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A study to learn how well the treatment combination of finerenone and empagliflozin works and how safe it is compared to each treatment alone in adult participants with long-term kidney disease (chronic kidney disease) and type 2 diabetes.

Phase 2
Completed
Conditions
Chronic kidney disease in type 2 diabetes mellitus
Registration Number
2023-506981-30-00
Lead Sponsor
Bayer AG
Brief Summary

To demonstrate that combination therapy using finerenone and empagliflozin is superior in reducing UACR (Urinary albumin to-creatinine ratio) than either empagliflozin or finerenone alone.

Detailed Description

Not available

Recruitment & Eligibility

Status
Ended
Sex
Not specified
Target Recruitment
220
Inclusion Criteria

Participant with a clinical diagnosis of chronic kidney disease (CKD) and the following: a. In Part A: eGFR 40-90 ml/min/1.73m^2 (with no more than 20% having an eGFR >75 ml/min/1.73m^2) using Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) formula at screening visit and at least one historical value of eGFR <60 mL/min/1.73 m^2 within 3 months or have a registered diagnosis of CKD. b. In Part B: eGFR 30-90 ml/min/1.73m^2 (with no more than 20% having an eGFR >75 ml/min/1.73m^2) using CKD-EPI formula at screening visit and at least one historical value of eGFR <60 mL/min/1.73 m^2 within 3 months or have a registered diagnostic of CKD. c. 100 ≤UACR <5000 mg/g at screening visit (mean value from 3 morning void samples) and documentation of albuminuria/proteinuria (quantitative or semi-quantitative measurement) in the participant's medical records at least 3 months prior to screening

Participant with type 2 diabetes (T2D) as defined by the American Diabetes Association (ADA 2021), with glycated hemoglobin (HbA1c) at screening <11%.

Participant treated with the clinically maximum tolerated dose, as per investigator judgment, of angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB), but not both, for more than 1 month at screening visit.

Exclusion Criteria

Participants with type 1 diabetes (T1D).

Participant with hepatic insufficiency classified as Child-Pugh C.

Participant with blood pressure at Day 1 visit (Visit 2) higher than 160 SBP or 100 DBP or SBP lower than 90 mmHg.

Participant currently treated with a sodium/glucose cotransporter-2 inhibitor (SGLT2i) or SGLT-1/2i or who received a SGLT2i or SGLT-1/2i which cannot be discontinued at least 8 weeks prior to the screening visit and during study intervention treatment.

Participant treated with another mineralocorticoid receptor antagonist (MRA) (e.g., eplerenone, esaxerenone, spironolactone, canrenone), a renin inhibitor, potassium supplements, a potassium sparing diuretic (e.g., amiloride, triamterene), a potassium binder agent, or angiotensin receptor-neprilysin inhibitor (ARNI) which cannot be discontinued at least 8 weeks prior to the screening visit and during study intervention treatment.

Participants currently treated or who were treated with Finerenone (Kerendia©) within 8 weeks prior to the screening visit.

Participant with serum/plasma potassium (K+) above 4.8 mmol/L at screening (central laboratory value).

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Mean ratio of change from baseline to Day 180 in Urinary albumin to creatinine ratio (UACR) for the combination therapy group, to empagliflozin alone.

Mean ratio of change from baseline to Day 180 in Urinary albumin to creatinine ratio (UACR) for the combination therapy group, to empagliflozin alone.

Mean ratio of change from baseline to Day 180 in UACR for the combination therapy group, to finerenone alone.

Mean ratio of change from baseline to Day 180 in UACR for the combination therapy group, to finerenone alone.

Secondary Outcome Measures
NameTimeMethod
Proportion of participants with urosepsis and pyelonephritis events.

Proportion of participants with urosepsis and pyelonephritis events.

Total number of urosepsis and pyelonephritis events.

Total number of urosepsis and pyelonephritis events.

Relative change in UACR between end of treatment visit and 30 days after end of treatment visit.

Relative change in UACR between end of treatment visit and 30 days after end of treatment visit.

Relative change in UACR between 30 days after end of treatment visit and baseline.

Relative change in UACR between 30 days after end of treatment visit and baseline.

Relative change in UACR category (>30%, >40%, >50%) at 180 days.

Relative change in UACR category (>30%, >40%, >50%) at 180 days.

Ratio of change from baseline in eGFR at 30 days.

Ratio of change from baseline in eGFR at 30 days.

eGFR decline greater than 30% at 30 days from baseline.

eGFR decline greater than 30% at 30 days from baseline.

Ratio of change in eGFR at 180 days and 210 days from day 30.

Ratio of change in eGFR at 180 days and 210 days from day 30.

Proportion of participants with of AKI events.

Proportion of participants with of AKI events.

Total number of AKI events.

Total number of AKI events.

Number of participants with hyperkalemia events (moderate hyperkalemia [5.5 6.0 mmol/L])

Number of participants with hyperkalemia events (moderate hyperkalemia [5.5 6.0 mmol/L])

Total number of hyperkalemia events (moderate hyperkalemia [5.5 6.0 mmol/L])

Total number of hyperkalemia events (moderate hyperkalemia [5.5 6.0 mmol/L])

Change from baseline in K+

Change from baseline in K+

Proportion of participants with severe hypoglycemia events.

Proportion of participants with severe hypoglycemia events.

Total number of events of severe hypoglycemia events.

Total number of events of severe hypoglycemia events.

Proportion of participants with symptomatic hypotension events.

Proportion of participants with symptomatic hypotension events.

Total number of symptomatic hypotension events.

Total number of symptomatic hypotension events.

Proportion of participants with genital mycotic events.

Proportion of participants with genital mycotic events.

Total number of genital mycotic events.

Total number of genital mycotic events.

Proportion of participants with ketoacidosis events.

Proportion of participants with ketoacidosis events.

Total number of ketoacidosis events.

Total number of ketoacidosis events.

Proportion of participants with necrotizing fasciitis of the perineum events.

Proportion of participants with necrotizing fasciitis of the perineum events.

Total number of necrotizing fasciitis of the perineum events.

Total number of necrotizing fasciitis of the perineum events.

Trial Locations

Locations (57)

Stichting OLVG

🇳🇱

Amsterdam, Netherlands

Gelre Hospitals

🇳🇱

Apeldoorn, Netherlands

Albert Schweitzer Ziekenhuis

🇳🇱

Dordrecht, Netherlands

Meander Medisch Centrum

🇳🇱

Amersfoort, Netherlands

Hospital Universitari Vall D Hebron

🇪🇸

Barcelona, Spain

Hospital Universitario Virgen De La Victoria

🇪🇸

Malaga, Spain

Hospital Clinico San Carlos

🇪🇸

Madrid, Spain

Hospital Universitario Dr Peset Aleixandre

🇪🇸

Valencia, Spain

Hospital Universitario Principe De Asturias

🇪🇸

Alcala De Henares, Spain

Hospital Clinico Universitario De Valencia

🇪🇸

Valencia, Spain

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Stichting OLVG
🇳🇱Amsterdam, Netherlands
Mirjam Anne Lips
Site contact
+31205107593
m.a.lips@olvg.nl

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