- ICH GCP
- Register voor klinische proeven in de VS.
- Klinische proef NCT00309309
Metabolic and Renal Effects of Rosiglitazone in Kidney Transplant
A Prospective, Longitudinal Study to Assess the Metabolic and Renal Effects of Rosiglitazone in Albuminuric Kidney Transplant Recipients
Studie Overzicht
Gedetailleerde beschrijving
INTRODUCTION Decreased insulin sensitivity, impaired glucose tolerance and dyslipidemia are common features in renal transplant patients on chronic immunosuppression with steroids and calcineurine inhibitors. In renal transplant patients with chronic allograft dysfunction these metabolic abnormalities typically cluster with well-established renal and cardiovascular risk-factors such as hypertension and albuminuria. Altogether these factors may sustain and accelerate the progression of chronic allograft dysfunction to end stage renal disease (ESRD) and increase the risk of premature cardiovascular morbidity and mortality.
Thiazolidinediones (glitazones) are a new class of oral antidiabetic agents that may increase insulin sensitivity through activation of the peroxisome prolipherator-activated receptor gamma (PPARgamma). By ameliorating insulin sensitivity, these drugs may also improve glucose tolerance and dyslipidemia. These properties have led to their current utility as antidiabetic drugs. Moreover, finding that one of these drugs - rosiglitazone - has been reported to decrease arterial blood pressure and albuminuria in patients with type 2 diabetes and nephropathy, has been taken to suggest that glitazones may also have a specific reno- and cardio-protective effect. This effect could specifically apply to renal transplant patients with chronic allograft dysfunction in whom glitazones, in addition to ameliorate insulin resistance, glucose tolerance and dyslipidemia, might help controlling arterial hypertension and reducing albuminuria.
Recent finding that glitazones ameliorate the insulin resistant status induced by steroid treatment in healthy subjects, provides a further rationale to evaluate the metabolic and renal effects of glitazones in renal transplant patients on chronic steroid therapy.
AIM To evaluate the short-term risk/benefit profile of rosiglitazone treatment in renal transplant patients with chronic allograft dysfunction.
DESIGN After a basal evaluation of systolic/diastolic blood pressure,body weight, insulin sensitivity (by euglycemic hyperinsulinemic clamp), glucose tolerance (by standard glucose tolerance test), lipid profile, renal hemodynamics (GFR and RPF by inulin and PAH renal clearances, respectively), albuminuria (mean of three consecutive overnight urine collections), albumin, IgG, Na+ and free water fractional clearances and other routine laboratory analyses, patients satisfying the selection criteria will enter 4-month therapy with rosiglitazone 4 mg/day, up-titrated, if well-tolerated, to 8 mg/day 4 weeks later. Baseline evaluations will be repeated at the end of the treatment period and 2 months after treatment withdrawal. Blood pressure, body weight and routine laboratory tests - including liver function tests - will be evaluated also at 1 and 2 weeks of rosiglitazone therapy, at month 1 and then every month up to study end. Albuminuria will also be evaluated at month 2 of rosiglitazone therapy.
No major change in diet and immunosuppressive, antihypertensive and other concomitant treatments will be introduced throughout the whole study period. A low salt (2 grams of Na+ per day) and a controlled dietary protein intake (0.8 g/kg/body weight per day) will be recommended to all patients. Should any evidence of clinically relevant water retention or of liver toxicity occur throughout the treatment period, rosiglitazone will be back-titrated to the initial dose or withdrawn as deemed clinically appropriate.
Studietype
Inschrijving (Werkelijk)
Fase
- Fase 2
Contacten en locaties
Studie Locaties
-
-
Bergamo
-
Ranica, Bergamo, Italië, 24020
- Clinical Research Center for Rare Diseases
-
-
Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- age: 18-70 years old
- kidney transplant since at least six months
- serum creatinine ≤ 3mg/dl without dialysis requirement
- serum creatinine changes ≤ + 30 % over the last three months
- overnight urinary albumin excretion rate ≥20µg/min
- well controlled hypertension (systolic/diastolic blood pressure <150/90 mmHg)
- concomitant treatment with inhibitors of the renin angiotensin system (RAS) since at least six months
- effective contraception
- written informed consent
- legal capacity
Exclusion Criteria:
- acute graft rejection over the last six months
- immunosuppressive therapy with FK506
- evidence of previous or concomitant liver disease and abnormal liver transaminases over the last six months
- evidence of heart failure (NYHA class II or more) or fluid overload
- overt diabetes or concomitant treatment with oral antidiabetic agents and/or insulin
- specific contraindication to the study drug
- legal incapacity and/or other circumstances rendering the patient unable to understand the nature, scope and possible consequences of the study
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Niet-gerandomiseerd
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
---|
Insulin sensitivity (at 0,4,6 months)
|
Blood pressure (at 0,4,6 months)
|
Albumin urinary excretion (at 0,4,6 months)
|
Medewerkers en onderzoekers
Onderzoekers
- Hoofdonderzoeker: Norberto Perico, MD, Mario Negri Institute
Studie record data
Bestudeer belangrijke data
Studie start
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Schatting)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- GLITA-TX
Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .
Klinische onderzoeken op Niertransplantatie
-
Children's Oncology GroupNational Cancer Institute (NCI)Actief, niet wervendStadium I Nier Wilms-tumor | Stadium II Kidney Wilms-tumor | Stadium III Kidney Wilms-tumor | Stadium IV Kidney Wilms-tumor | Volwassen Nier Wilms-tumor | Beckwith-Wiedemann-syndroom | Kidney Wilms-tumor | Diffuse hyperplastische perilobar nefroblastomatose | Rhabdoïde tumor van de nier | Stadium V Kidney...Verenigde Staten, Canada, Australië, Nieuw-Zeeland, Puerto Rico, Israël
-
Children's Oncology GroupNational Cancer Institute (NCI)VoltooidTerugkerend nierneoplasma bij kinderen | Stadium I Nier Wilms-tumor | Stadium II Kidney Wilms-tumor | Stadium III Kidney Wilms-tumor | Stadium IV Kidney Wilms-tumorVerenigde Staten
-
CAMC Health SystemOnbekendAKI (Acute Kidney Injury) als gevolg van traumaVerenigde Staten
-
Children's Oncology GroupNational Cancer Institute (NCI)WervingStadium II Kidney Wilms-tumor | Stadium III Kidney Wilms-tumor | Stadium IV Kidney Wilms-tumor | Terugkerende Nier Wilms-tumor | Anaplastische Nier Wilms-tumorVerenigde Staten, Canada, Puerto Rico, Australië, Nieuw-Zeeland, Saoedi-Arabië
-
Ain Shams UniversityVoltooidAKI (Acute Kidney Injury) als gevolg van traumaEgypte
-
Children's Oncology GroupNational Cancer Institute (NCI)Actief, niet wervendStadium III Kidney Wilms-tumor | Stadium IV Kidney Wilms-tumorVerenigde Staten, Canada, Australië, Nieuw-Zeeland, Puerto Rico, Israël, Zwitserland
-
Children's Oncology GroupNational Cancer Institute (NCI)Actief, niet wervendStadium I Nier Wilms-tumor | Stadium II Kidney Wilms-tumor | Stadium III Kidney Wilms-tumorVerenigde Staten, Canada, Australië, Nieuw-Zeeland, Puerto Rico, Israël, Zwitserland
Klinische onderzoeken op Rosiglitazon
-
GlaxoSmithKlineVoltooidDiabetes mellitus, type 2
-
GlaxoSmithKlineVoltooidDiabetes mellitus, type 2
-
GlaxoSmithKlineVoltooidNeuropathie, diabetesNederland
-
Medstar Health Research InstituteGlaxoSmithKlineBeëindigd
-
Baskent UniversityVoltooidObesitas | Diabetes mellitus type 2Kalkoen
-
Dana-Farber Cancer InstituteNational Cancer Institute (NCI)Voltooid
-
Jonsson Comprehensive Cancer CenterNational Institutes of Health (NIH)BeëindigdHersenen en tumoren van het centrale zenuwstelselVerenigde Staten
-
GlaxoSmithKlineBeëindigdZiekte van AlzheimerAustralië, Spanje, Verenigde Staten, Bulgarije, Duitsland, België, Canada, Hongkong, Korea, republiek van, Portugal, Argentinië, Chili, Griekenland, Slovenië, Tsjechië, Frankrijk, Hongarije, Italië, Zuid-Afrika, Indië, Zweden, Nede... en meer
-
University of California, San FranciscoNational Cancer Institute (NCI)OnbekendHoofd-halskankerVerenigde Staten
-
Hospital Authority, Hong KongOnbekendHart-en vaatziekten | Nier Ziekten | Chronische ziekteChina