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Tolvaptan Phase 3 Efficacy and Safety Study in Autosomal Dominant Polycystic Kidney Disease (ADPKD) (TEMPO3:4)

A Phase 3, Multi-center, Double-blind, Placebo-controlled, Parallel-arm Trial to Determine Long-term Safety and Efficacy of Oral Tolvaptan Tablets Regimens in Adult Subjects With Autosomal Dominant Polycystic Kidney Disease

This study's purpose is to evaluate the long-term safety and efficacy of tolvaptan versus placebo in patients with ADPKD.

Studie Overzicht

Gedetailleerde beschrijving

This study evaluated whether or not tolvaptan is potentially beneficial, while maintaining an adequate safety profile, by reducing the rate of total kidney volume increase, while impacting the onset, severity, and progression of other important consequences of ADPKD.

During the 3-week titration phase, tolvaptan or placebo was titrated in weekly intervals from lowest to highest tolerated levels given in split-dose regimens of 45/15 mg, 60/30 mg and 90/30 mg orally upon awakening and approximately 9 hours later. As soon as a subject could not tolerate a given dose, the titration phase was over and the maintenance phase began at the dose level tolerated. The maintenance phase lasted to Month 36. Subjects were able to titrate down at any point during the study. Subjects were able to titrate up during the maintenance phase with Medical Monitor approval.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

1445

Fase

  • Fase 3

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

      • Buenos Aires, Argentinië, 1425
        • Instituto de Nefrología, Nefrology SA
      • Buenos Aires, Argentinië, 1602
        • Hospital Municipal de Vicente Lopez, Dr Bernardo Houssay
      • Buenos Aires, Argentinië, B1664INZ
        • Hosptial Universitario Austral
      • Cordoba, Argentinië, X5000IUP
        • Sanatorio Allende
      • Cordoba, Argentinië, X5016KEA
        • Hospital Privado-Centro Medico de Cordoba
      • Adelaide, Australië, 5000
        • Royal Adelaide Hospital
      • Adelaide, Australië, 5011
        • Queen Elizebeth Hospital
      • Brisbane, Australië, 4102
        • Princess Alexandra Hospital
      • Melbourne, Australië, 3050
        • Royal Melbourne Hospital
      • Melbourne, Australië, 3121
        • Melbourne Renal Research Group
      • Perth, Australië, 6054
        • Royal Perth Hospital
      • Sydney, Australië, 2065
        • Royal North Shore Hospital
      • Sydney, Australië, 2145
        • Westmead Hospital
      • Brussel, België, 1090
        • UZ Brussel
      • Brussels, België, 1200
        • UCL-St Luc
      • Gent, België, 9000
        • UZ Gent
    • Nova Scotia
      • Halifax, Nova Scotia, Canada, B3H1v8
        • Queen Elizabeth II Health Science Center, Division of Nephrology
    • Quebec
      • Montreal, Quebec, Canada, H3A1A1
        • Royal Victoria Hospital
      • Montreal, Quebec, Canada, H4J1C5
        • Hospital du Sacre- Coeur de Montreal
      • Herlev, Denemarken, 2730
        • Herlev Amtssygehus
      • Odense, Denemarken, 5000
        • Odense Universitetshospital
      • Dresden, Duitsland, 1307
        • Universitätsklinikum Carl Gustav Carus
      • Düsseldorf, Duitsland, 40210
        • Nephrologische Gemeinschaftspraxis/Dialysezentrum
      • Essen, Duitsland, 45147
        • Klinik für Nieren- und Hochdruckkrankheiten
      • Freiburg, Duitsland, 78106
        • Universitätsklinikum Freiburg
      • Heidelberg, Duitsland, 69120
        • Universitätskliniken Heidelberg
      • Nuernberg, Duitsland, 90471
        • UH Erlangen/Nürnberg
      • Bordeaux, Frankrijk, 33076
        • CHU-Hopital Pellegrin
      • Caen Cedex, Frankrijk, 14033
        • CHU - Hôpital Clémenceau
      • Lyon Cedex 3, Frankrijk, 69437
        • Hopital Edouard Herriot
      • Marseille, Frankrijk, 13005
        • Hôpital de la Conception
      • Montpellier, Frankrijk, 34295
        • CHU - Hôpital Lapeyronie
      • Paris, Frankrijk, 75018
        • Hopital Bichat-Claude Bernard
      • Reims cedex, Frankrijk, 51092
        • Centre Hospitalier Universitaire
      • Saint-Etienne Cedex 2, Frankrijk, 42055
        • CHU - Hôpital Nord
      • Toulouse Cedex 09, Frankrijk, 31059
        • Hopital Rangueil
      • Bergamo, Italië, 24128
        • Ospedali Riuniti di Bergamo
      • Milano, Italië, 20132
        • Università Vita e Salute, Ospedale San Raffaele
      • Modena, Italië, 41100
        • Policlinico di Modena
      • Napoli, Italië, 80131
        • Policlinico
      • Pavia, Italië, 27100
        • IRCCS Fondazione Salvatore Maugeri
      • Chiba, Japan, 2608677
        • Chiba University Hospital
      • Chiba, Japan, 2608712
        • National Hospital Organization Chiba-East Hospital
      • Fukuoka, Japan, 8128582
        • Kyusyu University Hospital
      • Fukushima, Japan, 9601295
        • Fukushima Medical University Hospital
      • Hiroshima, Japan, 7348551
        • Hiroshima University Hospital
      • Kumamoto, Japan, 8608556
        • Kumamoto Univeristy Hospital
      • Kyoto, Japan, 6068507
        • Kyoto University Hospital
      • Kyoto, Japan, 612-8555
        • National Hospital Organization Kyoto Medical Center
      • Niigata, Japan, 9518520
        • Niigata University Medical & Dental Hospital
      • Osaka, Japan, 5500015
        • Ohno Memorial Hospital
      • Saitama, Japan, 3308503
        • Saitama Medical Center Jichi Medical University
    • Aichi
      • Toyoake, Aichi, Japan, 4701192
        • Fujita Health University Hospital
    • Hokkaido
      • Sapporo, Hokkaido, Japan, 608648
        • Hokkaido University Hospital
    • Kanagawa
      • Isehara, Kanagawa, Japan, 2591193
        • Tokai University Hospital
      • Kawasaki, Kanagawa, Japan, 2138587
        • Toranomon Hospital Kajigaya
      • Sagamihara, Kanagawa, Japan, 2288555
        • Kitasato University Hospital
    • Miyagi
      • Sendai, Miyagi, Japan, 9808574
        • Tohoku University Hospital
    • Osaka
      • Osaka-City, Osaka, Japan, 5458586
        • Osaka City University Hospital
      • Suita, Osaka, Japan, 5650871
        • Osaka University Hospital
    • Saitama
      • Kasukabe, Saitama, Japan, 3440035
        • Shuwa General Hospital
      • Kawagoe, Saitama, Japan, 3508500
        • Saitama Medical Center
    • Shizuoka
      • Hamamatsu, Shizuoka, Japan, 4313192
        • Hamamatsu University School of Medicine, University Hospital
    • Tochigi
      • Shimotsuke, Tochigi, Japan, 3290498
        • Jichi Medical School Hospital
    • Tokyo
      • Bunkyo-ku, Tokyo, Japan, 1138603
        • Nippon Medical School Hospital
      • Bunkyo-ku, Tokyo, Japan, 1138519
        • Tokyo Medical & Dental University Hospital, Faculty of Medicine
      • Itabashi-ku, Tokyo, Japan, 1738606
        • Teikyo University Hospital
      • Minato-Ku, Tokyo, Japan, 1058471
        • The jikei University Hospital
      • Minato-ku, Tokyo, Japan, 1058470
        • Toranomon Hospital
      • Mitaka, Tokyo, Japan, 1818611
        • Kyorin University Hospital
      • Shinjuku-ku, Tokyo, Japan, 1628666
        • Tokyo Women's Medical University Hospital
      • Amsterdam, Nederland, 1081 HV
        • VU Medisch Centrum
      • Groningen, Nederland, 9713 GZ
        • UMCG Groningen
      • Ciechanow, Polen, 06-400
        • Oddział Nefrologiczny Stacja Dializ
      • Gdansk, Polen, 80-952
        • Akademickie Centrum Kliniczne AMG
      • Gdansk, Polen, 80-952
        • Samodzielny Publiczny Szpital Kliniczny nr 1, Akademickie Centrum Kliniczne AMG
      • Krakow, Polen, 31-501
        • Samodzielny Publiczny Zaklad Opieki Zdrowotnej, Szpital Uniwersytecki w Krakowie
      • Lodz, Polen, 90-153
        • SOP ZOZ Uniwersytecki Szpital Kliniczny
      • Lublin, Polen, 20-954
        • Samodzielny Publiczny Szpital Kliniczny nr 4 w Lublinie
      • Warsaw, Polen, 04-749
        • Miedzyleski Szpital Specjalistyczny w Warszawie
      • Warsaw, Polen, 02-507
        • Klinika Chorób Wewnętrznych i Nefrologii
      • Warszawa, Polen, 03-401
        • Szpital Praski p.w. Przemienienia Panskiego, Samodzielny Publiczny Zaklad Opieki Zdrowotnej
      • Warszawa, Polen, 03-401
        • Szpital Praski, Samodzielny Publiczny ZOZ
      • Wroclaw, Polen, 50-417
        • Akademicki Szpital Kliniczny im J Mikulicza Radeckiego
      • Bucharest, Roemenië, 22328
        • Institutul Clinic Fundeni
      • Bucharest, Roemenië, 10731
        • Spitalul Clinic de Nefrologie Dr. Carol Davila
      • Iasi, Roemenië, 700503
        • Spitalul Clinic "C.I.Parhon"
      • Kemerovo, Russische Federatie, 650061
        • Kemerovo Medical Academy, Regional Clinical Hospital
      • Moscow, Russische Federatie, 123060
        • City Clinical Hospital #52
      • St. Petersburg, Russische Federatie, 191104
        • City Mariinskiy Hospital
      • St.-Petersburg, Russische Federatie, 194291
        • Leningrad Regional Clinical Hospital
      • Tomsk, Russische Federatie, 634063
        • Tomsk Regional Clinical Hospital
      • Belfast, Verenigd Koninkrijk, BT9 7AB
        • Belfast City Hospital
      • Birmingham, Verenigd Koninkrijk, B15 2TH
        • Oueen Elizabeth Hospital
      • Brighton, Verenigd Koninkrijk, BN2 5BE
        • Sussex Renal Unit Royal Sussex County Hospital
      • Coventry, Verenigd Koninkrijk, CV2 2DX
        • Uhcw Mhs Trust
      • Edinburgh, Verenigd Koninkrijk, EH16 4SA
        • Royal Infirmary
      • Inverness, Verenigd Koninkrijk, IV2 3UJ
        • Raigmore Hospital
      • London, Verenigd Koninkrijk, NW3 2PF
        • Royal Free and University College Medical School
      • London, Verenigd Koninkrijk, SE5-9RS
        • King's College Hospital
      • London, Verenigd Koninkrijk, SW170RE
        • St. George's Hospital
      • Sheffield, Verenigd Koninkrijk, S5 7AU
        • Royal Hallamshire Hospital
      • Swansea, Verenigd Koninkrijk, SA6 6NL
        • Morriston Hospital
    • Alabama
      • Mobile, Alabama, Verenigde Staten, 36617
        • University Of South Alabama
      • Mobile, Alabama, Verenigde Staten, 36608
        • Coastal Clinical Research
    • California
      • Riverside, California, Verenigde Staten, 92503
        • Apex Research of Riverside
      • Stanford, California, Verenigde Staten, 94305-5114
        • Stanford University Medical Center
    • Colorado
      • Denver, Colorado, Verenigde Staten, 80262
        • University of Colorado Health Sciences Center
    • Connecticut
      • New Haven, Connecticut, Verenigde Staten, 06510
        • Yale University School of Medicine
    • Florida
      • Jacksonville, Florida, Verenigde Staten, 32216
        • Jacksonville Center for Clinical Research
      • Port Charlotte, Florida, Verenigde Staten, 33952
        • Coastal Nephrology Associates Research Center, LLC
    • Georgia
      • Atlanta, Georgia, Verenigde Staten, 30308
        • Emory University School of Medicine
    • Illinois
      • Chicago, Illinois, Verenigde Staten, 60611
        • Northwestern University
    • Kansas
      • Kansas City, Kansas, Verenigde Staten, 66160
        • University of Kansas Medical Center
    • Louisiana
      • Baton Rouge, Louisiana, Verenigde Staten, 70809
        • Renal Associates of Baton Rough, L.L.C.
    • Maryland
      • Baltimore, Maryland, Verenigde Staten, 21205
        • John Hopkins School of Medicine
    • Massachusetts
      • Boston, Massachusetts, Verenigde Staten, 02215
        • Beth Israel Deaconess Medical Center
      • Boston, Massachusetts, Verenigde Staten, 02111
        • Tufts- New England Medical Center
    • Minnesota
      • Rochester, Minnesota, Verenigde Staten, 55905
        • Mayo Medical Center
    • New York
      • Buffalo, New York, Verenigde Staten, 14215
        • Erie County Medical Center
      • Hawthorne, New York, Verenigde Staten, 10532
        • Nephrology Associates of Westchester
      • New York, New York, Verenigde Staten, 10032
        • Columbia University Medical Center
      • New York, New York, Verenigde Staten, 10021
        • The Rogosin Institute
    • North Carolina
      • Chapel Hill, North Carolina, Verenigde Staten, 27599
        • University of North Carolina, UNC, Kidney Center
      • Greenville, North Carolina, Verenigde Staten, 27834
        • East Carolina University
    • Ohio
      • Cincinnati, Ohio, Verenigde Staten, 45220
        • Kidney and Hypertension Center
      • Cleveland, Ohio, Verenigde Staten, 44106
        • University Hospitals of Cleveland/Case
    • Oregon
      • Portland, Oregon, Verenigde Staten, 97210
        • Northwest Renal Clinic, Inc.
    • Pennsylvania
      • Philadelphia, Pennsylvania, Verenigde Staten, 19104
        • University of Pennsylvania Medical Center
    • South Carolina
      • Charleston, South Carolina, Verenigde Staten, 29405
        • Charleston Nephrology Associates
    • Tennessee
      • Nashville, Tennessee, Verenigde Staten, 37205
        • Nephrology Associates, P.C.
      • Nashville, Tennessee, Verenigde Staten, 37232-1371
        • Vanderbilt University Medical Center
    • Virginia
      • Charlottesville, Virginia, Verenigde Staten, 22908
        • University of Virginia, Nephrology Clinical Research Center

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar tot 50 jaar (Volwassen)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  • Legal adult age and able to give Informed Consent.
  • Adult subjects with a diagnosis of ADPKD. A diagnosis of ADPKD (age 18 or 20-50) required several cysts in each kidney (3 if by sonography, 5 if by CT or MRI) in those with a family history of ADPKD and 10 cysts (by any radiologic method) in each kidney and exclusion of other cystic kidney diseases if there was no family history.
  • Willingness to comply with reproductive precautions, if female.
  • Estimated creatinine clearance ≥ 60 mL/min. Estimated from serum creatinine during screening using Cockcroft-Gault with correction for gender and race, where possible.
  • Rapidly progressive kidney growth (total volume ≥ 750 cc) by magnetic resonance imaging (MRI) at randomization.

Exclusion Criteria:

  • Prior exposure to tolvaptan or other experimental PKD therapies.
  • Currently taking medication for purpose of affecting PKD cysts.
  • Women who are breast feeding and females of childbearing potential who are not using acceptable contraceptive methods.
  • In the opinion of the study investigator or sponsor may present a safety risk or confound study objectives.
  • Patients who are unlikely to adequately comply with study procedures.
  • Patients having contraindications to MRI.
  • Patients taking medications or having any illnesses likely to affect ADPKD outcomes.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Verviervoudigen

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Tolvaptan
Participants received the highest tolerated split-dose regimen (upon awakening and 9 hours later) of tolvaptan 45/15 mg, 60/30 mg, or 90/30 mg orally for 36 months.
Tolvaptan was supplied as tablets.
Andere namen:
  • OPC-41061
  • OPC-156
Placebo-vergelijker: Placebo
Participants received placebo (upon awakening and 9 hours later) orally for 36 months.
Placebo was supplied as tablets.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Percentage Change Per Year in Total Kidney Volume From Baseline to Month 36
Tijdsspanne: Baseline to Month 36
Kidney volume was assessed in T1-weighted magnetic resonance images collected at each study site and sent to a central reviewing facility. At the central reviewing facility, blinded radiologists used proprietary software to measure the volume of both kidneys.
Baseline to Month 36

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Number of ADPKD Clinical Progression Events Per 100 Follow-up Years From Baseline to Month 36
Tijdsspanne: Baseline to Month 36
These ADPKD events in the key secondary Outcome Measure were selected on the basis of their potential relationship to progressing cystogenesis. Reducing the rate of cyst development and expansion would likely slow the progression of ADPKD. The 4 events were: (1) Onset or progression of hypertension (someone is hypertensive if they have > 139 mmHg systolic blood pressure [BP], > 89 mmHg diastolic BP, or if they are taking antihypertensive medication at any BP level); (2) severe renal pain requiring medical intervention; (3) worsening albuminuria (by category, see below); and (4) worsening renal function, defined as a 25% decrease in 1/serum creatinine from Baseline. Albuminuria was assessed using spot urine albumin/creatinine ratio measurements (all measurements in mg/mmol). Categories included normal (< 2.8 female or < 2.0 male), microalbuminuria (2.8-28 female or 2.0-20 male), and overt proteinuria (> 28 female or > 20 male.
Baseline to Month 36
Change in Renal Function Per Year From Week 3 to Month 36
Tijdsspanne: Week 3 to Month 36
Renal function was assessed using serum creatinine measurements and was estimated using 1/serum creatinine. The formula for 1/serum creatinine is: 1/Pcr, where Pcr = serum creatinine concentration (mg/dL). The change in renal function per year was based on the slope of change, obtained by regressing renal function data against time by subject.
Week 3 to Month 36
Change in Mean Arterial Blood Pressure Per Year in Non-hypertensive Participants From Baseline to Month 36
Tijdsspanne: Baseline to Month 36
For participants who were non-hypertensive (systolic BP ≤ 139 mmHg and diastolic BP ≤ 89 mmHg without taking antihypertensive medications) at baseline, mean arterial blood pressure was measured at scheduled clinic visits up to the point of exposure to antihypertensive therapy for any reason. The change in mean arterial blood pressure per year was based on the slope of blood pressure, obtained by regressing blood pressure against time by subject.
Baseline to Month 36
Area Under the Concentration-time Curve of Change in Renal Pain From Baseline to Month 36
Tijdsspanne: At screening, Baseline, Day 1, every 4 months up to month 36/early tremination (ET), follow-up visit 1 and 2
Change from baseline in renal pain was assessed by a 0 to 10 pain scale as average area under the concentration-time curve (AUC) between baseline and the last trial visit or the last visit prior to initiating medical (eg, narcotic or anti-nociceptives [eg, tricyclic antidepressants]) or surgical therapy for pain. In the pain scale, score 0 represented no pain at all and score 10 represented the worst pain. A negative change score indicates less pain. AUC of renal pain was derived from renal pain scores within treatment period and was calculated using the trapezoidal rule, by dividing the number of days between the first and last assessment.
At screening, Baseline, Day 1, every 4 months up to month 36/early tremination (ET), follow-up visit 1 and 2
Number of Hypertensive Events Per 100 Follow-up Years in Non-hypertensive Participants From Baseline to Month 36
Tijdsspanne: Baseline to Month 36
A hypertensive event was defined as a change from non-hypertensive (systolic BP ≤ 139 mmHg and diastolic BP ≤ 89 mmHg without taking antihypertensive medications) status to 1 of 3 conditions: (1) High pre-hypertensive (systolic BP [sBP] > 129 mmHg and/or diastolic BP [dBP] > 84 mmHg), (2) hypertensive (sBP > 139 mmHg and/or dBP > 89 mmHg), or (3) requiring antihypertensive therapy.
Baseline to Month 36
Percentage of Participants With a Clinically Sustained Decrease of Blood Pressure Leading to a Sustained Reduction in Antihypertensive Therapy From Baseline to Month 36
Tijdsspanne: Baseline to Month 36
Baseline to Month 36

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Onderzoekers

  • Hoofdonderzoeker: Vicente Torres, MD, PhD, Mayo Medical Center
  • Studie directeur: Frank Czerwiec, MD, PhD, Otsuka Pharmaceutical Development and Commercialization, Inc.
  • Studie directeur: Osamu Sato, Otsuka Pharmaceutical Corporation, Ltd. Japan

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Algemene publicaties

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start

1 januari 2007

Primaire voltooiing (Werkelijk)

1 januari 2012

Studie voltooiing (Werkelijk)

1 januari 2012

Studieregistratiedata

Eerst ingediend

26 januari 2007

Eerst ingediend dat voldeed aan de QC-criteria

29 januari 2007

Eerst geplaatst (Schatting)

30 januari 2007

Updates van studierecords

Laatste update geplaatst (Werkelijk)

2 juli 2017

Laatste update ingediend die voldeed aan QC-criteria

30 mei 2017

Laatst geverifieerd

1 mei 2017

Meer informatie

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 Tolvaptan

3
Abonneren