Clinical trial • Phase III • Cardiology|Nephrology

BAXDROSTAT for Chronic kidney disease | Hypertension

Phase III trial of BAXDROSTAT for Chronic kidney disease | Hypertension.

Overview

Trial Therapeutic Area
Cardiology|Nephrology
Trial Disease
Chronic kidney disease | Hypertension
Trial Stage
Phase III
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
31-01-2024
First CTIS Authorization Date
22-05-2024

Trial design

Randomised, baxdrostat in combination with dapagliflozin compared with dapagliflozin alone (placebo/dapagliflozin). dapagliflozin (forxiga) 10 mg oral daily is specified; baxdrostat oral tablet (dose not specified in part i product entry). baxdrostat placebo used for blinding.-controlled Phase III trial in France, Poland, Italy and others.

Randomised
Yes
Comparator
Baxdrostat in combination with dapagliflozin compared with dapagliflozin alone (placebo/dapagliflozin). Dapagliflozin (Forxiga) 10 mg oral daily is specified; Baxdrostat oral tablet (dose not specified in Part I product entry). Baxdrostat placebo used for blinding.
Target Sample Size
1825

Eligibility

Recruits 1825 Vulnerable population is selected in the application. Only adults (≥18 years) are eligible. Country- and language-specific subject information sheets and informed consent forms are provided (including optional genomics consent and addenda for handling personal data); separate materials for pregnant subjects are available. Informed consent is provided by the participant (no assent for minors, as minors are excluded)..

Vulnerable Population
Vulnerable population is selected in the application. Only adults (≥18 years) are eligible. Country- and language-specific subject information sheets and informed consent forms are provided (including optional genomics consent and addenda for handling personal data); separate materials for pregnant subjects are available. Informed consent is provided by the participant (no assent for minors, as minors are excluded).

Inclusion criteria

  • {"criterion_text":"- Participants of any sex and gender must be ≥ 18 years old, or older, at the time of signing the informed consent."}
  • {"criterion_text":"- Participants with CKD and eGFR ≥ 30 and < 90 mL/min/1.73 m2 at screening"}
  • {"criterion_text":"- Urine albumin creatinine ratio > 200 mg/g (22.6 mg/mmol) and < 5000 mg/g (565 mg/mmol) at screening"}
  • {"criterion_text":"- Participants with history of HTN and a SBP ≥ 130 mmHg at screening and ≥ 120 mmHg at the randomisation visit"}
  • {"criterion_text":"- Stable and maximum tolerated dose of an ACE inhibitor or an ARB (not both) for at least 4 weeks prior to Screening Visit"}
  • {"criterion_text":"- 6. Central laboratory serum potassium must meet the following criteria at the Screening Visit, based on screening eGFR: o for participants with screening eGFR ≥ 45 mL/min/1.73 m2, potassium must be ≥ 3.0 and ≤ 4.8 mmol/L at the Screening Visit o for participants with screening eGFR < 45 mL/min/1.73 m2, potassium must be ≥ 3.0 and ≤ 4.5 mmol/L at the Screening Visit"}

Exclusion criteria

  • {"criterion_text":"- Medical Conditions 1. Systolic blood pressure > 180 mmHg, or DBP > 110 mmHg at screening."}
  • {"criterion_text":"- History or ongoing allergy/hypersensitivity, as judged by the investigator, to SGLT2 inhibitor (eg, empagliflozin) or ASI."}
  • {"criterion_text":"- Any clinical condition requiring systemic immunosuppression therapy other than stable maintenance therapy for at least 3 months prior to Visit 1."}
  • {"criterion_text":"- Any use of mineralocorticoid receptor antagonists (such as spironolactone, eplerenone, or finerenone), potassium-sparing diuretics (such as triamterene or amiloride), or potassium binders (such as sodium zirconium cyclosilicate, patiromer, or sodium polystyrene sulfonate) within 4 weeks prior to screening."}
  • {"criterion_text":"- Known hyperkalaemia, defined as potassium of ≥ 5.5 mmol/L within 3 months at screening."}
  • {"criterion_text":"- Serum sodium < 135 mmol/L at the Screening Visit, determined as per central laboratory."}
  • {"criterion_text":"- Type 1 diabetes mellitus or uncontrolled Type 2 diabetes mellitus with HbA1c > 10.5% (> 91 mmol/mol) at Screening."}
  • {"criterion_text":"- New York Heart Association functional HF class IV at screening."}
  • {"criterion_text":"- Stroke, transient ischaemic cerebral attack, valve implantation or valve replacement, carotid surgery, or carotid angioplasty, acute coronary syndrome, or hospitalisation for worsening heart failure within previous 3 months prior to randomisation."}
  • {"criterion_text":"- Any dialysis (including for acute kidney injury) within 3 months prior to Screening Visit."}
  • {"criterion_text":"- Any acute kidney injury within 3 months prior to the Screening Visit"}
  • {"criterion_text":"- History of organ transplant or bone marrow transplant, or planned organ transplant within 6 months following randomisation (including kidney transplant)."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Change from baseline in eGFR to post treatment.","definition_or_measurement_approach":"Assessed as change in eGFR (estimated glomerular filtration rate) over time (effect on change in eGFR over time)."}

Secondary endpoints

  • {"endpoint_text":"- 1. Change from baseline in UACR.","definition_or_measurement_approach":"Change from baseline in urine albumin-creatinine ratio (UACR)."}
  • {"endpoint_text":"- 2. Change from baseline in systolic BP (blood pressure).","definition_or_measurement_approach":"Change from baseline in systolic blood pressure (SBP)."}
  • {"endpoint_text":"- 3. Kidney hierarchical composite endpoint.* *Defined as the most severe outcome of the following: 1. Death; 2. KFRT (chronic dialysis or kidney transplant); 3. Sustained GFR < 15 mL/min/1.73 m2; 4. Sustained GFR decline from baseline of ≥ 57%; 5 Sustained GFR decline from baseline of ≥ 50%; or 6. individual change from baseline to post-treatment eGFR if none of the outcomes occurred.","definition_or_measurement_approach":"Hierarchical composite renal endpoint defined as the most severe outcome in the ordered list (death; KFRT; sustained GFR <15; sustained GFR decline ≥57%; sustained GFR decline ≥50%; or individual change in eGFR if none occurred)."}
  • {"endpoint_text":"- 4. Change in eGFR from following randomisation.","definition_or_measurement_approach":"Change in eGFR measured after randomisation vs baseline."}
  • {"endpoint_text":"- 5. Time to the first occurrence of any of the components of the composite of: 1) CV death 2) HF with and without hospitalisation 3) MI 4) Stroke","definition_or_measurement_approach":"Time-to-event for first occurrence of composite cardiovascular outcomes (MACE components: CV death, heart failure with/without hospitalisation, myocardial infarction, stroke)."}

Recruitment

Digital Remote Recruitment
True, documented methods include online landing pages, web recruitment, prescreening questionnaires, use of databases and SMS for outreach (country-specific recruitment materials reference web/landing page, database, Pratia web, and SMS approaches).
Planned Sample Size
1825
Recruitment Window Months
47
Consent Approach
Informed consent is obtained from adult participants (≥18) using country- and language-specific subject information sheets and informed consent forms. Multiple ICF versions and addenda exist (including optional genomics consent, addenda for handling personal data, and separate materials for pregnant subjects). Documents available in multiple languages according to country (examples in repository: French, English, Spanish, Italian, Czech, Hungarian, Polish, Swedish, Romanian, Greek, Bulgarian, Dutch, etc.).

Methods

  • Posters and pamphlets (site-level K2 recruitment materials documented for multiple countries).
  • Patient letters and printed pamphlets (country-specific K2 materials).
  • Scripts for recruitment videos and site videos (documented).
  • Digital recruitment: online landing pages, study web pages, web prescreening questionnaires, databases and web-based recruitment (documents reference vendor materials such as Pratia web/landing page/database and SMS approaches).

Geography

Total Number Of Participants
1825

France

Earliest CTIS Part Ii Submission Date
22-03-2024
Latest Decision Or Authorization Date
23-05-2024
Processing Time Days
62
Number Of Participants
50

Poland

Earliest CTIS Part Ii Submission Date
25-04-2024
Latest Decision Or Authorization Date
27-05-2024
Processing Time Days
32
Number Of Participants
50

Italy

Earliest CTIS Part Ii Submission Date
20-02-2024
Latest Decision Or Authorization Date
23-05-2024
Processing Time Days
93
Number Of Participants
30

Sweden

Earliest CTIS Part Ii Submission Date
26-04-2024
Latest Decision Or Authorization Date
27-05-2024
Processing Time Days
31
Number Of Participants
35

Hungary

Earliest CTIS Part Ii Submission Date
20-03-2024
Latest Decision Or Authorization Date
23-05-2024
Processing Time Days
64
Number Of Participants
35

Romania

Earliest CTIS Part Ii Submission Date
26-04-2024
Latest Decision Or Authorization Date
27-05-2024
Processing Time Days
31
Number Of Participants
60

Denmark

Earliest CTIS Part Ii Submission Date
29-04-2024
Latest Decision Or Authorization Date
22-05-2024
Processing Time Days
23
Number Of Participants
30

Spain

Earliest CTIS Part Ii Submission Date
19-04-2024
Latest Decision Or Authorization Date
23-05-2024
Processing Time Days
34
Number Of Participants
45

Czechia

Earliest CTIS Part Ii Submission Date
26-04-2024
Latest Decision Or Authorization Date
23-05-2024
Processing Time Days
27
Number Of Participants
55

Bulgaria

Earliest CTIS Part Ii Submission Date
20-05-2024
Latest Decision Or Authorization Date
28-05-2024
Processing Time Days
8
Number Of Participants
70

Netherlands

Earliest CTIS Part Ii Submission Date
15-05-2024
Latest Decision Or Authorization Date
27-05-2024
Processing Time Days
12
Number Of Participants
30

Germany

Earliest CTIS Part Ii Submission Date
26-04-2024
Latest Decision Or Authorization Date
22-05-2024
Processing Time Days
26
Number Of Participants
60

Greece

Earliest CTIS Part Ii Submission Date
26-04-2024
Latest Decision Or Authorization Date
23-05-2024
Processing Time Days
27
Number Of Participants
35

Slovakia

Earliest CTIS Part Ii Submission Date
19-04-2024
Latest Decision Or Authorization Date
24-05-2024
Processing Time Days
35
Number Of Participants
50

Belgium

Earliest CTIS Part Ii Submission Date
23-04-2024
Latest Decision Or Authorization Date
23-05-2024
Processing Time Days
30
Number Of Participants
40

Sponsor

Primary sponsor

Full Name
Astrazeneca AB
Organisation Type
Pharmaceutical company
Country Of Registered Address
Sweden

Investigational products

Investigational Product Name
Baxdrostat
Active Substance
BAXDROSTAT
Modality
Small molecule
Routes Of Administration
ORAL USE
Route
ORAL
Authorisation Status
Investigational (no marketing authorisation listed in Part I product entry)
Investigational Product Name
Forxiga 10 mg film-coated tablets
Active Substance
DAPAGLIFLOZIN
Modality
Small molecule
Routes Of Administration
ORAL USE
Route
ORAL
Authorisation Status
Marketing authorisation (EU) – marketing authorisation number EU/1/12/795/011
Starting Dose
10 mg
Dose Levels
10 mg (documented clinical product max daily dose amount 10 mg)
Frequency
Daily
Maximum Dose
10 mg daily
Investigational Product Name
Baxdrostat placebo
Modality
Other
Authorisation Status
Placebo (not applicable)
Combination Treatment
Yes

Related trials

Other published trials that may interest you.