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A Study of the Effect and Safety of Sparsentan in the Treatment of Patients With IgA Nephropathy (PROTECT)

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ClinicalTrials.gov Identifier: NCT03762850
Recruitment Status : Recruiting
First Posted : December 4, 2018
Last Update Posted : May 12, 2020
Sponsor:
Information provided by (Responsible Party):
Retrophin, Inc.

Study Description
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Brief Summary:
To determine the long-term (approximately 2 years) nephroprotective potential of treatment with sparsentan as compared to an angiotensin receptor blocker in patients with immunoglobulin A nephropathy (IgAN).

Condition or disease Intervention/treatment Phase
Immunoglobulin A Nephropathy Drug: sparsentan Drug: irbesartan Phase 3

Detailed Description:

This is a randomized, multicenter, double-blind, parallel-group, active-control study. Approximately 280 patients aged ≥18 years will be enrolled in the study globally. The investigational drug (sparsentan) is a dual acting angiotensin receptor blocker and endothelin receptor antagonist. The active control is irbesartan.

The purpose of the study is to evaluate the potential benefit of sparsentan on kidney function by analyzing change in proteinuria (protein in urine) and estimated glomerular filtration rate (eGFR) as compared to current standard treatment.

Patients enrolled in the PROTECT study (Protocol 021IGAN17001) will be those at high risk of progressing to renal failure. They will be randomly assigned n a 1:1 ratio to either sparsentan or irbesartan, as the active control (current standard treatment) at the Day 1 (Randomization) visit. Study medication (sparsentan and irbesartan) will be administered as a single oral morning dose.

The primary analysis is change in proteinuria (urine protein/creatinine ratio) from baseline at Week 36 in sparsentan-treated patients as compared to irbesartan-treated patients.

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 280 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: A Randomized, Multicenter, Double-blind, Parallel-group, Active-control Study of the Efficacy and Safety of Sparsentan for the Treatment of Immunoglobulin A Nephropathy
Actual Study Start Date : December 20, 2018
Estimated Primary Completion Date : March 2023
Estimated Study Completion Date : April 2023

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Kidney Diseases
Drug Information available for: Irbesartan

Arms and Interventions
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Arm Intervention/treatment
Experimental: sparsentan
Sparsentan will be administered daily as a 200-mg oral tablet, over-encapsulated (blinded) size 00 capsule for the first 2 weeks of the study following randomization. For patients who tolerate the initial dose of 200 mg after 2 weeks will increase their dose to 400 mg and continue treatment to Week 110.
 Drug: sparsentan
Target dose of 400 mg daily
Other Name: RE-021
Active Comparator: irbesartan
Irbesartan will be administered daily as a 150-mg oral tablet, over-encapsulated (blinded) size 00 capsule for the first 2 weeks of the study following randomization. For patients who tolerate the initial dose of 150 mg after 2 weeks will increase their dose to 300 mg and continue treatment to Week 110.
 Drug: irbesartan
Target dose of 300 mg daily
Other Name: Irbesartan Tablets USP


Outcome Measures
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Primary Outcome Measures :
  1. Urine protein/creatinine ratio (UP/C) at Week 36 [ Time Frame: After the last patient randomized has undergone the Week 36 visit ]
    The primary efficacy endpoint is the change from baseline in the urine protein/creatinine ratio (UP/C), based on a 24-hour urine sample, at Week 36.


Secondary Outcome Measures :
  1. Overall eGFR change from baseline [ Time Frame: Week 114 post-randomization ]
    Change in eGFR from baseline (Week 0) to 4 weeks post-cessation of randomized treatment (Week 114).

  2. eGFR over a 52-week period [ Time Frame: Week 58 post-randomization ]
    The rate of change in estimated glomerular filtration rate (eGFR) over a 52-week period following the initial acute effect of randomized therapy (the initial acute effect of randomized therapy is defined as the first 6 weeks of randomized treatment with study medication; thus, the analysis is from 6 weeks post-randomization to 58 weeks post-randomization).

  3. eGFR over a 104-week period [ Time Frame: Week 110 post-randomization ]
    The rate of change in estimated glomerular filtration rate (eGFR) over a 104-week period following initial acute effect of randomized therapy (the initial acute effect of randomized therapy is defined as the first 6 weeks of randomized treatment with study medication; thus, the analysis is from 6 weeks post-randomization to 110 weeks post-randomization).


Eligibility Criteria
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Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Key Inclusion Criteria:

  • Age 18 years or older at screening
  • Biopsy-proven primary IgAN
  • Proteinuria of >=1 g/day at screening
  • eGFR >=30 mL/min/1.73 m2 at screening
  • Currently on stable dose of ACEI and/or ARB therapy, for at least 12 weeks prior to screening (maximum tolerated dose and at least one-half of the maximum labeled dose)
  • Systolic BP <=150 mmHg and diastolic BP <=100 mmHg at screening
  • Agree to contraception

Key Exclusion Criteria:

  • IgAN secondary to another condition
  • Presence of cellular glomerular crescents in >25% of glomeruli on renal biopsy (if biopsy available within 6 months of screening)
  • History of type 1 diabetes mellitus, uncontrolled type 2 diabetes mellitus (HbA1c >8%), or nonfasting blood glucose >180 mg/dL at screening
  • History of organ transplantation, with exception of corneal transplants
  • Require any prohibited medications
  • Treatment of systemic immunosuppressive medications (including corticosteroids) for >2 weeks within 3 months of screening
  • History of heart failure or previous hospitalization for heart failure or unexplained dyspnea, orthopnea, paroxysmal nocturnal dyspnea, ascites, and/or peripheral edema
  • Clinically significant cerebrovascular disease or coronary artery disease within 6 months of screening
  • Jaundice, hepatitis, or known hepatobiliary disease or elevations of transaminases (ALT/AST) >2 times upper limit of normal at screening
  • History of malignancy other than adequately treated basal cell or squamous cell skin cancer or cervical carcinoma within the past 2 years
  • Hematocrit value <27% or hemoglobin value <9 g/dL at Screening
  • Potassium >5.5 mEq/L at Screening
  • History of alcohol of illicit drug use disorder
  • History of serious side effect or allergic response to any angiotensin II antagonist or endothelin receptor antagonist, including sparsentan or irbesartan, or has a hypersensitivity to any of the excipients in the study medications
  • For female: Pregnancy, or planning to become pregnant during the course of the study, or breastfeeding
  • For male: planning to father a child during the course of the study
  • Participation in a study of another investigational product within 28 days of screening
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03762850


Contacts
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Contact: Retrophin Call Center 1-877-659-5518 medinfo@retrophin.com
Contact: Michelle Greenman 1-760-288-8062 michelle.greenman@retrophin.com

Locations
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Sponsors and Collaborators
Retrophin, Inc.
Investigators
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Study Director: Radko Komers, MD, PhD Retrophin, Inc.
More Information
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Additional Information:

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Responsible Party: Retrophin, Inc.
ClinicalTrials.gov Identifier: NCT03762850    
Other Study ID Numbers: 021IGAN17001
First Posted: December 4, 2018    Key Record Dates
Last Update Posted: May 12, 2020
Last Verified: May 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Kidney Diseases
Glomerulonephritis, IGA
Urologic Diseases
Glomerulonephritis
Nephritis
Autoimmune Diseases
 Immune System Diseases
Irbesartan
Antihypertensive Agents
Angiotensin II Type 1 Receptor Blockers
Angiotensin Receptor Antagonists
Molecular Mechanisms of Pharmacological Action