Cargando…
Study Design of the Phase 3 Sparsentan Versus Irbesartan (DUPLEX) Study in Patients With Focal Segmental Glomerulosclerosis
INTRODUCTION: Focal segmental glomerulosclerosis (FSGS), a histologic lesion in the kidney caused by varied pathophysiological processes, leads to end-stage kidney disease in a large proportion of patients. Sparsentan is a first-in-class orally active compound combining endothelin type A (ET(A)) rec...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136327/ https://www.ncbi.nlm.nih.gov/pubmed/32274453 http://dx.doi.org/10.1016/j.ekir.2019.12.017 |
_version_ | 1783518225127964672 |
---|---|
author | Komers, Radko Diva, Ulysses Inrig, Jula K. Loewen, Andrea Trachtman, Howard Rote, William E. |
author_facet | Komers, Radko Diva, Ulysses Inrig, Jula K. Loewen, Andrea Trachtman, Howard Rote, William E. |
author_sort | Komers, Radko |
collection | PubMed |
description | INTRODUCTION: Focal segmental glomerulosclerosis (FSGS), a histologic lesion in the kidney caused by varied pathophysiological processes, leads to end-stage kidney disease in a large proportion of patients. Sparsentan is a first-in-class orally active compound combining endothelin type A (ET(A)) receptor blockade with angiotensin II type 1 (AT(1)) receptor antagonism in a single molecule. A Randomized, Multicenter, Double-Blind, Parallel, Active-Control Study of the Effects of Sparsentan, a Dual Endothelin Receptor and Angiotensin Receptor Blocker, on Renal Outcomes in Patients With Primary FSGS (DUPLEX) study evaluates the long-term antiproteinuric efficacy, nephroprotective potential, and safety profile of sparsentan compared with an AT(1) receptor blocker alone in patients with FSGS. METHODS: DUPLEX is a multicenter, international, phase 3, randomized, double-blind, active-controlled study of sparsentan in patients with FSGS. Approximately 300 patients aged 8 to 75 years, inclusive (United States), and 18 to 75 years, inclusive (outside United States) will be randomized 1:1 to daily treatment with sparsentan or irbesartan. After renin-angiotensin-aldosterone system inhibitor washout, treatment will be administered for 108 weeks, with the final assessment at week 112, four weeks after withdrawal of study drug. RESULTS: The primary endpoint will be the slope of estimated glomerular filtration rate from week 6 to week 108. A novel surrogate efficacy endpoint, the proportion of patients achieving urinary protein-to-creatinine (UP/C) ratio of ≤1.5 g/g and >40% reduction from baseline in UP/C (FSGS partial remission endpoint: FPRE), will be evaluated at a planned interim analysis at week 36. Safety and tolerability of sparsentan will also be assessed. CONCLUSION: The phase 3 DUPLEX study will characterize the long-term antiproteinuric efficacy and nephroprotective potential of dual ET(A) and AT(1) receptor blockade with sparsentan in patients with FSGS. |
format | Online Article Text |
id | pubmed-7136327 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-71363272020-04-09 Study Design of the Phase 3 Sparsentan Versus Irbesartan (DUPLEX) Study in Patients With Focal Segmental Glomerulosclerosis Komers, Radko Diva, Ulysses Inrig, Jula K. Loewen, Andrea Trachtman, Howard Rote, William E. Kidney Int Rep Clinical Research INTRODUCTION: Focal segmental glomerulosclerosis (FSGS), a histologic lesion in the kidney caused by varied pathophysiological processes, leads to end-stage kidney disease in a large proportion of patients. Sparsentan is a first-in-class orally active compound combining endothelin type A (ET(A)) receptor blockade with angiotensin II type 1 (AT(1)) receptor antagonism in a single molecule. A Randomized, Multicenter, Double-Blind, Parallel, Active-Control Study of the Effects of Sparsentan, a Dual Endothelin Receptor and Angiotensin Receptor Blocker, on Renal Outcomes in Patients With Primary FSGS (DUPLEX) study evaluates the long-term antiproteinuric efficacy, nephroprotective potential, and safety profile of sparsentan compared with an AT(1) receptor blocker alone in patients with FSGS. METHODS: DUPLEX is a multicenter, international, phase 3, randomized, double-blind, active-controlled study of sparsentan in patients with FSGS. Approximately 300 patients aged 8 to 75 years, inclusive (United States), and 18 to 75 years, inclusive (outside United States) will be randomized 1:1 to daily treatment with sparsentan or irbesartan. After renin-angiotensin-aldosterone system inhibitor washout, treatment will be administered for 108 weeks, with the final assessment at week 112, four weeks after withdrawal of study drug. RESULTS: The primary endpoint will be the slope of estimated glomerular filtration rate from week 6 to week 108. A novel surrogate efficacy endpoint, the proportion of patients achieving urinary protein-to-creatinine (UP/C) ratio of ≤1.5 g/g and >40% reduction from baseline in UP/C (FSGS partial remission endpoint: FPRE), will be evaluated at a planned interim analysis at week 36. Safety and tolerability of sparsentan will also be assessed. CONCLUSION: The phase 3 DUPLEX study will characterize the long-term antiproteinuric efficacy and nephroprotective potential of dual ET(A) and AT(1) receptor blockade with sparsentan in patients with FSGS. Elsevier 2020-01-08 /pmc/articles/PMC7136327/ /pubmed/32274453 http://dx.doi.org/10.1016/j.ekir.2019.12.017 Text en © 2020 International Society of Nephrology. Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Clinical Research Komers, Radko Diva, Ulysses Inrig, Jula K. Loewen, Andrea Trachtman, Howard Rote, William E. Study Design of the Phase 3 Sparsentan Versus Irbesartan (DUPLEX) Study in Patients With Focal Segmental Glomerulosclerosis |
title | Study Design of the Phase 3 Sparsentan Versus Irbesartan (DUPLEX) Study in Patients With Focal Segmental Glomerulosclerosis |
title_full | Study Design of the Phase 3 Sparsentan Versus Irbesartan (DUPLEX) Study in Patients With Focal Segmental Glomerulosclerosis |
title_fullStr | Study Design of the Phase 3 Sparsentan Versus Irbesartan (DUPLEX) Study in Patients With Focal Segmental Glomerulosclerosis |
title_full_unstemmed | Study Design of the Phase 3 Sparsentan Versus Irbesartan (DUPLEX) Study in Patients With Focal Segmental Glomerulosclerosis |
title_short | Study Design of the Phase 3 Sparsentan Versus Irbesartan (DUPLEX) Study in Patients With Focal Segmental Glomerulosclerosis |
title_sort | study design of the phase 3 sparsentan versus irbesartan (duplex) study in patients with focal segmental glomerulosclerosis |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136327/ https://www.ncbi.nlm.nih.gov/pubmed/32274453 http://dx.doi.org/10.1016/j.ekir.2019.12.017 |
work_keys_str_mv | AT komersradko studydesignofthephase3sparsentanversusirbesartanduplexstudyinpatientswithfocalsegmentalglomerulosclerosis AT divaulysses studydesignofthephase3sparsentanversusirbesartanduplexstudyinpatientswithfocalsegmentalglomerulosclerosis AT inrigjulak studydesignofthephase3sparsentanversusirbesartanduplexstudyinpatientswithfocalsegmentalglomerulosclerosis AT loewenandrea studydesignofthephase3sparsentanversusirbesartanduplexstudyinpatientswithfocalsegmentalglomerulosclerosis AT trachtmanhoward studydesignofthephase3sparsentanversusirbesartanduplexstudyinpatientswithfocalsegmentalglomerulosclerosis AT rotewilliame studydesignofthephase3sparsentanversusirbesartanduplexstudyinpatientswithfocalsegmentalglomerulosclerosis |