Trial record 15 of 189 for:
"National Institute of Dental and Craniofacial Research (NIDCR)" [Exact]
Cinacalcet for Fibroblast Growth Factor 23 (FGF23)-Mediated Hypophosphatemia (Hypophosphatemic Rickets)
This study is currently recruiting participants.
Verified August 2013 by National Institutes of Health Clinical Center (CC)
Information provided by (Responsible Party):
National Institutes of Health Clinical Center (CC) ( National Institute of Dental and Craniofacial Research (NIDCR) )
First received: December 11, 2012
Last updated: November 27, 2013
Last verified: August 2013
- Hypophosphatemia is a condition where a person has low levels of phosphorus in the blood. Low blood phosphorus can cause muscle and bone weakness (such as rickets) and teeth problems. One cause of the condition is having too much fibroblast growth factor 23 (FGF23). FGF23 is a hormone that causes the kidney to get rid of phosphorus in the urine. It can also prevent the body from making vitamin D, which helps the body absorb phosphorus in food.
- Many people with low blood phosphorus take high doses of phosphorus and calcium medications. However, one side effect of these drugs is increased blood levels of parathyroid hormone (PTH). The drug cinacalcet can help lower PTH levels, which may decrease the amount of phosphorus lost in the urine and increase the phosphorus levels in the blood. Researchers want to see if cinacalcet can help blood phosphorus and decrease the amount of phosphorus supplements that people need to take.
- To see if cinacalcet can be a safe and effective treatment for people with low phosphorus conditions due to high FGF23.
- Individuals between 18 and 70 years of age who have different forms of hypophosphatemic rickets and tumor-induced hypophosphatemia
- Participants will have up to 25 study visits over about 28 weeks.
- Participants will be screened with a physical exam and medical history. Blood and urine samples will be collected.
- Up to three more lab visits for blood and urine tests will be required before treatment. Imaging studies of the bones, spine, and kidneys will be performed.
- Participants will have a 3-night hospital stay to start treatment. They will take cinacalcet once a day. Treatment will be monitored with frequent blood tests and imaging studies.
- Participants will continue to take cinacalcet once a day for 3 weeks. They will have regular study visits to monitor the treatment.
- There will be up to two other overnight hospital stays (1 to 3 nights) to adjust cinacalcet doses. The dose will increase until the maximum dose is reached, or side effects develop.
- After the end of the cinacalcet study, participants will have several more followup visits to monitor the effects of treatment.
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
||Open-label Dose-titration Study of the Tolerability and Efficacy of Cinacalcet to Treat Fibroblast Growth Factor 23 (FGF23)-Mediated Hypophosphatemia
Primary Outcome Measures:
- Evaluate the tolerability of cinacalcet in individuals with FGF23-mediated hypophosphatemia [ Time Frame: 4 years ]
Secondary Outcome Measures:
- To explore the effectiveness of cinacalcet at decreaing renal phosphate wasting [ Time Frame: 4 years ]
- Evaluate the pharmacodynamics of cinacalcet in this subject population. [ Time Frame: 4 years ]
| Estimated Enrollment:
| Study Start Date:
| Estimated Study Completion Date:
| Estimated Primary Completion Date:
||October 2015 (Final data collection date for primary outcome measure)
|Ages Eligible for Study:
||18 Years to 70 Years
|Genders Eligible for Study:
|Accepts Healthy Volunteers:
- Chronological age: 18-70 years
Diagnosis of a genetic form of FGF23-mediated hypophosphatemia:
- X-linked hypophosphatemic rickets (XLH)
- Autosomal dominant hypophosphatemic rickets (ADHR)
- Autosomal recessive hypophosphatemic rickets (ARHR)
Or, diagnosis of a non-genetic form of FGF23-mediated hypophosphatemia, i.e. tumor-induced osteomalacia (TIO)
- Ability to understand and provide informed consent
- Ability to complete the protocol scheduled assessments and medication regimen
- Women of child-bearing potential (not surgically sterile via tubal ligation, bilateral oophorectomy or hysterectomy, or who are not postmenopausal for greater than or equal to 1 year) must agree to practice adequate contraception that may include, but is not limited to, abstinence, monogamous relationship with vasectomized partner, barrier methods such as condoms, diaphragms, spermicides, intrauterine devices, and licensed hormonal methods for the duration of the treatment portion of the study.
- Chronic or recurrent hypocalcemia defined by a serum calcium < 8.4 mg/dL (2.1 mmol/L)
- Tertiary hyperparathyroidism as evidenced by concurrent PTH and calcium levels above the upper limit of normal
- History of parathyroid surgery and/or hypoparathyroidism
- Hypercalciuria as defined as > 4 mg/kg/day (0.1 mmol/kg/day) on optimized conventional therapy (as determined during SOC optimization phase)
- Moderate to severe hepatic insufficiency as defined by total bilirubin > 2 mg/dL and serum albumin < 3 g/dL and International Normalized Ratio (INR) > 2 OR presence of ascites or hepatic encephalopathy.
- A calculated eGFR < 50 mL/min/1.73 m(2), using the CKD-EPI equation
- History of a non-febrile seizure disorder
- History of a clinically significant cardiac arrhythmia
- History of chronic gastrointestinal disease
- Current therapy (at the time of informed consent) bisphosphonates, calcitonin, diuretics or medications that may have a significant drug interaction with cinacalcet
- Known hypersensitivity to cinacalcet or any of its constituents
- Positive pregnancy test or lactation
- Use of another investigational agent (i.e., in the context of a clinical trial, use of an investigational product that may have impact on the study) within the last 3 months
Please refer to this study by its ClinicalTrials.gov identifier: NCT01748812
|National Institutes of Health Clinical Center, 9000 Rockville Pike
|Bethesda, Maryland, United States, 20892 |
|Contact: For more information at the NIH Clinical Center contact Patient Recruitment and Public Liaison Office (PRPL) 800-411-1222 ext TTY8664111010 email@example.com |
||Rachel I Gafni, M.D.
||National Institute of Dental and Craniofacial Research (NIDCR)
||National Institutes of Health Clinical Center (CC) ( National Institute of Dental and Craniofacial Research (NIDCR) )
History of Changes
|Other Study ID Numbers:
|Study First Received:
||December 11, 2012
||November 27, 2013
||United States: Federal Government
Keywords provided by National Institutes of Health Clinical Center (CC):
Tumor Induced Osteomalacia
Additional relevant MeSH terms:
ClinicalTrials.gov processed this record on December 05, 2013
Hypophosphatemic Rickets, X-Linked Dominant
Bone Diseases, Metabolic
Calcium Metabolism Disorders
Vitamin D Deficiency
Phosphorus Metabolism Disorders
Renal Tubular Transport, Inborn Errors
Genetic Diseases, X-Linked
Genetic Diseases, Inborn
Metal Metabolism, Inborn Errors
Metabolism, Inborn Errors
Molecular Mechanisms of Pharmacological Action