Patient-centred Intervention With Virtual Support for Obesity and Kidney Transplant Access (PIVOT)
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.
Przegląd badań
Status
Status
Warunki
Warunki
Interwencja / Leczenie
Interwencja / Leczenie
Typ studiów
Typ studiów
Zapisy (Szacowany)
Zapisy
Faza
Faza
- Faza 4
Kontakty i lokalizacje
Kontakt w sprawie studiów
Kontakt w sprawie studiów
- Nazwa: Heather LaPier
- Numer telefonu: 65373 519-646-6100
- E-mail: heather.lapier@sjhc.london.on.ca
Lokalizacje studiów
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Ontario
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London, Ontario, Kanada
- London Health Sciences Centre
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Kontakt:
- Heather LaPier, MD
- Numer telefonu: 65373 519-646-6100
- E-mail: heather.lapier@sjhc.london.on.ca
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London, Ontario, Kanada, N6A4V2
- St. Joseph's Health Care
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Kontakt:
- Heather LaPier
- Numer telefonu: 65373 519-646-6100
- E-mail: heather.lapier@sjhc.london.on.ca
-
-
Kryteria uczestnictwa
Kryteria kwalifikacji
Kryteria kwalifikacji
Wiek uprawniający do nauki
Akceptuje zdrowych ochotników
Płeć kwalifikująca się do nauki
Opis
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
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Brak (otwarta etykieta)
Liczba ramion
Broń i interwencje
Grupa uczestników / ArmGrupa uczestników / Arm |
Interwencja / LeczenieInterwencja / Leczenie |
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Eksperymentalny: 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.
Inne nazwy:
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.
Inne nazwy:
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Brak interwencji: 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. |
Co mierzy badanie?
Podstawowe miary wyniku
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Change in Body Weight
Ramy czasowe: 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
|
Miary wyników drugorzędnych
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Quality of Life - Kidney Disease Quality of Life 36-Item Short Form
Ramy czasowe: 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
Ramy czasowe: 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
|
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Change in Functional Status - Kidney Disease Quality of Life 36-Item Short form (KDQOL-36)
Ramy czasowe: 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
|
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Change in Functional Status - European Quality of Life five-dimensional, five-level generic measure (EQ-5D-5L) scores across treatment arms.
Ramy czasowe: 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
|
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Weight Loss ≥5%
Ramy czasowe: 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
|
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Weight Loss ≥10%
Ramy czasowe: 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
|
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Weight Loss ≥15%
Ramy czasowe: 26 weeks +/- 14 days
|
Percentage of participants achieving at least 15% reduction in body weight from baseline. |
26 weeks +/- 14 days
|
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Weight Loss ≥20%
Ramy czasowe: 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
|
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Body Mass Index (BMI)
Ramy czasowe: Baseline to 26 weeks +/- 14 days
|
Change in BMI across treatment arms. Measured in kg/m² |
Baseline to 26 weeks +/- 14 days
|
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Body Surface Area (BSA)
Ramy czasowe: Baseline to 26 weeks +/- 14 days
|
Change in BSA across treatment arms. Measured in m². |
Baseline to 26 weeks +/- 14 days
|
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Body Mass Index <35 kg/m²
Ramy czasowe: 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
|
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Dalhousie Clinical Frailty Scale Rating
Ramy czasowe: 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
|
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SARC-F Score
Ramy czasowe: 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
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FRAIL Scale
Ramy czasowe: Baseline to 26 weeks +/- 14 days
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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
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Acute Kidney Injury (AKI)
Ramy czasowe: Baseline to 26 weeks +/- 14 days
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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
|
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Hypoglycemia
Ramy czasowe: 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
|
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Gastrointestinal Symptoms
Ramy czasowe: Baseline to 26 weeks +/- 14 days
|
Incidence of gastrointestinal symptoms, including nausea, vomiting, constipation |
Baseline to 26 weeks +/- 14 days
|
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Acute Biliary Disease
Ramy czasowe: Baseline to 26 weeks +/- 14 days
|
Incidence of acute biliary disease. |
Baseline to 26 weeks +/- 14 days
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Acute Pancreatitis
Ramy czasowe: Baseline to 26 weeks +/- 14 days
|
Incidence of acute pancreatitis. |
Baseline to 26 weeks +/- 14 days
|
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Diabetic Retinopathy Interventions
Ramy czasowe: Baseline to 26 weeks +/- 14 days
|
Incidence of interventions for diabetic retinopathy |
Baseline to 26 weeks +/- 14 days
|
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Injection-site reactions
Ramy czasowe: Baseline to 26 weeks +/- 14 days
|
Incidence of injection-site reactions in the intervention arm. |
Baseline to 26 weeks +/- 14 days
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Malignant Neoplasms
Ramy czasowe: Baseline to 26 weeks +/- 14 days
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Incidence of malignant neoplasms. |
Baseline to 26 weeks +/- 14 days
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Coaching Visit Adherence
Ramy czasowe: Baseline to 26 weeks +/- 14 days
|
Percentage of participants completing ≥4 of 6 coaching visits. |
Baseline to 26 weeks +/- 14 days
|
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Semaglutide Discontinuation
Ramy czasowe: Baseline to 26 weeks +/- 14 days
|
Percentage of participants discontinuing semaglutide in the intervention arm. |
Baseline to 26 weeks +/- 14 days
|
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Achievement of semaglutide dose ≥1.0 mg/week
Ramy czasowe: Week 26 +/- 14 days
|
Percentage of participants in the intervention group achieving a semaglutide dose of ≥1.0 mg/week. |
Week 26 +/- 14 days
|
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Achievement of Semaglutide Dose ≥2.0 mg/week
Ramy czasowe: 26 weeks +/- 14 days
|
Percentage of participants achieving a semaglutide dose of ≥2.0 mg/week |
26 weeks +/- 14 days
|
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Semaglutide Initiation in Usual Care
Ramy czasowe: Baseline to 26 weeks +/- 14 days
|
Percentage of usual care arm participants initiating semaglutide during the study period. |
Baseline to 26 weeks +/- 14 days
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Use of Semaglutide in Usual Care Participants
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 26 Weeks +/- 14 days
|
Percentage of usual care participants achieving semaglutide dose ≥2.0 mg/week |
26 Weeks +/- 14 days
|
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Body Fat Percentage Measured with Smart Scale
Ramy czasowe: 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
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Muscle Mass Measured with Smart Scale
Ramy czasowe: 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
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Intervention Costs
Ramy czasowe: Baseline to 26 weeks
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The total cost of the intervention incurred by participants during the 26-week follow-up period, in Canadian dollars (CAD) |
Baseline to 26 weeks
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Out-of-pocket costs
Ramy czasowe: 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
|
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Lost Productivity Costs
Ramy czasowe: 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
|
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Health care utilization costs
Ramy czasowe: 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
|
Inne miary wyników
Inne miary wyników
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Change in HbA1c
Ramy czasowe: Baseline to 24 Months
|
Change in glycated hemoglobin among participants with diabetes across treatment arms. |
Baseline to 24 Months
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Hospitalization for Hyperglycemia
Ramy czasowe: Baseline to 24 Months
|
Incidence of hospitalization for hyperglycemia in participants with diabetes across treatment arms |
Baseline to 24 Months
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Hospitalization for hypoglycemia
Ramy czasowe: Baseline to 24 Months
|
Incidence of hospitalization for hypoglycemia in participants with diabetes across treatment arms. |
Baseline to 24 Months
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Initiation of Dialysis
Ramy czasowe: Baseline to 24 Months
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Percentage of non-dialysis participants initiating dialysis across treatment arms |
Baseline to 24 Months
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Cardiovascular Composite
Ramy czasowe: Baseline to 24 Months
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Composite of hospitalization for acute myocardial infarction, stroke, amputation, or heart failure across treatment arms. |
Baseline to 24 Months
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Kidney Transplantation
Ramy czasowe: Baseline to 24 months
|
Percentage of participants receiving kidney transplantation across treatment arms. |
Baseline to 24 months
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Healthcare utilization
Ramy czasowe: 24 months
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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
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Health care costs
Ramy czasowe: 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
|
Współpracownicy i badacze
Sponsor
Sponsor
Śledczy
Śledczy
- Główny śledczy: Kristin Clemens, MD, St. Joseph's Health Care London, Western University
- Główny śledczy: Louise Moist, MD, London Health Sciences Centre
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Szacowany)
Rozpoczęcie studiów
Zakończenie podstawowe (Szacowany)
Zakończenie podstawowe
Ukończenie studiów (Szacowany)
Ukończenie studiów
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Pierwszy wysłany
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia wysłana aktualizacja
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Dodatkowe istotne warunki MeSH
- Choroby układu moczowo-płciowego
- Procesy patologiczne
- Zaburzenia odżywiania
- Choroby układu moczowo-płciowego u mężczyzn
- Choroby nerek
- Choroby Urologiczne
- Choroby układu moczowo-płciowego kobiet
- Choroby układu moczowo-płciowego kobiet i powikłania ciąży
- Przewlekła choroba
- Atrybuty choroby
- Przekarmienie
- Masy ciała
- Niewydolność nerek
- Nadwaga
- Stany patologiczne, oznaki i objawy
- Choroby żywieniowe i metaboliczne
- Objawy i symptomy
- Otyłość
- Niewydolność nerek, przewlekła
- Semaglutyd
Inne numery identyfikacyjne badania
Inne numery identyfikacyjne badania
- PIVOT
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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