A Phase III Study to assess efficacy, safety, and tolerability of Zibotentan combined with Dapagliflozin, compared to Dapagliflozin, in patients with Chronic Kidney Disease and High Proteinuria
- Conditions
- Chronic Kidney Disease and High ProteinuriaMedDRA version: 21.1Level: PTClassification code: 10064848Term: Chronic kidney disease Class: 100000004857MedDRA version: 20.0Level: SOCClassification code: 10038359Term: Renal and urinary disorders Class: 18Therapeutic area: Phenomena and Processes [G] - Metabolism [G03]
- Registration Number
- CTIS2023-504124-26-00
- Lead Sponsor
- AstraZeneca AB
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Recruiting
- Sex
- All
- Target Recruitment
- 1500
1.Participant must be = 18 years of age and of legal age of consent in the jurisdiction in which the study is taking place, at the time of signing the informed consent., 2.Diagnosis of CKD, with eGFR = 20 and < 90 mL/min/1.73 m2 and UACR > 700 mg/g (> 79 mg/mmol) or UPCR > 1000 mg/g (> 113mg/mmoL)., 3.All female participants must have a negative serum pregnancy test result at screening (unless participants meet inclusion criterion 4a for being of not childbearing potential.), 4. Female participants must be either - not of child-bearing potential or - WOCBP using at least one highly effective birth control method for at least 3 months prior to first dose of study intervention, 5. Capable of giving signed informed consent, 6. Provision of signed informed consent prior to any study specific procedure., 7. Provision of electronic informed consent prior to completion of the optional Study Participant Feedback Questionnaire (SPFQ)., 8. Provision of signed and dated written Optional Genomics Initiative Research Information and Consent Form prior to collection of samples for optional genomics imitative research that supports the Genomic Initiative 5., 9.Receiving RAASi therapy (ACEi or ARB), and for the patient maximum tolerated labelled daily dose, that has been stable for at least 4 weeks.
1.Participants with NYHA class III or class IV Congestive HF at the time of enrolment., 10. History or ongoing allergy/hypersensitivity, as judged by the Investigator, to SGLT2i therapy (eg, dapagliflozin, canagliflozin, empagliflozin or other SGLT2 inhibitors) or Endothelin Receptor Antagonists (eg, ambrisentan, atrasentan, bosentan, or other) or any of the excipients of the products., 11. Any condition with a life expectancy of less than 2 years based on investigator´s clinical judgment, 12. Malignancy within the past 5 years. Exceptions to this criterion include non-melanoma skin cancer and curatively treated cervical carcinoma in situ, 13. Significant liver disease as judged by the investigator or severe hepatic impairment with AST or ALT > 3 × ULN; or total bilirubin > 2 × ULN at time of screening. An isolated increase in bilirubin in participants with known Gilbert's syndrome is not a reason for exclusion, 14. Known blood-borne diseases., 15. Clinically significant, unstable, or uncontrolled medical condition as assessed by the Investigator., 16. Participants on renal replacement therapy or previous kidney transplant., 17. Known history of drug or alcohol abuse within 12 months of screening., 18. Participants on treatment with strong or moderate CYP3A4 inducer., 19.Participants on systemic immunosuppression therapy other than stable maintenance therapy defined as prednisone 10 mg/day (or equivalent) or less, aziothioprine 100 mg/day or less; MMF 1000 mg/day or less for at least 3 months prior to Visit 1. Inhaled, nasal or dermatological steroids are also allowed., 2. Participants hospitalised for HF during the last 6 month prior to screening., 20.Participants treated or expecting to be treated with tolvaptan, any other ERAs, or budesonide (where used to treat IBD or IgAN)., 21. Participation in another clinical study with a study intervention administered in the last 3 months., 3. Evidence of rales or jugular venous distention on physical examination, 4. Participants with T1DM., 5. History of any life-threatening ventricular dysrhythmia (continuous or paroxysmal)., 6. Blood pressure above 160 mmHg systolic., 7. Blood pressure below 90 mmHg systolic, 8. Participants hospitalised for heart disease or cardiac procedures or for COVID-19 during the last 3 months prior to screening., 9. History of solid organ transplantation or bone marrow transplant.
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Main Objective: To determine whether zibotentan and dapagliflozin in fixed-dose combination is superior to dapagliflozin alone to slow decline in kidney function;Secondary Objective: 1.To determine whether zibotentan and dapagliflozin in fixed-dose combination is superior to dapagliflozin alone in: a) reducing proteinuria b) reducing albuminuria c) reducing the incidence of the renal composite endpoint of 40% sustained decline in eGFR or ESKD or renal death d) reducing systolic blood pressure e) reducing proteinuria, as measured by the proportion of participants achieving UPCR < 1g/g and > 30% reduction from baseline 2. To assess the safety and tolerability of treatment with zibotentan and dapagliflozin in fixed-dose combination compared to dapagliflozin alone.;Primary end point(s): Change in eGFR from baseline to Month 24
- Secondary Outcome Measures
Name Time Method Secondary end point(s):1.Change in UPCR from baseline to each participant’s mean level across the visits from Day 15 up to Month 24.;Secondary end point(s):2.Change in UACR from baseline to each participant’s mean level across the visits from Day 15 up to Month 24.;Secondary end point(s):3. Time to the first occurrence of any of the components of the renal composite endpoint of 40% sustained decline in eGFR or ESKD or renal death;Secondary end point(s):4. Change from baseline in systolic blood pressure from baseline to each participant’s mean level across the visits from Day 15 up to Month 24.;Secondary end point(s):5. Proportion of participants achieving UPCR < 1000 mg and > 30% reduction from baseline for each participant’s mean level across the visits from Day 15 up to Month 24.