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The study will be a single center, double-blind, randomized, placebo-controlled study to evaluate the safety, tolerability, PK and PD of AP303 following 2-week oral administration to Diabetic Kidney Disease patients.
Eligible patients will be enrolled into one of the two dose cohorts, each cohort will include 9 participants randomized to AP303 and placebo at a 2:1 ratio (6 on AP303 and 3 on placebo).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AP303 | Experimental |
| |
| Placebo | Placebo Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| AP303 150μg | Drug | AP303 Tablet 150μg QD |
| |
| Placebo 150μg |
| Measure | Description | Time Frame |
|---|---|---|
| Cmax | Maximum observed plasma concentration | Day 1, Day 14 |
| Tmax | Time to maximum observed plasma concentration | Day 1, Day 14 |
| AUC0-24h | Area under the plasma concentration versus time curve up to 24 hours | Day 1 |
| AUC0-last | Area under the plasma concentration versus time curve up to the last measurable concentration | Day 1 |
| AUC0-inf | Area under the plasma concentration versus time curve extrapolated to infinity | Day 1 |
| AUC0-t | Area under the plasma concentration-time curve for a dosing interval | Day 14 |
| t1/2 | Apparent terminal half-life, computed as ln(2)/λz | Day 1, Day 14 |
| CL/F | Apparent oral clearance calculated from Dose/ AUC0-inf | Day 1 |
| V/F | Apparent volume of distribution of oral drug |
| Measure | Description | Time Frame |
|---|---|---|
| Fasting glucose | Change of fasting glucose | Baseline, Days 6, 10, 14 and 28 |
| Fasting lipid profile | Change of Triglyceride, HDL-C, LDL-C, Total cholesterol |
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Inclusion Criteria:
Exclusion Criteria:
Chronic kidney disease other than type 2 diabetic kidney disease.
Patient receiving corticosteroid immunotherapy or other immunosuppressants (such as calcineurin inhibitors ciclosporin, cyclophosphamide, or mycophenolate mofetil) in the past 3 months before screening.
Recently having acute kidney injury or received renal surgery within the last 6 months before screening visit, or have received renal transplantation.
Congestive heart failure classified New York Heart Association (NYHA) class II to IV within the last 3 months before the screening visit.
Peripheral edema above the ankle level at the screening or randomization visit.
Confirmed (based on the average of 2 separate resting blood pressure measurements in a sitting position, after at least 5 minutes rest) systolic BP greater than 160 or less than 90 mmHg, and diastolic BP greater than 100 or less than 50 mmHg at screening.
Myocardial infarction, acute coronary syndrome, stroke or transient ischemic attack, cardiovascular surgery within 6 months prior to the screening visit.
Abnormalities of ECG parameters and abnormal shape of ECG wave on screening ECG: e.g.
Implantation of cardiac pacemaker or clinically significant arrhythmia, e.g. atrial fibrillation, atrial flutter, right or left bundle branch block, Wolf-Parkinson-White Syndrome.
Current or previous treatment with a thiazolidinedione (e.g., medications containing pioglitazone or rosiglitazone, like Actos, Avandia, ActoplusMet, Avandamet, Avandaryl), PPARa agonist (like fenofibrate) or any dual/multiple PPARa/g agonist (e.g., Chiglitazar Sodium) in the 3 months preceding screening visit.
Previous treatment with CYP2C8 inducer or strong/moderate inhibitor (refer to the list in Appendix 4) in the 1 month preceding screening visit.
Chronic therapy with non-steroidal anti-inflammatory drugs (NSAIDs) (except prophylactic stable low dose aspirin, defined as its dose not higher than 100 mg daily; paracetamol/acetaminophen was allowed) in the last month before screening.
ALT or AST >1.5 × ULN, or laboratory tests revealed other clinically significant abnormalities in liver function at screening.
Creatine phosphokinase (CPK) elevated > 3 x ULN at screening visit or history of drug-induced myopathy.
History of malignancy within 5 years before screening (exceptions: squamous and basal cell carcinomas of the skin and carcinoma of the cervix in situ, or a malignancy that in the opinion of the investigator, with concurrence with the sponsor's medical monitor, is considered cured with minimal risk of recurrence).
Participants who have had significant acute infection, e.g., COVID-19, influenza, local infection, acute gastrointestinal symptoms or any other clinically significant illness within two weeks before study drug administration.
Positive test at screening of any of the following: Hepatitis B (HBsAg), Hepatitis C (HCVAb), human immunodeficiency virus (HIV Ab) or syphilis AB.
Dosed with a small-molecule investigational drug within 3 months, or biologic investigational drug within 3 months or 5 half-lives (whichever is the longer) prior to first dose of this study.
History of drug and/or alcohol abuse or addiction. History (within 3 months of screening) of alcohol consumption exceeding 3 and 2 standard drinks per day on average (1 standard drink = 10 grams of alcohol) for male and female, respectively.
Within 2 weeks prior to admission, use of >5 cigarettes or equivalent nicotine-containing product per day.
Medical or social conditions that would potentially interfere with the participant's ability to comply with the study visit schedule or the study assessments.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yuran Zhang | Contact | +8613661548603 | yuran.zhang@alebund.com | |
| Jue Huang | Contact | +8613764056397 | jue.huang@alebund.com |
| Name | Affiliation | Role |
|---|---|---|
| Hong Zhang | Peking University First Hospital | Principal Investigator |
| Ying Gao | Peking University First Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Peking University First Hospital | Recruiting | Beijing | Beijing Municipality | 100009 | China |
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| ID | Term |
|---|---|
| D003928 | Diabetic Nephropathies |
| ID | Term |
|---|---|
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
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| Drug |
Placebo Tablet 150μg QD |
|
| Day 1, Day 14 |
| Cav | Average plasma concentration | Day 14 |
| Ctrough | Trough plasma concentration | Day 3-14 |
| Rac | Ratio of accumulation | Day 3-14 |
| Incidence and severity of adverse events | Incidence and severity of adverse events | Day 1-28 |
| Incidence of laboratory abnormalities, based on hematology, clinical chemistry, coagulation and urinalysis test results | Incidence of laboratory abnormalities, based on hematology, clinical chemistry, coagulation and urinalysis test results | Day 1-28 |
| Effect of AP303 on ECG parameters | Change of Heart rate in beats/min | Day 1-28 |
| Effect of AP303 on ECG parameters | change of QT in ms | Day 1-28 |
| Effect of AP303 on ECG parameters | Change of PR in ms | Day 1-28 |
| Effect of AP303 on ECG parameters | Change of QRS in ms | Day 1-28 |
| Effect of AP303 on ECG parameters | Change of QTcF in ms | Day 1-28 |
| Effect of AP303 on ECG parameters | Change of QTcB in ms | Day 1-28 |
| Vital signs(Systolic blood pressure) | Change of systolic blood pressure | Day 1-28 |
| Effect of AP303 on physical examination result | Number of pariticipants with abnormal physical examination findings by nature and severity | Day 1-28 |
| Body weight | Change of body weight | Day 1-28 |
| Vital signs (Diastolic blood pressure) | Change of diastolic blood pressure | Day1-28 |
| Vitlal signs (Body temperature) | Change of body temperature | Day 1-28 |
| Effect of AP303 on ECG parameters | Number of participants with abnormal QTcB. | Day 1-28 |
| Effect of AP303 on ECG parameters | Number of participants with abnormal QTcF | Day 1-28 |
| Effect of AP303 on ECG parameters | Number of participants with abnormal QRS | Day 1-28 |
| Effect of AP303 on ECG parameters | Number of participants with abnormal PR | Day 1-28 |
| Effect of AP303 on ECG parameters | Number of participants with abnormal QT | Day 1-28 |
| Effect of AP303 on ECG parameters | Number of participants with abnormal heart rate | Day 1-28 |
| Baseline, Days 6, 10, 14 and 28 |
| Serum creatinine | Change of serum creatinine | Baseline, Days 6, 10, 14 and 28 |
| eGFR | Change of estimated glomerular filtration rate | Baseline, Days 6, 10, 14 and 28 |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D048909 | Diabetes Complications |
| D003920 | Diabetes Mellitus |
| D004700 | Endocrine System Diseases |