The Effect of Lanthanum Carbonate on Fibroblast Growth Factor 23 ( FGF23) in Chronic Kidney Disease

NCT ID: NCT01002872

Last Updated: 2023-09-21

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

19 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-10-31

Study Completion Date

2012-12-31

Brief Summary

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The aim of the study is to assess the effects of the drug lanthanum carbonate (a phosphorus binder drug) on c-terminal and on FGF23 levels in patients with Chronic Kidney Disease (CKD).

Targeting FGF23 measurement in CKD patients may impact both the progression of kidney disease and patient mortality.

Detailed Description

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This is a double blind randomized placebo controlled pilot study. Subjects with Chronic Kidney Disease ( CKD) stages 3-5 who are not undergoing renal replacement therapy and have not been started on phosphate binders will be randomized to either lanthanum carbonate 1500 mg daily or placebo for a 60 day treatment period. Patient doses will be increased up to a maximum dose of 3000 mg if the serum phosphate is greater than 5.5 mg/dL.

Conditions

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Metabolic Bone Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Lanthanum Carbonate (Fosrenol)

Subjects will receive the study drug Lanthanum Carbonate ( Fosrenol)

Group Type ACTIVE_COMPARATOR

Lanthanum Carbonate (Fosrenol)

Intervention Type DRUG

Randomization To either Lanthanum Carbonate 1 pill TID/Placebo 1 pill three times a day (TID) Day 15 If phosphorus is 3.5mg/dL-5.5mg/dL Continue with 1 pill TID. If phosphorus \<3.5mg/dL Reduce to 1 pill twice a day (BID). If Phosphorus \>5.5mg/dL 1 pill with breakfast 1 pill with lunch 2 pills with dinner Day 30 If phosphorus is 3.5mg/dL-5.5mg/dL Continue with 1 pill TID If phosphorus is \<3.5mg/dL Reduce to 1 pill daily. If phosphorus \>5.5mg/dL 1 pill with breakfast 2 pills with lunch 2 pills with dinner Day 45 If phosphorus is 3.5mg/dL-5.5mg/dL Continue with 1 pill TID If phosphorus \<3.5mg/dL stop the drug If phosphorus is \>5.5mg/dL 2 pills with breakfast 2 pills with lunch 2 pills with dinner

Placebo

Subject will receive placebo

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type DRUG

Initial dose of placebo will be 1 pill three times a day

Interventions

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Lanthanum Carbonate (Fosrenol)

Randomization To either Lanthanum Carbonate 1 pill TID/Placebo 1 pill three times a day (TID) Day 15 If phosphorus is 3.5mg/dL-5.5mg/dL Continue with 1 pill TID. If phosphorus \<3.5mg/dL Reduce to 1 pill twice a day (BID). If Phosphorus \>5.5mg/dL 1 pill with breakfast 1 pill with lunch 2 pills with dinner Day 30 If phosphorus is 3.5mg/dL-5.5mg/dL Continue with 1 pill TID If phosphorus is \<3.5mg/dL Reduce to 1 pill daily. If phosphorus \>5.5mg/dL 1 pill with breakfast 2 pills with lunch 2 pills with dinner Day 45 If phosphorus is 3.5mg/dL-5.5mg/dL Continue with 1 pill TID If phosphorus \<3.5mg/dL stop the drug If phosphorus is \>5.5mg/dL 2 pills with breakfast 2 pills with lunch 2 pills with dinner

Intervention Type DRUG

placebo

Initial dose of placebo will be 1 pill three times a day

Intervention Type DRUG

Other Intervention Names

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Fosrenol sugar pill

Eligibility Criteria

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Inclusion Criteria

* Males and non-pregnant females ages 18 years of age or older
* Estimated glomerular filtration rate (GFR) between 15-60 ml/min/1.73m
* Serum phosphate \> 3.5 mg/dL
* Fibroblast growth factor 2 (FGF2) \> 100 relative units per milliliter (RU/mL)
* Corrected serum calcium \>8.0mg/dL

Exclusion Criteria

* Current use of a phosphate binder
* Corrected serum calcium \<8.0mg/dL
* Current use of prescription-based vitamin D therapy
* Acute kidney injury in last 3 months
* Significant GI disorder
* History of allergic reaction or sensitivity to lanthanum carbonate
* History of non compliance with visits or medications that preclude study compliance in the opinion of the investigator
* Pregnant or able to become pregnant and unwilling to use a birth control method considered reliable by the principal investigator
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shire

INDUSTRY

Sponsor Role collaborator

Endeavor Health

OTHER

Sponsor Role lead

Responsible Party

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Stuart Sprague

Chief, Division of Nephrology and Hypertension Professor of Medicine University of Chicago Medical School

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Stuart M Sprague, DO

Role: PRINCIPAL_INVESTIGATOR

Endeavor Health

Locations

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NorthShore University HealthSystem

Evanston, Illinois, United States

Site Status

Countries

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United States

References

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Stubbs JR, Quarles LD. Fibroblast growth factor 23: uremic toxin or innocent bystander in chronic kidney disease? Nephrol News Issues. 2009 May;23(6):33-4, 36-7.

Reference Type BACKGROUND
PMID: 19534362 (View on PubMed)

Saji F, Shiizaki K, Shimada S, Okada T, Kunimoto K, Sakaguchi T, Hatamura I, Shigematsu T. Regulation of fibroblast growth factor 23 production in bone in uremic rats. Nephron Physiol. 2009;111(4):p59-66. doi: 10.1159/000210389. Epub 2009 Apr 1.

Reference Type BACKGROUND
PMID: 19339809 (View on PubMed)

Ibrahim S, Rashed L. Serum fibroblast growth factor-23 levels in chronic haemodialysis patients. Int Urol Nephrol. 2009;41(1):163-9. doi: 10.1007/s11255-008-9466-0. Epub 2008 Oct 7.

Reference Type BACKGROUND
PMID: 18839328 (View on PubMed)

Moe SM, Chen NX, Seifert MF, Sinders RM, Duan D, Chen X, Liang Y, Radcliff JS, White KE, Gattone VH 2nd. A rat model of chronic kidney disease-mineral bone disorder. Kidney Int. 2009 Jan;75(2):176-84. doi: 10.1038/ki.2008.456. Epub 2008 Sep 17.

Reference Type BACKGROUND
PMID: 18800026 (View on PubMed)

Fliser D, Kollerits B, Neyer U, Ankerst DP, Lhotta K, Lingenhel A, Ritz E, Kronenberg F; MMKD Study Group; Kuen E, Konig P, Kraatz G, Mann JF, Muller GA, Kohler H, Riegler P. Fibroblast growth factor 23 (FGF23) predicts progression of chronic kidney disease: the Mild to Moderate Kidney Disease (MMKD) Study. J Am Soc Nephrol. 2007 Sep;18(9):2600-8. doi: 10.1681/ASN.2006080936. Epub 2007 Jul 26.

Reference Type BACKGROUND
PMID: 17656479 (View on PubMed)

Fukagawa M, Kazama JJ. FGF23: its role in renal bone disease. Pediatr Nephrol. 2006 Dec;21(12):1802-6. doi: 10.1007/s00467-006-0230-3. Epub 2006 Aug 24.

Reference Type BACKGROUND
PMID: 16932898 (View on PubMed)

Other Identifiers

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EH 09-156

Identifier Type: -

Identifier Source: org_study_id

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