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WithdrawnNCT04786574Updated Dec 24, 2025

A Study to See if Tolvaptan Can Delay Dialysis in Infants and Children Who at Enrollment Are 28 Days to Less Than 12 Weeks Old With Autosomal Recessive Polycystic Kidney Disease (ARPKD)

A Phase 3 interventional study of Tolvaptan (OPC-41061) in Autosomal Recessive Polycystic Kidney Disease (ARPKD), sponsored by Otsuka Pharmaceutical Development & Commercialization, Inc.. Withdrawn. Open to participants aged 4 Weeks to 12 Weeks. Per ClinicalTrials.gov, last updated 2025-12-24.

Sponsored by Otsuka Pharmaceutical Development & Commercialization, Inc. (part of Otsuka Holdings Co., Ltd.) · Phase 3, Interventional, and Treatment

Why this study was withdrawn
Study stopped before enrolling any participants.
Phase
Phase 3
Study type
Interventional
Enrollment
0
Allocation
Not applicable
Ages
4 Weeks to 12 Weeks
Sex
All
01

Study summary

The primary objective of this study is to evaluate the effect of tolvaptan on the need for renal replacement therapy in pediatric subjects with autosomal recessive polycystic kidney disease (ARPKD)

Read the detailed description

Tolvaptan has been demonstrated to delay the decline of kidney function in adults with rapidly progressing ADPKD (CKD stages 1 to 3), a closely related indication to ARPKD, as measured by estimated glomerular filtration rate (eGFR) and Total Kidney Volume (TKV).

The trial will be the first trial of tolvaptan in a pediatric ARPKD population.

Participants in this study will be assigned to tolvaptan for 24 months and closely monitored over the course of the study.

02

Conditions studied

  • Autosomal Recessive Polycystic Kidney Disease (ARPKD)

Keywords

  • ARPKD
  • Tolvaptan
  • Polycystic Kidney Disease
  • Autosomal Recessive Polycystic Kidney Disease
  • Renal Cysts
  • Nephromegaly
  • Oligohydramnios
  • Anhydramnios
03

In context

Polycystic Kidney Diseases

59 studies on the registry are indexed under Polycystic Kidney Diseases; 12 are open to participants now.

Browse Polycystic Kidney Diseases studies →

Lead sponsor

Otsuka Pharmaceutical Development & Commercialization, Inc. is the lead sponsor of 295 studies on the registry; 18 are open to participants now.

Of its 106 completed or terminated interventional studies of FDA-regulated products, 71 (67%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
4 Weeks to 12 Weeks
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Male or female subjects between 28 days and \< 12 weeks of age, inclusive at the time of enrollment.
  2. Must have clinical and imaging features that are consistent with a diagnosis of ARPKD with all the following characteristics:

    • Nephromegaly (> 2 standard deviations from age-appropriate standard via ultrasound)
    • Multiple renal cysts
    • History of oligohydramnios or anhydramnios
  3. Ability for parent or guardian to provide written, prior to initiation of any trial-related procedures, and ability, in the opinion of the principal investigator, to comply with all the requirements of the trial.

Exclusion criteria

Exclusion Criteria:

  1. Premature birth (≤ 32 weeks gestational age)
  2. Anuria or RRT, defined as intermittent or continuous hemodialysis, peritoneal dialysis, hemofiltration, hemodiafiltration or history of kidney transplantation
  3. Evidence of syndromic conditions associated with renal cysts (other than ARPKD)
  4. Abnormal liver function tests including and AST, > 1.2 ×
  5. Parents with renal cystic disease
  6. Need for chronic diuretic use
  7. Cannot be monitored for fluid balance
  8. Has or at risk of having sodium and potassium electrolyte imbalances
  9. Has or at risk of having significant hypovolemia as determined by investigator
  10. anemia, as determined by investigator
  11. Severe systolic dysfunction defined as \< 14%
  12. Serum sodium levels \< 130 mmol/L or >145 mmol/L
  13. Taking any other experimental medications
  14. Require ventilator support
  15. Taking medications known to induce
  16. Having an infection including viral that would require therapy disruptive to IMP dosing
  17. count \<50,000 µL
  18. Significant Portal Hypertension
  19. Bladder dysfunction or difficulty voiding
  20. Taking vasopressin agonist
  21. Having concomitant illness or taking medications that are likely to confound endpoint assessments.
  22. History of cholangitis
  23. Received or scheduled to receive a liver transplant
Terms in these criteria, in plain language(7)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

CYP3A (CYP3A4) inhibitors and inducers

CYP3A is a group of enzymes, mainly CYP3A4, in the liver and gut that break down many medicines. Some medicines, supplements and foods (grapefruit, St John’s wort) slow them down or speed them up, which changes how much of a study drug stays in the body.

Studies list them so they can be avoided or switched; bring a list of everything you take, including supplements.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
0 participants (actual)

Study arms

  • Experimental
    Tolvaptan (OPC-41061)

    Drug: Tolvaptan (OPC-41061)

Interventions

  • Tolvaptan suspension will be administered orally or via nasogastric tube at doses of 0.15 mg/kg once daily in the AM, 0.30 mg/kg once daily in the AM, 0.5 mg/kg once daily in the AM, 0.75 mg/kg split dose (0.5 mg/kg AM and 0.25 mg/kg 8 hours later), and 1 mg/kg split dose (0.67 mg/kg AM and 0.33 mg/kg 8 hours later) based on age. Treatment duration is 2 years.

06

What researchers measure

Primary outcomes

  1. The percentage of subjects that will have Renal Replacement Therapy (RRT) by 1 year of age.

    Time frame: From Enrollment to 1 year of age

Secondary outcomes

  1. Rate of change of eGFR by Schwartz formula from pre-treatment to after 2 years of treatment

    Time frame: From Enrollment to 2 years of age

  2. Palatability of the suspension formulation as assessed by a parent questionnaire immediately after and within 15-20 minutes after the first oral dose

    Time frame: From Enrollment to 2 years of age

  3. Acceptance of the suspension formulation as assessed by a parent questionnaire immediately after and within 15-20 minutes after the first oral dose

    Time frame: From Enrollment to 2 years of age

07

Study locations

No study locations are listed for this record.

08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 24, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04786574
Responsible party
Sponsor
First posted
Mar 8, 2021
Start date
Jul 1, 2022
Primary completion
Dec 10, 2025
Completion
Dec 10, 2025
Last update
Dec 24, 2025

Study contacts

Olga Sergeyeva, MD
study director · Otsuka Pharmaceutical Development & Commercialization, Inc.

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is withdrawn, as verified in Dec 2025. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Tolvaptan

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