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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT05196035
Registration number
NCT05196035
Ethics application status
Date submitted
7/01/2022
Date registered
19/01/2022
Titles & IDs
Public title
A Study to Learn More About How Well the Study Treatment Finerenone Works, How Safe it is, How it Moves Into, Through, and Out of the Body, and the Effects it Has on the Body When Taken With an ACE Inhibitor or Angiotensin Receptor Blocker in Children With Chronic Kidney Disease and Proteinuria
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Scientific title
A 6-month Multicenter, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Efficacy, Safety and PK/PD of an age-and Body Weight-adjusted Oral Finerenone Regimen, in Addition to an ACEI or ARB, for the Treatment of Children, 6 Months to <18 Years of Age, With Chronic Kidney Disease and Proteinuria
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Secondary ID [1]
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2023-504884-17-00
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Secondary ID [2]
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19920
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Universal Trial Number (UTN)
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Trial acronym
FIONA
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic Kidney Disease
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Proteinuria
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Condition category
Condition code
Renal and Urogenital
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Kidney disease
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Renal and Urogenital
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Other renal and urogenital disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Finerenone (Kerendia, BAY94-8862)
Treatment: Drugs - Placebo
Experimental: Finerenone (Kerendia, BAY94-8862) - Participants will receive finerenone treatment.
Placebo comparator: Placebo - Participants will receive placebo to finerenone.
Treatment: Drugs: Finerenone (Kerendia, BAY94-8862)
Finerenone in different doses, treatment duration will be 180±7 days
Treatment: Drugs: Placebo
Placebo to finerenone, treatment duration will be 180±7 days
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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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Urinary protein-to-creatinine ratio (UPCR) reduction of at least 30% from baseline to day 180±7
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Assessment method [1]
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Proportion of participants at day 180±7 with a \>=30% reduction in UPCR compared to baseline.
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Timepoint [1]
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From baseline to day 180±7
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Secondary outcome [1]
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Number participants with treatment emergent adverse events (TEAEs)
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Assessment method [1]
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Below sub-categories will be considered:
1. Serious Treatment Emergent Adverse Events (TEAEs)
2. TEAEs and serious TEAEs leading to discontinuation of treatment
3. Study drug related TEAEs and serious TEAEs
4. TEAEs categorized by severity (mild, moderate, severe)
5. TEAEs by maximum intensity
6. Number of participants hospitalized with hyperkalemia,
7. Number of participants discontinuing due to hyperkalemia,
8. Number of participants with hospitalization for worsening of renal function
9. Number of participants discontinuing due to worsening of renal function
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Timepoint [1]
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From the start of study intervention to last study intervention + 3 days (up to 190 days)
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Secondary outcome [2]
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Change in serum potassium levels from baseline to day 180±7
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Assessment method [2]
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Timepoint [2]
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From baseline to day 180±7
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Secondary outcome [3]
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Change in serum creatinine from baseline to day 180±7
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Assessment method [3]
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Timepoint [3]
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From baseline to day 180±7
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Secondary outcome [4]
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Change in eGFR from baseline to day 180±7
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Assessment method [4]
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Estimated glomerular filtration rate (eGFR)
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Timepoint [4]
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From baseline to day 180±7
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Secondary outcome [5]
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Change in systolic blood pressure from baseline to day 180±7
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Assessment method [5]
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Timepoint [5]
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From baseline to day 180±7
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Secondary outcome [6]
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Mean reduction from baseline to day 180±7 in UPCR
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Assessment method [6]
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Percent change from baseline to day 180±7 in UPCR will be calculated.
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Timepoint [6]
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From baseline to day 180±7
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Secondary outcome [7]
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Change in UACR from baseline to day 180±7
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Assessment method [7]
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Urinary albumin-to-creatinine ratio (UACR)
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Timepoint [7]
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From baseline to day 180±7
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Secondary outcome [8]
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Pharmacokinetics (PK) finerenone Cmax, md
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Assessment method [8]
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Maximum observed finerenone concentration in plasma after multiple doses.
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Timepoint [8]
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Pre-dose, post-dose (1.5-5 hours after intake of intervention), up to day 180±7
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Secondary outcome [9]
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Pharmacokinetics (PK) finerenone AUCt,md
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Assessment method [9]
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Area under the curve for finerenone concentration in plasma after multiple doses.
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Timepoint [9]
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Pre-dose, post-dose (1.5-5 hours after intake of intervention), up to day 180±7
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Secondary outcome [10]
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Taste and texture questionnaire of the pediatric formulation
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Assessment method [10]
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Timepoint [10]
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On day 30±3 and day 180±7
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Eligibility
Key inclusion criteria
* Participants must be 6 months to <18 years old at the time when the informed consent/assent is signed
* Participants must have a clinical diagnosis of chronic kidney disease (CKD) at screening which is defined as
* CKD stages 1-3 (eGFR =30 mL/min/1.73m^2) for children =1 year to <18 years of age or
* a serum creatinine = 0.40 mg/dL for infants 6 months to < 1 year of age and
* severely increased proteinuria as defined by
* Urinary protein-to-creatinine ratio (UPCR) of = 0.50 g/g in participants = 2 years with CKD stage 2 and 3 or
* UPCR = 1.0 g/g for patients < 2 years of age or = 2 years of age and with CKD stage 1
* Participants must have stable kidney function between screening and D0 defined as:
* no increase or decrease in eGFR = 15% for children =1 year or
* no increase or decrease in creatinine = 0.10 mg/dL for children <1 year
* Treated with an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) at optimized doses defined as maximally tolerable doses within the recommended dose range according to guidelines on blood pressure management, unchanged for at least 30 days prior to screening
* K+ =5.0 mmol/L for children =2 years of age at both screening and D0, and =5.3 mmol/L for children <2 years of age at both screening and D0
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Minimum age
6
Months
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Maximum age
17
Years
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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
* Planned urological surgery expected to influence renal function
* Children with hemolytic uremic syndrome (HUS) diagnosed =6 months prior to screening
* Patients with nephrotic syndrome receiving albumin infusions within the last 6 months prior to screening
* Patients who are candidates for renal transplantation, i.e., a kidney transplantation scheduled within the study time frame
* Renal allograft in place
* Bilateral renal artery stenosis
* Acute kidney injury requiring dialysis within 6 months prior to screening
* Systemic hypertension stage 2 in children =1 year of age defined according to guidelines on blood pressure management at screening or randomization
* Systolic blood pressure (SBP) above 110 mmHg in infants 6 months to <1 year of age at screening or randomization
* Systemic hypotension defined as a systolic blood pressure below the 5th percentile for age, sex and height at either screening or randomization but no lower than 80 mmHg (although for some participants the 5th percentile of SBP is < 80 mmHg they must be excluded if their SBP is <80 mmHg)
* Participants with immune-mediated CKD using rituximab, cyclophosphamide, abatacept, or high-dose glucocorticoids, within <6 months prior to screening
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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 administering the treatment/s
The people assessing the outcomes
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
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
28/03/2022
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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
11/03/2027
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Actual
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Sample size
Target
219
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,VIC
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Recruitment hospital [1]
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The Children's Hospital at Westmead - Westmead
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Queensland Children's Hospital - South Brisbane
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Monash Children's Hospital - Clayton
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Royal Children's Hospital Melbourne - Parkville
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Many Locations - Multiple Locations
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2145 - Westmead
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4101 - South Brisbane
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3168 - Clayton
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3052 - Parkville
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Spain
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Madrid
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Spain
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Spain
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Spain
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Lund
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Sweden
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Uppsala
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Switzerland
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Basel-Stadt
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Switzerland
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Vaud
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Geneva
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Turkey
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Adana
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Turkey
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Ankara
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Turkey
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Istanbul
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Turkey
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United Kingdom
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West Midlands
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United Kingdom
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Glasgow
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United Kingdom
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London
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United Kingdom
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Manchester
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United Kingdom
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United Kingdom
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Nottingham
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Funding & Sponsors
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Bayer
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Summary
Brief summary
Researchers are looking for a better way to treat children who have chronic kidney disease (CKD), which is long-term kidney disease, and proteinuria, a condition in which a person´s kidneys leak protein into the urine. The kidneys filter waste and fluid from the blood to form urine. In children with CKD, the kidney´s filters do not work as well as they should. This can lead to accumulation of waste and fluid in the body and proteinuria. CKD can lead to other medical problems, such as high blood pressure, also known as hypertension. Vice versa, hypertension and proteinuria can also contribute to worsening of CKD. Therefore, the treatment of CKD aims to control blood pressure and proteinuria. There are treatments available for doctors to prescribe to children with CKD and hypertension and/or proteinuria. These include "angiotensin-converting enzyme inhibitors" (ACEI) and "angiotensin receptor blockers" (ARB). Both ACEI and ARB can improve kidney function by helping the renin-angiotensin-aldosterone system (RAAS) to work normally. The RAAS is a system that works with the kidneys to control blood pressure and the balance of fluid and electrolytes in the blood. In people with CKD, the RAAS is often too active, which can stop the kidneys from working properly and cause hypertension and proteinuria. However, ACEI or ARB treatment alone does not work for all patients with CKD as they only target the angiotensin part of the renin-angiotensin-aldosterone system. The study treatment, finerenone, is expected to help control RAAS overactivation together with an ACEI or ARB. So, the researchers in this study want to learn more about whether finerenone given in addition to either an ACEI or ARB can help their kidney function. The main purpose of this study is to learn more about whether finerenone added to either ACEI or ARB can help reduce the amount of protein in the participants' urine more than a placebo. A placebo looks like a treatment but does not have any medicine in it. Participants will also continue to receive their other medications. To see how the treatment work, the doctors will take samples of the participants' urine to measure their protein levels before and during taking treatment and after their last treatment. In addition, blood samples will be taken to monitor kidney function, electrolytes and the amount of finerenone in the blood as well as for other tests. This study will include children with CKD and proteinuria aged from 6 months up to less than 18 years. The participants will take: * either finerenone or the placebo, in addition to * either ACEI or ARB, whichever they take as part of their normal treatment Two visits are required up to 104 days, to check whether a child can take part in the treatment phase of the study. If participants qualify for the treatment phase, they will then undergo treatment for about 180 days. During this time, they will visit the study site at least 7 times. During these visits, the participants will: * have their blood pressure, heart rate, temperature, height and weight measured * have blood and urine samples taken * have physical examinations * have their heart examined by an electrocardiogram and echocardiography (a sonogram of the heart) * answer questions about their medication and whether they have any adverse events , or have their parents or guardians answer * answer questions about how they are feeling, or have their parents or guardians answer * answer question about how they like the study medication, or have their parents or guardians answer The doctors will keep track of any adverse events. An adverse event is any medical problem that a participant has during a study. Doctors keep track of all adverse events that happen in studies, even if they do not think the adverse events might be related to the study treatments. The doctors will check the participants' health about 30 days after the participants take their last treatment.
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Trial website
https://clinicaltrials.gov/study/NCT05196035
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Contacts
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Bayer Clinical Trials Contact
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(+) 1-888-84 22937
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Availability of this study's data will later be determined according to Bayer's commitment to the EFPIA/PhRMA "Principles for responsible clinical trial data sharing". This pertains to scope, timepoint and process of data access. As such, Bayer commits to sharing upon request from qualified researchers patient-level clinical trial data, study-level clinical trial data, and protocols from clinical trials in patients for medicines and indications approved in the US and EU as necessary for conducting legitimate research. This applies to data on new medicines and indications that have been approved by the EU and US regulatory agencies on or after January 01, 2014.
Interested researchers can use www.vivli.org to request access to anonymized patient-level data and supporting documents from clinical studies to conduct research. Information on the Bayer criteria for listing studies and other relevant information is provided in the member section of the portal.
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What supporting documents are/will be available?
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Results publications and other study-related documents
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Results not provided in
https://clinicaltrials.gov/study/NCT05196035