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

28 settembre 2026 aggiornato da: 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.

Panoramica dello studio

Stato

Non ancora reclutamento

Condizioni

Intervento / Trattamento

Tipo di studio

Interventistico

Iscrizione (Stimato)

880

Fase

  • Fase 4

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Luoghi di studio

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

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

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: 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.
Droga: Semaglutide

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

Altri nomi:
  • Ozempico
  • Wegovy
  • Generic Semaglutide
  • Apo-Semaglutide
  • Semaglutide Injection
Comportamentale: Virtual Weight Management Coaching

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.

Altri nomi:
  • Controllo del peso
  • Istruire
Nessun intervento: 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.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Change in Body Weight
Lasso di tempo: 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

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Quality of Life - Kidney Disease Quality of Life 36-Item Short Form
Lasso di tempo: 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
Lasso di tempo: 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)
Lasso di tempo: 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.
Lasso di tempo: 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%
Lasso di tempo: 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%
Lasso di tempo: 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%
Lasso di tempo: 26 weeks +/- 14 days

Percentage of participants achieving at least 15% reduction in body weight from baseline.
26 weeks +/- 14 days
Weight Loss ≥20%
Lasso di tempo: 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)
Lasso di tempo: 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)
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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)
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: Baseline to 26 weeks +/- 14 days

Incidence of gastrointestinal symptoms, including nausea, vomiting, constipation
Baseline to 26 weeks +/- 14 days
Acute Biliary Disease
Lasso di tempo: Baseline to 26 weeks +/- 14 days

Incidence of acute biliary disease.
Baseline to 26 weeks +/- 14 days
Acute Pancreatitis
Lasso di tempo: Baseline to 26 weeks +/- 14 days

Incidence of acute pancreatitis.
Baseline to 26 weeks +/- 14 days
Diabetic Retinopathy Interventions
Lasso di tempo: Baseline to 26 weeks +/- 14 days

Incidence of interventions for diabetic retinopathy
Baseline to 26 weeks +/- 14 days
Injection-site reactions
Lasso di tempo: Baseline to 26 weeks +/- 14 days

Incidence of injection-site reactions in the intervention arm.
Baseline to 26 weeks +/- 14 days
Malignant Neoplasms
Lasso di tempo: Baseline to 26 weeks +/- 14 days

Incidence of malignant neoplasms.
Baseline to 26 weeks +/- 14 days
Coaching Visit Adherence
Lasso di tempo: Baseline to 26 weeks +/- 14 days

Percentage of participants completing ≥4 of 6 coaching visits.
Baseline to 26 weeks +/- 14 days
Semaglutide Discontinuation
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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

Altre misure di risultato

Misura del risultato
Misura Descrizione
Lasso di tempo
Change in HbA1c
Lasso di tempo: Baseline to 24 Months

Change in glycated hemoglobin among participants with diabetes across treatment arms.
Baseline to 24 Months
Hospitalization for Hyperglycemia
Lasso di tempo: Baseline to 24 Months

Incidence of hospitalization for hyperglycemia in participants with diabetes across treatment arms
Baseline to 24 Months
Hospitalization for hypoglycemia
Lasso di tempo: Baseline to 24 Months

Incidence of hospitalization for hypoglycemia in participants with diabetes across treatment arms.
Baseline to 24 Months
Initiation of Dialysis
Lasso di tempo: Baseline to 24 Months

Percentage of non-dialysis participants initiating dialysis across treatment arms
Baseline to 24 Months
Cardiovascular Composite
Lasso di tempo: 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
Lasso di tempo: Baseline to 24 months

Percentage of participants receiving kidney transplantation across treatment arms.
Baseline to 24 months
Healthcare utilization
Lasso di tempo: 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
Lasso di tempo: 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

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Kristin Clemens

Investigatori

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

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

1 gennaio 2027

Completamento primario (Stimato)

1 gennaio 2029

Completamento dello studio (Stimato)

1 gennaio 2029

Date di iscrizione allo studio

Primo inviato

10 settembre 2026

Primo inviato che soddisfa i criteri di controllo qualità

28 settembre 2026

Primo Inserito (Effettivo)

5 ottobre 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

5 ottobre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

28 settembre 2026

Ultimo verificato

1 settembre 2026

Maggiori informazioni

Termini relativi a questo studio

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • PIVOT

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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