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Study Evaluating Subjects With Distal Renal Tubular Acidosis

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ClinicalTrials.gov Identifier: NCT03644706
Recruitment Status : Not yet recruiting
First Posted : August 23, 2018
Last Update Posted : June 21, 2021
Information provided by (Responsible Party):
Advicenne Pharma

Brief Summary:
This is a phase 3, prospective, multicenter, randomized, double-blinded, placebo-controlled, study product withdrawal study comparing the efficacy of ADV7103 versus placebo in preventing the development of metabolic acidosis defined by serum bicarbonate level in pediatric (6 months to < 18 years of age) and adult (18 to 65 years of age) subjects with primary dRTA.

Condition or disease Intervention/treatment Phase
Distal Renal Tubular Acidosis Drug: ADV7103 Drug: Placebo Phase 3

Detailed Description:
The study will target enrolling at least 4 subjects in each of the following age groups: 6 months - 23 months; 2-11 years, and ≥ 12 years. Subjects will be in the study for up to 21 weeks. After screening and enrollment, subjects will participate in an 8-12 week open label period where there dose of ADV7103 will be titrated to effect, then continued for the remainder of the open label period. Periodic measurements of bicarbonate and potassium levels will be collected during this period. Following the open-label period, subjects will enter a 6-day randomized withdrawal period. For this portion of the study, subjects will be admitted to an inpatient setting. A follow-up period up to four weeks on re-established therapy completes the trial. Subjects will have the opportunity to subsequently enter a long-term, open label extension.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 40 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Prevention
Official Title: A Phase 3 Multicenter, Randomized, Double-Blinded, Placebo-Controlled Withdrawal Study Evaluating ADV7103 In Pediatric and Adult Subjects With Distal Renal Tubular Acidosis (dRTA)
Estimated Study Start Date : June 2021
Estimated Primary Completion Date : April 2022
Estimated Study Completion Date : August 2022

Arm Intervention/treatment
Active Comparator: ADV7103
Patients continue to receive ADV7103 twice a day at their open label dose over 6 days
Drug: ADV7103
Each dose of ADV7103 contains a fixed ratio of 1/3 of ADV7103-CK (potassium citrate) and 2/3 of ADV7103-BK (potassium bicarbonate) based on the mass of active substances. The strength is 6.44 (± 10 %) mEq/g of ADV7103 (alkalinizing power).
Other Name: Potassium Citrate and Potassium Bicarbonate

Placebo Comparator: Placebo Comparator
Patients receive matched placebo twice a day until they reach a bicarbonate level of 18mEq/L
Drug: Placebo

Placebo is a combination of 2 mm green coated lactose granules and 2 mm white coated lactose granules.

Each dose of placebo contains a fixed ratio of 1/3 of green granules and 2/3 of white granules.

Primary Outcome Measures :
  1. Mean change in blood bicarbonate levels [ Time Frame: 6 days ]
    Compare the efficacy of ADV7103 versus placebo in preventing metabolic acidosis, defined as 2 consecutive serum bicarbonate levels < 18 mEq/L for subjects ≥ 4 years old and < 17 mEq/L for subjects < 4 years old, during the Withdrawal Period

Information from the National Library of Medicine

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Ages Eligible for Study:   6 Months to 65 Years   (Child, Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Female or male subjects ≥ 6 months of age and ≤ 65 years of age at time of consent;
  2. Subject presents with a previous diagnosis of primary dRTA of at least 4 months duration for subjects < 12 years of age, and at least one year for those ≥ 12 years of age, based on documented history of non-anion gap, hyperchloremic, hypokalemic metabolic acidosis;
  3. Subject requires ≥ 0.9 mEq/kg/day of alkali therapy to maintain serum bicarbonate levels above the LLN for the laboratory providing results;

Exclusion Criteria:

  1. Female subject who is pregnant or lactating or has plans for pregnancy during the study;
  2. Subject has evidence of proximal tubule dysfunction (eg, hypophosphatemia, low serum uric acid, glycosuria, or amino aciduria);
  3. Subject presents with another diagnosed condition as a potential etiology for her/his dRTA (eg, systemic lupus erythematosus, Sjogren's syndrome), in the opinion of the Investigator;
  4. Subject requires therapy with potassium sparing diuretics, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, trimethoprim, drospirenone and other progestins, nephrotoxic antibiotics, penicillins, tacrolimus, or medications known to delay gastric emptying or otherwise interfere with absorption of study product;
  5. Subject has evidence of obstructive uropathy or other findings on renal ultrasound associated with Visit 1 expected to require intervention during the course of the study, in the opinion of the Investigator;
  6. Subject has any of the following laboratory abnormalities associated with Visit 1:

    1. AST and/or ALT > 1.5x upper limit of normal (ULN)
    2. Serum potassium > 5.0 mEq/L or <3.0 mEq/L or hypokalemia accompanied by clinical symptoms (eg, muscle cramps) or significant ECG changes (eg T wave depression, U wave elevation)
    3. Estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 (according to the updated Schwartz formula for children and Chronic Kidney Disease - Epidemiology Collaboration [CKD-EPI] formula for adults)
    4. Total bilirubin > ULN, except with known Gilbert's disease.
  7. Subject has been hospitalized or had outpatient surgery (other than minor skin and dRTA disease-related procedures or ear tube placement) in the past 6 months or is planning surgery in the next 6 months;

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03644706

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United States, California
University of California
San Francisco, California, United States, 94158
United States, Colorado
Children's Hospital Colorado
Aurora, Colorado, United States, 80045
United States, Connecticut
Connecticut Children's Hospital
Hartford, Connecticut, United States, 06106
United States, Florida
University of South Florida Pediatric Infectious Disease
Tampa, Florida, United States, 33606
United States, Georgia
Emory Children's Center
Atlanta, Georgia, United States, 30322
United States, Indiana
J.W. Riley Hospital for Children
Indianapolis, Indiana, United States, 46202
United States, Missouri
Washington University/St. Louis Children's Hospital
Saint Louis, Missouri, United States, 63110
United States, New York
Montefiore Medical Center
Bronx, New York, United States, 10467
United States, Pennsylvania
The Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States, 19104
Canada, Alberta
University of Alberta
Edmonton, Alberta, Canada, T6G 2R3
Canada, Ontario
The Hospital for Sick Children
Toronto, Ontario, Canada, M5G 1X8
Canada, Quebec
The Research Institute of the McGill University Health Centre
Montreal, Quebec, Canada, H4A 3J1
Sponsors and Collaborators
Advicenne Pharma
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Study Chair: Andre Ulmann, MD, Ph.D. Advicenne Pharma
Additional Information:
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Responsible Party: Advicenne Pharma
ClinicalTrials.gov Identifier: NCT03644706    
Other Study ID Numbers: B23CS
First Posted: August 23, 2018    Key Record Dates
Last Update Posted: June 21, 2021
Last Verified: June 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Acidosis, Renal Tubular
Acid-Base Imbalance
Metabolic Diseases
Renal Tubular Transport, Inborn Errors
Kidney Diseases
Urologic Diseases
Genetic Diseases, Inborn
Potassium Citrate
Natriuretic Agents
Physiological Effects of Drugs
Respiratory System Agents