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    Clinical Trial Results:
    Dose-response study of gevokizumab (S78989) 3mg, 10mg, 30mg or 60mg in patients with type 2 diabetes and diabetic kidney disease (DKD). A 66-week, international, multicenter, randomized, double-blind, parallel-group, placebo controlled study.

    Summary
    EudraCT number
    2013-003610-41
    Trial protocol
    CZ   SK   BE   DE   DK   SE   ES   PT   PL  
    Global end of trial date
    28 Oct 2015

    Results information
    Results version number
    v1(current)
    This version publication date
    27 Aug 2016
    First version publication date
    27 Aug 2016
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CL2-78989-011
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    U1111-1146-9287
    Sponsors
    Sponsor organisation name
    Institut de Recherches Internationales Servier
    Sponsor organisation address
    50 rue Carnot, Suresnes, France, 92284
    Public contact
    Clinical Studies Department, Institut de Recherches Internationales Servier, +33 1 55 72 43 66, clinicaltrials@servier.com
    Scientific contact
    Clinical Studies Department, Institut de Recherches Internationales Servier, +33 1 55 72 43 66, clinicaltrials@servier.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    28 Oct 2015
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    28 Oct 2015
    Global end of trial reached?
    Yes
    Global end of trial date
    28 Oct 2015
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    The primary objective of the study was to detect the existence of an overall dose-response relationship with gevokizumab (3 mg, 10 mg, 30 mg, or 60 mg) subcutaneous (SC), on the measured glomerular filtration rate (mGFR) in patients with type 2 diabetes and diabetic kidney disease (DKD) using the rate of decline of kidney function, assessed by the glomerular filtration rate measured (mGFR) by plasma clearance of iohexol after 52 weeks of treatment.
    Protection of trial subjects
    This study was conducted in accordance with Good Clinical Practice standards, ethical principles stated in the Declaration of Helsinki and applicable regulatory requirements. After the subject has ended his/her participation in the trial, the investigator provided appropriate medication and/or arranged access to appropriate care for the patient.
    Background therapy
    Patients were to be treated with: - an angiotensin converting enzyme (ACE) inhibitor or by angiotensin-II receptor blocker (ARB) unless medically justified and documented - at least one glucose-lowering therapy (insulin included) (Dapagliflozin or any SGLT 2 inhibitors were prohibited).
    Evidence for comparator
    -
    Actual start date of recruitment
    24 Apr 2015
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Australia: 1
    Country: Number of subjects enrolled
    Canada: 3
    Country: Number of subjects enrolled
    Czech Republic: 2
    Country: Number of subjects enrolled
    South Africa: 2
    Country: Number of subjects enrolled
    Korea, Republic of: 6
    Worldwide total number of subjects
    14
    EEA total number of subjects
    2
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    6
    From 65 to 84 years
    8
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Male or female ≤ 85 years old with diagnosis of type 2 diabetes mellitus first made at age ≥ 30 years, ≥ 8 years prior to selection, Estimated glomerular filtration rate (eGFR) within 20-60 mL/min/1.73 m² range and Urinary albumin/creatinine ratio (UACR)> 300 mg/g. HbA1c <10% with at least one glucose-lowering therapy (insulin incl.) at stable dose

    Period 1
    Period 1 title
    treatment period (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Gevokizumab 3mg
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    Gevokizumab
    Investigational medicinal product code
    S78989
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    one subcutaneous injection of Gevokizumab 3 mg at inclusion and every 4 weeks until W48

    Arm title
    Gevokizumab 10mg
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    Gevokizumab
    Investigational medicinal product code
    S78989
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    one subcutaneous injection of Gevokizumab 10 mg at inclusion and every 4 weeks until W48

    Arm title
    Gevokizumab 30mg
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    Gevokizumab
    Investigational medicinal product code
    S78989
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    one subcutaneous injection of Gevokizumab 30 mg at inclusion and every 4 weeks until W48

    Arm title
    Gevokizumab 60mg
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    Gevokizumab
    Investigational medicinal product code
    S78989
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    one subcutaneous injection of Gevokizumab 60 mg at inclusion and every 4 weeks until W48

    Arm title
    Placebo
    Arm description
    -
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    one subcutaneous injection of placebo at inclusion and every 4 weeks until W48

    Number of subjects in period 1
    Gevokizumab 3mg Gevokizumab 10mg Gevokizumab 30mg Gevokizumab 60mg Placebo
    Started
    3
    3
    2
    3
    3
    Completed
    0
    0
    0
    0
    0
    Not completed
    3
    3
    2
    3
    3
         Sponsor’s decision to discontinue the study
    3
    3
    2
    3
    3

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Gevokizumab 3mg
    Reporting group description
    -

    Reporting group title
    Gevokizumab 10mg
    Reporting group description
    -

    Reporting group title
    Gevokizumab 30mg
    Reporting group description
    -

    Reporting group title
    Gevokizumab 60mg
    Reporting group description
    -

    Reporting group title
    Placebo
    Reporting group description
    -

    Reporting group values
    Gevokizumab 3mg Gevokizumab 10mg Gevokizumab 30mg Gevokizumab 60mg Placebo Total
    Number of subjects
    3 3 2 3 3 14
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    2 0 1 1 2 6
        From 65-84 years
    1 3 1 2 1 8
    Gender categorical
    Units: Subjects
        Female
    0 1 0 0 1 2
        Male
    3 2 2 3 2 12

    End points

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    End points reporting groups
    Reporting group title
    Gevokizumab 3mg
    Reporting group description
    -

    Reporting group title
    Gevokizumab 10mg
    Reporting group description
    -

    Reporting group title
    Gevokizumab 30mg
    Reporting group description
    -

    Reporting group title
    Gevokizumab 60mg
    Reporting group description
    -

    Reporting group title
    Placebo
    Reporting group description
    -

    Subject analysis set title
    Included Set
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    All patients included and having at least one dose of IMP.

    Primary: Change from baseline to W52 in mGFR

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    End point title
    Change from baseline to W52 in mGFR [1]
    End point description
    The primary endpoint was the mGFR measured by plasma clearance of an exogenous filtration marker
    End point type
    Primary
    End point timeframe
    At W0, W24, and W52 visit (end of study visit) or premature discontinuation visit
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: In the specific context of the study (study discontinued due to general strategic and business reasons unrelated to safety), it was decided to not perform the efficacy analyses planned in the study protocol. No mGFR data available under treatment.
    End point values
    Included Set
    Number of subjects analysed
    0 [2]
    Units: mL/min/1.73 m²
        arithmetic mean (standard deviation)
    ( )
    Notes
    [2] - No primary endpoint analysed
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All adverse events which occurred, worsened, or became serious according to the investigator or upgraded by the Sponsor, after the first IMP intake date (included).
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    18
    Reporting groups
    Reporting group title
    Gevokizumab 3mg
    Reporting group description
    -

    Reporting group title
    Gevokizumab 10mg
    Reporting group description
    -

    Reporting group title
    Gevokizumab 30mg
    Reporting group description
    -

    Reporting group title
    Gevokizumab 60mg
    Reporting group description
    -

    Reporting group title
    Placebo
    Reporting group description
    -

    Serious adverse events
    Gevokizumab 3mg Gevokizumab 10mg Gevokizumab 30mg Gevokizumab 60mg Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 3 (0.00%)
    1 / 3 (33.33%)
    0 / 2 (0.00%)
    0 / 3 (0.00%)
    0 / 3 (0.00%)
         number of deaths (all causes)
    0
    0
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    0
    0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    0 / 3 (0.00%)
    1 / 3 (33.33%)
    0 / 2 (0.00%)
    0 / 3 (0.00%)
    0 / 3 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    Chronic kidney disease
         subjects affected / exposed
    0 / 3 (0.00%)
    1 / 3 (33.33%)
    0 / 2 (0.00%)
    0 / 3 (0.00%)
    0 / 3 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 1%
    Non-serious adverse events
    Gevokizumab 3mg Gevokizumab 10mg Gevokizumab 30mg Gevokizumab 60mg Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    1 / 3 (33.33%)
    2 / 3 (66.67%)
    1 / 2 (50.00%)
    2 / 3 (66.67%)
    1 / 3 (33.33%)
    Investigations
    Blood creatinine increased
         subjects affected / exposed
    1 / 3 (33.33%)
    0 / 3 (0.00%)
    0 / 2 (0.00%)
    0 / 3 (0.00%)
    0 / 3 (0.00%)
         occurrences all number
    1
    0
    0
    0
    0
    Serum ferritin decreased
         subjects affected / exposed
    1 / 3 (33.33%)
    0 / 3 (0.00%)
    0 / 2 (0.00%)
    0 / 3 (0.00%)
    0 / 3 (0.00%)
         occurrences all number
    1
    0
    0
    0
    0
    Injury, poisoning and procedural complications
    Animal scratch
         subjects affected / exposed
    0 / 3 (0.00%)
    0 / 3 (0.00%)
    1 / 2 (50.00%)
    0 / 3 (0.00%)
    0 / 3 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    Contusion
         subjects affected / exposed
    0 / 3 (0.00%)
    0 / 3 (0.00%)
    1 / 2 (50.00%)
    0 / 3 (0.00%)
    0 / 3 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    Vascular disorders
    Orthostatic hypotension
         subjects affected / exposed
    1 / 3 (33.33%)
    0 / 3 (0.00%)
    0 / 2 (0.00%)
    0 / 3 (0.00%)
    0 / 3 (0.00%)
         occurrences all number
    1
    0
    0
    0
    0
    General disorders and administration site conditions
    Injection site pain
         subjects affected / exposed
    1 / 3 (33.33%)
    0 / 3 (0.00%)
    0 / 2 (0.00%)
    0 / 3 (0.00%)
    0 / 3 (0.00%)
         occurrences all number
    1
    0
    0
    0
    0
    Vessel puncture site haemorrhage
         subjects affected / exposed
    1 / 3 (33.33%)
    0 / 3 (0.00%)
    0 / 2 (0.00%)
    0 / 3 (0.00%)
    0 / 3 (0.00%)
         occurrences all number
    1
    0
    0
    0
    0
    Malaise
         subjects affected / exposed
    0 / 3 (0.00%)
    0 / 3 (0.00%)
    1 / 2 (50.00%)
    0 / 3 (0.00%)
    0 / 3 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    Injection site pruritus
         subjects affected / exposed
    1 / 3 (33.33%)
    0 / 3 (0.00%)
    0 / 2 (0.00%)
    0 / 3 (0.00%)
    0 / 3 (0.00%)
         occurrences all number
    1
    0
    0
    0
    0
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    0 / 3 (0.00%)
    2 / 3 (66.67%)
    1 / 2 (50.00%)
    0 / 3 (0.00%)
    0 / 3 (0.00%)
         occurrences all number
    0
    2
    2
    0
    0
    Umbilical hernia
         subjects affected / exposed
    1 / 3 (33.33%)
    0 / 3 (0.00%)
    0 / 2 (0.00%)
    0 / 3 (0.00%)
    0 / 3 (0.00%)
         occurrences all number
    1
    0
    0
    0
    0
    Skin and subcutaneous tissue disorders
    Onychoclasis
         subjects affected / exposed
    0 / 3 (0.00%)
    0 / 3 (0.00%)
    1 / 2 (50.00%)
    0 / 3 (0.00%)
    0 / 3 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    Urticaria
         subjects affected / exposed
    0 / 3 (0.00%)
    0 / 3 (0.00%)
    0 / 2 (0.00%)
    1 / 3 (33.33%)
    0 / 3 (0.00%)
         occurrences all number
    0
    0
    0
    1
    0
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    0 / 3 (0.00%)
    0 / 3 (0.00%)
    0 / 2 (0.00%)
    0 / 3 (0.00%)
    1 / 3 (33.33%)
         occurrences all number
    0
    0
    0
    0
    1
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    0 / 3 (0.00%)
    0 / 3 (0.00%)
    0 / 2 (0.00%)
    1 / 3 (33.33%)
    1 / 3 (33.33%)
         occurrences all number
    0
    0
    0
    1
    2
    Urinary tract infection
         subjects affected / exposed
    0 / 3 (0.00%)
    1 / 3 (33.33%)
    0 / 2 (0.00%)
    0 / 3 (0.00%)
    0 / 3 (0.00%)
         occurrences all number
    0
    1
    0
    0
    0
    Metabolism and nutrition disorders
    Type 2 diabetes mellitus
         subjects affected / exposed
    0 / 3 (0.00%)
    1 / 3 (33.33%)
    0 / 2 (0.00%)
    0 / 3 (0.00%)
    0 / 3 (0.00%)
         occurrences all number
    0
    1
    0
    0
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    25 Jun 2015
    Concerned all centres in all countries. Main changes were the following: - Modification of Diet in renal Disease (MDRD) equation noted in the protocol was replaced. - Modification of total amount of blood volume withdrawn over the study (maximum blood volume to be sampled per visit: initially 65 mL brought to 89 mL). - Urinary Albumin/Creatinine Ratio (UACR) conversion factor was updated: 300 mg/g was to be equivalent to 34 mg/mmol, instead of 30 mg/mmol. - Regarding incl/sel criterion and allowed prior/concomitant medications, the Amendment clarified that anti-hyperglycemic medication taken by patients should be at a stable dose for at least 6 weeks prior to selection visit. - The protocol mentionned that ophthalmological examination assessed by fundal examination was to be performed by an ophthalmologist. Following this Amendment it was not required that fundal examinations are to be performed by ophthalmologists only. - At selection (ASS2) visit, new or worsened clinically significant abnormalities noticed during the physical examination should be reported in Medical History instead of being reported as adverse events. - A Section related to "Dialysis during the course of the study" was added in the study protocol for patients suffering from acute kidney injury (AKI) and for patients reaching end-stage renal disease (ESRD) suffering from progressive GFR decline. In addtion, the premature discontinuation criteria were updated accordingly.

    Interruptions (globally)

    Were there any global interruptions to the trial? Yes
    Date
    Interruption
    Restart date
    22 Sep 2015
    The study was prematurely discontinued due to a strategic decision unrelated to the safety
    -

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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