NCT01748812终止1 期
Open-label Dose-titration Study of the Tolerability and Efficacy of Cinacalcet to Treat Fibroblast Growth Factor 23 (FGF23)-Mediated Hypophosphatemia
National Institute of Dental and Craniofacial Research (NIDCR)2 个研究点 分布在 1 个国家目标入组 1 人开始时间: 2012年11月16日最近更新:
适应症
相关药物
试验速览
- 阶段
- 1 期
- 状态
- 终止
- 发起方
- 入组人数
- 1
- 试验地点
- 2
- 主要终点
- Evaluate the tolerability of cinacalcet in individuals with FGF23-mediated hypophosphatemia
研究概览
简要总结
Background:
- Hypophosphatemia is a condition where a person has low levels of phosphorus in the blood. Low blood phosphorus can cause muscle and bone weakness (such as rickets) and teeth problems. One cause of the condition is having too much fibroblast growth factor 23 (FGF23). FGF23 is a hormone that causes the kidney to get rid of phosphorus in the urine. It can also prevent the body from making vitamin D, which helps the body absorb phosphorus in food.
- Many people with low blood phosphorus take high doses of phosphorus and calcium medications. However, one side effect of these drugs is increased blood levels of parathyroid hormone (PTH). The drug cinacalcet can help lower PTH levels, which may decrease the amount of phosphorus lost in the urine and increase the phosphorus levels in the blood. Researchers want to see if cinacalcet can help blood phosphorus and decrease the amount of phosphorus supplements that people need to take.
Objectives:
- To see if cinacalcet can be a safe and effective treatment for people with low phosphorus conditions due to high FGF23.
Eligibility:
- Individuals between 18 and 70 years of age who have different forms of hypophosphatemic rickets and tumor-induced hypophosphatemia
Design:
- Participants will have up to 25 study visits over about 28 weeks.
- Participants will be screened with a physical exam and medical history. Blood and urine samples will be collected.
- Up to three more lab visits for blood and urine tests will be required before treatment. Imaging studies of the bones, spine, and kidneys will be performed.
- Participants will have a 3-night hospital stay to start treatment. They will take cinacalcet once a day. Treatment will be monitored with frequent blood tests and imaging studies.
- Participants will continue to take cinacalcet once a day for 3 weeks. They will have regular study visits to monitor the treatment.
- There will be up to two other overnight hospital stays (1 to 3 nights) to adjust cinacalcet doses. The dose will increase until the maximum dose is reached, or side effects develop.
- After the end of the cinacalcet study, participants will have several more followup visits to monitor the effects of treatment.
详细描述
OBJECTIVES:
The primary objective of this protocol is to evaluate the tolerability of cinacalcet in individuals with fibroblast growth factor 23 (FGF23)-mediated hypophosphatemia, using an open-label, dose-titration study of once-daily dosing. Secondary objectives are to evaluate the pharmacodynamics of cinacalcet in this subject population and to explore the efficacy of cinacalcet by comparing a) level of oral phosphate required at baseline to the level required at maximum tolerated dose (MTD) and b) change in renal phosphate handling from baseline to MTD. Tertiary objectives are to evaluate tolerability, pharmacodynamics, and efficacy of twice daily dosing of each subject s MTD of cinacalcet after completion of the once-daily dose-titration phase. A final objective is to determine the length of time it takes for subjects to return to their pre-treatment steady state once treatment is complete.
STUDY POPULATION:
Up to 17 subjects with FGF23-mediated hypophosphatemia will be treated.
DESIGN:
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •* INCLUSION CRITERIA:
- •1. \Chronological age: 18-70 years
- •2. \Diagnosis of a genetic form of FGF23-mediated hypophosphatemia:
- •1. \X-linked hypophosphatemic rickets (XLH)
- •2. \Autosomal dominant hypophosphatemic rickets (ADHR)
- •3. \Autosomal recessive hypophosphatemic rickets (ARHR)
- •Or, diagnosis of a non-genetic form of FGF23-mediated hypophosphatemia, i.e. tumor-induced osteomalacia (TIO)
- •3. \Ability to understand and provide informed consent
- •4. \Ability to complete the protocol scheduled assessments and medication regimen
- •5. \Women of child-bearing potential (not surgically sterile via tubal ligation, bilateral oophorectomy or hysterectomy, or who are not postmenopausal for greater than or equal to 1 year) must agree to practice adequate contraception that may include, but is not limited to, abstinence, monogamous relationship with vasectomized partner, barrier methods such as condoms, diaphragms, spermicides, intrauterine devices, and licensed hormonal methods for the duration of the treatment portion of the study.
排除标准
- •1. \Chronic or recurrent hypocalcemia defined by a serum calcium \< 8.4 mg/dL (2.1 mmol/L)
- •2. \Tertiary hyperparathyroidism as evidenced by concurrent PTH and calcium levels above the upper limit of normal
- •3. \History of parathyroid surgery and/or hypoparathyroidism
- •4. \Hypercalciuria as defined as \> 4 mg/kg/day (0.1 mmol/kg/day) on optimized conventional therapy (as determined during SOC optimization phase)
- •5. \Moderate to severe hepatic insufficiency as defined by total bilirubin \> 2 mg/dL and serum albumin \< 3 g/dL and International Normalized Ratio (INR) \>2 OR presence of ascites or hepatic encephalopathy.
- •6. \A calculated eGFR \< 50 mL/min/1.73 m(2), using the CKD-EPI equation
- •7. \History of a non-febrile seizure disorder
- •8. \History of a clinically significant cardiac arrhythmia
- •9. \History of chronic gastrointestinal disease
- •10. \Current therapy (at the time of informed consent) bisphosphonates, calcitonin, diuretics or medications that may have a significant drug interaction with cinacalcet
- •11. \Known hypersensitivity to cinacalcet or any of its constituents
- •12. \Positive pregnancy test or lactation
- •13. \Use of another investigational agent (i.e., in the context of a clinical trial, use of an investigational product that may have impact on the study) within the last 3 months
结局指标
主要结局
Evaluate the tolerability of cinacalcet in individuals with FGF23-mediated hypophosphatemia
时间窗: 4 years
次要结局
未报告次要终点
研究者
研究点 (2)
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