong P, Prasongwatana V, Savok S. Changes in erythrocyte contents of potassium, sodium and magnesium and Na, K-pump activity after the administration of potassium and magnesium salts. J Med Assoc Thai. 2004 Dec;87(12):1506-12.
- Zerwekh JE, Odvina CV, Wuermser LA, Pak CY. Reduction of renal stone risk by potassium-magnesium citrate during 5 weeks of bed rest. J Urol. 2007 Jun;177(6):2179-84. doi: 10.1016/j.juro.2007.01.156.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- MPC-5971
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