- ICH GCP
- Rejestr badań klinicznych w USA
- Badanie kliniczne 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)
Przegląd badań
Status
Warunki
Interwencja / Leczenie
Szczegółowy opis
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 (see section XX) 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, 30, 48, and 72. The total study duration of participation will be up to 78 weeks, inclusive of screening and follow-up visits. Participants will be enrolled in this study at Oregon Health and 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.
Typ studiów
Zapisy (Szacowany)
Faza
- Faza 2
Kontakty i lokalizacje
Kontakt w sprawie studiów
- Nazwa: Laura Nguyen
- Numer telefonu: (971) 509-4222
- E-mail: nguyelau@ohsu.edu
Kopia zapasowa kontaktu do badania
- Nazwa: Aly Carlson
- Numer telefonu: (971) 610-3005
- E-mail: carlsaly@ohsu.edu
Lokalizacje studiów
-
-
Michigan
-
Ann Arbor, Michigan, Stany Zjednoczone, 48109
- University of Michigan
-
Pod-śledczy:
- Matthias Kretzler, MD
-
Kontakt:
- Hailey Desmond, MS
- Numer telefonu: (734) 764-6955
- E-mail: heturner@med.umich.edu
-
Główny śledczy:
- Lynn Ang, MD
-
-
Oregon
-
Portland, Oregon, Stany Zjednoczone, 97239
- Oregon Health & Science University
-
Główny śledczy:
- Rodica Busui, MD, PhD
-
Pod-śledczy:
- Brian Davidson, MD
-
Kontakt:
- Laura Nguyen
- Numer telefonu: 971-509-4222
- E-mail: nguyelau@ohsu.edu
-
Kontakt:
- Aly Carlson
- Numer telefonu: 971-610-3005
-
Pod-śledczy:
- Jonathan Purnell, MD
-
Pod-śledczy:
- David Ellison, MD
-
Pod-śledczy:
- Kristin Childress, MD, MPH
-
-
Kryteria uczestnictwa
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dorosły
- Starszy dorosły
Akceptuje zdrowych ochotników
Opis
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 study therapies outside study assignment within 2 months prior to screening. See Appendix A for active therapy arms.:
- Use of GLP-1 receptor agonists if in use for less than 1 month and/or not on stable dose for at least 2 weeks at screening
- 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 either of the following:
- History of diabetic ketoacidosis (DKA) or non-ketotic hyperosmolar state within 3 months prior to screening, or
- >1 episode of DKA or non-ketotic hyperosmolar state within 12 months prior to screening
- Serum potassium > 5 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, HIV, or hepatitis B or C at screening
- 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 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 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 investigator concern that may interfere with any aspect of study conduct or interpretation of results
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Brak (otwarta etykieta)
Broń i interwencje
Grupa uczestników / Arm |
Interwencja / Leczenie |
|---|---|
|
Eksperymentalny: 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.
Inne nazwy:
|
|
Eksperymentalny: 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.
Inne nazwy:
|
Co mierzy badanie?
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Markers of Renal Health [Safety and Tolerability]
Ramy czasowe: 26 weeks
|
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.
|
26 weeks
|
|
Markes of Cardio Health [Safety and Tolerability]
Ramy czasowe: 26 weeks
|
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.
|
26 weeks
|
|
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
Ramy czasowe: 26 weeks
|
The primary safety endpoints are defined as incidence of serious adverse events, adverse events and clinically significant abnormal laboratory tests.
|
26 weeks
|
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Immediate Outcomes of Renal Health (week 6)
Ramy czasowe: 20 weeks
|
The secondary endpoints are measures of immediate outcomes on markers of renal health as defined by changes from baseline to week 6 in UACR.
|
20 weeks
|
|
Immediate Outcomes of Cardio Health (week 6)
Ramy czasowe: 20 weeks
|
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.
|
20 weeks
|
|
Immediate (week 6) and Early (week 26) Outcomes of Nephron Function Failure
Ramy czasowe: 26 weeks
|
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.
|
26 weeks
|
Współpracownicy i badacze
Śledczy
- Krzesło do nauki: Rodica Busui, MD, PhD, Oregon Health and Science University
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Szacowany)
Zakończenie podstawowe (Szacowany)
Ukończenie studiów (Szacowany)
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
- Choroby układu hormonalnego
- Choroby układu krążenia
- Choroby serca
- Choroby metaboliczne
- Choroby Autoimmunologiczne
- Choroby układu odpornościowego
- Zaburzenia metabolizmu glukozy
- Cukrzyca
- Choroby żywieniowe i metaboliczne
- Niewydolność serca
- Cukrzyca typu 1
- (2S,3R,4R,5S,6R)-2-(4-chloro-3-(4-etoksybenzylo)fenylo)-6-(metylotio)tetrahydro-2H-pirano-3,4,5-triol
- Finerenone
Inne numery identyfikacyjne badania
- 30027
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Opis planu IPD
Ramy czasowe udostępniania IPD
Kryteria dostępu do udostępniania IPD
Typ informacji pomocniczych dotyczących udostępniania IPD
- PROTOKÓŁ BADANIA
- SOK ROŚLINNY
- ICF
- ANALITYCZNY_KOD
- CSR
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
produkt wyprodukowany i wyeksportowany z USA
Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .
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