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Efficacy and Safety of Lorundrostat in Addition to Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2i) in Subjects With Hypertension and Chronic Kidney Disease (CKD) With Albuminuria

Phase 2
Active, not recruiting
Conditions
Chronic Kidney Disease
Interventions
Drug: Placebo QD + SGLT2i QD, Washout, Lorundrostat 25mg+SGLT2i QD
Drug: Lorundrostat 25mg+SGLT2i QD, Washout, Placebo+SGLT2i QD
Registration Number
NCT06150924
Lead Sponsor
Mineralys Therapeutics Inc.
Brief Summary

This is a randomized, double-blind (DB), placebo controlled, crossover study with a two-period, two-sequence (2x2) design evaluating the efficacy and safety of 25 mg QD lorundrostat (an aldosterone synthase inhibitor \[ASI\]) in addition to a SGLT2i for the treatment of hypertension in subjects with CKD and albuminuria while receiving stable treatment with an Angiotensin-converting enzyme inhibitor (ACEi) or an Angiotensin receptor blocker (ARB). Subjects will be at least 18 years old with hypertension, and mild to severe CKD with albuminuria at the Screening Visit.

Detailed Description

The study consists of up to a 2-week Screening period, a 2-week run-in period where subjects will either begin study provided dapagliflozin 10 mg or continue on their regularly prescribed SGLT2i, and two DB 4-week treatment periods separated by a 4-week washout period. Subjects will be randomized (1:1) to two treatment sequences: lorundrostat-placebo (LP) and placebo-lorundrostat (PL).

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
60
Inclusion Criteria
  1. At Screening, UACR of 200-5000 mg/g, inclusive, in first morning urine void
  2. At Screening, eGFRs of ≥30 mL/min/1.73 m2
  3. At Screening, AOBP SBP of 135-180 mmHg, inclusive
  4. On a stable treatment with an ACEi or ARB for at least 2 months prior to Screening
  5. At Screening, body mass index (BMI) of >18 kg/m2

Major

Exclusion Criteria
  1. Subjects with known hypersensitivity to lorundrostat or any of its respective excipients
  2. Subjects with known hypersensitivity to dapagliflozin or any of its respective excipients (subjects beginning dapagliflozin only)
  3. At Screening, serum potassium >5.0 mmol/L
  4. History of clinically significant hyponatremia within 1 year prior to Screening
  5. Use of epithelial sodium channel (ENaC) inhibitors or Mineralocorticoid receptor antagonist (MRAs), including, but not limited to amiloride, triamterene, spironolactone, eplerenone, finerenone, from 4 weeks prior to the Screening Visit and during study participation. With the exception of MRAs in primary aldosteronism
  6. Medical history of kidney disease related to autoimmune diseases (lupus, anti-neutrophil cytoplasmic antibody [ANCA] vasculitis), multiple myeloma or other known paraproteins, infiltrative diseases of the kidney, obstructive nephropathy, cystic kidney diseases, and renal transplantation
  7. Medical history of advanced liver disease, including cirrhosis
  8. Medical history of active autoimmune disease or recent (within 30 days) or anticipated need for immunosuppressive therapy
  9. Diabetes mellitus with a glycosylated hemoglobin (HbA1c) >10% (>86 mmol/mol) at Screening

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Cohort 2Placebo QD + SGLT2i QD, Washout, Lorundrostat 25mg+SGLT2i QD-
Cohort 1Lorundrostat 25mg+SGLT2i QD, Washout, Placebo+SGLT2i QD-
Primary Outcome Measures
NameTimeMethod
Placebo-adjusted change from baseline in automated office blood pressure (AOBP) systolic blood pressure (SBP) at Week 4baseline to Week 4
Incidence and severity of adverse events (AEs)baseline to Week 14
Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (44)

Arizona Kidney Disease & Hypertension Centers (AKDHC) - Thunderbird Office

🇺🇸

Glendale, Arizona, United States

Arizona Kidney Disease & Hypertension Centers (AKDHC) - Thomas Office

🇺🇸

Phoenix, Arizona, United States

Balboa Nephrology Medical Group, Inc. (BNMG) - California Institute of Renal Research (CIRR) - Chula Vista

🇺🇸

Chula Vista, California, United States

Balboa Nephrology Medical Group, Inc. (BNMG) - El Centro

🇺🇸

El Centro, California, United States

Amicis Research Center - Granada Hills

🇺🇸

Granada Hills, California, United States

Balboa Nephrology Medical Group, Inc. (Bnmg) - La Mesa

🇺🇸

La Mesa, California, United States

Academic Medical Research Institute (AMRI) - Los Angeles

🇺🇸

Los Angeles, California, United States

Amicis Research Center

🇺🇸

Northridge, California, United States

Amicis Research Center - Vacaville

🇺🇸

Vacaville, California, United States

Colorado Kidney Care (Denver Nephrology) - Denver Office

🇺🇸

Denver, Colorado, United States

Qway Research

🇺🇸

Coconut Grove, Florida, United States

Indago Research and Health Center

🇺🇸

Hialeah, Florida, United States

Elixia Pines, LLC

🇺🇸

Hollywood, Florida, United States

Elixia Central Florida, LLC

🇺🇸

Orlando, Florida, United States

Infigo Clinical Research, Llc

🇺🇸

Sanford, Florida, United States

Genesis Clinical Research - Tampa

🇺🇸

Tampa, Florida, United States

Palm Beach Diabetes and Endocrine Specialists, PA (PBDES) - West Palm Beach Office

🇺🇸

West Palm Beach, Florida, United States

American Clinical Trials Llc

🇺🇸

Acworth, Georgia, United States

Nephrology of the Golden Isles - Brunswick

🇺🇸

Brunswick, Georgia, United States

ClinCept, LLC

🇺🇸

Columbus, Georgia, United States

Georgia Nephrology, Llc

🇺🇸

Lawrenceville, Georgia, United States

Nephrology Associates of Kentuckiana, PSC (NAK)

🇺🇸

Louisville, Kentucky, United States

Lcms Health University Medical Center New Orleans

🇺🇸

New Orleans, Louisiana, United States

Northwest Louisiana Nephrology, Llc - Shreveport

🇺🇸

Shreveport, Louisiana, United States

Tufts University School of Medicine (Tusm) - Tufts Medical Center (Tmc) (Tufts-New England Medical Center)

🇺🇸

Boston, Massachusetts, United States

Elixia MKC, LLC

🇺🇸

Pontiac, Michigan, United States

Kansas City Kidney Consultants (Arms, Dodge, Robinson, Wilber & Crouch, Inc.) - Kansas City

🇺🇸

Kansas City, Missouri, United States

Seacoast Kidney & Hypertension Specialists - Portsmouth Office

🇺🇸

Portsmouth, New Hampshire, United States

Suny Downstate Medical Center - Parkside Dialysis Center

🇺🇸

Brooklyn, New York, United States

Nephrology Associates, PC

🇺🇸

Fresh Meadows, New York, United States

Nephrology Associates

🇺🇸

Fresh Meadows, New York, United States

Triad Internal Medicine

🇺🇸

Asheboro, North Carolina, United States

Nephrology Associates, Pllc - Winston-Salem

🇺🇸

Winston Salem, North Carolina, United States

Nephrology Consultants - Oklahoma City

🇺🇸

Oklahoma City, Oklahoma, United States

Columbia Nephrology

🇺🇸

Columbia, South Carolina, United States

Southeast Renal Research Institute

🇺🇸

Chattanooga, Tennessee, United States

Dallas Nephrology Associates (Dna) - Renal Disease Research Institute (Rdri)

🇺🇸

Dallas, Texas, United States

Liberty Research Center

🇺🇸

Dallas, Texas, United States

R&H Clinical Research

🇺🇸

Katy, Texas, United States

E T Nephrology Associates - Lufkin

🇺🇸

Lufkin, Texas, United States

Prx Research

🇺🇸

Mesquite, Texas, United States

Gamma Medical Research, Inc

🇺🇸

Mission, Texas, United States

Chrysalis Clinical Research (CCR)

🇺🇸

Saint George, Utah, United States

Mendez Center for Clinical Research, LLC

🇺🇸

Woodbridge, Virginia, United States

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