Pharmacokinetics, Pharmacodynamics and Safety of Basis in Acute Kidney Injury Study

NCT ID: NCT03176628

Last Updated: 2019-06-27

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 24 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2017-11-01
• Study Completion Date: 2018-09-11

Brief Summary

This study will determine the pharmacokinetics, pharmacodynamics and safety of escalating doses of Basis following twice daily oral administration in patients with acute kidney injury (AKI). Basis is a commercially available nutritional supplement consisting of nicotinamide riboside (NR) and pterostilbene that acts to increase sirtuin activity.

Detailed Description

Acute kidney injury (AKI) is common, growing in incidence, and associated with significant morbidity and mortality. Sirtuins are anti-aging enzymes that play a diverse role in cellular energy metabolism and gene regulation. Mice deficient in SIRT1 are more susceptible to developing AKI and sirtuin activation is a potential treatment for AKI.

This is a randomized, double-blind, placebo-controlled, stepwise study of escalating doses of Basis (NR/pterostilbene) in patients with AKI. The study will potentially comprise up to four Steps. The purpose of the stepwise approach is to identify the dose of Basis that achieves at least a 50% and up to 100% increase in white blood cell (WBC) content of nicotinamide adenine dinucleotide (NAD+) without side-effects.

During each Step, Basis (5 patients) or placebo (1 patient) will be given twice a day for 2 days. Patients will have frequent blood sampling performed for a 24 hour period following dosing on Day 1 and then at 48 hr. The measurements in blood will include NR/pterostilbene blood concentrations and NAD+ and NAAD (nicotinic acid adenine dinucleotide) concentrations in WBCs.

Conditions

Acute Kidney Injury

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: OTHER
• Blinding Strategy: TRIPLE

Study Groups

Basis

Nicotinamide riboside (NR) and pterostilbene oral capsules 250mg/50mg (Step 1) twice daily for 2 days. If the study progresses to Steps 2, 3, and 4, then 2x, 3x, and 4x the doses in Step 1 will be administered.

Group Type: EXPERIMENTAL

Basis

Intervention Type: DIETARY_SUPPLEMENT

NR is a form of vitamin B3; Pterostilbene is a natural dietary compound and the primary antioxidant component of blueberries

Placebo

Capsules identical in appearance and number to the agent used in Steps 1-4.

Group Type: PLACEBO_COMPARATOR

Placebo

Intervention Type: DIETARY_SUPPLEMENT

Placebo capsule(s)

Interventions

Basis

NR is a form of vitamin B3; Pterostilbene is a natural dietary compound and the primary antioxidant component of blueberries

Intervention Type: DIETARY_SUPPLEMENT

Placebo

Placebo capsule(s)

Intervention Type: DIETARY_SUPPLEMENT

Other Intervention Names

nicotinamide riboside (NR) and pterostilbene

Eligibility Criteria

Inclusion Criteria

1. Male or female hospitalized patients, age ≥ 18 years.

2. Patients who have developed AKI (defined by an increase in serum creatinine by ≥0.3 mg/dL within 48 hours; or an increase in serum creatinine to ≥1.5 times baseline, which is known or presumed to have occurred within the prior seven days).

3. Adequate hematological and liver function, as assessed by the following laboratory requirements:

1. Hemoglobin ≥10.0 g/dL

2. Absolute neutrophil count (ANC) ≥1,500/mm3

3. Platelet count 100,000/mm3

4. Total bilirubin ≤1.5 x upper limit of normal (ULN).

5. ALT and AST ≤2.5 x ULN.

4. Able to provide written informed consent in compliance with the Human Investigation Review Committee (IRB).

Exclusion Criteria

1. Exposure to any investigational agent within 30 days prior to enrollment.

2. Known allergy to any of the study drugs or their excipients.

3. Currently pregnant (confirmed with a positive serum pregnancy test) or nursing.

4. Unstable or clinically significant concurrent medical condition, psychiatric illness or social situation that would, in the opinion of the investigator, jeopardize the safety of a subject and/or their compliance with the protocol.

5. Baseline CKD stage 4-5 (eGFR<30 mL/minute/1.73 m2 as determined using the Modification of Diet in Renal Disease (MDRD) equation; in cases where the MDRD equation may not be suitable, a 24 hour urine creatinine clearance test may be substituted), prior to current hospitalization

6. Any malignancy with the exception of cervical carcinoma in situ,nonmelanoma skin cancer, or superficial bladder tumors that have been successfully and curatively treated with no evidence of recurrent or residual disease.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Elysium Health

INDUSTRY

Sponsor Role: collaborator

Massachusetts General Hospital

OTHER

Sponsor Role: lead

Responsible Party

Eugene Rhee

Assistant Professor of Medicine

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Eugene Rhee, MD

Role: PRINCIPAL_INVESTIGATOR

Massachusetts General Hospital

Locations

Massachusetts General Hospital

Boston, Massachusetts, United States

Countries

United States

References

Simic P, Vela Parada XF, Parikh SM, Dellinger R, Guarente LP, Rhee EP. Nicotinamide riboside with pterostilbene (NRPT) increases NAD+ in patients with acute kidney injury (AKI): a randomized, double-blind, placebo-controlled, stepwise safety study of escalating doses of NRPT in patients with AKI. BMC Nephrol. 2020 Aug 13;21(1):342. doi: 10.1186/s12882-020-02006-1.

Reference Type: DERIVED

PMID: 32791973 (View on PubMed)

Other Identifiers

2017P000908

Identifier Type: -

Identifier Source: org_study_id