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)
研究概览
地位
详细说明
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.
研究类型
注册 (估计的)
阶段
- 阶段2
联系人和位置
学习联系方式
- 姓名:Laura Nguyen
- 电话号码:(971) 509-4222
- 邮箱:nguyelau@ohsu.edu
研究联系人备份
- 姓名:Aly Carlson
- 电话号码:(971) 610-3005
- 邮箱:carlsaly@ohsu.edu
学习地点
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Michigan
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Ann Arbor、Michigan、美国、48109
- University of Michigan
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副研究员:
- Matthias Kretzler, MD
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接触:
- Hailey Desmond, MS
- 电话号码:(734) 764-6955
- 邮箱:heturner@med.umich.edu
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首席研究员:
- Lynn Ang, MD
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Oregon
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Portland、Oregon、美国、97239
- Oregon Health & Science University
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首席研究员:
- Rodica Busui, MD, PhD
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副研究员:
- Brian Davidson, MD
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接触:
- Laura Nguyen
- 电话号码:971-509-4222
- 邮箱:nguyelau@ohsu.edu
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接触:
- Aly Carlson
- 电话号码:971-610-3005
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副研究员:
- Jonathan Purnell, MD
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副研究员:
- David Ellison, MD
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副研究员:
- Kristin Childress, MD, MPH
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参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
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
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的: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.
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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.
其他名称:
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实验性的: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.
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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.
其他名称:
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Markers of Renal Health [Safety and Tolerability]
大体时间: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]
大体时间: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]
大体时间: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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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Immediate Outcomes of Renal Health (week 6)
大体时间: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.
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20 weeks
|
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Immediate Outcomes of Cardio Health (week 6)
大体时间: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
大体时间: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
|
合作者和调查者
调查人员
- 学习椅:Rodica Busui, MD, PhD、Oregon Health and Science University
研究记录日期
研究主要日期
学习开始 (估计的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
- 30027
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
IPD 计划说明
IPD 共享时间框架
IPD 共享访问标准
IPD 共享支持信息类型
- 研究方案
- 树液
- 国际碳纤维联合会
- 分析代码
- 企业社会责任
药物和器械信息、研究文件
研究美国 FDA 监管的药品
研究美国 FDA 监管的设备产品
在美国制造并从美国出口的产品
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