A Phase 2 interventional study of TMX-049 and Placebo in Diabetic Kidney Disease, sponsored by Teijin America, Inc.. Completed at 55 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-08-30.
Sponsored by Teijin America, Inc. · Phase 2, Interventional, and Treatment
The primary objective of this study is to assess the effect of 2 dose levels of TMX-049 on urinary albumin excretion in subjects with Type 2 diabetes and albuminuria (a urinary albumin-to-creatinine ratio (UACR) 200 to 3000 mg/g and an estimated glomerular filtration rate (eGFR) ≥30 ml/min/1.73m2). Effects of each TMX-049 dose on UACR will be assessed in terms of ratios using log-transformed UACR at Baseline and after a 12-week period of treatment.
Exclusion Criteria:
TMX-049: 40 mg of TMX-049 to be taken orally, once daily
Drug: TMX-049
TMX-049: 200 mg of TMX-049 to be taken orally, once daily
Drug: TMX-049
Drug: Placebo
A certain dose of TMX-049 to be taken orally, once daily
Matching placebo to be taken orally, once daily
Changes in Log-transformed Urinary Albumin-to-creatinine Ratio (UACR) at Week 12
UACR from Baseline to Weeks 2, 6, 12, and 16(Follow-up) were measured. The change from baseline at Week 12 in log-transformed UACR was analyzed and reported as a primary outcome.
Time frame: Baseline and Week 12
Changes in Estimated Glomerular Filtration Rate (GFR)
Estimated Glomerular Filtration Rate from Baseline to Weeks 2, 6, 12/early termination, and 16 (Follow-up) were measured. The eGFR (estimated glomerular filtration rate) was calculated using the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) formula based on the serum creatinine measurement.
Time frame: Baseline and Week 2, 6, 12, 16 (Follow-up)
Changes in Serum Uric Acid (sUA)
Serum Uric Acid from Baseline to Weeks 2, 6, 12/early termination, and 16 (Follow-up) were measured in order to explore the sUA (Serum Uric Acid) lowering effect in DKD (diabetic kidney disease) patients and the relationship between sUA and efficacy to DKD.
Time frame: Baseline and Week 2, 6, 12, 16 (Follow-up)
Changes in Urinary Albumin-to-Creatinine Ratio (UACR)
Urinary Albumin-to-Creatinine Ratio from Baseline to Weeks 2, 6, 12/early termination, and 16 (Follow-up) were measured.
Time frame: Baseline and Week 2, 6, 12, 16 (Follow-up)
Proportion of Subjects With a Greater Than 30% Reduction From Baseline to Week 12 in Urinary Albumin-to-Creatinine Ratio
Changes in Proportion of Subjects With a Greater Than 30% Reduction From Baseline to Week 12 in Urinary Albumin-to-Creatinine Ratio were measured. Subject with greater than 30% reduction is estimated as responder, less than or equal to 30% reduction is estimated as non-responder.
Time frame: 16 Weeks
Changes in Exploratory Blood Biomarkers (C Reactive Protein)
Changes in Exploratory Blood Biomarkers for inflammation (C Reactive Protein) from Baseline to Weeks 2, 6, 12/early termination, and 16 (Follow-up) were measured.
Time frame: 16 Weeks
Changes in Exploratory Blood Biomarkers (Soluble TNF Receptor Type I)
Changes in Exploratory Blood Biomarkers for inflammation (Soluble TNF \[tumor necrosis factor\] Receptor Type I) from Baseline to Weeks 2, 6, 12/early termination, and 16 (Follow-up) were measured.
Time frame: 16 Weeks
Changes in Exploratory Renal Biomarkers (Creatinine-Corrected Fatty Acid Binding Protein 1)
Changes in Exploratory Renal Biomarkers for renal tubular diseases (Creatinine-Corrected Fatty Acid Binding Protein 1) from Baseline to Weeks 2, 6, 12/early termination, and 16 (Follow-up) were measured.
Time frame: 16 Weeks
Changes in Exploratory Renal Biomarkers (Creatinine-Corrected Hydroxy Deoxyguanosine)
Changes in Exploratory Renal Biomarkers for renal tubular diseases (Creatinine-Corrected Hydroxy Deoxyguanosine) from Baseline to Weeks 2, 6, 12/early termination, and 16 (Follow-up) were measured.
Time frame: 16 Weeks
Changes in Exploratory Renal Biomarkers (Creatinine-Corrected Kidney Injury Molecule-1)
Changes in Exploratory Renal Biomarkers for renal tubular diseases (Creatinine-Corrected Kidney Injury Molecule-1) from Baseline to Weeks 2, 6, 12/early termination, and 16 (Follow-up) were measured.
Time frame: 16 Weeks
Changes in Exploratory Renal Biomarkers (Creatinine-Corrected N-acetyl-beta-D-glucosaminidase)
Changes in Exploratory Renal Biomarkers for renal tubular diseases (Creatinine-Corrected N-acetyl-beta-D-glucosaminidase) from Baseline to Weeks 2, 6, 12/early termination, and 16 (Follow-up) were measured.
Time frame: 16 Weeks
| Milestone | TMX-049 Placebo | TMX-049 40mg QD | TMX-049 200mg QD |
|---|---|---|---|
| Started | 42 | 44 | 44 |
| Completed | 41 | 43 | 42 |
| Not completed | 1 | 1 | 2 |
| Withdrew: Lost to follow-up | 1 | 1 | 0 |
| Withdrew: Protocol deviation | 0 | 0 | 1 |
| Withdrew: Withdrawal by subject | 0 | 0 | 1 |
UACR from Baseline to Weeks 2, 6, 12, and 16(Follow-up) were measured. The change from baseline at Week 12 in log-transformed UACR was analyzed and reported as a primary outcome.
| Log(mg/g) | TMX-049 Placebo | TMX-049 40 mg QD | TMX-049 200 mg QD |
|---|---|---|---|
| Changes in Log-transformed Urinary Albumin-to-creatinine Ratio (UACR) at Week 12 | -0.10 ± 0.153 | -0.15 ± 0.151 | -0.53 ± 0.150 |
Estimated Glomerular Filtration Rate from Baseline to Weeks 2, 6, 12/early termination, and 16 (Follow-up) were measured. The eGFR (estimated glomerular filtration rate) was calculated using the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) formula based on the serum creatinine measurement.
| ml/min/1.73 m^2 | TMX-049 Placebo | TMX-049 40 mg QD | TMX-049 200 mg QD |
|---|---|---|---|
| Visit 4 (Week 2) | -0.02 ± 1.591 | 0.98 ± 1.601 | 0.18 ± 1.561 |
| Visit 5 (Week 6) | -1.41 ± 1.757 | -1.06 ± 1.732 | 0.00 ± 1.724 |
| Visit 6/ET (Week 12) | -2.34 ± 1.585 | -0.62 ± 1.563 | 1.09 ± 1.556 |
| Visit 7/Follow up (Week 16) | -2.39 ± 1.726 | 1.57 ± 1.702 | 0.99 ± 1.695 |
Serum Uric Acid from Baseline to Weeks 2, 6, 12/early termination, and 16 (Follow-up) were measured in order to explore the sUA (Serum Uric Acid) lowering effect in DKD (diabetic kidney disease) patients and the relationship between sUA and efficacy to DKD.
| mg/dL | TMX-049 Placebo | TMX-049 40 mg QD | TMX-049 200 mg QD |
|---|---|---|---|
| Visit 4 (Week 2) | -0.03 ± 0.238 | -2.57 ± 0.240 | -3.54 ± 0.234 |
| Visit 5 (Week 6) | -0.22 ± 0.256 | -2.54 ± 0.252 | -3.34 ± 0.251 |
| Visit 6/ET (Week 12) | -0.07 ± 0.269 | -2.51 ± 0.266 | -3.30 ± 0.265 |
| Visit 7/Follow up (Week 16) | 0.21 ± 0.190 | -0.13 ± 0.188 | -0.33 ± 0.187 |
Urinary Albumin-to-Creatinine Ratio from Baseline to Weeks 2, 6, 12/early termination, and 16 (Follow-up) were measured.
| mg/g | TMX-049 Placebo | TMX-049 40 mg QD | TMX-049 200 mg QD |
|---|---|---|---|
| Visit 4 (Week 2) | 25.44 ± 69.166 | 53.88 ± 68.229 | -86.20 ± 67.932 |
| Visit 5 (Week 6) | -81.90 ± 68.156 | -30.37 ± 67.233 | -86.12 ± 66.940 |
| Visit 6/ET (Week 12) | 61.92 ± 92.291 | -40.10 ± 91.041 | -135.57 ± 90.645 |
| Visit 7/ Follow up (Week 16) | 72.07 ± 90.045 | 58.31 ± 88.825 | -8.27 ± 88.439 |
Changes in Proportion of Subjects With a Greater Than 30% Reduction From Baseline to Week 12 in Urinary Albumin-to-Creatinine Ratio were measured. Subject with greater than 30% reduction is estimated as responder, less than or equal to 30% reduction is estimated as non-responder.
| Participants | TMX-049 Placebo | TMX-049 40 mg QD | TMX-049 200 mg QD |
|---|---|---|---|
| Responder | 10 | 14 | 19 |
| Non-responder | 32 | 29 | 25 |
Changes in Exploratory Blood Biomarkers for inflammation (C Reactive Protein) from Baseline to Weeks 2, 6, 12/early termination, and 16 (Follow-up) were measured.
| mg/dL | TMX-049 Placebo | TMX-049 40 mg QD | TMX-049 200 mg QD |
|---|---|---|---|
| Visit 4 (Week 2) | 0.046 ± 0.5168 | 0.014 ± 0.5384 | 0.087 ± 0.6194 |
| Visit 5 (Week 6) | -0.011 ± 0.6443 | 0.003 ± 0.3688 | -0.084 ± 0.4303 |
| Visit 6/ET (Week 12) | 0.000 ± 0.7527 | -0.144 ± 0.3691 | 0.000 ± 0.5176 |
| Visit 7/ Follow up (Week 16) | 0.012 ± 0.6507 | -0.084 ± 0.3606 | -0.046 ± 0.3917 |
Changes in Exploratory Blood Biomarkers for inflammation (Soluble TNF \[tumor necrosis factor\] Receptor Type I) from Baseline to Weeks 2, 6, 12/early termination, and 16 (Follow-up) were measured.
| ng/L | for 12 weeksTMX-049 Placebo | TMX-049 40 mg QD | TMX-049 200 mg QD |
|---|---|---|---|
| Visit 4 (Week 2) | -13.7 ± 367.11 | -92.3 ± 298.83 | 38.7 ± 360.03 |
| Visit 5 (Week 6) | -77.1 ± 295.50 | 47.6 ± 485.92 | 60.7 ± 397.76 |
| Visit 6 (Week 12) | 16.5 ± 371.88 | 10.8 ± 455.11 | 43.8 ± 265.35 |
| Visit 7/Follow up (Week 16) | -25.8 ± 366.94 | -36.3 ± 308.79 | 13.8 ± 320.22 |
Changes in Exploratory Renal Biomarkers for renal tubular diseases (Creatinine-Corrected Fatty Acid Binding Protein 1) from Baseline to Weeks 2, 6, 12/early termination, and 16 (Follow-up) were measured.
| ug/L/mg/dL | TMX-049 Placebo | TMX-049 40 mg QD | TMX-049 200 mg QD |
|---|---|---|---|
| Visit 4 (Week 2) | 0.03 ± 0.161 | 0.01 ± 0.214 | -0.04 ± 0.201 |
| Visit 5 (Week 6) | -0.04 ± 0.309 | 0.04 ± 0.258 | -0.04 ± 0.201 |
| Visit 6 (Week 12) | -0.01 ± 0.317 | -0.01 ± 0.136 | -0.01 ± 0.218 |
| Visit 7/Follow up (Week 16) | 0.02 ± 0.321 | 0.04 ± 0.289 | 0.00 ± 0.188 |
Changes in Exploratory Renal Biomarkers for renal tubular diseases (Creatinine-Corrected Hydroxy Deoxyguanosine) from Baseline to Weeks 2, 6, 12/early termination, and 16 (Follow-up) were measured.
| nmol/L/mg/dL | TMX-049 Placebo | TMX-049 40 mg QD | TMX-049 200 mg QD |
|---|---|---|---|
| Visit 4 (Week 2) | 1.47 ± 4.266 | 4.70 ± 4.123 | 6.08 ± 5.809 |
| Visit 5 (Week 6) | 1.72 ± 5.179 | 3.22 ± 5.321 | 4.88 ± 5.930 |
| Visit 6 (Week 12) | -1.86 ± 5.372 | 3.75 ± 6.157 | 6.87 ± 10.476 |
| Visit 7/ Follow up (Week 16) | 1.20 ± 5.480 | -0.07 ± 5.647 | -3.14 ± 5.211 |
Changes in Exploratory Renal Biomarkers for renal tubular diseases (Creatinine-Corrected Kidney Injury Molecule-1) from Baseline to Weeks 2, 6, 12/early termination, and 16 (Follow-up) were measured.
| ug/L/mg/dL | TMX-049 Placebo | TMX-049 40 mg QD | TMX-049 200 mg QD |
|---|---|---|---|
| Visit 4 (Week 2) | 0.00 ± 0.010 | 0.00 ± 0.016 | 0.00 ± 0.007 |
| Visit 5 (Week 6) | 0.00 ± 0.010 | 0.00 ± 0.015 | 0.00 ± 0.006 |
| Visit 6 (Week 12) | 0.00 ± 0.019 | 0.00 ± 0.015 | 0.00 ± 0.008 |
| Visit 7/Follow up (Week 16) | 0.00 ± 0.009 | 0.00 ± 0.0014 | 0.00 ± 0.009 |
Changes in Exploratory Renal Biomarkers for renal tubular diseases (Creatinine-Corrected N-acetyl-beta-D-glucosaminidase) from Baseline to Weeks 2, 6, 12/early termination, and 16 (Follow-up) were measured.
| U/L/mg/dL | TMX-049 Placebo | TMX-049 40 mg QD | TMX-049 200 mg QD |
|---|---|---|---|
| Visit 4 (Week 2) | -0.01 ± 0.129 | 0.03 ± 0.136 | -0.01 ± 0.152 |
| Visit 5 (Week 6) | 0.02 ± 0.154 | 0.02 ± 0.121 | -0.02 ± 0.147 |
| Visit 6 (Week 12) | 0.00 ± 0.123 | 0.02 ± 0.143 | -0.02 ± 0.108 |
| Visit 7/Follow up (Week 16) | 0.01 ± 0.089 | 0.02 ± 0.116 | -0.01 ± 0.132 |
Collected over Adverse event (AE) reporting began from the time of informed consent and ends at the Follow-up Visit (Visit 7), up to 16 weeks. For subjects without the Follow-up Visit, the reporting ends 28 days after the last dose of the Investigational Medicinal Product, up to 12 weeks.. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| TMX-049 Placebo | 0/42 (0%) | 4/42 (9.5%) | 18/42 (42.9%) |
| TMX-049 40 mg QD | 0/44 (0%) | 4/44 (9.1%) | 19/44 (43.2%) |
| TMX-049: 200 mg | 0/44 (0%) | 2/44 (4.5%) | 17/44 (38.6%) |
| Event | TMX-049 Placebo | TMX-049 40 mg QD | TMX-049: 200 mg |
|---|---|---|---|
| Cardiac failure chronicCardiac disorders | 1/42 | 0/44 | 0/44 |
| Cholecystitis infectiveInfections and infestations | 1/42 | 0/44 | 0/44 |
| PneumoniaInfections and infestations | 1/42 | 0/44 | 0/44 |
| Lumbar radiculopathyNervous system disorders | 1/42 | 0/44 | 0/44 |
| Acute kidney injuryRenal and urinary disorders | 1/42 | 1/44 | 0/44 |
| AsthmaRespiratory, thoracic and mediastinal disorders | 1/42 | 0/44 | 0/44 |
| Respiratory failureRespiratory, thoracic and mediastinal disorders | 1/42 | 0/44 | 0/44 |
| Pancreatitis acuteGastrointestinal disorders | 0/42 | 1/44 | 0/44 |
| SepsisInfections and infestations | 0/42 | 1/44 | 0/44 |
| HypoglycaemiaMetabolism and nutrition disorders | 0/42 | 1/44 | 0/44 |
| Event | TMX-049 Placebo | TMX-049 40 mg QD | TMX-049: 200 mg |
|---|---|---|---|
| NasopharyngitisInfections and infestations | 3/42 | 0/44 | 1/44 |
| Urinary tract infectionInfections and infestations | 3/42 | 1/44 | 1/44 |
| DiarrhoeaGastrointestinal disorders | 2/42 | 0/44 | 3/44 |
| NauseaGastrointestinal disorders | 0/42 | 3/44 | 3/44 |
| Oedema peripheralGeneral disorders | 1/42 | 3/44 | 0/44 |
| HeadacheNervous system disorders | 2/42 | 0/44 | 1/44 |
| HypothyroidismEndocrine disorders | 0/42 | 2/44 | 0/44 |
| OedemaGeneral disorders | 1/42 | 2/44 | 0/44 |
| InfluenzaInfections and infestations | 0/42 | 2/44 | 0/44 |
| Upper respiratory tract infectionInfections and infestations | 0/42 | 2/44 | 0/44 |
| Age, Continuous(years) | TMX-049 Placebo | TMX-049 40 mg QD | TMX-049 200 mg QD | Total |
|---|---|---|---|---|
| Mean | 65 ± 10.3 | 66 ± 10.7 | 68 ± 10 | 66 ± 10.3 |
| Sex: Female, Male(Participants) | TMX-049 Placebo | TMX-049 40 mg QD | TMX-049 200 mg QD | Total |
|---|---|---|---|---|
| Female | 18 | 17 | 18 | 53 |
| Male | 24 | 26 | 26 | 76 |
| Race (NIH/OMB)(Participants) | TMX-049 Placebo | TMX-049 40 mg QD | TMX-049 200 mg QD | Total |
|---|---|---|---|---|
| American Indian or Alaska Native | 0 | 1 | 0 | 1 |
| Asian | 4 | 2 | 1 | 7 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 | 0 |
| Black or African American | 5 | 2 | 8 | 15 |
| White | 32 | 38 | 35 | 105 |
| More than one race | 1 | 0 | 0 | 1 |
| Unknown or Not Reported | 0 | 0 | 0 | 0 |
| Weight(kg) | TMX-049 Placebo | TMX-049 40 mg QD | TMX-049 200 mg QD | Total |
|---|---|---|---|---|
| Mean | 90.1 ± 19.81 | 95.9 ± 20.58 | 98.8 ± 23.63 | 95.0 ± 21.57 |
| BMI(kg/m^2) | TMX-049 Placebo | TMX-049 40 mg QD | TMX-049 200 mg QD | Total |
|---|---|---|---|---|
| Mean | 31.6 ± 6.00 | 33.6 ± 6.57 | 34.3 ± 7.26 | 32.2 ± 6.69 |
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Teijin America, Inc.