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Polycystic Kidney, Autosomal DominantPhase 2TAMENCT02656017

Metformin as a Novel Therapy for Autosomal Dominant Polycystic Kidney Disease

A Phase 2 study testing Metformin in people with Polycystic Kidney, Autosomal Dominant, run by Kyongtae Ty Bae, M.D., Ph.D. at 2 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This study will test to see if metformin is safe and if it is tolerated compared to placebo in adult Autosomal Dominant Polycystic Kidney Disease (ADPKD) patients with beginning stages of chronic kidney disease. Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
Polycystic Kidney, Autosomal Dominant
What is being tested?
Metformin
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
97 participants
Where
2 sitesUnited States
Study dates
27 Jun 2016to 7 Dec 2020
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Subject has Autosomal Dominant Polycystic Kidney Disease; Subject is fluent in English

Who cannot join

  • Subject is not on active military duty; Subject is not currently participating in another clinical trial; Subject's current GFR is not <50 cc/min/1.73m2; Subject does not have diabetes; Subject does not have a systemic disease other than hypertension and PKD; Subject does not have a solitary kidney; Subject does not have an allergy or intolerance to metformin; Subject is not pregnant or lactating or intending to become pregnant within the next three years; Subject does not have an unstable or unclipped cerebral aneurysm; Subject does not have active coronary artery disease; Subject does not have an MRI incompatible device/implant; Subject does not have severe claustrophobia; Subject has not had any solid organ transplant; Subject does not have a Vitamin B12 deficiency; Subject does not currently take any medications that interact with metformin, such as nifedipine, furosemide, cationic drugs (amiloride, ranitidine, triamterene digoxin, procainamide, quinidine, vancomycin, trimethoprim); Subject does not currently take nor has taken (within 2 weeks) the drug tolvaptan (Jynarque or Samsca)

Trial locations and contacts

2 sites in 1 country.

United States2 sites
  • University of Maryland Medical Center

    Baltimore, Maryland, 21201

  • Tufts Medical Center

    Boston, Massachusetts, 02111

Other trials in United States

About this study

This study will test to see if metformin is safe and if it is tolerated compared to placebo in adult Autosomal Dominant Polycystic Kidney Disease (ADPKD) patients with beginning stages of chronic kidney disease. We will also measure its effect on progression of kidney disease as reflected in the kidney size and the kidney function, along with its effect on kidney pain and quality of life.

Read the detailed description

There is growing evidence that metformin, a drug widely used for the treatment of type 2 diabetes and polycystic ovary syndrome, may serve as a novel therapy for individuals in the early stages of Autosomal Dominant Polycystic Kidney Disease ADPKD by activating the metabolic sensor AMP-activated protein kinase (AMPK). AMPK is activated under conditions of metabolic and other cellular stresses. Through its actions on downstream mediators, AMPK activation during low energy states decreases cellular energy consumption while stimulating energy generating pathways. It has been shown that AMPK phosphorylates and inhibits cystic fibrosis transmembrane conductance regulator (CFTR), thus suppressing epithelial fluid and electrolyte secretion. Similarly, AMPK phosphorylates the tuberin protein, leading to indirect inhibition of the mTOR pathway. Thus, AMPK inhibits both CFTR and mTOR, suggesting that targeted activation of this kinase by metformin may provide a therapeutic benefit in ADPKD. It has been shown that metformin treatment of kidney epithelial cells leads to stimulation of AMPK and subsequent inhibition of both mTOR and CFTR activity. It has also been shown that metformin slows cystogenesis in animal models of PKD, supporting the potential of this drug in ADPKD treatment.

Being tested
Metformin, Placebo
Keywords
kidney disease, polycystic kidney disease, autosomal dominant kidney disease, kidney cysts, PKD
Medical subject headings
Polycystic Kidney, Autosomal Dominant, Kidney Diseases, Polycystic Kidney Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • MetforminDrug

    Also called Glucophage, Metformin hydrochloride

    Monitoring of tolerability and symptoms.

  • PlaceboOther

    Monitoring of tolerability and symptoms.

Study groups in NCT02656017
Study groupRoleWhat they receive
MetforminExperimentalParticipants will be started on 500 mg of metformin once daily, with the following scheduled dose titrations: * Increase to 500mg twice daily at week 2 * Increase to 1000mg qAM, 500mg qPM at week 4 * Increase to 1000mg twice daily at week 6 for the duration of their participation (26 months). * Increased titrations based on tolerability
Receives: Drug: Metformin
PlaceboPlacebo comparatorParticipants will be started on 500 mg of placebo once daily, with the following scheduled dose titrations: * Increase to 500mg twice daily at week 2 * Increase to 1000mg qAM, 500mg qPM at week 4 * Increase to 1000mg twice daily at week 6 for the duration of their participation (26 months). * Increased titrations based on tolerability
Receives: Other: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in the Gastrointestinal Symptoms Rating Scale (GSRS) to 24 Months

    GSRS is a widely used, validated 15-item questionnaire used to assess GI symptom burden (minimum, maximum: 1, 7, where higher mean score is worse outcome).

    Mean change to 24 months, estimated with a repeated measures analysis (baseline, 2 weeks, 6 weeks, 1 month, 3 months and every 3 months thereafter to 24 months) using a linear mixed model.

    Measured: Baseline, 2 weeks, 6 weeks, 1 month, 3 months and every 3 months thereafter to 24 months

  2. Drug Tolerability

    Tolerability was based on the first visit a participant responded no to the following question "Can you tolerate this dose of study drug the rest of your life?", which was asked at baseline, 2 weeks, 6 weeks, 1 month, 3 months and every 3 months thereafter to 24 months.

    Measured: Baseline, 2 weeks, 6 weeks, 1 month, 3 months and every 3 months thereafter to 24 months

  3. Rate of Serious Adverse Events (SAE)

    Serious adverse events (SAE) occurring from the time a participant signs the informed consent (at the screening visit) until the end of the study, meeting 1 or more of the criteria of: 1) Resulting in death, 2) Non-elective hospitalization, 3) Life threatening (if patient continued on study drug would result in death), 4) Harming or disabling persistently or permanently , 5) Exceeding the nature, severity or frequency of risk described in the protocol or 6) Resulting in congenital anomaly.

    Measured: 26 months

Secondary outcomes (11)
  1. Quality of Life Physical Component

    Short Form-36 Quality of Life Physical Component Summary (SF-36 PCS) ranges from 0 (worst possible outcome) to 100 (best possible outcome).

    Mean change to 24 months, estimated with a repeated measures analysis (baseline, 1 month, 3 months and every 3 months thereafter to 24 months) using a linear mixed model.

    Measured: Baseline, 1 month, 3 months and every 3 months thereafter to 24 months

  2. Quality of Life Mental Component

    Short Form-36 Quality of Life Mental Component Summary (SF-36 MCS) ranges from 0 (worst possible outcome) to 100 (best possible outcome).

    Mean change to 24 months, estimated with a repeated measures analysis (baseline, 1 month, 3 months and every 3 months thereafter to 24 months) using a linear mixed model.

    Measured: Baseline, 1 month, 3 months and every 3 months thereafter to 24 months

  3. Back Pain Frequency Over the Past 3 Months Since Last Visit

    Odds ratio (OR) per month of back pain Often, Usually, or Always (vs. Never, Rarely, Sometimes) estimated with a repeated measures analysis (baseline, 1 month, 3 months and every 3 months thereafter to 24 months) using a generalized linear mixed model.

    Measured: Baseline, 1 month, 3 months and every 3 months thereafter to 24 months

  4. Estimated Glomerular Filtration Rate (eGFR)

    Mean change to 24 months, estimated with a repeated measures analysis (baseline, 2 weeks, 6 weeks, 1 month, 3 months and every 3 months thereafter to 24 months) using a linear mixed model.

    Measured: Baseline, 2 weeks, and 6 weeks, 1 month, 3 months and every 3 months thereafter to 24 months

  5. Total Kidney Volume From Magnetic Resonance Imaging

    Annual percent change of height adjusted and natural log transformed total kidney volume [ln(htTKV)] was estimated with a linear mixed model.

    Measured: Baseline, 6 months, 12 months, 18 months, 24 months

  6. Total Kidney Cyst Volume From Magnetic Resonance Imaging

    Annual percent change of height adjusted and natural log transformed total kidney cyst volume [ln(htTKCV)] was estimated with a linear mixed model.

    Measured: Baseline, 6 months, 12 months, 18 months, 24 months

  7. Liver Volume From Magnetic Resonance Imaging

    Annual percent change of height adjusted and natural log transformed liver volume [ln(htLV)] was estimated with a linear mixed model.

    Measured: Baseline, 6 months, 12 months, 18 months, 24 months

  8. Liver Cyst Volume From Magnetic Resonance Imaging

    Annual percent change of height adjusted and natural log transformed liver cyst volume [ln(htLCV)] was estimated with a linear mixed model.

    Measured: Baseline, 6 months, 12 months, 18 months, 24 months

  9. Frequency Abdominal Fullness Interfered With Ability to Perform Usual Physical Activity Over the Past 3 Months Since Last Visit.

    Odds ratio (OR) per month of abdominal fullness interfered Often, Usually, or Always (vs. Never, Rarely, Sometimes) estimated with a repeated measures analysis (baseline, 1 month, 3 months and every 3 months thereafter to 24 months) using a generalized linear mixed model.

    Measured: Baseline, 1 month, 3 months and every 3 months thereafter to 24 months

  10. Interference of Pain With Sleep Over the Past 3 Months Since Last Visit

    Odds ratio (OR) per month of pain interfered with sleep Quite a bit or Extremely (vs. Not at all, A little bit, Moderately) estimated with a repeated measures analysis (baseline, 1 month, 3 months and every 3 months thereafter to 24 months) using a generalized linear mixed model.

    Measured: Baseline, 1 month, 3 months and every 3 months thereafter to 24 months

  11. Interference of Pain With Strenuous Physical Activity Over the Past 3 Months Since Last Visit

    Odds ratio (OR) per month of pain interfered with strenuous physical activity Quite a bit or Extremely (vs. Not at all, A little bit, Moderately) estimated with a repeated measures analysis (baseline, 1 month, 3 months and every 3 months thereafter to 24 months) using a generalized linear mixed model.

    Measured: Baseline, 1 month, 3 months and every 3 months thereafter to 24 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Jan 2016 (estimated)
  2. Study start27 Jun 2016
  3. Primary completion7 Dec 2020
  4. Study completion7 Dec 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
97 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02656017
Sponsor's protocol ID
PRO15060422
Other IDs
CDMRP-PR141606
Acronym
TAME
Status last verified
Aug 2022
First submitted
23 Dec 2015
Last updated
9 Aug 2022
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • St Pierre K, Cashmore BA, Bolignano D, Zoccali C, Ruospo M, Craig JC, Strippoli GF, Mallett AJ, Green SC, Tunnicliffe DJ. Interventions for preventing the progression of autosomal dominant polycystic kidney disease. Cochrane Database Syst Rev. 2024 Oct 2;10(10):CD010294. doi: 10.1002/14651858.CD010294.pub3.

    PubMed 39356039
  • El-Damanawi R, Stanley IK, Staatz C, Pascoe EM, Craig JC, Johnson DW, Mallett AJ, Hawley CM, Milanzi E, Hiemstra TF, Viecelli AK. Metformin for preventing the progression of chronic kidney disease. Cochrane Database Syst Rev. 2024 Jun 4;6(6):CD013414. doi: 10.1002/14651858.CD013414.pub2.

    PubMed 38837240
  • Seliger SL, Watnick T, Althouse AD, Perrone RD, Abebe KZ, Hallows KR, Miskulin DC, Bae KT. Baseline Characteristics and Patient-Reported Outcomes of ADPKD Patients in the Multicenter TAME-PKD Clinical Trial. Kidney360. 2020 Dec 31;1(12):1363-1372. doi: 10.34067/KID.0004002020.

    PubMed 33768205

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Metformin in people with Polycystic Kidney, Autosomal Dominant, run by Kyongtae Ty Bae, M.D., Ph.D. at 2 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 9 Aug 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 9 Aug 2022). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in the Gastrointestinal Symptoms Rating Scale (GSRS) to 24 Months (time frame: Baseline, 2 weeks, 6 weeks, 1 month, 3 months and every 3 months thereafter to 24 months). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02656017, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Aug 2022.

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