Clinical Trial To Evaluate Safety And Efficacy Of US-APR2020 In Subjects With Chronic Kidney Disease Stage IV (CKD)

  • STATUS
    Recruiting
  • End date
    Dec 15, 2022
  • participants needed
    630
  • sponsor
    Kibow Pharma
Updated on 15 June 2022

Summary

The aim of this Phase 2 study is to evaluate the safety and efficacy of the live biotherapeutic product, US-APR2020, in the management of patients with CKD Stage IV.

Description

Kidney diseases are a global public health problem that affects over 200 million people worldwide. It is estimated that about 30 million adults in the United States have Chronic Kidney Disease (CKD) and most are undiagnosed. In addition, CKD represents the ninth leading cause of death in the United States. Kidney diseases also represent great socio-economical cost worldwide. In the United States, treating Medicare beneficiaries with CKD costed over $79 billion, and treating people with End Stage Kidney Disease (ESKD) costed an additional $35 billion in 2016. To date, there is no cure for CKD.

The most important CKD risk factors in adults include diabetes and high blood pressure. Other risk factors include heart disease, obesity, a family history of CKD, past damage to the kidneys, and old age. Having CKD increases the chances of also having heart disease and stroke.

CKD is a condition characterized by a gradual loss of kidney function over time. Depending on the kidney function measured with glomerular filtration rate (GFR) CKD can be classified into several stages (I, II, III, IV and V). CKD Stage V, also known as End Stage Kidney Disease (ESKD), is a very advanced stage of kidney disease where the kidneys have lost nearly all ability to do their job effectively, and eventually dialysis or a kidney transplant is needed to live. Treatment may slow the decline in kidney function and failure. However, not everyone with CKD develops ESKD, and in some cases ESKD develops even with treatment.

CKD is accompanied by altered pathogenic gut bacteria, inflammation, and accumulation of uremic toxins in the blood. These blood uremic toxins can diffuse passively into the bowel. Scientific research has shown that probiotic bacteria could metabolize various uremic toxins such as urea, uric acid, and creatinine. In addition, by supplementing the gut microbiome with probiotic bacteria, it is possible to metabolize the nitrogenous waste products and other toxins which diffuse into the gut, and thus lower levels of inflammation and blood uremic toxins.

US-APR2020 is a live biotherapeutic (LBT) intended to restore the gut microbiome to improve the removal of uremic toxins in the bowel in CKD patients. The aim of this Phase 2 study is to evaluate the safety and efficacy of the US-APR2020 in the management of patients with CKD Stage IV.

Details
Condition Chronic Kidney Disease stage4
Treatment Placebo, US-APR2020
Clinical Study IdentifierNCT04913272
SponsorKibow Pharma
Last Modified on15 June 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Adults between the ages of 18-80 years
CKD Stage IV (eGFR = 15-29 mL/min) with declining kidney function for a period > 6 months
Serum Creatinine > 2.0 mg/dL
Adherence to low protein diet (LPD) of 0.6-0.8 g/kg/day based on subject response and on advisory

Exclusion Criteria

Those on probiotic supplements in the past 3 months
Pregnancy, breast feeding or females of child-bearing potential who are unwilling to use a reliable form of contraception
Immunosuppressant medications therapy specific to immune mediated renal diseases
HIV/AIDs
Underweight (BMI ≤ 18.5)
Subject with an infection that requires oral antibiotic administration at the time of randomization or close to that visit
Those with gastrointestinal disease (irritable bowel syndrome or anal fissures or anal fistulas or perianal abscesses or perianal infections or diverticular diseases or colitis or colon polyps) at the time of screening and randomization, or within 6 months prior to the randomization visit (Visit 2)
Those with internal prosthesis including orthopedics, neurosurgery, heart valves, vascular stents ˂ 2 years post -surgery procedure. Those with Prosthesis > 2 years should not be excluded
Those with biological/tissue grafts or prosthesis or implant
Those on anticoagulant medicines, including Vit K antagonists (e.g., warfarin, coumadin) or the new class of oral anti-coagulants approved by FDA in the last 10 years
Those on peritoneal dialysis
Those with acute kidney injury
Those with mental conditions or medically debilitating disease/disorder other than CKD, which, in the judgment of the investigator, would interfere with or serve as a contraindication to adherence to the study protocol or affect the ability to give informed consent or affect overall prognosis of the patient
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