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CompletedNCT03203642Updated Feb 6, 2023Results posted

Study of the Efficacy and Safety of Tesevatinib in Subjects With ADPKD

A Phase 2 interventional study of Tesevatinib and Placebo in Autosomal Dominant Polycystic Kidney and ADPKD, sponsored by Kadmon, a Sanofi Company. Completed at 19 sites in United States. Open to participants aged 18 Years to 60 Years. Per ClinicalTrials.gov, last updated 2023-02-06.

Sponsored by Kadmon, a Sanofi Company · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
80
Allocation
Randomized
Ages
18 Years to 60 Years
Sex
All
01

Study summary

The goal of the study was to compare and evaluate safety and efficacy of tesevatinib 50 milligrams (mg) versus placebo in participants with autosomal dominant polycystic kidney disease (ADPKD).

Read the detailed description

Safety and efficacy of 50 mg tesevatinib in comparison to placebo in participants with ADPKD was assessed.

The primary purpose of this study was focused on evaluating the change from Baseline in height-adjusted total kidney volume (htTKV) as measured by magnetic resonance imaging (MRI) at Months 12, 18, and 24, and 30 days post-dose in participants with ADPKD treated with tesevatinib or placebo.

If eligible for the study participation, participants were randomly assigned to either investigational treatment group or placebo group. Treatment group received 50 mg tesevatinib once daily for 24 months and control group received the placebo once daily for 24 months.

02

Conditions studied

  • Autosomal Dominant Polycystic Kidney
  • ADPKD

Keywords

  • ADPKD
  • Autosomal Dominant Polycystic Kidney Disease
  • Polycystic Kidney
  • Tesevatinib
  • Polycystic Kidney Disease
  • PKD
03

Who can participate

Ages eligible
18 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • ADPKD diagnosis based on Ravine's criteria.
  • Cysts of at least 1 centimeter.
  • Estimated glomerular filtration rate greater than or equal to (>=) 25 milliliter per minute per 1.73 square meter (mL/min/1.73 m\^2) and less than or equal to (\<=) 90 mL/min/1.73 m\^2, using the Modification of Diet in Renal Disease-4 variable formula.
  • htTKV must meet the following requirements: >= 500 milliliters (mL) for participants 18-35 years of age; >= 750 mL for participants 36-49 years of age; >= 900 mL for participants 50-60 years of age.
  • The participant had the following laboratory values:

Platelets greater than (>) lower limit of normal (LLN); Hemoglobin > 9 grams per deciliter; Total bilirubin \<= 1.5 milligrams per deciliter; Aspartate aminotransferase less than (\<) 2.5*upper limit of normal (ULN); Alanine aminotransferase \< 2.5*ULN; Prothrombin time/partial thromboplastin time \<=1.5*ULN; Serum potassium levels within normal limits; Serum magnesium levels within normal limits; Albumin >= LLN; Amylase \<=1.5*ULN; Lipase \<=1.5*ULN; Prothrombin time and partial thromboplastin time \<=1.5*ULN; International normalized ratio (INR) \<=1.5, except those participants taking warfarin who must have INR \<=3.

  • Female participants of childbearing potential with negative pregnancy test at screening.
  • If sexually active, the participant agreed to use 2 accepted methods of contraception during the course of the study and for 6 months after their last dose of study drug.

Exclusion criteria

Exclusion Criteria:

  • Previous nephrectomy.
  • Kidney transplant.
  • Tuberous sclerosis.
  • Hippel-Lindau disease.
  • Acquired cystic disease.
  • Congenital absence of 1 kidney and/or need for dialysis or transplantation in the foreseeable future.
  • Moderate hematuria.
  • Uncontrolled hypertension.
  • Presence of renal or hepatic calculi (stones) causing symptoms.
  • Received any investigational therapy within 30 days prior to initiation of therapy (Day 1 visit).
  • Received tolvaptan 30 days prior to initiation of therapy (Day 1 visit).
  • Received active treatment for urinary tract infection 4 weeks prior to initiation of therapy (Day 1 visit).
  • History of pancreatitis or known risk of pancreatitis.
  • The participant met any of the following cardiac criteria:
  • Mean QTc interval corrected for heart rate using Fridericia's formula (QTcF) of >450 milliseconds.
  • History of torsade de pointes, ventricular tachycardia or fibrillation, pathologic sinus bradycardia (\< 50 beats per minute), heart block (excluding first-degree block, being PR interval prolongation only), congenital long QT syndrome or new ST segment elevation or depression or new Q wave on electrocardiogram.
  • Participants with a history of atrial arrhythmias were discussed with the Medical Monitor.
  • Family history of congenital long QT syndrome or unexplained cardiac death.
  • Symptomatic heart failure (per New York Heart Association guidelines), unstable angina, myocardial infarction, or cerebrovascular accident within 6 months prior to study entry.
  • History of ventricular rhythm disturbances.
  • History of cardiac arrhythmias, stroke, or myocardial infarction.
  • Has a cardiac pacemaker.
  • History of pericardial effusion or presence of pericardial effusion on screening echocardiogram.
  • Taking any medication known to inhibit the cytochrome P450 (CYP)3A4 isozyme or any drugs that are CYP3A4 inducers, or any drugs associated with torsade de pointes or known to prolong the QTcF interval, including anti-arrhythmic medications within 2 weeks prior to screening.
  • Uncontrolled intercurrent illness that would limit compliance with study requirements.
  • Participant was pregnant, planed to become pregnant, or nursing.
  • Human immunodeficiency virus positive.
  • Hepatitis B or C positive.
  • Immunocompromised.
  • Documented renal vascular disease resulting in uncontrolled hypertension.
  • Previously received an epithelial growth factor receptor (EGFR).
  • Allergy or hypersensitivity to components of tesevatinib or placebo or their formulations.
  • Been aphakic due to previous cataract surgery or congenital abnormality.
04

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
80 participants (actual)

Study arms

  • Experimental
    Tesevatinib

    Participants received tesevatinib 50 mg tablet orally once daily (QD) for up to 25.3 months.

    Drug: Tesevatinib

  • Placebo comparator
    Placebo

    Participants received placebo matched to tesevatinib tablet orally QD for up to 25.3 months.

    Drug: Placebo

Interventions

  • DrugTesevatinib

    Pharmaceutical form: Tablet; Route of administration: orally

    Also known as: KD019

  • DrugPlacebo

    Pharmaceutical form: Tablet (identical to tesevatinib); Route of administration: orally

05

What researchers measure

Primary outcomes

  1. Change From Baseline in Height Adjusted Total Kidney Volume (htTKV) at Month 12

    htTKV was calculated using total kidney volume (in milliliters) obtained from magnetic resonance imaging (MRI) divided by height (in meters). Least square (LS) mean and standard error (SE) were estimated by using analysis of covariance (ANCOVA) model. Change from Baseline in htTKV at Month 12 was reported in this outcome measure.

    Time frame: Baseline (Day 1), Month 12

  2. Change From Baseline in Height Adjusted Total Kidney Volume at Month 18

    htTKV was calculated using total kidney volume (in milliliters) obtained from MRI divided by height (in meters). LS mean and SE were estimated by using ANCOVA model. Change from Baseline in htTKV at Month 18 was reported in this outcome measure.

    Time frame: Baseline (Day 1), Month 18

  3. Change From Baseline in Height Adjusted Total Kidney Volume at Month 24

    htTKV was calculated using total kidney volume (in milliliters) obtained from MRI divided by height (in meters). LS mean and SE were estimated by using ANCOVA model. Change from Baseline in htTKV at Month 24 was reported in this outcome measure.

    Time frame: Baseline (Day 1), Month 24

  4. Change From Baseline in Height Adjusted Total Kidney Volume at End of Study

    htTKV was calculated using total kidney volume (in milliliters) obtained from MRI divided by height (in meters). LS mean and SE were estimated by using ANCOVA model. Change from Baseline in htTKV at end of study (i.e., up to 26 months) was reported in this outcome measure.

    Time frame: Baseline (Day 1), End of study (anytime up to 26 months)

Secondary outcomes

  1. Number of Participants With Treatment-emergent Adverse Events (TEAEs)

    An adverse event (AE) was any untoward medical occurrence in a clinical study participant administered a medicinal product and which did not necessarily had to have a causal relationship with the treatment. TEAEs were AEs that developed or worsened or became serious from the first dose (Day 1) of the study drug until end of study.

    Time frame: From Baseline (Day 1) up to 30 days post last dose of study drug (i.e., up to 26 months)

  2. Change From Baseline in Estimated Glomerular Filtration Rate (eGFR) at Months 12, 18, 24 and End of Study

    eGFR is a test for renal function. eGFR was calculated by using the 4-variable modification of diet in renal disease (MDRD-4) formula reported as milliliters per minute per 1.73 square meter (mL/min/1.73 m\^2). LS mean and SE were estimated using ANCOVA model.

    Time frame: Baseline (Day 1), Months 12, 18, 24 and at end of study (i.e., anytime up to 26 months)

06

Results

Posted Feb 6, 2023

Participant flow

The study was conducted at 20 active sites in the United States. A total of 191 participants were screened between 12 October 2017 and 29 January 2020, of which 80 participants were enrolled.

Participant flow — Overall Study
MilestoneTesevatinibPlacebo
Started4040
Treated3840
Completed2529
Not completed1511
Withdrew: Adverse event31
Withdrew: Withdrawal by subject66
Withdrew: Lost to follow-up21
Withdrew: Termination of the study by sponsor11
Withdrew: Participant moved01
Withdrew: Investigator's decision30
Withdrew: Other than above specified01

Outcome measures

PrimaryChange From Baseline in Height Adjusted Total Kidney Volume (htTKV) at Month 12

htTKV was calculated using total kidney volume (in milliliters) obtained from magnetic resonance imaging (MRI) divided by height (in meters). Least square (LS) mean and standard error (SE) were estimated by using analysis of covariance (ANCOVA) model. Change from Baseline in htTKV at Month 12 was reported in this outcome measure.

Time frame:
Baseline (Day 1), Month 12
Reported as:
Least squares mean · milliliters per meter
Change From Baseline in Height Adjusted Total Kidney Volume (htTKV) at Month 12
milliliters per meterTesevatinibPlacebo
Change From Baseline in Height Adjusted Total Kidney Volume (htTKV) at Month 120.0236 ± 0.00590.0288 ± 0.0057
Statistical analysis
  • Tesevatinib vs Placebo · ANCOVA · p = 0.5265 (Threshold for significance at 0.05 level.) · Ls mean difference: -0.0052 · 95% CI -0.0217 to - 0.0112
PrimaryChange From Baseline in Height Adjusted Total Kidney Volume at Month 18

htTKV was calculated using total kidney volume (in milliliters) obtained from MRI divided by height (in meters). LS mean and SE were estimated by using ANCOVA model. Change from Baseline in htTKV at Month 18 was reported in this outcome measure.

Time frame:
Baseline (Day 1), Month 18
Reported as:
Least squares mean · milliliters per meter
Change From Baseline in Height Adjusted Total Kidney Volume at Month 18
milliliters per meterTesevatinibPlacebo
Change From Baseline in Height Adjusted Total Kidney Volume at Month 180.0383 ± 0.00810.0425 ± 0.0075
Statistical analysis
  • Tesevatinib vs Placebo · ANCOVA · p = 0.7076 (Threshold for significance at 0.05 level.) · Ls mean difference: -0.0042 · 95% CI -0.0264 to - 0.0180
PrimaryChange From Baseline in Height Adjusted Total Kidney Volume at Month 24

htTKV was calculated using total kidney volume (in milliliters) obtained from MRI divided by height (in meters). LS mean and SE were estimated by using ANCOVA model. Change from Baseline in htTKV at Month 24 was reported in this outcome measure.

Time frame:
Baseline (Day 1), Month 24
Reported as:
Least squares mean · milliliters per meter
Change From Baseline in Height Adjusted Total Kidney Volume at Month 24
milliliters per meterTesevatinibPlacebo
Change From Baseline in Height Adjusted Total Kidney Volume at Month 240.0485 ± 0.01030.0607 ± 0.0095
Statistical analysis
  • Tesevatinib vs Placebo · ANCOVA · p = 0.3895 (Threshold for significance at 0.05 level.) · Ls mean difference: -0.0122 · 95% CI -0.0404 to - 0.0160
PrimaryChange From Baseline in Height Adjusted Total Kidney Volume at End of Study

htTKV was calculated using total kidney volume (in milliliters) obtained from MRI divided by height (in meters). LS mean and SE were estimated by using ANCOVA model. Change from Baseline in htTKV at end of study (i.e., up to 26 months) was reported in this outcome measure.

Time frame:
Baseline (Day 1), End of study (anytime up to 26 months)
Reported as:
Least squares mean · milliliters per meter
Change From Baseline in Height Adjusted Total Kidney Volume at End of Study
milliliters per meterTesevatinibPlacebo
Change From Baseline in Height Adjusted Total Kidney Volume at End of Study0.0604 ± 0.00900.0589 ± 0.0094
Statistical analysis
  • Tesevatinib vs Placebo · ANCOVA · p = 0.9093 (Threshold for significance at 0.05 level.) · Ls mean difference: 0.0015 · 95% CI -0.0248 to - 0.0278
SecondaryNumber of Participants With Treatment-emergent Adverse Events (TEAEs)

An adverse event (AE) was any untoward medical occurrence in a clinical study participant administered a medicinal product and which did not necessarily had to have a causal relationship with the treatment. TEAEs were AEs that developed or worsened or became serious from the first dose (Day 1) of the study drug until end of study.

Time frame:
From Baseline (Day 1) up to 30 days post last dose of study drug (i.e., up to 26 months)
Reported as:
Count of participants · Participants
Number of Participants With Treatment-emergent Adverse Events (TEAEs)
ParticipantsTesevatinibPlacebo
Number of Participants With Treatment-emergent Adverse Events (TEAEs)3740
SecondaryChange From Baseline in Estimated Glomerular Filtration Rate (eGFR) at Months 12, 18, 24 and End of Study

eGFR is a test for renal function. eGFR was calculated by using the 4-variable modification of diet in renal disease (MDRD-4) formula reported as milliliters per minute per 1.73 square meter (mL/min/1.73 m\^2). LS mean and SE were estimated using ANCOVA model.

Time frame:
Baseline (Day 1), Months 12, 18, 24 and at end of study (i.e., anytime up to 26 months)
Reported as:
Least squares mean · mL/min/1.73m^2
Change From Baseline in Estimated Glomerular Filtration Rate (eGFR) at Months 12, 18, 24 and End of Study
mL/min/1.73m^2TesevatinibPlacebo
Month 12-6.8032 ± 1.2293-2.1780 ± 1.1709
Month 18-7.3626 ± 1.6645-3.8950 ± 1.6971
Month 24-9.7307 ± 1.4708-6.4070 ± 1.4138
End of study-3.2757 ± 0.5990-3.7497 ± 0.6323

Adverse events

Collected over From Baseline (Day 1) up to 30 days post last dose of the study drug (i.e., up to 26 months). Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Tesevatinib0/38 (0%)6/38 (15.8%)37/38 (97.4%)
Placebo0/40 (0%)2/40 (5%)40/40 (100%)
Most frequent serious events
Most frequent serious events
EventTesevatinibPlacebo
Renal cyst infectionInfections and infestations1/380/40
Pain in extremityMusculoskeletal and connective tissue disorders1/380/40
Rheumatoid arthritisMusculoskeletal and connective tissue disorders1/380/40
Coronary artery diseaseCardiac disorders1/380/40
Retinal detachmentEye disorders1/380/40
Colitis ulcerativeGastrointestinal disorders1/380/40
DehydrationMetabolism and nutrition disorders1/380/40
AppendicitisInfections and infestations0/381/40
Pulmonary embolismRespiratory, thoracic and mediastinal disorders0/381/40
Most frequent other events
Showing 10 of 100
Most frequent other events
EventTesevatinibPlacebo
DiarrhoeaGastrointestinal disorders21/3813/40
NauseaGastrointestinal disorders14/386/40
HeadacheNervous system disorders13/389/40
Viral upper respiratory tract infectionInfections and infestations12/3812/40
Muscle spasmsMusculoskeletal and connective tissue disorders12/384/40
DizzinessNervous system disorders12/380/40
RashSkin and subcutaneous tissue disorders9/386/40
VomitingGastrointestinal disorders7/385/40
Upper respiratory tract infectionInfections and infestations7/386/40
Flank painMusculoskeletal and connective tissue disorders7/384/40

Baseline characteristics

Analysis was performed on modified Intent-To-Treat (mITT) population which included all randomized participants who receive at least 1 dose of study drug.

Age, Continuous
Age, Continuous(years)TesevatinibPlaceboTotal
Mean47.0 ± 9.645.6 ± 10.046.3 ± 9.7
Sex: Female, Male
Sex: Female, Male(Participants)TesevatinibPlaceboTotal
Female241842
Male142236
Race (NIH/OMB)
Race (NIH/OMB)(Participants)TesevatinibPlaceboTotal
American Indian or Alaska Native011
Asian224
Native Hawaiian or Other Pacific Islander000
Black or African American336
White323365
More than one race000
Unknown or Not Reported112
07

Study locations

19 sites
  • University of California San Diego
    La Jolla, California 92037, United States
  • California Institute for Renal Research
    La Mesa, California 91942, United States
  • University of California Los Angeles
    Los Angeles, California 90095, United States
  • University of California San Francisco
    San Francisco, California 94143, United States
  • University of Colorado Denver
    Aurora, Colorado 80045, United States
  • Yale Nephrology Clinical Research
    New Haven, Connecticut 06520, United States
  • Coastal Nephrology Associates Research Center, LLC
    Port Charlotte, Florida 33952, United States
  • Genesis Clinical Research
    Tampa, Florida 33614, United States
  • Emory University School of Medicine
    Atlanta, Georgia 30322, United States
  • University of Maryland
    Baltimore, Maryland 21201, United States
  • Tufts Medical Center
    Boston, Massachusetts 02111, United States
  • Beth Israel Deaconess Medical Center
    Boston, Massachusetts 02215, United States
  • Mayo Clinic
    Rochester, Minnesota 55905, United States
  • Washington University
    Saint Louis, Missouri 63110, United States
  • Rogosin Institute
    New York, New York 10021, United States
  • University of Pennsylvania
    Philadelphia, Pennsylvania 19104, United States
  • Baylor Scott & White Research Institute
    Temple, Texas 10016, United States
  • University of Virginia
    Charlottesville, Virginia 22908, United States
  • Medical College of Wisconsin
    Milwaukee, Wisconsin 53226, United States
08

References and documents

Study documents

  • Study protocol · Aug 31, 2018
  • Statistical analysis plan · Apr 11, 2022

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Yes — Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org

09

Registry details

Key details

Study ID
NCT03203642
Lead sponsor
Kadmon, a Sanofi Company
Responsible party
Sponsor
First posted
Jun 29, 2017
Start date
Oct 12, 2017
Primary completion
Jan 25, 2022
Completion
Jan 25, 2022
Results posted
Feb 6, 2023
Last update
Feb 6, 2023

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
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