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Patient-centred Intervention With Virtual Support for Obesity and Kidney Transplant Access (PIVOT)

28. September 2026 aktualisiert von: Kristin Clemens

Obesity has a serious impact on people's health and quality of life. For those with advanced kidney disease (i.e. approaching the need for dialysis), obesity is especially problematic - obesity can not only lead to worsening kidney function and kidney failure, but it can also prevent patients from receiving a lifesaving kidney transplantation due to concerns about operation risks. Unfortunately, there is an urgent need but no rigorously proven treatments to help people with advanced kidney disease lose weight effectively and safely.

The investigative team is a large team of doctors, nurses, dieticians, exercise specialists, social scientists, and patients with a lived experience, have spent three years advancing research to help people with advanced kidney disease achieve a healthier body weight. They have created a special weight loss program that combines individualized coaching on diet and save activity with a medication proven to help people with healthier kidneys lose weight (i.e. Ozempic). This research program is called PIVOT: Patient-centred Intervention with Virtual support for Obesity and kidney Transplant access.

The investigators have started to test PIVOT in a small pilot study and early results show that there is potential to study the program on a much larger scale (i.e. across Canada). With funding from CIHR, the investigators aim to reach more Canadians with advanced kidney disease (including people of lower income, women, and people of different races) with an aim of helping them lose weight safely, feel better, obtain a kidney transplant, and staying healthier over the longer term.

Studienübersicht

Status

Noch keine Rekrutierung

Bedingungen

Intervention / Behandlung

Studientyp

Interventionell

Einschreibung (Geschätzt)

880

Phase

  • Phase 4

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

Studienorte

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

18 Jahre und älter (Erwachsene, Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Beschreibung

Inclusion Criteria:

  • 18 years or older
  • BMI >35 kg/m2
  • eGFR <15ml/min/1.73m2 at baseline OR 2-year KFRE2 of 10% or greater

Exclusion Criteria:

  • Known contraindication to a GLP-1RA (pancreatitis, personal or family history of medullary thyroid cancer, hypersensitivity, pregnancy, breastfeeding)
  • Type 1 diabetes

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Keine (Offenes Etikett)

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Virtual Weight Management Program

A maximum tolerated dose of semaglutide will be administered once weekly subcutaneously, up to a dose of 2.0 mg. Participants will also receive nutritional and movement advice, as well as virtual coaching once every 4 weeks for 6 months.

Maximum tolerated dose of semaglutide subcutaneously once weekly. Maximum dose of 2.0 mg.

Andere Namen:
  • Ozempic
  • Wegovy
  • Generic Semaglutide
  • Apo-Semaglutide
  • Semaglutide Injection

Virtual meeting with intervention coach once every 4 weeks for 6 months, where the coach will discuss the goals and progress with participant, nutritional advice, exercise advice, and motivational support.

Andere Namen:
  • Gewichtsmanagement
  • Coaching
Kein Eingriff: Usual Care

Usual care participants will continue to receive the typical standard of kidney and diabetes care. They will not receive any study medication or coaching.

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Change in Body Weight
Zeitfenster: Baseline to 26 weeks +/- 14 days

Continuous measure of weight in kilograms assessed on calibrated clinic scales (dry weight for those receiving dialysis given fluid shifts)

Baseline to 26 weeks +/- 14 days

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Quality of Life - Kidney Disease Quality of Life 36-Item Short Form
Zeitfenster: Baseline to 26 weeks +/- 14 days

Change in Kidney Disease Quality of Life (KDQOL-36) score across treatment arms. KDQOL-36 is scored on a 0-100 scale across five domains, with higher scores indicating better health-related quality of life.

Baseline to 26 weeks +/- 14 days
Health-Related Quality of Life - European Quality of Life 5 Dimensions, 5 Level (EQ-5D-5L) Questionnaire
Zeitfenster: Baseline to 26 weeks +/- 14 days

Change in health-related quality of life measured using the European Quality of Life 5-Dimension, 5-Level questionnaire across treatment arms. A score of 11111 = no problems in any dimension (best), and a score of 55555 = extreme problems in all dimensions (worst).

Baseline to 26 weeks +/- 14 days
Change in Functional Status - Kidney Disease Quality of Life 36-Item Short form (KDQOL-36)
Zeitfenster: Baseline to 26 weeks +/- 14 days

Change in functional status measured with KDQOL-36™ scores across treatment arms. KDQOL-36 is scored on a 0-100 scale across five domains, with higher scores indicating better health-related quality of life.

Baseline to 26 weeks +/- 14 days
Change in Functional Status - European Quality of Life five-dimensional, five-level generic measure (EQ-5D-5L) scores across treatment arms.
Zeitfenster: Baseline to 26 weeks +/- 14 days

Measured via EQ-5D-5L (European Quality of Life five-dimensional, five-level generic measure) scores across treatment arms. A score of 11111 = no problems in any dimension (best), and a score of 55555 = extreme problems in all dimensions (worst).

Baseline to 26 weeks +/- 14 days
Weight Loss ≥5%
Zeitfenster: Baseline to 26 weeks +/- 14 days

Percentage of participants achieving at least 5% reduction in body weight from baseline.

Baseline to 26 weeks +/- 14 days
Weight Loss ≥10%
Zeitfenster: Baseline to 26 weeks +/- 14 days

Percentage of participant achieving at least 10% reduction in body weight from baseline.

Baseline to 26 weeks +/- 14 days
Weight Loss ≥15%
Zeitfenster: 26 weeks +/- 14 days

Percentage of participants achieving at least 15% reduction in body weight from baseline.

26 weeks +/- 14 days
Weight Loss ≥20%
Zeitfenster: Baseline to 26 weeks +/- 14 days

Percentage of participants achieving at least 20% reduction in body weight from baseline.

Baseline to 26 weeks +/- 14 days
Body Mass Index (BMI)
Zeitfenster: Baseline to 26 weeks +/- 14 days

Change in BMI across treatment arms. Measured in kg/m²

Baseline to 26 weeks +/- 14 days
Body Surface Area (BSA)
Zeitfenster: Baseline to 26 weeks +/- 14 days

Change in BSA across treatment arms. Measured in m².

Baseline to 26 weeks +/- 14 days
Body Mass Index <35 kg/m²
Zeitfenster: Week 26 +/- 14 days

Percentage of participants achieving a BMI below <35 kg/m², corresponding to the specified weight-based threshold for transplant listing.

Week 26 +/- 14 days
Dalhousie Clinical Frailty Scale Rating
Zeitfenster: Baseline to 26 weeks +/- 14 days

Change in Dalhousie Clinical Frailty Scale rating across treatment arms. The scale ranges from 1 (very fit) to 9 (terminally ill).

Baseline to 26 weeks +/- 14 days
SARC-F Score
Zeitfenster: Baseline to 26 weeks +/- 14 days

Change in sarcopenia measured by SARC-F score across treatment arms. This questionnaire is scored out of 10, with a score of 4 or higher indicating probable sarcopenia.

Baseline to 26 weeks +/- 14 days
FRAIL Scale
Zeitfenster: Baseline to 26 weeks +/- 14 days

Change in frailty measured by the FRAIL Scale across treatment arms. The scale scores five components - fatigue, resistance, ambulation, illnesses, and loss of weight - on a 0-5 scale, with 0 indicating robust, 1-2 pre-frail, and 3 or more indicating frailty.

Baseline to 26 weeks +/- 14 days
Acute Kidney Injury (AKI)
Zeitfenster: Baseline to 26 weeks +/- 14 days

Incidence of AKI. AKI defined by KDIGO as creatinine ≥ 1.5x baseline within 7 days in non-dialysis participants

Baseline to 26 weeks +/- 14 days
Hypoglycemia
Zeitfenster: Baseline to week 26 +/- 14 days

Incidence of hypoglycemia (blood glucose <4 mmol/L or time below target using continuous glucose monitoring)

Baseline to week 26 +/- 14 days
Gastrointestinal Symptoms
Zeitfenster: Baseline to 26 weeks +/- 14 days

Incidence of gastrointestinal symptoms, including nausea, vomiting, constipation

Baseline to 26 weeks +/- 14 days
Acute Biliary Disease
Zeitfenster: Baseline to 26 weeks +/- 14 days

Incidence of acute biliary disease.

Baseline to 26 weeks +/- 14 days
Acute Pancreatitis
Zeitfenster: Baseline to 26 weeks +/- 14 days

Incidence of acute pancreatitis.

Baseline to 26 weeks +/- 14 days
Diabetic Retinopathy Interventions
Zeitfenster: Baseline to 26 weeks +/- 14 days

Incidence of interventions for diabetic retinopathy

Baseline to 26 weeks +/- 14 days
Injection-site reactions
Zeitfenster: Baseline to 26 weeks +/- 14 days

Incidence of injection-site reactions in the intervention arm.

Baseline to 26 weeks +/- 14 days
Malignant Neoplasms
Zeitfenster: Baseline to 26 weeks +/- 14 days

Incidence of malignant neoplasms.

Baseline to 26 weeks +/- 14 days
Coaching Visit Adherence
Zeitfenster: Baseline to 26 weeks +/- 14 days

Percentage of participants completing ≥4 of 6 coaching visits.

Baseline to 26 weeks +/- 14 days
Semaglutide Discontinuation
Zeitfenster: Baseline to 26 weeks +/- 14 days

Percentage of participants discontinuing semaglutide in the intervention arm.

Baseline to 26 weeks +/- 14 days
Achievement of semaglutide dose ≥1.0 mg/week
Zeitfenster: Week 26 +/- 14 days

Percentage of participants in the intervention group achieving a semaglutide dose of ≥1.0 mg/week.

Week 26 +/- 14 days
Achievement of Semaglutide Dose ≥2.0 mg/week
Zeitfenster: 26 weeks +/- 14 days

Percentage of participants achieving a semaglutide dose of ≥2.0 mg/week

26 weeks +/- 14 days
Semaglutide Initiation in Usual Care
Zeitfenster: Baseline to 26 weeks +/- 14 days

Percentage of usual care arm participants initiating semaglutide during the study period.

Baseline to 26 weeks +/- 14 days
Use of Semaglutide in Usual Care Participants
Zeitfenster: Baseline to 26 weeks +/- 14 days

Percentage of participants using semaglutide in the usual care arm.

Baseline to 26 weeks +/- 14 days
Semaglutide Dose ≥1.0 mg/Week in Usual care Arm
Zeitfenster: 26 weeks +/- 14 days

Percentage of usual care participants achieving semaglutide dose ≥1.0 mg/week

26 weeks +/- 14 days
Semaglutide Dose ≥2.0 mg/Week in Usual Care Arm
Zeitfenster: 26 Weeks +/- 14 days

Percentage of usual care participants achieving semaglutide dose ≥2.0 mg/week

26 Weeks +/- 14 days
Body Fat Percentage Measured with Smart Scale
Zeitfenster: Baseline to 26 weeks +/- 14 days

Change in body fat percentage among the subsample of intervention participants using the study smart scale.

Baseline to 26 weeks +/- 14 days
Muscle Mass Measured with Smart Scale
Zeitfenster: Baseline to 26 weeks +/- 14 days

Measured in kilograms. Change in muscle mass among the subsample of intervention participants using the study smart scale.

Baseline to 26 weeks +/- 14 days
Intervention Costs
Zeitfenster: Baseline to 26 weeks

The total cost of the intervention incurred by participants during the 26-week follow-up period, in Canadian dollars (CAD)

Baseline to 26 weeks
Out-of-pocket costs
Zeitfenster: Baseline to 26 weeks

Total out-of-pocket costs incurred by participants during the 26-week study period-including costs directly related to the intervention. Measured in Canadian dollars (CAD)

Baseline to 26 weeks
Lost Productivity Costs
Zeitfenster: Baseline to 26 weeks

Costs associated with productivity losses during the 26-week follow-up period, including costs directly related to the participant's health care and intervention. Measured in Canadian dollars (CAD)

Baseline to 26 weeks
Health care utilization costs
Zeitfenster: Baseline to 26 weeks

Total costs associated with health care utilization during the study period, including physician visits, hospitalizations, emergency department visits, medications, allied health services. Measured in Canadian dollars (CAD) using provincial administrative health data.

Baseline to 26 weeks

Andere Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Change in HbA1c
Zeitfenster: Baseline to 24 Months

Change in glycated hemoglobin among participants with diabetes across treatment arms.

Baseline to 24 Months
Hospitalization for Hyperglycemia
Zeitfenster: Baseline to 24 Months

Incidence of hospitalization for hyperglycemia in participants with diabetes across treatment arms

Baseline to 24 Months
Hospitalization for hypoglycemia
Zeitfenster: Baseline to 24 Months

Incidence of hospitalization for hypoglycemia in participants with diabetes across treatment arms.

Baseline to 24 Months
Initiation of Dialysis
Zeitfenster: Baseline to 24 Months

Percentage of non-dialysis participants initiating dialysis across treatment arms

Baseline to 24 Months
Cardiovascular Composite
Zeitfenster: Baseline to 24 Months

Composite of hospitalization for acute myocardial infarction, stroke, amputation, or heart failure across treatment arms.

Baseline to 24 Months
Kidney Transplantation
Zeitfenster: Baseline to 24 months

Percentage of participants receiving kidney transplantation across treatment arms.

Baseline to 24 months
Healthcare utilization
Zeitfenster: 24 months

Health care utilization over 24 months including number of hospital admissions, emergency department, outpatient and primary care visits, specialist visits, rehabilitation, allied health care visits. Measured using provincial administrative health data.

24 months
Health care costs
Zeitfenster: 24 months

Health care costs over 24 months, including total health care costs, hospitalization-related costs, emergency department costs, outpatient and physician costs, medication costs. Measured in Canadian dollars (CAD) using provincial administrative health data.

24 months

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Ermittler

  • Hauptermittler: Kristin Clemens, MD, St. Joseph's Health Care London, Western University
  • Hauptermittler: Louise Moist, MD, London Health Sciences Centre

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Geschätzt)

1. Januar 2027

Primärer Abschluss (Geschätzt)

1. Januar 2029

Studienabschluss (Geschätzt)

1. Januar 2029

Studienanmeldedaten

Zuerst eingereicht

10. September 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

28. September 2026

Zuerst gepostet (Tatsächlich)

5. Oktober 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

5. Oktober 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

28. September 2026

Zuletzt verifiziert

1. September 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • PIVOT

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

NEIN

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

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