Status:

RECRUITING

Keeping RAASi Treatment With Optimal Potassium Control

Lead Sponsor:

Fundación para la Investigación del Hospital Clínico de Valencia

Conditions:

Chronic Kidney Diseases

Eligibility:

All Genders

18+ years

Phase:

PHASE3

Brief Summary

Phase III, multicenter, randomized, open-label, parallel-group, non-inferiority, phase III clinical trial comparing CSZ (Lokelma) vs. iSRAA discontinuation/reduction and/or ARM (standard treatment).

Detailed Description

Hyperkalemia is a potentially life-threatening condition associated with ventricular arrhythmias and sudden cardiac arrest. It is common in patients with some comorbidities such as chronic kidney dise...

Eligibility Criteria

Inclusion

  • Patients must present serum potassium levels of 5.5-6.5 mEq/L at patient selection visit (V0)
  • Patients must present serum potassium levels of 5.0-6.5 mEq/L at randomization visit (V1).
  • Provision of patient or legal representative informed consent prior to any study specific procedures.
  • Individuals receiving background standard of care for HF and treated according to locally recognized guidelines. Specific treatment should include RAASi and/or MRA treatment at first consultation and at least should have been stable for ≥ 4 weeks at maximum tolerated doses.
  • Patients with CKD not on dialysis (Stages 2-5: estimated glomerular filtration rate (eGFR) between 15-60 ml/min/1,73m2 or eGFR between 60-90 ml/min/ 1.73 m2 with albuminuria/creatinuria (\> 30 mg/g) in the previous three months). The estimated GFR can be reported by the laboratory or calculated by the researcher with serum creatinine, age, and sex (CKD-EPI equation).
  • 18 years at the time of signing ICF.
  • Negative pregnancy test (urine or serum) for female subjects of childbearing potential.
  • Female subjects must be 1 year post-menopausal, surgically sterile, or using an acceptable method of contraception (an acceptable method of contraception is defined as a barrier method in conjunction with a spermicide) for the duration of the study (from the time they sign ICF) and for 3 months after the last dose of SZC. In addition, oral contraceptives, approved contraceptive implant, long-term injectable contraception, intrauterine device, or tubal ligation are allowed. Oral contraception alone is not acceptable; additional barrier methods in conjunction with spermicide must be used.

Exclusion

  • Involvement in the planning and/or conduct of the study (applies to both Investigator staff and/or staff at the study site).
  • Previous enrollment or randomization in the present study.
  • HF due to restrictive cardiomyopathy, active myocarditis, constrictive pericarditis, hypertrophic (obstructive) cardiomyopathy or uncorrected primary valvular disease.
  • Current acute decompensated HF, hospitalization due to decompensated HF, myocardial infarction, unstable angina, stroke or transient ischemic attack within 12 weeks prior to enrollment.
  • Coronary revascularization (percutaneous coronary intervention or coronary artery bypass grafting or valvular repair/replacement within 12 weeks prior to enrollment or planned to undergo any of these operations after randomization).
  • Implantation of a Cardiac Resynchronization Therapy (CRT) device or Implantable Cardioverter Defibrillator (ICD) within 12 weeks prior to enrollment or intent to perform atrial fibrillation ablation or to implant a CRT or ICD device.
  • Previous cardiac transplantation or implantation of a ventricular assistance device or similar device, or transplantation or implantation expected after randomization
  • Oropharingeal dysfunction that precludes normal swallow.
  • Female who is pregnant, breast-feeding or intends to become pregnant or is of child-bearing potential and not using a highly effective contraceptive method.
  • Patients with amputated limbs or pacemaker devices will be excluded of bioimpedance analysis.
  • Participation in another clinical study with an investigational product during the last 6 months.
  • Patients with a known hypersensitivity to SZC or any of the excipients of the product.
  • Treated with potassium binding resins such as sodium polystyrene sulfonate (SPS; e.g. Kayexalate®) or calcium polystyrene sulfonate (CPS; e.g. Resonium®) or the cation exchange polymer, patiromer sorbitex calcium (Veltassa®), within 7 days prior to the first dose of study drug.
  • Judgment by the investigator that the subject should not participate in the study if the subject is unlikely to comply with study procedures, restrictions and requirements.
  • Subjects with a family history of long QT syndrome, presence of cardiac arrhythmias or conduction defects that require immediate treatment, or a QTc (corrected QT interval) of ≥ 550 msec.
  • History of QT prolongation associated with other medications that required discontinuation of that medications.
  • Symptomatic or uncontrolled atrial fibrillation despite treatment, or asymptomatic sustained ventricular tachycardia. Subjects with atrial fibrillation controlled by medication are permitted.

Key Trial Info

Start Date :

September 30 2022

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

July 30 2026

Estimated Enrollment :

78 Patients enrolled

Trial Details

Trial ID

NCT06578533

Start Date

September 30 2022

End Date

July 30 2026

Last Update

August 29 2024

Active Locations (5)

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Page 1 of 2 (5 locations)

1

Hospital General Universitario Dr. Balmis

Alicante, Spain, 03010

2

Hospital Universitario Vall d'Hebrón

Barcelona, Spain, 08035

3

Hospital Universitario 12 de Octubre

Madrid, Spain, 28041

4

Hospital Clínico Universitario de Valencia

Valencia, Spain, 46010