Paricalcitol for the Treatment of Immunoglobulin A Nephropathy
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Purpose
Immunoglobulin A (IgA) nephropathy is the common type of primary glomerulonephritis in the world. A wealth of literature suggests that vitamin D and its analogs have profound effects on immune system function and glomerular mesangial cell proliferation. However, calcitriol, the standard form of vitamin D, carries a substantial risk of hypercalcemia. Recently, paricalcitol (19-nor-1,25-dihydroxyvitamin D2) was approved for the treatment of secondary hyperparathyroidism in chronic renal failure, and the incidence of hypercalcemia is much lower than calcitriol. Therefore, the investigators plan to conduct a randomized cross-over study to evaluate the efficacy of paricalcitol in the treatment of IgA nephropathy. Thirty patients with biopsy-proven IgA nephropathy will be recruited. They will be randomized to paricalcitol for 12 weeks or no treatment, followed by cross over to the other arm after a washout period. Proteinuria, renal function, serum and urinary inflammatory markers will be monitored. This study will explore the potential anti-proteinuric and anti-inflammatory effects of paricalcitol in the treatment of IgA nephropathy, which has no specific treatment at present.
| Condition | Intervention | Phase |
|---|---|---|
|
IGA Nephropathy |
Drug: paricalcitol |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Crossover Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Paricalcitol for the Treatment of Immunoglobulin A Nephropathy - A Randomized Cross-Over Study |
- change in the degree of proteinuria [ Time Frame: 12 weeks ] [ Designated as safety issue: Yes ]
- rate of decline of estimated GFR (as determined by the least square method) and change in other serum inflammatory markers [ Time Frame: 12 weeks ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 30 |
| Study Start Date: | January 2008 |
| Estimated Study Completion Date: | December 2009 |
| Estimated Primary Completion Date: | October 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
paricalcitol 1 mg/day for 12 weeks, followed by a washout period of 4 weeks, then crossed over to no treatment for another 12 weeks
|
Drug: paricalcitol
paricalcitol 1 mg/day
|
|
Active Comparator: 2
no treatment for 12 weeks, followed by a washout period of 4 weeks, then crossed over to paricalcitol for another 12 weeks
|
Drug: paricalcitol
paricalcitol 1 mg/day
|
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- aged 18-65 years
- biopsy-confirmed IgA nephropathy
- proteinuria > 1 g/day (or proteinuria > 1 g/g-Cr) in 3 consecutive samples within 12 weeks despite ACE inhibitor or angiotensin receptor blocker treatment (e.g. ramipril 5 mg daily, lisinopril 10 mg daily, or valsartan 80 mg daily) for at least 3 months
- estimated glomerular filtration rate > 60 ml/min/1.73m2
- corrected serum calcium level > or = 2.45 mmol/l
- willingness to give written consent and comply with the study protocol
Exclusion Criteria:
- Pregnancy, lactating or childbearing potential without effective method of birth control
- Severe gastrointestinal disorders that interfere with their ability to receive or absorb oral medication
- History of malignancy, including leukemia and lymphoma within the past 2 years
- Systemic infection requiring therapy at study entry
- Any other severe coexisting disease such as, but not limited to, chronic liver disease, myocardial infarction, cerebrovascular accident, malignant hypertension
- History of drug or alcohol abuse within past 2 years
- Participation in any previous trial on paricalcitol
- Patients receiving treatment of vitamin D and/or its analogue for other medical reasons within the past 3 months
- Patients receiving treatment of corticosteroid
- On other investigational drugs within last 30 days
- History of a psychological illness or condition such as to interfere with the patient's ability to understand the requirement of the study
- History of non-compliance
- Known history of sensitivity or allergy to paricalcitol or other vitamin D analogs
Contacts and Locations| China | |
| Department of Medicine & Therapeutics, Prince of Wales Hospital | |
| Hong Kong, China | |
| Principal Investigator: | Cheuk Chun Szeto, MD | Chinese University of Hong Kong |
More Information
No publications provided
| Responsible Party: | Dr. SZETO, Cheuk Chun, The Chinese University of Hong Kong |
| ClinicalTrials.gov Identifier: | NCT00599963 History of Changes |
| Other Study ID Numbers: | CRE-2007.409-T, CRE-2007.409-T |
| Study First Received: | January 2, 2008 |
| Last Updated: | January 29, 2009 |
| Health Authority: | Hong Kong: Joint CUHK-NTEC Clinical Research Ethics Committee |
Additional relevant MeSH terms:
|
Glomerulonephritis, IGA Kidney Diseases Glomerulonephritis Nephritis Urologic Diseases Autoimmune Diseases Immune System Diseases Immunoglobulin A Immunoglobulins |
Antibodies Ergocalciferols Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions Bone Density Conservation Agents Vitamins Micronutrients Growth Substances |
ClinicalTrials.gov processed this record on May 23, 2013