Dapagliflozin ved aktiv lupusnefritis (Dapa-Active LN)
Sodium-Glucose Co-Transporter-2-hæmmere ved lupus nefritis
Lupus nephritis is a chronic and life-threatening autoimmune cause of kidney disease that predominately impacts young people and can lead to kidney failure. Sodium-glucose co-transporter-2 inhibitors, including dapagliflozin, are known to improve outcomes for people with other causes of chronic kidney disease. This pilot and feasibility randomized clinical trial will test the use of dapagliflozin versus placebo in addition to standard of care treatment for patients with early and active lupus nephritis, a group who has not been included in past trials.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
This is a pilot and feasibility randomized, double-blind, placebo-controlled trial involving patients with active lupus nephritis. It will be a concealed allocation, blinded randomized controlled trial of dapagliflozin 10 mg/day or matched placebo in a 2:1 allocation ratio (22 subjects active arm: 11 subjects placebo arm), in addition to standard-of-care treatment, for 12 weeks. After informed consent, 33 eligible subjects will be randomized 2:1 to oral dapagliflozin 10 mg/day or identical oral placebo/day for 12 weeks. Study visits will occur at screening (Visit -1), baseline (Visit 0) and weeks 4 (Visit 1), 8 (Visit 2) and 12 (Visit 3). Observational data including laboratory test results obtained in routine clinical care will be collected through 12 months of follow-up.
The primary outcomes are:
- the overall proportion of identified as potentially eligible/pre-screened patients who enroll in the trial;
- feasibility and completeness of data collection procedures;
- changes in urine protein-to-creatinine ratio (UPCR) and precision of these estimates from baseline to week 12 in each group; and
- rates and proportions of serious adverse events and of adverse events of interest, including genitourinary infections and volume depletion.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 4
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Karen H Costenbader, MD, MPH
- Telefonnummer: (617) 525-8785
- E-mail: kcostenbader@bwh.harvard.edu
Undersøgelse Kontakt Backup
- Navn: April M Jorge, MD
- Telefonnummer: 617-643-9624
- E-mail: amjorge@mgh.harvard.edu
Studiesteder
-
-
Massachusetts
-
Boston, Massachusetts, Forenede Stater, 02115
- Rekruttering
- Brigham and Women's Hospital
-
Kontakt:
- Karen H. Costenbader, MD, MPH
- Telefonnummer: 617-732-6088
- E-mail: KCostenbader@bwh.harvard.edu
-
Boston, Massachusetts, Forenede Stater, 02114
- Rekruttering
- Massachusetts General Hospital
-
Kontakt:
- April M. Jorge, MD
- Telefonnummer: 617-643-9624
- E-mail: amjorge@mgh.harvard.edu
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
-
• Age 18-70 years, fulfilling 2012 SLICC or 2019 ACR/EULAR criteria for SLE, with biopsy-proven class III, IV and/or V LN
-
Active (new or relapsing) LN within the prior six months, with at least one of the following:
- Kidney biopsy with activity index >2 and/or
- Active urinary sediment (>5 RBCs, >5 WBCs, or cellular casts)
-
Receiving standard-of-care immunosuppression regimen for active LN, including mycophenolate, cyclophosphamide, belimumab, azathioprine, a calcineurin inhibitor, and/or B cell depleting therapies
-
Recent or ongoing glucocorticoids use for active LN within the past 6 months
-
Receiving standard-of-care antimalarial therapy and RAAS blockade, unless contraindicated
-
Estimated ≥0.5 g/g 24 hr proteinuria or ≥0.3 mg/g 24 hr microalbuminuria at enrollment (on first morning urine)
-
Ability to given informed consent
-
Exclusion Criteria:
-
GFR < 25 ml/min/1.73m2
- Acute kidney injury at study enrollment (>50 percent rise in creatinine within 90 days)
- Type I diabetes, underweight (BMI <18.5), active malignancy, active infection, or recurrent genitourinary infections
- For females: pregnancy, or desiring of pregnancy and not using contraception, or unable to use contraception
- Current use of >1mg/kg/day prednisone equivalent
- Current or prior use of SGLT2 inhibitors or GLP-1 receptor agonists
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Firedobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Aktiv komparator: Dapagliflozin 10 mg daily
Subjects will receive masked dapagliflozin 10 mg daily for 12 weeks |
Pilot and feasibility of adding dapagliflozin to standard medical therapy in active lupus nephritis (LN) |
|
Placebo komparator: Matching placebo pill daily
Subjects will receive a matching placebo pill to take daily for 12 weeks |
Matching placebo daily with standard of care |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Proportion of eligible enrolled
Tidsramme: 3 years
|
The overall proportion of identified as potentially eligible/pre-screened patients who enroll in the trial |
3 years
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Feasibility of data collection
Tidsramme: 3 years
|
We will assess the percent of missing data elements overall at pilot trial completion. |
3 years
|
Andre resultatmål
Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Change in urine protein-to-creatinine ratio
Tidsramme: 12 weeks per subject
|
Change in urine protein-to-creatinine ratio (UPCR) from baseline to week 12 in each group |
12 weeks per subject
|
|
Adverse outcomes
Tidsramme: 3 years
|
Rates and proportions of serious adverse events and of adverse events of interest, including genitourinary infections and volume depletion |
3 years
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Urogenitale sygdomme
- Mandlige urogenitale sygdomme
- Nyresygdomme
- Urologiske sygdomme
- Urogenitale sygdomme hos kvinder
- Kvinders urogenitale sygdomme og graviditetskomplikationer
- Bindevævssygdomme
- Autoimmune sygdomme
- Sygdomme i immunsystemet
- Glomerulonefritis
- Lupus erythematosus, systemisk
- Nefritis
- Hud- og bindevævssygdomme
- Lupus nefritis
- Farmaceutiske præparater
- Doseringsformer
- Tabletter
- dapagliflozin
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 2025P003238
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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