/A
- Conditions
- IgA nephropathy (IgAN)Therapeutic area: Diseases [C] - Nutritional and Metabolic Diseases [C18]
- Registration Number
- EUCTR2014-000331-16-GB
- Lead Sponsor
- Rigel Pharmaceuticals Inc
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ot Recruiting
- Sex
- Not specified
- Target Recruitment
- 92
Signed informed consent prior to any study specific screening
procedures.
2. Male or female between 18 to 70 years of age.
3. Females must be either post-menopausal for at least 1 year,
surgically sterile, or, if of child-bearing potential, must not be pregnant or lactating. If sexually active, must agree to use a highly effective method of birth control throughout the duration of the trial and for 30 days following the last dose.
4. A pre-study renal biopsy obtained within 180 days prior to the initial study visit (Visit 1a) will be reviewed by a member of the central panel of renal pathologists to ensure subjects meet the following histologic entry criteria:
• Consistent with IgAN
• Mesangial hypercellularity score of > 0.5 (M1) and/or presence of endocapillary hypercellularity (E1) on renal biopsy (using the Oxford Classification)
• < 50% of cortical area involved by tubular atrophy or interstitial fibrosis (T0 or T1)
• < 50% glomerular crescents
5. Treatment with an ACEi and/or an ARB for at least 90 days at a maximum approved (or tolerated) dose prior to Screening (Visit 1b). Subjects should remain on the same dose of ACEi or ARB during the treatment period (Visits 2-9).
6. Proteinuria > 1 gm/day, sPCR > 100 mg/mmol (> 884 mg/g), or Spot Albumin/Creatinine Ratio > 70 mg/mmol at diagnosis of IgAN or any time prior to screening.
7 Proteinuria > 0.50 gm/day [sPCR > 50 mg/mmol (> 442 mg/g)] at Screening (Visit 1b).
8. Blood pressure controlled to = 130/80 with angiotensin blockade with or without other anti-hypertensive agents. Subjects should be taking a maximum approved (or tolerated) dose of an ACEi or ARB before an additional anti-hypertensive agent is added. If additional antihypertensive therapy is required, other agents (beta blockers, calcium channel blockers, or diuretics) may be added. Patients may be
reassessed if BP < 140/90, but > 130/80.
9. Otherwise in stable health as determined by the Investigator based on medical history and laboratory tests during the screening period. See Exclusion Criteria for specific exclusions.
10. In the Investigator's opinion, has the ability to understand the nature of the study and any hazards of participation and to communicate satisfactorily with the Investigator.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 70
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 5
1. History of or active, clinically significant, respiratory,
gastrointestinal (including pancreatitis), hepatic, neurological,
psychiatric, musculoskeletal, genitourinary, dermatological, or other disorder that, in the Investigator's opinion, could affect the conduct of the study or the absorption, metabolism or excretion of the study drug.
2. Have had any major cardiovascular event within the 180 days prior to randomisation, including but not limited to: myocardial infarction, unstable angina, cerebrovascular accident, pulmonary embolism, or New York Heart Association Class III or IV heart failure.
3. Diagnosis or history suggestive of Henoch-Schonlein purpura.
4. Estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2
(using the MDRD equation) at the time of Screening (Visit 1b).
5. A 50% decrease in eGFR from most recent pre-study clinic visit to Visit 1b.
6. An absolute neutrophil count of < 1,500/µL, Hgb < 9 g/dL, ALT or AST of > 1.5x ULN, total bilirubin > 2.0 mg/dL at Visit 1b. The Investigator may reassess these laboratory abnormalities within 30 days after Screening (Visit 1b).
7. Acute gastrointestinal symptoms (eg, nausea, vomiting, diarrhoea) at Baseline (Visit 2). The subject may be reassessed after full recovery from the acute gastrointestinal illness.
8. Active bacterial or parasitic infections, including tuberculosis.
9. Serologic results suggestive of active hepatitis B or hepatitis C (subjects may be included if confirmed hepatitis C recombinant immunoblot assay negative or hepatitis C virus RNA negative [qualitative]), or subjects with suspected human immunodeficiency virus (HIV).
10. Use within 6 months prior to pre-study renal biopsy of
cyclophosphamide, mycophenolate mofetil, azathioprine, or Rituximab (or other anti-B cell therapies). Those subjects who had been treated with an anti- B cell therapy must have a normal CD19 count by Visit 1b.
11. Use of > 15 mg/day prednisone (or other corticosteroid
equivalent). For those subjects taking corticosteroids for renal
indication, the daily dose should not change from baseline (visit 2) to the end of study drug treatment (visit 9).
12. Prior or current use of cyclosporine or tacrolimus.
13. Have a clinically significant infection, or who are known to have an active inflammatory process (other than IgAN) at the time of Screening (Visit 1b) or Baseline (Visit 2). The subject may be reassessed after recovery from an acute infection.
14. Currently enrolled in an investigational drug or device study or have used an investigational drug or device within 30 days or 5 half-lives (whichever is longer) of Screening (Visit 1a).
15. Are unable or unwilling to follow instructions, including
participation in all study assessments and visits.
16. Have a history of alcohol or substance abuse that, in the judgment of the Investigator, may impair or risk the subject's full participation in the study.
17. Have a condition or be in a situation that the Investigator feels may put the subject at significant risk, may confound the study results, or may interfere significantly with the
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Main Objective: To assess the efficacy of fostamatinib administered orally for 24 weeks to subjects with IgA nephropathy, as measured by change in renal function and histology. ;Secondary Objective: To investigate the safety and tolerability of fostamatinib administered orally for 24 weeks to subjects with IgA nephropathy.;Primary end point(s): The primary efficacy endpoint is the mean change from Baseline (Visit 2) of proteinuria (as measured by spot protein-creatinine ratio sPCR) at 24 weeks (Visit 9).;Timepoint(s) of evaluation of this end point: 24 weeks
- Secondary Outcome Measures
Name Time Method