Safety and Efficacy of Different Oral Doses of BAY94-8862 in Subjects With Type 2 Diabetes Mellitus and the Clinical Diagnosis of Diabetic Nephropathy (ARTS-DN)
A Randomized, Double-blind, Placebo-controlled, Multi-center Study to Assess the Safety and Efficacy of Different Oral Doses of BAY94-8862 in Subjects With Type 2 Diabetes Mellitus and the Clinical Diagnosis of Diabetic Nephropathy
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
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Box Hill, Australia, 3128
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Woolloongabba, Australia, 4102
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New South Wales
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St Leonards, New South Wales, Australia, 2065
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Victoria
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Clayton, Victoria, Australia, 3168
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Melbourne, Victoria, Australia, 3052
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Prahran, Victoria, Australia, 3181
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Reservoir, Victoria, Australia, 3073
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Graz, Austria, 3086
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Innsbruck, Austria, 6020
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Salzburg, Austria, 5020
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Salzburg, Austria, 5026
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St. Pölten, Austria, 3100
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Wien, Austria, 1130
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Haskovo, Bulgaria, 6300
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Lukovit, Bulgaria, 5770
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Plovdiv, Bulgaria, 4002
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Ruse, Bulgaria, 7003
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Sofia, Bulgaria, 1431
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Stara Zagora, Bulgaria, 6000
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Varna, Bulgaria, 9010
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Varna, Bulgaria, 9000
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British Columbia
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Vancouver, British Columbia, Canada, V5Z 1L8
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Vancouver, British Columbia, Canada, V6E 1M7
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Ontario
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Courtice, Ontario, Canada, L1E 3C3
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Kitchener, Ontario, Canada, N2H 5Z8
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Scarborough, Ontario, Canada, M1H 3G4
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Toronto, Ontario, Canada, M4N 3M5
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Toronto, Ontario, Canada, M4C 5T2
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Quebec
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Montreal, Quebec, Canada, H1T 2M4
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Chrudim, Czechia, 537 01
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Koprivnice, Czechia, 742 21
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Krnov, Czechia, 794 01
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Praha 2, Czechia, 12808
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Aarhus C, Denmark, 8000
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Gentofte, Denmark, 2820
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Herlev, Denmark, 2730
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Hillerød, Denmark, DK-3400
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Holbaek, Denmark, 4300
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Holstebro, Denmark, DK-7500
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Kolding, Denmark, 6000
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Helsinki, Finland, 00180
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Jyväskylä, Finland, 40620
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Oulu, Finland, 90100
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Tampere, Finland, 33520
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Turku, Finland, 20520
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Amiens, France, 80000
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La Tronche, France, 38700
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Lyon Cedex, France, 69437
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Paris Cedex 15, France, 75908
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Strasbourg, France, 67091
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Niedersachsen
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Hannover, Niedersachsen, Germany, 30625
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Nordrhein-Westfalen
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Bad Oeynhausen, Nordrhein-Westfalen, Germany, 32545
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Düsseldorf, Nordrhein-Westfalen, Germany, 40210
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Rheinland-Pfalz
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Ludwigshafen, Rheinland-Pfalz, Germany, 67059
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Neuwied, Rheinland-Pfalz, Germany, 56564
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Hong Kong, Hong Kong
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Shatin, Hong Kong
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Budapest, Hungary, 1085
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Debrecen, Hungary, 4032
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Eger, Hungary, 3300
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Nagykanizsa, Hungary, 8800
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Papa, Hungary, 8500
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Ashkelon, Israel, 7830604
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Holon, Israel, 5822012
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Jerusalem, Israel, 9112001
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Kfar Saba, Israel, 4428164
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Petach Tikva, Israel, 4941492
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Tel Aviv, Israel, 6203854
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Tel Aviv, Israel, 6937947
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Campania
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Napoli, Campania, Italy, 80131
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Lombardia
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Bergamo, Lombardia, Italy, 24127
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Bergamo, Lombardia, Italy, 24020
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Milano, Lombardia, Italy, 20157
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Milano, Lombardia, Italy, 20134
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Monza-Brianza, Lombardia, Italy, 20832
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Puglia
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Foggia, Puglia, Italy, 71013
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Sardegna
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Cagliari, Sardegna, Italy, 09134
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Toscana
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Pisa, Toscana, Italy, 56124
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Veneto
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Padova, Veneto, Italy, 35128
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Busan, Korea, Republic of, 49241
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Seoul, Korea, Republic of, 03722
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Seoul, Korea, Republic of, 06591
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AlMERE, Netherlands, 1311 RL
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Eindhoven, Netherlands, 5600 PD
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Groningen, Netherlands, 9713 GZ
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Hoogeveen, Netherlands, 7909 AA
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Maastricht, Netherlands, 6229 HX
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Hamar, Norway, 2326
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Ålesund, Norway, 6026
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Bialystok, Poland, 15-276
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Bydgoszcz, Poland, 85-822
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Lodz, Poland, 90-153
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Lublin, Poland, 20-081
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Olawa, Poland, 55-200
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Warszawa, Poland
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Wroclaw, Poland, 51-162
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Almada, Portugal, 2801-951
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Lisboa, Portugal, 1069-166
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Lisboa, Portugal, 1449-005
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Gauteng
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Klipsruit West, Gauteng, South Africa, 1812
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Krugersdorp, Gauteng, South Africa, 1739
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Lenasia South, Gauteng, South Africa, 1829
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Newtown, Gauteng, South Africa, 2113
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KwaZulu Natal
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Durban, KwaZulu Natal, South Africa, 4091
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Durban, KwaZulu Natal, South Africa, 4037
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Kwazulu-Natal
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Durban, Kwazulu-Natal, South Africa, 4067
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Merebank, Kwazulu-Natal, South Africa, 4052
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Tongaat, Kwazulu-Natal, South Africa, 4400
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Western Cape
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Cape Town, Western Cape, South Africa, 7570
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Goodwood, Western Cape, South Africa, 7460
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Somerset West, Western Cape, South Africa, 7130
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Worcester, Western Cape, South Africa, 6850
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Barcelona, Spain, 08025
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Girona, Spain, 17007
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Madrid, Spain, 28034
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Madrid, Spain, 28041
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A Coruña
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Ferrol, A Coruña, Spain, 15405
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Cádiz
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Jerez de la Frontera, Cádiz, Spain, 11407
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Valencia
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Sagunto, Valencia, Spain, 46520
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Karlstad, Sweden, 651 85
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Kristianstad, Sweden, 29185
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Skövde, Sweden, 541 85
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Stockholm, Sweden, 141 86
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Stockholm, Sweden, 113 24
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Stockholm, Sweden, 111 57
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Uppsala, Sweden, 753 19
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Vällingby, Sweden, 162 68
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Örebro, Sweden, 701 85
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Kaohsiung, Taiwan, 833
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Taipei, Taiwan, 11217
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Taipei, Taiwan, 110
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Taipei, Taiwan, 10002
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Alabama
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Birmingham, Alabama, United States, 35294
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California
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Chula Vista, California, United States, 91910
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Los Angeles, California, United States, 90022
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Los Gatos, California, United States, 95032
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Connecticut
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New Haven, Connecticut, United States, 06510
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Florida
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Miami, Florida, United States, 33015
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Pembroke Pines, Florida, United States, 33028
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Illinois
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Chicago, Illinois, United States, 60611
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Chicago, Illinois, United States, 60612
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Michigan
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Flint, Michigan, United States, 48504
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New York
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Flushing, New York, United States, 11355
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South Carolina
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Orangeburg, South Carolina, United States, 29118
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Tennessee
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Chattanooga, Tennessee, United States, 37408
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Texas
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Dallas, Texas, United States, 75235-3858
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Vermont
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Burlington, Vermont, United States, 05401
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Men and women aged 18 years and older.The lower age limit may be higher if legally required in the participating country
- Women of childbearing potential can only be included in the study if a pregnancy test is negative and if they agree to use adequate contraception when sexually active.
Subjects with type 2 diabetes mellitus fulfilling at least 1 of the following criteria
- are on oral antidiabetics and / or insulin,
- have a documented fasting glucose >/= 7.0 mmol/L in the medical history,
- have a 2 hour plasma glucose >/=11.1 mmol/L during an oral glucose tolerance test in the medical history, or
- have a glycated hemoglobin (HbA1c) >/=6.5% [National Glycohemoglobin Standardization Program (NGSP) / Diabetes Control and Complications Trial (DCCT)] in the medical history or at the run-in visit
Subjects with a clinical diagnosis of diabetic nephropathy (DN) based on at least 1 of the following criteria:
- Persistent very high albuminuria defined as urinary albumin-to-creatine ratio (UACR) of >/=300 mg/g ( >/= 34 mg/mmol) in 2 out of 3 first morning void samples and estimated glomerular filtration rate (eGFR) >/=30 mL/min/1.73 m² but < 90 mL/min/1.73m² (Chronic Kidney Disease Epidemiology Collaboration, CKD EPI) (mL = milliliter; min = minute; m2 = square meter; g = gram; mmol = millimole) or
- Persistent high albuminuria defined as UACR of >/=30 mg/g but <300 mg/g in (>/=3.4mg/mmol but <34 mg/mmol) in 2 out of 3 first morning void samples and eGFR >/=30 mL/min/1.73 m² but < 90 mL/min/1.73m²
- Subjects treated with an angiotensin-converting enzyme inhibitor (ACEI) and/or angiotensin receptor blocker (ARB) for at least 3 months without any adjustments to this therapy for at least 4 weeks prior to the screening visit
- Serum potassium </= 4.8 mmol/L at both the run-in visit and the screening visit
Exclusion Criteria:
- Non-diabetic renal disease
- Glycated hemoglobin (HbA1c) >12% at the run-in visit or the screening visit
- UACR >3000 mg/g (339mg/mmol) in any of the urinary first morning void samples at the run-in visit or screening visit
- Hypertension with mean sitting systolic blood pressure (SBP) >/=180 mmHg or mean sitting diastolic blood pressure (DBP) >/=110 mmHg at the run-in visit or mean supine SBP >/=160 mmHg or mean sitting DBP >/=100 mmHg at the screening visit
- Subjects with a clinical diagnosis of heart failure with reduced ejection fraction (HFrEF) and persistent symptoms (New York Heart Association class II-IV) at the run-in visit
- Concomitant therapy with eplerenone, spironolactone, any renin inhibitor, or potassium-sparing diuretic
- Dialysis for acute renal failure within the previous 6 months prior to the run-in visit
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: QUADRUPLE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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EXPERIMENTAL: Finerenone (BAY94-8862) (1.25 mg)
1.25 mg dose oral once daily for 90 days
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EXPERIMENTAL: Finerenone (BAY94-8862)(2.5 mg)
2.5 mg dose oral once daily for 90 days
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EXPERIMENTAL: Finerenone (BAY94-8862)(5 mg)
5 mg dose oral once daily for 90 days
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EXPERIMENTAL: Finerenone (BAY94-8862)(7.5 mg)
7.5 mg dose oral once daily for 90 days
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EXPERIMENTAL: Finerenone (BAY94-8862) (10 mg)
10 mg dose oral once daily for 90 days
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EXPERIMENTAL: Finerenone (BAY94-8862) (15 mg)
15 mg dose oral once daily for 90 days
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EXPERIMENTAL: Finerenone (BAY94-8862)(20 mg)
20 mg dose oral once daily for 90 days
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PLACEBO_COMPARATOR: Placebo
Placebo oral dose once daily for 90 days
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Ratio of UACR at Day 90 to UACR at Baseline
Time Frame: Baseline and Day 90±2
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Albumin-to-creatinine ratio (UACR) is defined as gram of albumin per kilogram of creatinine.
UACR was calculating the average of 3 first morning void samples taken on 3 consecutive days.
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Baseline and Day 90±2
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Change From Baseline to Day 90 in Serum Potassium
Time Frame: Baseline and Day 90±2
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Baseline and Day 90±2
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Change From Baseline to Day 90 in eGFR
Time Frame: Baseline and Day 90±2
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An estimated glomerular filtration rate (eGFR) indicates the renal function.
An eGFR was calculated based on the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula.
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Baseline and Day 90±2
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Change From Baseline to Day 90 in KDQOL-36 Domain Score (Effects of Kidney Disease)
Time Frame: Baseline and Day 90±2
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The Kidney Disease QOL [KDQOL]-36 questionnaire is a specific measure of Health-Related Quality of Life (HRQoL) for chronic kidney disease (CKD) that includes effects and burden of kidney disease as well as physical and mental health scores.
Index score ranges from 0 (severe problems in all items) to 100 (no problem in all items).
"Effects of Kidney disease" subscore was analyzed.
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Baseline and Day 90±2
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Change From Baseline to Day 90 in EQ-5D Scores (EQ5D - Visual Analog Scale)
Time Frame: Baseline and Day 90±2
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EuroQol Group 5-Dimension, 3-Level (EQ-5D-3L) questionnaires consist of the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS).
The EQ-5D-3L descriptive system comprises the following 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.
Each dimension has 3 levels: no problems, some problems, extreme problems.
EQ VAS was analyzed for this endpoint and it ranges from 0 (worst possible health state) to 100 (best possible health state).
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Baseline and Day 90±2
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Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Bakris GL, Agarwal R, Chan JC, Cooper ME, Gansevoort RT, Haller H, Remuzzi G, Rossing P, Schmieder RE, Nowack C, Kolkhof P, Joseph A, Pieper A, Kimmeskamp-Kirschbaum N, Ruilope LM; Mineralocorticoid Receptor Antagonist Tolerability Study-Diabetic Nephropathy (ARTS-DN) Study Group. Effect of Finerenone on Albuminuria in Patients With Diabetic Nephropathy: A Randomized Clinical Trial. JAMA. 2015 Sep 1;314(9):884-94. doi: 10.1001/jama.2015.10081.
- Snelder N, Heinig R, Drenth HJ, Joseph A, Kolkhof P, Lippert J, Garmann D, Ploeger B, Eissing T. Population Pharmacokinetic and Exposure-Response Analysis of Finerenone: Insights Based on Phase IIb Data and Simulations to Support Dose Selection for Pivotal Trials in Type 2 Diabetes with Chronic Kidney Disease. Clin Pharmacokinet. 2020 Mar;59(3):359-370. doi: 10.1007/s40262-019-00820-x.
- Chung EY, Ruospo M, Natale P, Bolignano D, Navaneethan SD, Palmer SC, Strippoli GF. Aldosterone antagonists in addition to renin angiotensin system antagonists for preventing the progression of chronic kidney disease. Cochrane Database Syst Rev. 2020 Oct 27;10(10):CD007004. doi: 10.1002/14651858.CD007004.pub4.
- Erraez S, Lopez-Mesa M, Gomez-Fernandez P. Mineralcorticoid receptor blockers in chronic kidney disease. Nefrologia (Engl Ed). 2021 May-Jun;41(3):258-275. doi: 10.1016/j.nefro.2020.10.001. Epub 2020 Dec 24. English, Spanish.
Study record dates
Study Major Dates
Study Start (ACTUAL)
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
- 16243
- 2012-004179-38 (EUDRACT_NUMBER)
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