Effect of Pirfenidone on Glomerular Filtration Rate and Albuminuria in Patients With Diabetic Nephropathy

Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran

Status and phase: Completed; Phase 3

Conditions: Diabetic Nephropathy; Albuminuria

Treatments: Drug: Pirfenidone; Drug: Placebo

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT02689778

1497

Details and patient eligibility

About

It is estimated that approximately 30% of patients with diabetes develop diabetic nephropathy. Diabetic nephropathy is a multifactorial progressive disease that occurs through various mechanisms such as hyperglycemia, oxidative stress, inflammation and fibrosis, control or blocking these mechanisms are therefore potential therapeutical targets for this entity. Current treatment options are based on the glycemic control, blood pressure control, as well as the use of medications such as angiotensin-converting enzyme inhibitors and Angiotensin II receptor antagonists, these actions are not enough to stop progression. Pirfenidone is a drug with antifibrotic, antioxidant, and anti-inflammatory properties. Although the specific mechanism is unknown, pirfenidone interferes with the expression, secretion and the effect of the β (TGF-β) transforming growth factor. The investigators plan to carry out a controlled clinical study to evaluate the effect of pirfenidone in patients with type 2 diabetes and nephropathy. The period of time the treatment will be administered will be of 12 months, 62 patients will be included. The primary outcome will be improvement in glomerular filtration rate. The secondary outcomes will be number of patients requiring replacement therapy, 24 hour urine microalbuminuria and change in the concentration of TGF - β. Change in these parameters will be evaluated at the end of the treatment period (12 months). Throughout the study the incidence of adverse events will be recorded, wich will allow us to learn about the safety and security of the drug in this population.

Enrollment: 62 patients

Sex: All

Ages: 18 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion criteria

• Body mass index (BMI) less than 35 kg/m2
• Diagnosis of diabetes mellitus type 2
• Glomerular filtration rate of 15-89 ml/min
• Albuminuria ≥30 mg/24 h and < 3.5 g/24 h
• Individuals with blood pressure less than 140/90 mmHg or treated with stable doses of anti-hypertensive drugs.
• Glycated hemoglobin <10%

Exclusion criteria

• Another etiology of renal disease (autoimmune diseases, polycystic kidney disease)
• Repeated urinary tract infections (more than three episodes in the past year)
• Photosensitivity to any drug
• Liver disease
• Pregnancy
• Breastfeeding

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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62 participants in 2 patient groups, including a placebo group

Pirfenidone

Experimental group

Description:

Oral pirfenidone 600 mg with breakfast and 1200 mg with dinner for 12 months.

Treatment:

Drug: Pirfenidone

Placebo

Placebo Comparator group

Description:

Oral placebo with breakfast and with dinner for 12 months.

Treatment:

Drug: Placebo