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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/ct2/show/NCT02156843




Registration number
NCT02156843
Ethics application status
Date submitted
28/05/2014
Date registered
5/06/2014
Date last updated
9/03/2016

Titles & IDs
Public title
Pyridorin in Diabetic Nephropathy
Scientific title
A Phase 3 Randomized, Double-Blind, Placebo-Controlled, Multi-Center Study to Evaluate the Safety and Efficacy of Pyridorin (Pyridoxamine Dihydrochloride) in Subjects With Nephropathy Due to Type 2 Diabetes (PIONEER)
Secondary ID [1] 0 0
2014-001641-24
Secondary ID [2] 0 0
PYR-311
Universal Trial Number (UTN)
Trial acronym
PIONEER
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Diabetic Nephropathy 0 0
Diabetic Kidney Disease 0 0
Condition category
Condition code
Renal and Urogenital 0 0 0 0
Kidney disease
Metabolic and Endocrine 0 0 0 0
Diabetes

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - Pyridorin
Treatment: Drugs - Placebo

Experimental: Pyridorin - Pyridorin (pyridoxamine dihydrochloride) 300 mg oral BID (twice daily, every 12 hours) Capsule

Placebo Comparator: Placebo - Placebo Oral Capsule taken BID (twice daily, every 12 hours)


Treatment: Drugs: Pyridorin
300 mg BID (twice daily, every 12 hours), oral capsule taken until end stage renal disease or death occurs, or the study is terminated by the sponsor.

Treatment: Drugs: Placebo
Placebo excipients without the active drug, oral capsule taken BID (twice daily, every 12 hours), until end stage renal disease or death occurs, or the study is terminated by the sponsor.
Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Time to composite endpoint of >=50% SCr increase from baseline or ESRD
Timepoint [1] 0 0
Approximately 45 Months
Secondary outcome [1] 0 0
Time to the composite endpoint >=100% SCr increase or ESRD
Timepoint [1] 0 0
Approximately 45 Months

Eligibility
Key inclusion criteria
Patients meeting all of the following criteria will be eligible to participate in the
study:

1. Patients who have given voluntary written informed consent to participate in this
study prior to conducting Screening (Visit 1) procedures;

2. Patients 18 years of age or older with a diagnosis of type 2 diabetes;

3. Women of childbearing potential (WOCBP) who agree to use appropriate birth control
(double-barrier methods, hormonal contraceptives, or intrauterine device) for the
duration of the study (women of childbearing potential is defined as all women who are
not surgically sterile or are not at least 1 year post menopausal). All women of
childbearing potential must have a negative serum pregnancy test at Visit 1;

4. All men (unless surgically sterile, as defined below) who have sexual intercourse with
a WOCBP must agree and commit to use a highly effective method of contraception for
the duration of the study (defined as the time of the signing of the informed consent
form through the conclusion of patient participation). Highly effective methods of
contraception include:

i. Male subjects agreeing that they and their female spouse/partners will use adequate
contraception (2 forms of birth control, one of which must be barrier method) or be of
non-childbearing potential.

ii. To be considered surgically sterilized, a male partner must have had a vasectomy
at least 24 weeks before Visit 1;

5. At Visit 1, patients must have a history of overt diabetic nephropathy, as defined by
the following:

- A SCr measurement =1.3 (=1.25)mg/dL (111 µmol/L) for females or =1.5 (=1.45)
mg/dL (128 µmol/L) for males;

- At Visit 1 or 1.1 24-hour urine collection PCR >1200 mg/g (130 mg/µmol) and, if
applicable for PS phase, at Visit 1S or 1.1S a 24-urine collection PCR >600 mg/g
(67 mg/µmol)

- For eligibility determination, laboratory reported values of PCR will be rounded
up to 2 significant digits (e.g. =1150 mg/g to 1200 mg/g; =595 mg/g to 600 mg/g),

6. Patients must have a SCr measurement <3.0 mg/dL (265 µmol/L);

7. Patients must have an eGFR of =20 mL/min/1.73m2, using the 4-variable Modification of
Diet in Renal Disease equation in which eGFR = 175 x (SCr(mg/dL))-1.154 x
(Age(years))-0.203 x (0.742 if female) x (1.212 if African American);

8. Patient must have a second screening SCr measurement at Visit 1.1 or 1.1S taken 1 week
(± 2 days) after screening (Visit 1 or 1S). The value of the second screening SCr
measurement must be <3.0 mg/dL (265 µmol/L) for both genders and within 25% of the
first screening measurement;

9. Patients must be taking a single ACE-I or ARB at a constant dose for at least 26 weeks
prior to Visit 1, where the dose of the ACE-I or the ARB is considered appropriate for
that patient (can be zero to max dose approved by the FDA) and it is anticipated that
the same dose can and will be maintained throughout the course of the study;

10. Patients taking any blood pressure medications in addition to an ACE-I or ARB,
including diuretics, must be on a stable dose for 13 weeks prior to Visit 1 (and Visit
1S if applicable) with a seated blood pressure of = 150/90 mmHg;

11. Patients not taking any blood pressure medications, including diuretics, other than an
ACE-I or ARB must have a seated blood pressure = 150/90 mmHg at Visit 1 (and Visit 1S
if applicable) and a seated blood pressure considered appropriate for the patient and
one that can be sustained throughout the study.
Minimum age
18 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
Patients are excluded from participation in the study if any of the following criteria
apply

1. Patients with type 1 diabetes or MODY (a monogenic form of diabetes);

2. Patients with a diagnosis of chronic kidney disease other than diabetic renal disease
with or without hypertensive renal disease

3. Patients receiving a renin inhibitor or an aldosterone antagonist or a combination of
an ACE-I and an ARB within 26 weeks of Visit 1

4. Patients with a history of solid organ transplantation

5. Patients with a history of myocardial infarction, coronary re-vascularization
procedures (including percutaneous transluminal coronary angioplasty), stroke, or
transient ischemic attack within 30 days prior to Visit 1

6. Patients with a diagnosis of New York Heart Association Class III or IV congestive
heart failure at any time

7. Patients with a history of being treated for neoplastic disease (except basal or
squamous cell carcinoma of the skin) within 5 years prior to Visit 1

8. Patients with any history of dialysis within 2 years prior to Visit 1

9. Patients in whom dialysis or renal transplantation is anticipated by their physician
within 1 year after Visit 1

10. Patients who used SCr-altering drugs within 30 days prior to Visit 1

11. Patients who require systemic immunosuppression therapy for >2 weeks (except for
inhalant steroids)

12. Patients with clinically significant liver disease or transaminase (alanine
aminotransferase and aspartate aminotransferase) levels >2.5 × the upper limit of
normal (ULN) measured at Visit 1.1 or Visit 1.1S

13. Patients with bilirubin levels >1.5 × ULN measured at Visit 1.1 or Visit 1.1S

14. Patients with a history of allergic or other adverse response to vitamin B
preparations

15. Patients who require >50 mg of vitamin B6 daily

16. Patients who have an active history of dysphagia or swallowing disorders

17. Patients with a history of hypersensitivity to Pyridorin or any of the excipients
(non-active ingredients) in the Pyridorin formulation

18. Patients who have taken pyridoxamine or any other investigational drug within 30 days
prior to Visit 1, or have participated in a previous Pyridorin study or another
interventional clinical study within 30 days prior to Visit 1

19. Patients with an active history of drug or alcohol abuse

20. Patients unlikely to comply with the study protocol (eg, an inability and
unwillingness to participate in adequate training, an uncooperative attitude,
inability to return for follow-up visits, or unlikelihood of completing the study)

21. Women who are lactating, pregnant, or intend to become pregnant during the course of
the study

22. Persons employed with the sponsor, CRO, or one of the study investigative sites must
be excluded from participation, even if they are not involved directly in the conduct
of the study.

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
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
Intervention assignment
Parallel
Other design features
Phase
Phase 3
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Terminated
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
1/06/2014
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
1/03/2018
Actual
Sample size
Target
Accrual to date
Final
328
Recruitment in Australia
Recruitment state(s)
NSW,SA,VIC
Recruitment hospital [1] 0 0
CSG Investigational Site (#205) - Camperdown
Recruitment hospital [2] 0 0
CSG Investigational Site (#201) - Gosford
Recruitment hospital [3] 0 0
CSG Investigational Site (#206) - Liverpool
Recruitment hospital [4] 0 0
CSG Investigational Site (#208) - St. Leonards
Recruitment hospital [5] 0 0
CSG Investigative Site (#204) - Adelaide
Recruitment hospital [6] 0 0
CSG Investigational Site (#207) - Footscray
Recruitment hospital [7] 0 0
CSG Investigational Site (#200) - Reservoir
Recruitment hospital [8] 0 0
CSG Investigational Site (#202) - Richmond
Recruitment hospital [9] 0 0
CSG Investigational Site (#209) - Parkville
Recruitment postcode(s) [1] 0 0
2050 - Camperdown
Recruitment postcode(s) [2] 0 0
2250 - Gosford
Recruitment postcode(s) [3] 0 0
2170 - Liverpool
Recruitment postcode(s) [4] 0 0
2065 - St. Leonards
Recruitment postcode(s) [5] 0 0
5000 - Adelaide
Recruitment postcode(s) [6] 0 0
2011 - Footscray
Recruitment postcode(s) [7] 0 0
3073 - Reservoir
Recruitment postcode(s) [8] 0 0
3121 - Richmond
Recruitment postcode(s) [9] 0 0
3050 - Parkville
Recruitment outside Australia
Country [1] 0 0
United States of America
State/province [1] 0 0
Alabama
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Arizona
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California
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Colorado
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Connecticut
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Georgia
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Illinois
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Indiana
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Louisiana
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Maryland
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Massachusetts
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Michigan
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Missouri
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Nevada
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New York
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North Carolina
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Ohio
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Pennsylvania
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Rhode Island
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Tennessee
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Texas
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Utah
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Vermont
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Washington
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Wisconsin
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Plovdiv
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Sofia
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Stara Zagora
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France
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Cedex
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Boulogne Sur Mer
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Colmar
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Rhone
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Valenciennes
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Aschaffenburg
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Berlin
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Elsterwerda
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Heidelberg
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Herzberg
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Hoyerswerda
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Mainz
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Germany
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Munchen
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Hong Kong
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Hong Kong
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Hong Kong
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Kwai Chung
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Hong Kong
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Sha Tin
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Hungary
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Budapest
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Zalaegerszeg
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Zefad
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Ashkelon
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Haifa
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Holon
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Israel
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Jerusalem
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Israel
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Kfar Saba
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Nahariya
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Petah Tikva
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Israel
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Poriya
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Israel
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Rishon Le-Zion
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Israel
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Tel Aviv
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Israel
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Tel Hasomer
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Israel
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Zerifin
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Mauritius
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Phoenix
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Poland
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Bydgoszcz
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Chojnice
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Kielce
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Nowy Sacz
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Poland
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Poznan
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Puerto Rico
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Rio Piedras
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Puerto Rico
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San Juan
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Puerto Rico
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Toa Baja
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Spain
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Madrid
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Spain
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Barcelona
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Spain
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Girona
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Spain
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Lleida
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Spain
State/province [85] 0 0
Valencia

Funding & Sponsors
Primary sponsor type
Commercial sector/Industry
Name
NephroGenex, Inc.
Address
Country
Other collaborator category [1] 0 0
Other
Name [1] 0 0
Collaborative Study Group (CSG)
Address [1] 0 0
Country [1] 0 0
Other collaborator category [2] 0 0
Commercial sector/Industry
Name [2] 0 0
Medpace, Inc.
Address [2] 0 0
Country [2] 0 0

Ethics approval
Ethics application status

Summary
Brief summary
The purpose of this study is to evaluate the safety and efficacy of oral Pyridorin 300 mg BID
in reducing the rate of progression of nephropathy due to type 2 diabetes mellitus.
Trial website
https://clinicaltrials.gov/ct2/show/NCT02156843
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Jamie Dwyer, MD
Address 0 0
The Collaborative Study Group (CSG) [Co-Chair]
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/ct2/show/NCT02156843