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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04578834
Registration number
NCT04578834
Ethics application status
Date submitted
9/09/2020
Date registered
8/10/2020
Titles & IDs
Public title
Study of Efficacy and Safety of LNP023 in Primary IgA Nephropathy Patients
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Scientific title
A Multi-center, Randomized, Double-blind, Placebo-controlled, Parallel Group, Phase III Study to Evaluate the Efficacy and Safety of LNP023 in Primary IgA Nephropathy Patients
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Secondary ID [1]
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CLNP023A2301
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Universal Trial Number (UTN)
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Trial acronym
APPLAUSE-IgAN
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
IgA Nephropathy
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Condition category
Condition code
Renal and Urogenital
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Kidney disease
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Inflammatory and Immune System
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Autoimmune diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Placebo
Treatment: Drugs - LNP023
Experimental: LNP023 200mg b.i.d -
Placebo comparator: Placebo to LNP023 200mg b.i.d -
Treatment: Drugs: Placebo
Placebo to LNP023 200mg b.i.d
Treatment: Drugs: LNP023
LNP023 200mg b.i.d
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Ratio to baseline in Urine Protein to Creatinine Ratio (sampled from 24h urine collection) at 9 months
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Assessment method [1]
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Evaluated at interim analysis - To demonstrate superiority of LNP023 vs. placebo in the change of proteinuria at 9 months by measuring Urine Protein to Creatinine Ratio sampled from a 24h urine collection.
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Timepoint [1]
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Baseline and 9 months
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Primary outcome [2]
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Annualized total estimated Glomerular Filtration Rate (eGFR) slope over 24 months).
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Assessment method [2]
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Evaluated at the final analysis - to demonstrate superiority of LNP023 vs. placebo in slowing IgAN progression measured by the annualized total slope of Estimated Glomerular Filtration Rate (eGFR) change over 24 months.
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Timepoint [2]
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Baseline and 24 months
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Secondary outcome [1]
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Change from baseline in estimated glomerular filtration rate at 9 months
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Assessment method [1]
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Evaluated at interim analysis - To evaluate the effect of LNP023 vs. placebo on slowing estimated glomerular filtration rate decrease as measured by the change from baseline in eGFR
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Timepoint [1]
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Baseline and 9 months
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Secondary outcome [2]
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Proportion of participants reaching Urine Protein To Creatinine Ratio <1g/g without receiving Corticosteroids/Immunosuppressant or other newly approved drugs or initiating new background therapy for treatment of IgAN or Kidney Replacement Therapy (KRT)
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Assessment method [2]
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Evaluated at interim analysis - To assess the effect of LNP023 vs. placebo on the proportion of study participants reaching proteinuria below 1g/g of Urine Protein To Creatinine Ratio (sampled from 24h urine collection) at 9 months.
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Timepoint [2]
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Baseline and 9 months
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Secondary outcome [3]
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Annualized total Estimated Glomerular Filtration Rate slope estimated over 12 months
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Assessment method [3]
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Evaluated at interim analysis - To evaluate the effect of LNP023 vs. placebo on slowing IgAN progression measured by the annualized total slope of Estimated Glomerular Filtration Rate change over 1 year.
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Timepoint [3]
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Baseline and 12 months
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Secondary outcome [4]
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Change from baseline to 9 months in the fatigue scale measured by the Functional Assessment Of Chronic Illness Therapy-Fatigue questionnaire
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Assessment method [4]
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Evaluated at interim analysis - To assess the effect of LNP023 vs. placebo on the change from baseline to 9 months in fatigue scale measured by the Functional Assessment Of Chronic Illness Therapy-Fatigue questionnaire.
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Timepoint [4]
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Baseline and 9 months
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Secondary outcome [5]
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Time from randomization to first occurrence of composite kidney failure endpoint event
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Assessment method [5]
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Evaluated at final analysis - demonstrate the superiority of LNP023 vs. placebo on delaying the time to first occurrence of a composite kidney failure endpoint, defined as reaching either sustained =30% decline in Estimated Glomerular Filtration Rate (eGFR) relative to baseline or sustained eGFR \<15 mL/min/1.73m2 or maintenance dialysis or receipt of kidney transplant or death from kidney failure.
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Timepoint [5]
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Up to 24 months
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Secondary outcome [6]
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Ratio to baseline in Urine Protein-To-Creatinine Ratio (sampled from 24h urine collection) at 9 months
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Assessment method [6]
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Evaluated at final analysis - To demonstrate superiority of LNP023 vs. placebo in the change of proteinuria at 9 months by measuring Urine Protein To Creatinine Ratio sampled from a 24h urine collection.
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Timepoint [6]
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Baseline and 9 months
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Secondary outcome [7]
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Proportion of participants reaching Urine Protein-To-Creatinine Ratio <1g/g without receiving Corticosteroids/Immunosuppressant Therapy or other newly approved drugs or initiating new background therapy for treatment of IgAN or initiating KRT
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Assessment method [7]
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Evaluated at final analysis - To demonstrate the superiority of LNP023 vs. placebo on the proportion of study participants reaching proteinuria below 1g/g of Urine Protein To Creatinine Ratio (sampled from 24h urine collection) at 9 months.
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Timepoint [7]
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Baseline and 9 months
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Secondary outcome [8]
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Change from baseline to 9 months in the fatigue scale measured by the Functional Assessment Of Chronic Illness Therapy-Fatigue questionnaire.
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Assessment method [8]
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Evaluated at final analysis - To demonstrate the superiority of LNP023 vs. placebo on the change from baseline to 9 months in the fatigue scale measured by Functional Assessment Of Chronic Illness Therapy-Fatigue questionnaire.
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Timepoint [8]
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Baseline and 9 months
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Eligibility
Key inclusion criteria
* Male and female patients = 18 years of age with an eGFR level and biopsy-confirmed IgA nephropathy as follows:
* For patients eGFR* = 45ml/min/1.73m2, a qualifying biopsy performed within the last 5 years is required.
* For patients with eGFR* 30 to <45ml/min/1.73m2, a qualifying biopsy performed within 2 years with < 50% tubulointerstitial fibrosis is required.
* For patients with eGFR* 20 to <30ml/min/1.73m2, a qualifying biopsy performed at any time.
In all cases, if a historical biopsy is not available, one may be performed during screening. *eGFR calculated using the CKD-EPI formula (or modified MDRD formula according to specific ethnic groups and local practice guidelines)
* Proteinuria due to primary diagnosis of IgA nephropathy as assessed at screening by UPCR =1 g/g (113 mg/mmol) sampled from FMV or 24h urine collection, as well as at the completion of the run-in period by UPCR =1 g/g (113 mg/mmol) calculated as the (geometric) mean of two 24h urine collections obtained within 14 days of each other at baseline.
* Vaccination against Neisseria meningitidis and Streptococcus pneumoniae infection is required prior to the start of study treatment. If the patient has not been previously vaccinated, or if a booster is required, vaccine should be given according to local regulations at least 2 weeks prior to first study drug administration. If study treatment has to start earlier than 2 weeks post vaccination, prophylactic antibiotic treatment should be initiated.
* If not previously vaccinated, vaccination against Haemophilus influenzae infections should be given, if available and according to local regulations, at least 2 weeks prior to first study drug administration.
* All patients must have been on supportive care including stable dose regimen of ACEi or ARB at either the locally approved maximal daily dose or the maximally tolerated dose (per investigators' judgment) for approximately 90 days before first study drug administration. In addition, if patients are taking diuretics, other antihypertensive medication, or other background medication for IgAN, the doses should also be stabilized for approximately 90 days prior to the first dosing of study treatment.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Any secondary IgAN as defined by the investigator; secondary IgAN can be associated with cirrhosis, celiac disease, Human Immunodeficiency Virus (HIV) infection, dermatitis herpetiformis, seronegative arthritis, small-cell carcinoma, lymphoma, disseminated tuberculosis, bronchiolitis obliterans, and inflammatory bowel disease, familial mediterranean fever, etc.
* Sitting office SBP >140 mmHg or DBP >90 mmHg at the randomization visit
* Patients previously treated with immunosuppressive or other immunomodulatory agents such as but not limited to cyclophosphamide, rituximab, infliximab, eculizumab, canakinumab, mycophenolate mofetil (MMF) or mycophenolate sodium (MPS), cyclosporine, tacrolimus, sirolimus, everolimus, or systemic corticosteroids exposure (>7.5 mg/d prednisone/prednisolone equivalent) within 90 days (or 180 days for rituximab) prior to first study drug administration. Participants previously or currently treated with oral budesonide. Participants treated with endothelin (receptor) antagonists within 90 days prior to first study drug administration.
* Prior use of iptacopan (LNP023) or prior enrollment in any other LNP023 clinical trial where study drug was taken, including matching placebo
* History of recurrent invasive infections caused by encapsulated organisms, such as meningococcus and pneumococcus.
* Active systemic bacterial, viral (including COVID-19) or fungal infection within 14 days prior to study drug administration.
Other protocol-defined inclusion/exclusion criteria may apply.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
25/01/2021
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
15/10/2025
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Actual
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Sample size
Target
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Accrual to date
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Final
519
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Recruitment in Australia
Recruitment state(s)
QLD,SA,VIC
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Recruitment hospital [1]
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Novartis Investigative Site - Woolloongabba
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Novartis Investigative Site - Adelaide
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Novartis Investigative Site - Parkville
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Novartis Investigative Site - St Albans
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4102 - Woolloongabba
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Recruitment postcode(s) [2]
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5000 - Adelaide
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3065 - Parkville
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3021 - St Albans
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Bergen
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Omsk
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Rostov On Don
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Russian Federation
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St Petersburg
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Singapore
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Kosice
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Slovenia
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Ljubljana
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Slovenia
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Maribor
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Free State
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Spain
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Andalucia
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Spain
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Castilla Y Leon
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Catalunya
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Spain
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Danderyd
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Sweden
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Stockholm
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Taiwan
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Kaohsiung
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Taiwan
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New Taipei City
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Taiwan
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New Taipei
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Taiwan
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Taichung
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Taiwan
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Taipei
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Taoyuan
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Thailand
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Bangkok
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Turkey
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Sultangazi
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Turkey
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TUR
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Ankara
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Turkey
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Antalya
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Turkey
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Istanbul
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Turkey
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Kocaeli
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Mersin
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Turkey
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Talas Kayseri
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United Kingdom
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Manchester
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United Kingdom
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Leicester
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United Kingdom
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London
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United Kingdom
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Newcastle Upon Tyne
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Vietnam
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VNM
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Vietnam
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Ho Chi Minh
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Novartis Pharmaceuticals
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
The study is designed as a multicenter, randomized, double-blind, placebo controlled study to demonstrate the superiority of iptacopan (LNP023) at a dose of 200 mg b.i.d. compared to placebo on top of maximally tolerated ACEi or ARB on reduction of proteinuria and slowing renal disease progression in primary IgA Nephropathy patients.
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Trial website
https://clinicaltrials.gov/study/NCT04578834
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Trial related presentations / publications
Reich HN, Floege J. How I Treat IgA Nephropathy. Clin J Am Soc Nephrol. 2022 Aug;17(8):1243-1246. doi: 10.2215/CJN.02710322. Epub 2022 Jun 8. No abstract available.
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Public notes
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Contacts
Principal investigator
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Novartis Pharmaceuticals
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Novartis Pharmaceuticals
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations.
This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
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When will data be available (start and end dates)?
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Available to whom?
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04578834