RecruitingPhase 4NCT06727409

Use of Clinical-trials and Simulation Models to Estimate Cost-effectiveness of Non-steroidal Mineralocorticoid Antagonists, RASi and SGLT2i as Triple Therapy With Type 2 Diabetes and Chronic Kidney Disease


Sponsor

Chinese University of Hong Kong

Enrollment

82 participants

Start Date

Dec 12, 2024

Study Type

INTERVENTIONAL

Conditions

Summary

To evaluate triple therapy with nsMRA, RASi and SGLT2i on albuminuria in individuals with T2D and CKD


Eligibility

Min Age: 18 Years

Inclusion Criteria7

  • Adults aged 18 years or above
  • Diagnosis of type 2 diabetes at least 6 months
  • CKD (eGFR by CKD-EPI 25-90 ml/min/1.73m2 with uACR 30 to \<300 mg/g) and/or those with severely elevated albuminuria (uACR 30-5000 mg/g) and eGFR \> 60 ml/min/1.73m2.
  • Patients should have a serum potassium \<4.8 mmol/l at screening
  • On SGLT2i (dapagliflozin or empaglifozin) at screening at stable doses for at least 4 weeks.
  • On ACEi or ARB at maximum tolerated dose per manufacturer's label that did not cause unacceptable side effects
  • In the opinion of the investigator, absence of any physical limitations, addictive diseases, or underlying medical conditions (including mental health) that may preclude the patient from being a suitable study candidate.

Exclusion Criteria15

  • Type 1 diabetes
  • Allergy, contraindications or intolerance to ACEi/ARB
  • Contraindications or intolerance to mineralocorticoid receptor antagonists
  • Allergy, contraindications to SGLT2is
  • Currently pregnant or planning pregnancy
  • HbA1c \>9% at enrolment
  • Uncontrolled hypertension SBP \> 160mmHg or hypotension \<90 mmHg at enrolment
  • Concomitant therapy with eplenerone, spironolactone that cannot be discontinued.
  • History of stroke or worsening heart failure in the past 6 months prior to screening
  • Diabetic ketoacidosis, hyperosmolar hyperglycaemic state or myocardial infarction in the six months prior to screening
  • Patients on renal replacement therapy or likely require kidney transplant or dialysis during the study period
  • On concomitant strong CYP3A4 inhibitors that cannot be discontinued
  • Adrenal insufficiency
  • Currently participating in another investigational study protocol where the testing or results may interfere with study compliance, diagnostic results, or data collection.
  • An identified protected vulnerable patient (including but not limited to those in detention, or a prisoner).

Interventions

DRUGFinerenone

Finerenone 10mg or 20 mg as tolerated on top of maximal tolerated RASi and stable SGLT2i therapy


Locations(1)

3M, Diabetes and Endocrine Research Center

Hong Kong, Hong Kong

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NCT06727409