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Study Evaluating the Efficacy and Safety of Selonsertib in Participants With Moderate to Advanced Diabetic Kidney Disease (MOSAIC)

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ClinicalTrials.gov Identifier: NCT04026165
Recruitment Status : Active, not recruiting
First Posted : July 19, 2019
Last Update Posted : July 29, 2021
Sponsor:
Information provided by (Responsible Party):
Gilead Sciences

Study Description
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Brief Summary:
The primary objective of this study is to evaluate whether selonsertib (SEL) can slow the decline in kidney function in participants with moderate to advanced diabetic kidney disease (DKD).

Condition or disease Intervention/treatment Phase
Diabetic Kidney Disease Drug: SEL Drug: Placebo Phase 2

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 310 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: MOSAIC - A Phase 2b, Randomized, Double-Blind, Placebo- Controlled, Parallel Group, Multicenter Study Evaluating the Efficacy and Safety of Selonsertib in Subjects With Moderate to Advanced Diabetic Kidney Disease
Actual Study Start Date : July 24, 2019
Estimated Primary Completion Date : September 2021
Estimated Study Completion Date : September 2021

Resource links provided by the National Library of Medicine


Arms and Interventions
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Arm Intervention/treatment
Experimental: Selonsertib

Run-in Period (5 Weeks): Participants will receive placebo for at least one week and then SEL 18 mg for at least 4 weeks.

Double-Blind Treatment: Participants will be randomized to receive SEL 18 mg until death, study drug discontinuation, kidney failure, or the global study end date.

 Drug: SEL
Tablet administered orally once daily

Drug: Placebo
Tablet administered orally once daily
Placebo Comparator: Placebo

Run-in Period (5 Weeks): Participants will receive placebo for at least one week and then SEL 18 mg for at least 4 weeks.

Double-Blind Treatment: Participants will be randomized to receive placebo until death, study drug discontinuation, kidney failure, or the global study end date.

 Drug: SEL
Tablet administered orally once daily

Drug: Placebo
Tablet administered orally once daily


Outcome Measures
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Primary Outcome Measures :
  1. Estimated Glomerular Filtration Rate Based on Creatinine (eGFRcr) Slope [ Time Frame: Up to 100 weeks ]

Secondary Outcome Measures :
  1. Proportion of Kidney Clinical Events at Week 48 [ Time Frame: Week 48 ]
    Kidney clinical event is defined as any of the following events: confirmed ≥ 40% decline in eGFRcr from baseline, or kidney failure (dialysis performed for at least 4 weeks, kidney transplantation, or confirmed decrease in eGFRcr to < 15 mL/min/1.73 m^2 for participants without dialysis or kidney transplantation), or death due to kidney disease.

  2. Time From Randomization to First Occurrence of a Kidney Clinical Event [ Time Frame: Up to 100 weeks ]
  3. Estimated Glomerular Filtration Rate Based on Cystatin C (eGFRcys) Slope [ Time Frame: Up to 100 weeks ]

Eligibility Criteria
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Ages Eligible for Study:   18 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Key Inclusion Criteria:

  • Diagnosis of type 2 diabetes mellitus (T2DM) as per local guidelines.

  • eGFR value calculated by central laboratory utilizing samples collected during screening and prior to enrollment of ≥ 20 mL/min/1.73 m^2 to < 60 mL/min/1.73 m^2 with albuminuria

    • eGFR and urine albumin to creatinine ratio (UACR) must meet criteria a, b, or c

      • a: eGFR (mL/min/1.73 m^2): ≥ 45 to < 60; UACR (mg/g): ≥ 600 to 5000
      • b: eGFR (mL/min/1.73 m^2): ≥ 30 to < 45; UACR (mg/g): ≥ 300 to 5000
      • c: eGFR (mL/min/1.73 m^2): ≥ 20 to < 30; UACR (mg/g): ≥ 150 to 5000

  • Treatment with either an angiotensin converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB)

    • Individuals not receiving an ACEi or ARB may be enrolled if there is documented intolerance to ACEi and ARB
    • Individuals receiving less-than-maximal dose of an ACEi or ARB may be enrolled if there is a documented reason that the maximum labeled dose of ACEi and ARB could not be reached
  • Individuals already receiving sodium-glucose co-transporter-2 (SGLT-2) inhibitors must be on a stable dose for at least 2 weeks prior to enrollment
  • Mean systolic blood pressure (SBP) must be <160 mmHg and mean diastolic blood pressure (DBP) must be <100 mmHg
  • Required baseline laboratory data, analyzed by central laboratory, within 30 days prior to enrollment

Key Exclusion Criteria:

  • HbA1c > 12.0% within 30 days prior to enrollment
  • Individuals with diagnosis of type 1 diabetes mellitus (T1DM) or maturity onset diabetes of the young (MODY)
  • Body mass index (BMI) > 50 kg/m^2
  • UACR > 5000 mg/g on any measurement during screening
  • End stage kidney disease (ESKD) (i.e., chronic hemodialysis, chronic peritoneal dialysis, or history of kidney transplantation)
  • Anticipated progression to ESKD (need for chronic hemodialysis, chronic peritoneal dialysis or receipt of kidney transplant) within 3 months after enrollment
  • Unstable CV disease
  • Pregnant or lactating females or planning to become pregnant or breastfeed during the study

  • Concurrent use of either

    1. ACEi and ARB or
    2. Mineralocorticoid receptor antagonist (MRA) or direct renin inhibitor (DRI) in combination with an ACEi or ARB for at least 2 weeks prior to Enrollment
  • Prior or ongoing clinically significant illness, medical condition, surgical history, physical finding, ECG finding, or laboratory abnormality that, in the investigator's opinion, could adversely affect the safety of the individual or impair the assessment of study results

Note: Other protocol defined Inclusion/Exclusion criteria may apply.

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): NCT04026165


Locations
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Sponsors and Collaborators
Gilead Sciences
Investigators
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Study Director: Gilead Study Director Gilead Sciences
More Information
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Responsible Party: Gilead Sciences
ClinicalTrials.gov Identifier: NCT04026165    
Other Study ID Numbers: GS-US-223-1017
JapicCTI-194911 ( Registry Identifier: Japan Pharmaceutical Information Center )
First Posted: July 19, 2019    Key Record Dates
Last Update Posted: July 29, 2021
Last Verified: July 2021
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
Diabetic Nephropathies
Urologic Diseases
 Diabetes Complications
Diabetes Mellitus
Endocrine System Diseases