- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT07594145
Precision T1D Platform - New Therapies for Cardio-Renal Complications
Accelerating Breakthrough Targeted New Therapies for Cardio-Renal Complications in People With T1D (Precision T1D Platform)
연구 개요
상태
개입 / 치료
상세 설명
This is a multicenter, open label pilot platform study to evaluate the impact of allocating patients with T1D and early signs of HF/DKD to targeted therapies based on their disease pathway activation signatures. The hypothesis is that stratifying T1D patients by molecularly-defined endophenotypes enables the use of targeted therapies that can more effectively prevent or slow cardio-renal complications.
There is no randomized allocation to treatment arms; rather, the eligible participant's clinical and biomarker data will be reviewed by the Molecular T1D Board which will adjudicate each participant to a treatment arm based on their based on their disease pathway activation signatures. Activation of different treatment arms may be initiated at different time points during the study.
The following sections describe the master protocol, outlining the requirements across all treatment arms, including the study-wide inclusion and exclusion criteria and study-wide procedures. Appendix A outlines any treatment arm/investigational agent specific information, including defining additional treatment-specific eligibility criteria and required study procedures.
The study schema can be found in Section 1.2 and the Schedule of Activities (SoA) in Section 1.3. Potential participants will undergo a two-part consent and screening process. The initial consent and screening visit will be limited to activities necessary for assessment by the Molecular T1D Board. Following review by the Molecular T1D Board, participants will be adjudicated to one treatment arm. At this time, participants will undergo the second consent and screening step, which will include information about specific requirements for their assigned investigational arm and, if in agreement, a complete eligibility assessment via a full screening visit. If the participant is deemed eligible, they will be notified and investigational product will be mailed to them directly. The screening visit results will also serve as the baseline results provided the first dose of study drug is taken within 14 (target) to 21 (limit) days of the screening visit. If more than 21 days, a retest of all laboratory measures will be performed.
Participants will receive open label treatment for 26 weeks, with planned study visits at weeks 2, 6, 12, 26, and 30. The total study duration of participation will be up to 36 weeks, inclusive of the screening period. Active study participation will conclude at Week 30 visit. Following completion of active study participation, participants will enter a passive follow-up period during which the study team may collect information on vital status, survival, hospitalizations, and other relevant clinical outcomes through review of medical records and other authorized data sources for up to 12 months after study participation ended. No additional protocol-required visits, procedures, or interventions will be conducted during the passive follow-up period. Participants will be enrolled in this study at Oregon Health & Science University and the University of Michigan.
The currently planned number of study arms is three, with 15-19 participants enrolled in each arm. The study sponsors will have the option to increase the number of study arms and potential targeted therapies, which would be documented in the appendices and this master protocol.
연구 유형
등록 (추정된)
단계
- 2 단계
연락처 및 위치
연구 연락처
- 이름: Laura Nguyen
- 전화번호: (971) 509-4222
- 이메일: nguyelau@ohsu.edu
연구 연락처 백업
- 이름: Aly Carlson
- 전화번호: (971) 610-3005
- 이메일: carlsaly@ohsu.edu
연구 장소
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Michigan
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Ann Arbor, Michigan, 미국, 48109
- University of Michigan
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부수사관:
- Matthias Kretzler, MD
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연락하다:
- Hailey Desmond, MS
- 전화번호: (734) 764-6955
- 이메일: heturner@med.umich.edu
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수석 연구원:
- Lynn Ang, MD
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Oregon
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Portland, Oregon, 미국, 97239
- Oregon Health & Science University
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수석 연구원:
- Rodica Busui, MD, PhD
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부수사관:
- Brian Davidson, MD
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연락하다:
- Laura Nguyen
- 전화번호: 971-509-4222
- 이메일: nguyelau@ohsu.edu
-
연락하다:
- Aly Carlson
- 전화번호: 971-610-3005
-
부수사관:
- Jonathan Purnell, MD
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부수사관:
- David Ellison, MD
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부수사관:
- Kristin Childress, MD, MPH
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참여기준
자격 기준
공부할 수 있는 나이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
설명
Inclusion Criteria:
Diagnosis of T1D, defined as hyperglycemia requiring treatment with insulin within one year from diagnosis or, if the onset was after age 35 years, documentation of the presence of hyperglycemia and one or more of the following:
- presence of circulating T1D-associated autoantibodies, or
- history of hospitalization for diabetic ketoacidosis, or
- documented plasma C-peptide below the limit of detection with standard assay (with concurrent blood glucose >100 mg/dL)
- Aged 18-75 years, inclusive
- T1D duration >10 years
- HbA1c: 7-10%
Meets one of the following, either
- UACR > 30 mg/dl with eGFR ≥ 60mL/min/1.73 m2 and receiving standard of care therapy for early DKD Stage 2, including renin angiotensin system blockade (RASB), unless contraindicated or not tolerated, or
- Early (Stage B HF) defined as NT-proBNP ≥125 pg/mL
- Willing and able to adhere to schedule of activities and protocol requirements, including written informed consent
Exclusion Criteria:
- Diagnosis of Type 2 diabetes or monogenic forms of diabetes or diabetes secondary to pancreatic disease
- Use of any active platform treatment arms outside study assignment within 2 months prior to screening. See Appendix A for active treatment arms
- Current use of GLP-1 receptor agonists or other non-glucose lowering agent
- Use of aldosterone inhibitors within 2 months prior to screening
- Immunosuppressive medications within 3 months prior to screening
- Systolic BP>160 or diastolic BP >95 mmHg at screening
- History of ≥3 severe hypoglycemic events requiring third-party assistance for correction within 3 months prior to screening
- Evidence of any episode of DKA or non-ketotic hyperosmolar state within 12 months prior to screening
- Serum potassium > 5.0 mmol/L at screening
- Absolute neutrophil count < 2.0 × 109 per L at screening
- Platelet count < 120 × 109 per L at screening
- Known active tuberculosis, hepatitis B or C at screening, or history of HIV
- Current or past history of decompensated cirrhosis (defined as variceal bleeding, ascites or hepatic encephalopathy), and/or known diagnosis of cirrhosis based on liver biopsy, imaging, or elastography, and/or AST or ALT >2 times upper limit of normal, and/or total bilirubin >1.3 times upper limit of normal at screening
- History of severe acquired immune deficiency syndrome or severely immunocompromised status in the opinion of the study site investigator
- History of biopsy-proven non-diabetic CKD
- History of any other cause of HF (viral, congenital, valvular)
- History of heart or renal transplant or currently on chronic dialysis
- Cancer treatment, excluding non-melanoma skin cancer treated by excision, carcinoma in situ of the cervix or uterus, ductal breast cancer in situ, resected non-metastatic breast or prostate cancer, within one year prior to screening
- Illicit drug abuse within 6 months prior to screening in the opinion of the study site investigator
- Current heavy alcohol use (for men, ≥5 drinks on any day or ≥15 drinks per week; for women, ≥4 drinks on any day or ≥8 drinks per week)
- Participation in another interventional clinical research study within 30 days prior to screening
- Breastfeeding, pregnancy, or unwillingness to be on contraception during the trial
- Presence of a clinically significant medical history, physical examination, laboratory finding or other identified study site investigator concern that may interfere with any aspect of study conduct or interpretation of results
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
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실험적: Finerenone
Study participants with biomarker profiles showing a match for finerenone will be adjudicated to this treatment arm.
The clinically recommended dose for finerenone based on manufacturer guidelines is 20 mg once daily (oral) if screening eGFR is ≥60 mL/min/1.73
m2.
|
Each treatment arm will be a different unique drug.
There will be no crossing over of participants between arms.
Each participant that is adjudicated to their treatment arm will remain on that arm for the duration of the study through study completion.
다른 이름들:
|
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실험적: Sotagliflozin
Study participants with biomarker profiles that match with sotagliflozin will be adjudicated to this treatment arm.
The clinically recommended dose of sotagliflozin is 200 mg per the manufacturer guidelines.
The dose of 200 mg has a lower DKA risk and similar kidney benefits to the higher doses.
|
Each treatment arm will be a different unique drug.
There will be no crossing over of participants between arms.
Each participant that is adjudicated to their treatment arm will remain on that arm for the duration of the study through study completion.
다른 이름들:
|
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Markers of Renal Health [Safety and Tolerability]
기간: 26 weeks
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The primary efficacy endpoints are measures of early (week 26) outcomes on markers of renal health, defined as the percent change from baseline to week 26 in UACR.
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26 weeks
|
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Markes of Cardio Health [Safety and Tolerability]
기간: 26 weeks
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The primary efficacy endpoints are measures of early (week 26) outcomes on markers of cardio health as defined by the percent change from baseline to week 26 in NT-proBNP.
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26 weeks
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Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
기간: 26 weeks
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The primary safety endpoints are defined as incidence of serious adverse events, adverse events and clinically significant abnormal laboratory tests.
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26 weeks
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Immediate Outcomes of Renal Health (week 6)
기간: 20 weeks
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The secondary endpoints are measures of immediate outcomes on markers of renal health as defined by changes from baseline to week 6 in UACR.
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20 weeks
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Immediate Outcomes of Cardio Health (week 6)
기간: 20 weeks
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The secondary endpoints are measures of immediate outcomes on markers of cardio health as defined by changes from baseline to week 6 in NT-proBNP.
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20 weeks
|
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Immediate (week 6) and Early (week 26) Outcomes of Nephron Function Failure
기간: 26 weeks
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The secondary endpoints are measures of immediate outcomes on markers of renal function failure as defined by changes from baseline to week 6 and from baseline to week 26 in eGFR.
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26 weeks
|
공동 작업자 및 조사자
수사관
- 연구 의자: Rodica Busui, MD, PhD, Oregon Health and Science University
연구 기록 날짜
연구 주요 날짜
연구 시작 (추정된)
기본 완료 (추정된)
연구 완료 (추정된)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
기타 연구 ID 번호
- 30027
개별 참가자 데이터(IPD) 계획
개별 참가자 데이터(IPD)를 공유할 계획입니까?
IPD 계획 설명
IPD 공유 기간
IPD 공유 액세스 기준
IPD 공유 지원 정보 유형
- 연구_프로토콜
- 수액
- ICF
- ANALYTIC_CODE
- CSR
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
미국에서 제조되어 미국에서 수출되는 제품
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