A Study of Acthar Gel Alone or With Tacrolimus to Reduce Proteinuria in Fibrillary Glomerulopathy Patients

NCT ID: NCT05546047

Last Updated: 2022-10-31

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

PHASE4

Total Enrollment

34 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-03-14

Study Completion Date

2024-10-27

Brief Summary

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A Multicenter, Comparative Safety and Efficacy Study of Acthar gel alone or in combination with oral Tacrolimus to reduce urinary proteinuria in patients with idiopathic DNAJB9 Positive Fibrillary glomerulopathy.

Detailed Description

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A Multicenter, Comparative Safety and Efficacy Study of Acthar gel alone or in combination with oral Tacrolimus to reduce urinary proteinuria in patients with idiopathic DNAJB9 Positive Fibrillary glomerulopathy. This study will be a multi-center, prospective, randomized, open-labeled intervention trial of 34 patients randomized to 52 weeks of ACTHar gel alone or Acthar gel plus oral Tacrolimus.

Conditions

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Fibrillary Glomerulonephritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A 12-month treatment with combination Acthar gel and Tacrolimus therapy will be superior to Acthar gel therapy alone in lowering urinary protein to creatinine ratios in patients with Fibrillary glomerulonephritis
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Treatment with Acthar gel

Group 1 - (17 patients) Acthar gel 80 units 2 times a week alone for 12 months of therapy.

Group Type ACTIVE_COMPARATOR

Acthar Gel 80 UNT/ML Injectable Solution

Intervention Type DRUG

Follow up and observation for 12 months off Acthar gel or Acthar gel and Tacrolimus

Treatment with combination Acthar gel and Tacrolimus therapy

Group 2 - (17 patients) Acthar get 80 units 2 times a week plus oral Tacrolimus 1.0 mg two times a day titrated to trough Tacrolimus levels between 4-6 ng/ml

Group Type ACTIVE_COMPARATOR

Acthar Gel 80 UNT/ML Injectable Solution

Intervention Type DRUG

Follow up and observation for 12 months off Acthar gel or Acthar gel and Tacrolimus

Interventions

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Acthar Gel 80 UNT/ML Injectable Solution

Follow up and observation for 12 months off Acthar gel or Acthar gel and Tacrolimus

Intervention Type DRUG

Other Intervention Names

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Tacrolimus 1.0 mg

Eligibility Criteria

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Inclusion Criteria

* Male/Female age \> 18
* Biopsy proven Fibrillary glomerulonephritis within 3 years of study randomization
* Stable Maximum Renin-Angiotensin-Aldosterone System inhibition times 4 weeks prior to randomization Note: Maximum RAAS inhibition will be left to the discretion of the site Principal Investigator
* Estimated Glomerular Filtration Rate \> 25 mls/min calculate by the Chronic Kidney Disease-EPI formula
* Protein/creatinine ratio \> 2000 mg/gm 5) Note: If protein/creatinine less than 2000 mg/gm, a formal 24- hour urine collection for total protein can be performed. The total 24-hour protein will need to \>/= 2000mg.
* Blood pressure targeted to \< 140/90 at the time of randomization
* Patients with Monoclonal Gammopathy without history of myeloma will be eligible.
* Patients with monoclonal staining for fibrillary fibers will be excluded
* Patients with Type II non-insulin dependent diabetes will be eligible provided the renal biopsy does not show nodular Kimmelstiel Wilson lesions

Exclusion Criteria

* Patients with MGUS and history of myeloma will not be eligible
* Patients with active viral production of either hepatitis B or C as evidence by historical polymerase chain reaction test positive for active viral shedding
* HIV seropositivity
* Renal biopsy data with \> 50% Interstitial Fibrosis
* Patient with active or a known history lymphoma
* Patients with insulin dependent diabetes mellitus will be excluded Note: patients with Type II diabetes mellitus that are well controlled without the need for insulin will be eligible for the study.
* Patients with Type II non-insulin dependent diabetes will be eligible provided the renal biopsy does not show nodular Kimmelstiel Wilson lesions.
* Patients receiving steroids, mycophenolate mofetil, cyclophosphamide, Azathioprine or other immunosuppressive agent with 4 weeks of study randomization Note: Washout of these medications will be allowed at the screening visit
* Patients having received Rituximab or B cell modifying biologic therapy within 6 months of randomization
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Mallinckrodt

INDUSTRY

Sponsor Role collaborator

NephroNet, Inc.

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jeremy Whitson, BS

Role: STUDY_DIRECTOR

NephroNet, Inc.

James Tumlin, MD

Role: PRINCIPAL_INVESTIGATOR

NephroNet, Inc.

Locations

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Stanford University

Stanford, California, United States

Site Status

University of Colorado Anschutz Medical Department of Medicine Division of Renal Diseases and Hypertension

Aurora, Colorado, United States

Site Status

Georgia Nephrology DBA Georgia Nephrology Research Institute

Lawrenceville, Georgia, United States

Site Status

Columbia University Research Dept of Nephrology

New York, New York, United States

Site Status

Northeast Clinical Research Center

Bethlehem, Pennsylvania, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol

View Document

Other Identifiers

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NN-002

Identifier Type: -

Identifier Source: org_study_id