Angiotensin-II Receptor Antibodies Blockade With Losartan in Patients With Lupus Nephritis

NCT ID: NCT03526042

Last Updated: 2018-05-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-09-10

Study Completion Date

2019-10-31

Brief Summary

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Antibodies directed against angiotensin-II receptor (AT1-Ab) are agonist antibodies previously studied in human diseases such as preeclampsia, transplantation and scleroderma. They act by binding to the AT1 receptor and their effects can be blocked with the use of angiotensin receptor blockers (ARB). In this randomized open clinical trial the investigators will study the effect of the blockade of AT1-Ab with losartan in carotid intima-media thickness progression in patients with lupus nephritis compared to patients treated with enalapril.

Detailed Description

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Angiotensin-II type 1 receptor antibodies (AT1R-Ab) are agonist antibodies directed against the second loop of the AT1 receptor. These antibodies have been studied in human diseases such as preeclampsia, transplantation and scleroderma. A previous study from the investigators' group found an elevated prevalence of AT1R-Ab in patients with lupus nephritis. As these antibodies have been linked to atherosclerosis development this open randomized clinical trial was designed to evaluate the effect of AT1R-Ab blockade with losartan compared to the use of enalapril in the progression of carotid intima-media thickness (CIMT) in patients with active lupus nephritis.

Biopsy-proven lupus nephritis patients who tested positive for AT1R-Ab will be performed a CIMT measurement by Doppler ultrasound at the time of the biopsy and then at 12-months follow up.

The primary outcome will be the change in the CIMT in the course of 12 months in both groups.

Conditions

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Atherosclerosis Lupus Nephritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Open randomized clinical trial with parallel group comparing AT1R-ab blockade with losartan and enalapril as a control group.
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Losartan

AT1R-ab effect can be blocked with the use of angiotensin-II receptor blockers. The participants will receive losartan.

Group Type EXPERIMENTAL

Losartan

Intervention Type DRUG

Competitive blockade of AT1R-antibodies effect by binding to the angiotensin 1 receptor

Enalapril

Angiotensin converting enzyme inhibitors are indicated in the management of active lupus nephritis but do not block the effect of AT1R-Ab.

Group Type ACTIVE_COMPARATOR

Enalapril

Intervention Type DRUG

Renin-angiotensin-aldosterone system (RAAS) blockade without any effect on AT1R-antibodies effect or concentration (control group)

Interventions

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Losartan

Competitive blockade of AT1R-antibodies effect by binding to the angiotensin 1 receptor

Intervention Type DRUG

Enalapril

Renin-angiotensin-aldosterone system (RAAS) blockade without any effect on AT1R-antibodies effect or concentration (control group)

Intervention Type DRUG

Other Intervention Names

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Angiotensin receptor blocker Angiotensin Converting Enzyme Inhibitor

Eligibility Criteria

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Inclusion Criteria

* Signed consent form for the study
* Biopsy-proven lupus nephritis with proteinuria \> 1.5g/g by 24 hour urine protein to creatinine ratio
* Need for immunosuppressive induction to remission therapy according to the treatment physician
* Systemic lupus erythematosus diagnosis based on at least 4 American College of Rheumatology criteria
* Age between 16 and 50 years

Exclusion Criteria

* Patient does not want to participate in the study
* Comorbid disease such as diabetes mellitus with macro/microangiopathy, previous diagnosis of hypertension \>5 years, scleroderma
* Comorbid findings in the histopathological analysis of the renal biopsy
Minimum Eligible Age

16 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Council of Science and Technology, Mexico

OTHER

Sponsor Role collaborator

Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran

OTHER

Sponsor Role lead

Responsible Party

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Luis Eduardo Morales Buenrostro

Clinical Professor of Nephrology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Luis E Morales-Buenrostro, PhD

Role: PRINCIPAL_INVESTIGATOR

Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran

Locations

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Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran

Mexico City, , Mexico

Site Status RECRUITING

Countries

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Mexico

Central Contacts

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Luis E Morales-Buenrostro, PhD

Role: CONTACT

54870900 ext. 4142

Juan M Mejia-Vilet, MD,MSc

Role: CONTACT

54870900 ext. 4142

Facility Contacts

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Juan M Mejia-Vilet, MD,MSc

Role: primary

54870900 ext. 4142

Luis E Morales-Buenrostro, PhD

Role: backup

54870900 ext. 4142

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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NMM-1816,16/16-1

Identifier Type: -

Identifier Source: org_study_id

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