- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03664414
Pentoxifylline Effect in Patients With Diabetic Nephropathy.(PENFOSIDINE STUDY) (PENFOSIDINE)
Pentoxifylline Effect on Renal Function, Oxidative Stress, Inflammation, and Fibrosis Markers, and Quality of Life in Patients With Diabetic Nephropathy
One of the purposes of the management of the patient with chronic kidney disease (CKD)is to slow the decline of renal function. The mechanisms by which the renal function declines involve inflammatory and fibrotic responses due in part by the effects of oxidative stress. Pentoxifylline (PTX)is a drug that stimulates adenosine receptors, and produces inhibition of phosphodiesterases, as well as being a dopaminergic modulator through D1 and D2 receptors. Its main effects are inhibition of the inflammatory state by decreasing serum levels of tumor necrosis factor alpha (TNF-ɒ) and monocyte chemo attractant protein 1 (MCP_1), which may slow down the decline of renal function. It also produces diminish of sympathetic activity, with the reduction of circulating levels of norepinephrine (NA), which may contribute to the reduction of glomerulosclerosis in diabetic patients. In the connective tissue increases the activity of the collagenases and decrease of collagen, fibronectin and glucosamine of the fibroblasts as well as inhibition of oxygen free radicals. Due to its antioxidant, anti-inflammatory and anti-fibrotic effects, PTX can result in an excellent therapeutic option for the prevention of CKD in DM2.
This work proposes the use of pentoxifylline as treatment CKD in DM2. Its application in patients with CKD will allow a therapeutic management with different targets, for its antioxidant, anti-inflammatory and antifibrotic effects that will be evaluated by means of fibrosis, inflammation and oxidative stress markers. The results will be of great importance in clinical practice, since they will justify the use of a new pharmacological tool, already known, with minimal adverse effects and low cost, accessible to all strata of the population since it is found as generic.
Study Overview
Status
Intervention / Treatment
Detailed Description
Patients will be randomly selected from the outpatient family medicine clinics. Once included, patients will be randomly allocated (by a computer-generated randomization list) to a study or control group. Over a period of 2 years, patients of the study group will receive one PTX tablet (400 mg) orally three times a day (at dinner time), whereas controls will receive one cellulose identical tablet on the same schedule.
All patients will continue with their usual treatment prescribed by their family doctor. Monthly visits will be scheduled for clinical and biochemical evaluations. A blood sample will be taken at baseline and every six months up to 24 months, for measurement of complete blood count, urea, creatinine, glucose, albumin, lipids, electrolytes, liver function tests, serum total proteins, (will be measure by usual methods). In serum samples at 0, 6, 12, 18 and 24 months, high sensibility C reactive protein will be measured by nephelometry, Brain natriuretic peptide and Serum Cystatin C will be measured by ELISA. Glomerular filtration rate (GFR) will be calculated based in Cystatin C level Grubb's equations. Vitamin C will be measured by HPLC. A 24 h ambulatory blood pressure monitoring (24 h ABPM), M-mode and two-dimensional echocardiographic, and an analysis of body composition by bioelectrical impedance will be done at baseline 6, 12, 18 and 24 months. To investigate health-related quality of life the short-form 36 (SF-36) questionnaire will be applied. Treatment compliance will be recorded by counting tablets left in the container at the end of each monthly visit and by the Morinsky Green test.
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Michoacán
-
Morelia, Michoacán, Mexico, 58290
- Recruiting
- Cibimi - Hgz 83 Imss
-
Contact:
- Oliva Mejía - Rodríguez, PhD
- Phone Number: 01 4431853008
- Email: oliva.mejia@imss.gob.mx
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- CKD
- Type 2 diabetes mellitus
- Microalbuminuria
- Proteinuria.
- Creatinine plasma clearance ˂ of 60 mL / min.
Exclusion criteria:
- History of psychiatric disorders,
- Immunosuppressants treatment
- Herbalism Treatment
- History of chronic alcoholism.
- Type 1 diabetes mellitus.
- Chronic obstructive pulmonary disease.
- Pulmonary fibrosis
- Heart failure
- HIV-AIDS.
- Liver cirrhosis.
- Chronic hepatitis.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: Placebo group
Placebo group will receive 1 tablet of cellulose pill to mimic pentoxifylline tablets three times a day with meals, during the following two years.
|
Pentoxifylline or placebo will be prescribed three times a day with meals.
All the participants will continue with the usual treatment.
Time frame: two years
Other Names:
|
Active Comparator: Pentoxifylline group
Pentoxifillyne or experimental group will receive 400 mg of pentoxifylline three times a day with meals, during the following two years.
|
Pentoxifylline or placebo will be prescribed three times a day with meals.
All the participants will continue with the usual treatment.
Time frame: two years
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in the glomerular filtration rate
Time Frame: The measurements will be done baseline and every six months up to 24 months.
|
It will be measure as to duplicate serum creatinine levels from baseline (mg/dL), or to pass from a stage of chronic kidney disease to he next stage (GFR mL/min)
|
The measurements will be done baseline and every six months up to 24 months.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in oxidative stress marker.
Time Frame: Change is assessed baseline, 6 months, 12 months, 18 months and 24 months.
|
The change in vit C level from baseline (normal range 4-8.8mg/
L)
|
Change is assessed baseline, 6 months, 12 months, 18 months and 24 months.
|
Change in fibrosis markers.
Time Frame: Change is assessed baseline, 6 months, 12 months, 18 months and 24 months.
|
Change in Nt_ProBNP from the baseline (Normal values up to 381 pg/mL)
|
Change is assessed baseline, 6 months, 12 months, 18 months and 24 months.
|
Change in inflammation markers.
Time Frame: Change is assessed baseline, 6 months, 12 months, 18 months and 24 months.
|
To assess inflammation high sensitivity C reactive protein will be measured by nephelometry.
(normal value < 5 mg/L
|
Change is assessed baseline, 6 months, 12 months, 18 months and 24 months.
|
Change in health-related quality of life
Time Frame: The questionnaire will be applied baseline and every six months up to 24 months.
|
This outcome will be measured by the SF 36 questionnaire, themaximun punctuation is 100, as greater punctuation a better quality of life
|
The questionnaire will be applied baseline and every six months up to 24 months.
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Oliva Mejía-Rodríguez, PhD, CIBIMI IMSS
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Glucose Metabolism Disorders
- Metabolic Diseases
- Urologic Diseases
- Endocrine System Diseases
- Diabetes Complications
- Diabetes Mellitus
- Renal Insufficiency
- Diabetes Mellitus, Type 2
- Kidney Diseases
- Renal Insufficiency, Chronic
- Diabetic Nephropathies
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Vasodilator Agents
- Enzyme Inhibitors
- Platelet Aggregation Inhibitors
- Protective Agents
- Antioxidants
- Phosphodiesterase Inhibitors
- Free Radical Scavengers
- Radiation-Protective Agents
- Pentoxifylline
Other Study ID Numbers
- CNIC-2015-785-065
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Type 2 Diabetes Mellitus
-
SanofiCompletedType 1 Diabetes Mellitus-Type 2 Diabetes MellitusHungary, Russian Federation, Germany, Poland, Japan, United States, Finland
-
Mannkind CorporationTerminatedType 2 Diabetes Mellitus | Type 1 Diabetes MellitusUnited States
-
RWTH Aachen UniversityBoehringer IngelheimCompletedDiabetes Mellitus Type 2 (T2DM)Germany
-
Scripps Whittier Diabetes InstituteSan Diego State UniversityCompletedType 2 Diabetes Mellitus (T2DM)United States
-
University Hospital Inselspital, BerneCompletedType 2 Diabetes MellitusSwitzerland
-
India Diabetes Research Foundation & Dr. A. Ramachandran...CompletedTYpe 2 Diabetes MellitusIndia
-
Griffin HospitalCalifornia Walnut CommissionCompletedDIABETES MELLITUS TYPE 2United States
-
US Department of Veterans AffairsAmerican Diabetes AssociationCompletedType 2 Diabetes MellitusUnited States
-
Dexa Medica GroupCompletedType-2 Diabetes MellitusIndonesia
-
Diabetes Foundation, IndiaNational Diabetes Obesity and Cholesterol FoundationRecruitingType 2 Diabetes Mellitus With ComplicationIndia
Clinical Trials on pentoxifylline
-
Hospital Universitario de CanariasUnknown
-
Beijing Tiantan HospitalCSPC Ouyi Pharmaceutical Co., Ltd.Not yet recruitingCerebral Small Vessel DiseasesChina
-
Institute of Liver and Biliary Sciences, IndiaUnknown
-
Assistance Publique - Hôpitaux de ParisMerck Sharp & Dohme LLCCompletedBenign Prostatic Hyperplasia (BPH) Requiring Surgical ResectionFrance
-
Hospital Universitario de CanariasInstituto Médico Tinerfeño IMETISAUnknown
-
Alexandria UniversityNot yet recruiting
-
National Cancer Institute (NCI)CompletedFibrosis | Radiation InjuriesUnited States
-
National Taiwan University HospitalCompletedPrimary GlomerulonephritisTaiwan
-
University of MichiganCompletedAcute Kidney FailureUnited States