Study of the Efficacy and Safety of Tesevatinib in Subjects With ADPKD

ADPKD Clinical Trial

Official title:

A Double-blind Randomized Parallel Group Study of the Efficacy and Safety of Tesevatinib in Subjects With Autosomal Dominant Polycystic Kidney Disease

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03203642
• Other study ID #: ACT17675
• Secondary ID: KD019-211
• Status: Completed
• Phase: Phase 2
• Start date: October 12, 2017
• Est. completion date: January 25, 2022

Study information

• Verified date: January 2023
• Source: Sanofi
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The goal of the study was to compare and evaluate safety and efficacy of tesevatinib 50 milligrams (mg) versus placebo in participants with autosomal dominant polycystic kidney disease (ADPKD).

Description:

Safety and efficacy of 50 mg tesevatinib in comparison to placebo in participants with ADPKD was assessed. The primary purpose of this study was focused on evaluating the change from Baseline in height-adjusted total kidney volume (htTKV) as measured by magnetic resonance imaging (MRI) at Months 12, 18, and 24, and 30 days post-dose in participants with ADPKD treated with tesevatinib or placebo. If eligible for the study participation, participants were randomly assigned to either investigational treatment group or placebo group. Treatment group received 50 mg tesevatinib once daily for 24 months and control group received the placebo once daily for 24 months.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 80
• Est. completion date: January 25, 2022
• Est. primary completion date: January 25, 2022
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 60 Years

Eligibility

Inclusion Criteria:

• ADPKD diagnosis based on Ravine's criteria.
• Cysts of at least 1 centimeter.
• Estimated glomerular filtration rate greater than or equal to (>=) 25 milliliter per minute per 1.73 square meter (mL/min/1.73 m^2) and less than or equal to (<=) 90 mL/min/1.73 m^2, using the Modification of Diet in Renal Disease-4 variable formula.
• htTKV must meet the following requirements: >= 500 milliliters (mL) for participants 18-35 years of age; >= 750 mL for participants 36-49 years of age; >= 900 mL for participants 50-60 years of age.
• The participant had the following laboratory values:

Platelets greater than (>) lower limit of normal (LLN); Hemoglobin > 9 grams per deciliter; Total bilirubin <= 1.5 milligrams per deciliter; Aspartate aminotransferase less than (<) 2.5*upper limit of normal (ULN); Alanine aminotransferase < 2.5*ULN; Prothrombin time/partial thromboplastin time <=1.5*ULN; Serum potassium levels within normal limits; Serum magnesium levels within normal limits; Albumin >= LLN; Amylase <=1.5*ULN; Lipase <=1.5*ULN; Prothrombin time and partial thromboplastin time <=1.5*ULN; International normalized ratio (INR) <=1.5, except those participants taking warfarin who must have INR <=3.

• Female participants of childbearing potential with negative pregnancy test at screening.
• If sexually active, the participant agreed to use 2 accepted methods of contraception during the course of the study and for 6 months after their last dose of study drug.

Exclusion Criteria:

• Previous nephrectomy.
• Kidney transplant.
• Tuberous sclerosis.
• Hippel-Lindau disease.
• Acquired cystic disease.
• Congenital absence of 1 kidney and/or need for dialysis or transplantation in the foreseeable future.
• Moderate hematuria.
• Uncontrolled hypertension.
• Presence of renal or hepatic calculi (stones) causing symptoms.
• Received any investigational therapy within 30 days prior to initiation of therapy (Day 1 visit).
• Received tolvaptan 30 days prior to initiation of therapy (Day 1 visit).
• Received active treatment for urinary tract infection 4 weeks prior to initiation of therapy (Day 1 visit).
• History of pancreatitis or known risk of pancreatitis.
• The participant met any of the following cardiac criteria:
• Mean QTc interval corrected for heart rate using Fridericia's formula (QTcF) of >450 milliseconds.
• History of torsade de pointes, ventricular tachycardia or fibrillation, pathologic sinus bradycardia (< 50 beats per minute), heart block (excluding first-degree block, being PR interval prolongation only), congenital long QT syndrome or new ST segment elevation or depression or new Q wave on electrocardiogram.
• Participants with a history of atrial arrhythmias were discussed with the Medical Monitor.
• Family history of congenital long QT syndrome or unexplained cardiac death.
• Symptomatic heart failure (per New York Heart Association guidelines), unstable angina, myocardial infarction, or cerebrovascular accident within 6 months prior to study entry.
• History of ventricular rhythm disturbances.
• History of cardiac arrhythmias, stroke, or myocardial infarction.
• Has a cardiac pacemaker.
• History of pericardial effusion or presence of pericardial effusion on screening echocardiogram.
• Taking any medication known to inhibit the cytochrome P450 (CYP)3A4 isozyme or any drugs that are CYP3A4 inducers, or any drugs associated with torsade de pointes or known to prolong the QTcF interval, including anti-arrhythmic medications within 2 weeks prior to screening.
• Uncontrolled intercurrent illness that would limit compliance with study requirements.
• Participant was pregnant, planed to become pregnant, or nursing.
• Human immunodeficiency virus positive.
• Hepatitis B or C positive.
• Immunocompromised.
• Documented renal vascular disease resulting in uncontrolled hypertension.
• Previously received an epithelial growth factor receptor (EGFR).
• Allergy or hypersensitivity to components of tesevatinib or placebo or their formulations.
• Been aphakic due to previous cataract surgery or congenital abnormality.

Related Conditions & MeSH terms

• ADPKD
• Arthrogryposis
• Autosomal Dominant Polycystic Kidney
• Polycystic Kidney Diseases
• Polycystic Kidney, Autosomal Dominant

Intervention

Drug:
• Tesevatinib
Pharmaceutical form: Tablet; Route of administration: orally
• Placebo
Pharmaceutical form: Tablet (identical to tesevatinib); Route of administration: orally

Locations

Country	Name	City	State
United States	Emory University School of Medicine	Atlanta	Georgia
United States	University of Colorado Denver	Aurora	Colorado
United States	University of Maryland	Baltimore	Maryland
United States	Beth Israel Deaconess Medical Center	Boston	Massachusetts
United States	Tufts Medical Center	Boston	Massachusetts
United States	University of Virginia	Charlottesville	Virginia
United States	University of California San Diego	La Jolla	California
United States	California Institute for Renal Research	La Mesa	California
United States	University of California Los Angeles	Los Angeles	California
United States	Medical College of Wisconsin	Milwaukee	Wisconsin
United States	Yale Nephrology Clinical Research	New Haven	Connecticut
United States	Rogosin Institute	New York	New York
United States	University of Pennsylvania	Philadelphia	Pennsylvania
United States	Coastal Nephrology Associates Research Center, LLC	Port Charlotte	Florida
United States	Mayo Clinic	Rochester	Minnesota
United States	Washington University	Saint Louis	Missouri
United States	University of California San Francisco	San Francisco	California
United States	Genesis Clinical Research	Tampa	Florida
United States	Baylor Scott & White Research Institute	Temple	Texas

Sponsors (1)

Lead Sponsor	Collaborator
Kadmon, a Sanofi Company

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change From Baseline in Height Adjusted Total Kidney Volume (htTKV) at Month 12	htTKV was calculated using total kidney volume (in milliliters) obtained from magnetic resonance imaging (MRI) divided by height (in meters). Least square (LS) mean and standard error (SE) were estimated by using analysis of covariance (ANCOVA) model. Change from Baseline in htTKV at Month 12 was reported in this outcome measure.	Baseline (Day 1), Month 12
Primary	Change From Baseline in Height Adjusted Total Kidney Volume at Month 18	htTKV was calculated using total kidney volume (in milliliters) obtained from MRI divided by height (in meters). LS mean and SE were estimated by using ANCOVA model. Change from Baseline in htTKV at Month 18 was reported in this outcome measure.	Baseline (Day 1), Month 18
Primary	Change From Baseline in Height Adjusted Total Kidney Volume at Month 24	htTKV was calculated using total kidney volume (in milliliters) obtained from MRI divided by height (in meters). LS mean and SE were estimated by using ANCOVA model. Change from Baseline in htTKV at Month 24 was reported in this outcome measure.	Baseline (Day 1), Month 24
Primary	Change From Baseline in Height Adjusted Total Kidney Volume at End of Study	htTKV was calculated using total kidney volume (in milliliters) obtained from MRI divided by height (in meters). LS mean and SE were estimated by using ANCOVA model. Change from Baseline in htTKV at end of study (i.e., up to 26 months) was reported in this outcome measure.	Baseline (Day 1), End of study (anytime up to 26 months)
Secondary	Number of Participants With Treatment-emergent Adverse Events (TEAEs)	An adverse event (AE) was any untoward medical occurrence in a clinical study participant administered a medicinal product and which did not necessarily had to have a causal relationship with the treatment. TEAEs were AEs that developed or worsened or became serious from the first dose (Day 1) of the study drug until end of study.	From Baseline (Day 1) up to 30 days post last dose of study drug (i.e., up to 26 months)
Secondary	Change From Baseline in Estimated Glomerular Filtration Rate (eGFR) at Months 12, 18, 24 and End of Study	eGFR is a test for renal function. eGFR was calculated by using the 4-variable modification of diet in renal disease (MDRD-4) formula reported as milliliters per minute per 1.73 square meter (mL/min/1.73 m^2). LS mean and SE were estimated using ANCOVA model.	Baseline (Day 1), Months 12, 18, 24 and at end of study (i.e., anytime up to 26 months)