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Sotagliflozin sikkerhed og tolerabilitet blandt nyretransplanterede modtagere (START)

13. oktober 2026 opdateret af: Martina McGrath, MD

This is an investigator-initiated, randomized controlled trial in adult KTRs (N=50) with stable allograft function to assess: 1) the reversibility of the expected acute changes in eGFR with sotagliflozin (donated by Lexicon); 2) proportion of patients completing the protocol according to different eGFR reporting strategies (using a predefined algorithm to manage the expected pharmacological effect of sotagliflozin on eGFR); 3) safety and tolerability of sotagliflozin.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

40

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Massachusetts
      • Boston, Massachusetts, Forenede Stater, 02115
        • Brigham and Women's

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Adults ≥18 years

  • Recipients of kidney transplant with stable eGFR*

  • eGFR-creatinine (CKD-EPI 2021) ≥25 mL/min/1.73 m2

  • Informed consent

    • Stable eGFR will be ascertained by careful chart review establishing that the patient's current graft has been functioning for at least 12 months post-transplantation, patients have not been treated for acute rejection within the prior 3 months, and a creatinine-based eGFR is stable (two consecutive measurements separated by at least 28 days within 5 mL/min/1.73 m2) and ≥25 mL/min/1.73 m2.

Exclusion Criteria:

  • Recurrent urinary tract infections (>2 episodes/year or antibiotic prophylaxis)
  • Biopsy-proven acute rejection within 12 weeks
  • Screening serum potassium >5.5 mmol/L
  • Uncontrolled hypertension (systolic blood pressure >180/100 mmHg)
  • New York Heart Association (NYHA) Class IV HF
  • Myocardial infarction, unstable angina, revascularization procedure (e.g., stent or bypass graft surgery), or cerebrovascular accident within 12 weeks
  • History of diabetic ketoacidosis
  • Type 1 Diabetes Mellitus
  • Hereditary glucose-galactose malabsorption or primary renal glucosuria
  • Liver disease (e.g., acute hepatitis, chronic active hepatitis, cirrhosis); Alanine aminotransferase (ALT) levels >2.0 times the upper limit of normal (ULN) or total bilirubin >1.5 times the ULN, unless consistent with Gilbert's disease
  • Malignancy within 5 years (exceptions: squamous and basal cell carcinomas of the skin and carcinoma of the cervix in situ, or a malignancy that in the opinion of the investigator is considered cured with minimal risk of recurrence)
  • Human immunodeficiency virus antibody positive
  • Major surgery within 12 weeks
  • Atraumatic amputation within past 12 months of screening, or an active skin ulcer, osteomyelitis, gangrene, or critical ischemia of the lower extremity within 6 months of screening
  • Combination use of ACEi and ARB
  • Current use of an SGLT2 inhibitor (within 12 weeks prior to randomization)
  • Known allergies, hypersensitivity, or intolerance to SGLT2i or its excipients
  • Digoxin plasma level >1.2 ng/mL
  • Clofibrate, fenofibrate, dronedarone, or ranolazine treatment that has not been at a stable dose in the 30 days prior to screening or randomization, or a dose adjustment is expected
  • Received an active investigational drug (including vaccines) other than a placebo agent, or used an investigational medical device within 12 weeks before Day 1/baseline
  • Pregnant or breast-feeding or planning to become pregnant or breast-feed during the study
  • Women of childbearing potential not willing to use a highly-effective method(s) of birth control, or who are unwilling or unable to be tested for pregnancy
  • Any condition that in the opinion of the investigator would make participation not in the best interest of the subject

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Patients and providers only aware of study eGFR values more than 25% below baseline

Any study-related eGFR value more than 25% below the baseline measurement will be reported to the patient and treating physician.

To test the proportion of patients successfully completing the protocol according to different eGFR reporting strategies, randomization in a 1:1 fashion at the patient level (n=50) will occur as follows:

  1. only study-related eGFR values >25% below baseline will be reported to patients and providers
  2. all study-related eGFR will be provided to patients and providers
Andet: Patients and providers aware of all study eGFR values

All study-related eGFR measurements will be reported to the treating physician and patient.

To test the proportion of patients successfully completing the protocol according to different eGFR reporting strategies, randomization in a 1:1 fashion at the patient level (n=50) will occur as follows:

  1. only study-related eGFR values >25% below baseline will be reported to patients and providers
  2. all study-related eGFR will be provided to patients and providers

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Reversibility of eGFR Changes
Tidsramme: 16 weeks total

Following 12 weeks of open-label drug treatment, participants will stop drug and be followed for a further four weeks (16 weeks total). Reversibility will be assessed as the proportion of patients who return to baseline eGFR (+/- 10%) by the end of the 4-week off-treatment period.

16 weeks total

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Proportion of Patients Successfully Completing the Full Treatment Protocol, According to Randomized Groups
Tidsramme: 16 weeks total

Following 12 weeks of open-label drug treatment, participants will stop drug and be followed for a further four weeks. The proportion of patients completing the full 16 weeks will be compared according to randomized groups.

16 weeks total

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Safety Assessments
Tidsramme: 4 weeks

- Acute changes in eGFR (baseline to 4 weeks)

4 weeks
Safety Assessments
Tidsramme: 12 weeks

- Longer-term changes in eGFR (baseline to 12 weeks and 4 weeks to 12 weeks)

12 weeks
Safety Assessments
Tidsramme: Weeks 12-16 (off-drug)

- Reversibility of changes in eGFR (12 to 16 weeks - after drug discontinuation)

Weeks 12-16 (off-drug)
Safety Assessments
Tidsramme: 12 weeks

- Acute Kidney Injury (>50% increase in serum creatinine/40% decline in eGFR within one week), which will be assessed throughout the on-drug period of 12 weeks

12 weeks
Safety Assessments
Tidsramme: 12 weeks

- All adverse events (AEs)

12 weeks
Safety Assessments
Tidsramme: 12 weeks

- All serious adverse events (SAEs)

12 weeks
Safety Assessments
Tidsramme: 12 weeks

- Diarrhea

12 weeks
Safety Assessments
Tidsramme: 12 weeks

- Infection requiring treatment with anti-microbials (including urogenital infection and urinary tract infections)

12 weeks
Safety Assessments
Tidsramme: 12 weeks

- Severe hypoglycemia (event that requires assistance of another person to actively administer carbohydrates, glucagon, or take other corrective actions)

12 weeks
Safety Assessments
Tidsramme: 12 weeks

- Diabetic ketoacidosis

12 weeks
Safety Assessments
Tidsramme: 12 weeks

- Hyperkalemia (>5.5 mmol/L)

12 weeks
Safety Assessments
Tidsramme: 12 weeks

- Hypotension (symptomatic SBP <90 mmHg or hypotension requiring adjustment in blood pressure medications or treatment in an emergency or hospitalized setting)

12 weeks
Tolerability Assessments
Tidsramme: 12 weeks

- Proportion of participants able to complete the full 12 weeks of treatment, according to randomized arm

12 weeks
Tolerability Assessments
Tidsramme: 12 weeks

- Study medication discontinuation rates

12 weeks
Tolerability Assessments
Tidsramme: 12 weeks

- KDQOL-36 questionnaire

12 weeks

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Ledende efterforsker: Martina M McGrath, MBBCh, Brigham and Women's Hospital

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

17. oktober 2022

Primær færdiggørelse (Faktiske)

10. maj 2024

Studieafslutning (Faktiske)

16. november 2024

Datoer for studieregistrering

Først indsendt

20. maj 2022

Først indsendt, der opfyldte QC-kriterier

1. juni 2022

Først opslået (Faktiske)

6. juni 2022

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

4. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

13. oktober 2026

Sidst verificeret

1. oktober 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 2022P000454

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

UBESLUTET

IPD-planbeskrivelse

Only sharing of anonymized data will be considered as per approved protocol. Written requests for data sharing will be considered on a case-by-case basis from qualified external researchers, based on scientific merit.

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ja

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .