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Paricalcitol in Fabry Disease

Not Applicable
Completed
Conditions
Fabry Disease
Proteinuria
Interventions
Registration Number
NCT02090608
Lead Sponsor
Federico II University
Brief Summary

Proteinuria is the predominant risk factor for renal disease progression in Fabry disease (FD). When urine protein excretion is controlled to \<0.50 g/24 hr, the rate loss of glomerular filtration rate (GFR) is not significantly different from 0. However, enzyme replacement therapy (ERT) alone does not decrease proteinuria and it has been recommended that patients receiving ERT also receive anti Renin-Angiotensin-System (RAS) therapy. Emerging evidences show that paricalcitol (PCT) reduces proteinuria in presence of intensified inhibition of RAS; however, there is no evidence in FD. The aim of this study is to evaluate the antiproteinuric effect of PCT in FD patients with proteinuria \>0.50 g/24 hr persisting despite the ERT and anti-RAS therapy titrated to maximum tolerated dosage.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
14
Inclusion Criteria
  • genetically proven FD
  • stable dose of ERT for at least 12 months
  • stable dose of ACEi or ARB titrated to maximum tolerated dosage for at least 6 months
  • persistent proteinuria >0.50 g/24 h despite the use of ERT and ACEi/ARBs in 2 consecutive samples within 12 weeks
Exclusion Criteria
  • steroid/immunosuppressive treatment or glomerular filtration rate change >30% in the past 3 months
  • PTH levels <20 pg/mL
  • serum phosphorus >5.0 mg/dL
  • serum calcium (adjusted for albumin) >10.0 mg/dL
  • active malignancy.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
ParicalcitolParicalcitolIn patients identified by the inclusion criteria, data will be collected at baseline , during administration of oral Paricalcitol (PCT) (after 1, 3 and 6 months), and three months after PCT withdrawal. PCT will administered at dosage of 1 mcg/day; this dosage was chosen as it is not associated with excessive decline of parathyroid hormone (PTH) levels in most patients
Primary Outcome Measures
NameTimeMethod
Effect of paricalcitol on proteinuria reduction6 months

Fourteen Fabry patients will be selected and studied in the first six months of add-on oral PCT (1 mcg/day) and, in order to verify the dependence of proteinuria reduction on PCT, three months after drug withdrawal.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

federico II university, department of nephrology

🇮🇹

Naples, Italy

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