E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Chronic kidney disease in type 2 diabetes mellitus |
Enfermedad renal crónica en diabetes mellitus de tipo 2 |
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E.1.1.1 | Medical condition in easily understood language |
Chronic kidney disease, a long-term progressive decrease in the kidneys' ability to work properly, and type 2 diabetes, a condition characterized by high blood sugar levels |
Enfermedad renal crónica,disminución progresiva a largo plazo de la capacidad de los riñones para funcionar correctamente;diabetes tipo 2,enfermedad caracterizada por altos niveles de azúcar en sangre |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cardiovascular Diseases [C14] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10045250 |
E.1.2 | Term | Type II diabetes mellitus with renal manifestations |
E.1.2 | System Organ Class | 100000004857 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective is to demonstrate that combination therapy using finerenone and empagliflozin is superior in reducing UACR than either empagliflozin or finerenone alone |
El objetivo principal es demostrar que el tratamiento combinado con finerenona y empagliflozina es mejor en cuanto a la reducción del CACo que la empagliflozina o la finerenona solas |
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E.2.2 | Secondary objectives of the trial |
The secondary outcomes are: - To further investigate the efficacy of combination therapy using finerenone and empagliflozin versus either finerenone or empagliflozin alone. - To evaluate the safety of combination therapy using finerenone and empagliflozin versus either finerenone or empagliflozin alone. |
Los objetivos secundarios son: - Investigar más a fondo la eficacia del tratamiento combinado con finerenona y empagliflozina frente a finerenona o empagliflozina solas. - Evaluar la seguridad del tratamiento combinado con finerenona y empagliflozina frente a finerenona o empagliflozina solas. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Participant with a clinical diagnosis of chronic kidney disease (CKD) and the following: a. In Part A: eGFR 40-90 ml/min/1.73m^2 (with no more than 20% having an eGFR >75 ml/min/1.73m^2) using Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) formula at screening visit and at least one historical value of eGFR <60 mL/min/1.73 m^2 within 3 months or have a registered diagnosis of CKD. b. In Part B: eGFR 30-90 ml/min/1.73m^2 (with no more than 20% having an eGFR >75 ml/min/1.73m^2) using CKD-EPI formula at screening visit and at least one historical value of eGFR <60 mL/min/1.73 m^2 within 3 months or have a registered diagnostic of CKD. c. 300 ≤UACR <5000 mg/g at screening visit (mean value from 3 morning void samples) and documentation of albuminuria/proteinuria (quantitative or semi-quantitative measurement) in the participant's medical records at least 3 months prior to screening. 2. Participant with type 2 diabetes (T2D) as defined by the American Diabetes Association (ADA 2021), with glycated hemoglobin (HbA1c) at screening <11%. 3. Participant treated with the clinically maximum tolerated dose, as per investigator judgment, of angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB), but not both, for more than 1 month at screening visit.
Please refer to the protocol for a full list of inclusion criteria |
1.Participante con diagnóstico clínico de ERC y lo siguiente: a.En la parte A: TFGe 40-90 ml/min/1,73 m2 (con un valor máximo del 20 % en la TFGe >75 ml/min/1,73 m2) utilizando la fórmula de colaboración de epidemiología de insuficiencia renal crónica (Chronic Kidney Disease Epidemiology Collaboration, CKD-EPI) en la visita de selección y al menos un valor histórico de TFGe <60 ml/min/1,73 m2 en el plazo de 3 meses o tener un diagnóstico registrado de ERC. b.En la parte B: TFGe 30-90 ml/min/1,73 m2 (con un valor máximo del 20 % en la TFGe >75 ml/min/1,73 m2) utilizando la fórmula CKD-EPI en la visita de selección y al menos un valor histórico de TFGe <60 ml/min/1,73 m2 en el plazo de 3 meses o tener un diagnóstico registrado de ERC. c.300 ≤UACR <5000 mg/g en la visita de selección (valor medio de 3 muestras de micción matutinas) y documentación de albuminuria/proteinuria (medición cuantitativa o semicuantitativa) en la historia clínica del participante al menos 3 meses antes de la selección. 2.Participante con DT2 definida por la ADA, con hemoglobina glicada (HbA1c) en la selección <11 %. Nota: Los valores históricos de HbA1c serán aceptables para la inclusión siempre que se hayan obtenido en los 3 meses anteriores a la visita de selección. 3.Participante tratado con la dosis máxima tolerable clínicamente, según el criterio del investigador, de IECA o BRA, pero no ambos, durante más de 1 mes en la visita de selección.
Para más información consultar la lista completa de los criterios de inclusión |
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E.4 | Principal exclusion criteria |
1. Participants with type 1 diabetes (T1D). 2. Participant with hepatic insufficiency classified as Child-Pugh C. 3. Participant with blood pressure at Day 1 visit higher than 160/100 or systolic blood pressure lower than 90 mmHg. 4. Participant currently treated with a sodium/glucose cotransporter-2 inhibitor (SGLT2i) or SGLT-1/2i or who received a SGLT2i or SGLT-1/2i which cannot be discontinued at least 8 weeks prior to the screening visit and during study intervention treatment. 5. Participant treated with another mineralocorticoid receptor antagonist (MRA) (e.g., eplerenone, esaxerenone, spironolactone, canrenone), a renin inhibitor, potassium supplements, a potassium sparing diuretic (e.g., amiloride, triamterene), a potassium binder agent, or angiotensin receptor-neprilysin inhibitor (ARNI) which cannot be discontinued at least 8 weeks prior to the screening visit and during study intervention treatment. 6. Participants currently treated or who were treated with Finerenone (Kerendia©) within 8 weeks prior to the screening visit. 7. Participant with serum/plasma potassium (K+) above 4.8 mmol/L at screening.
Please refer to the protocol for a full list of exclusion criteria |
1.Participantes con diabetes tipo 1 (DT1). 2.Participante con insuficiencia hepática clasificada como Child-Pugh C. 3.Participante con PA en la visita del día 1 superior a 160/100 o PAS inferior a 90 mm Hg. 4.Participante tratado actualmente con un SGLT2i o un inhibidor combinado de SGLT-1 y 2 (SGLT-1/2i) o que recibió un SGLT2i o un SGLT-1/2i que no se puede interrumpir al menos 8 semanas antes de la visita de selección y durante el tratamiento de intervención del estudio. 5.Participante tratado con otro ARM (p. ej., eplerenona, esaxerenona, espironolactona, canrenona), un inhibidor de la renina, suplementos de K+, un diurético ahorrador de K+ (p. ej., amilorida, triamtereno), un quelante de K+ o un inhibidor del receptor de angiotensina-neprilisina (IRAN) en las 8 semanas anteriores a la visita de selección y durante el tratamiento. 6.Participantes tratados actualmente o que fueron tratados con finerenona (Kerendia®) en las 8 semanas anteriores a la visita de selección. 7.Participante con K+ superior a 4,8 mmol/l en la visita de selección.
Para más información consultar la lista completa de los criterios de exclusión |
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E.5 End points |
E.5.1 | Primary end point(s) |
1. Mean ratio of change from baseline to Day 180 in Urinary albumin tocreatinine ratio (UACR) for the combination therapy group, to empagliflozin alone 2. Mean ratio of change from baseline to Day 180 in UACR for the combination therapy group, to finerenone alone. |
1.Cociente medio del cambio desde el inicio hasta el día 180 en el CACo para el grupo de tratamiento combinado, en comparación con la empagliflozina sola 2.Cociente medio del cambio desde el inicio hasta el día 180 en el CACo para el grupo de tratamiento combinado, en comparación con la finerenona sola |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Up to 180 Days |
Hasta 180 días |
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E.5.2 | Secondary end point(s) |
1.Relative change in UACR between end of treatment visit and 30 days after end of treatment visit 2.Relative change in UACR between 30 days after end of treatment visit and baseline 3.Relative change in UACR category (>30%, >40%, >50%) at 180 days 4.Ratio of change from baseline in eGFR at 30 days 5.eGFR decline greater than 30% at 30 days from baseline 6.Ratio of change in eGFR at 180 days and 210 days from day 30 7.Number of participants with of AKI events 8.Total number of AKI events 9.Number of participants with hyperkalemia events (moderate hyperkalemia [5.5 <K+ ≤6.0 mol/L], severe hyperkalemia [K+ >6.0 mmol/L]) 10.Total number of hyperkalemia events (moderate hyperkalemia [5.5 <K+ ≤6.0 mmol/L], severe hyperkalemia [K+ >6.0 mmol/L])
Please refer to the protocol for a full list of secondary end points |
1.Cambio relativo en el CACo entre la visita de final del tratamiento y 30 días después de la visita de final del tratamiento 2.Cambio relativo en el CACo entre 30 días después de la visita de final del tratamiento y el inicio 3.Cambio relativo en la categoría del CACo (>30 %, >40 %, >50 %) a los 180 días 4.Cociente del cambio desde el inicio en la TFGe a los 30 días 5.Disminución de la TFGe superior al 30 % a los 30 días con respecto al inicio 6.Cociente del cambio en la TFGe a los 180 días y a los 210 días desde el día 30 7.Número de participantes con acontecimientos de LRA 8.Número total de acontecimientos de LRA 9.Número de participantes con acontecimientos de hiperpotasemia (hiperpotasemia moderada [5,5 <K+ ≤6,0 mmol/l], hiperpotasemia grave [K+ >6,0 mmol/l]) 10.Número total de acontecimientos de hiperpotasemia (hiperpotasemia moderada [5,5 <K+ ≤6,0 mmol/l], hiperpotasemia grave [K+ >6,0 mmol/l])
Para más información consultar la lista completa de los criterios de valoración secundarios |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1. Up to 210 days 2. Up to 210 days 3. Up to 180 days 4. Up t0 30 days 5. Up to 30 days 6. Up to 210 days 7. to 23. Up to 180 days |
1. Hasta 210 días 2. Hasta 210 días 3. Hasta 180 días 4. Hasta 30 días 5. Hasta 30 días 6. Hasta 210 días 7. Desde 23 hasta 180 días |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 3 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 9 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 50 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Belgium |
Canada |
Denmark |
France |
Germany |
Israel |
Italy |
Japan |
Korea, Republic of |
Netherlands |
Spain |
Taiwan |
United States |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 5 |
E.8.9.1 | In the Member State concerned days | 14 |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 7 |
E.8.9.2 | In all countries concerned by the trial days | 15 |