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Autosomal Dominant Polycystic KidneyPhase 2NCT06582875

Glucagon-Like Peptide-1 Receptor Agonist in ADPKD

A Phase 2 study testing Tirzepatide in people with Autosomal Dominant Polycystic Kidney and Obesity, run by University of Colorado, Denver at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The proposed clinical trial aims to assess if a year of treatment with a glucagon-like peptide 1 receptor agonist, a medication approved for weight management that also improves the body's response to glucose and insulin, can slow kidney growth in adults with autosomal dominant polycystic kidney disease who are… Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Autosomal Dominant Polycystic Kidney, Obesity
What is being tested?
Tirzepatide
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
126 participants
Where
1 siteUnited States
Study dates
6 Mar 2025to 30 Jun 2029
Phase
Phase 2
Are there results?
Not yet: the study is under way

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 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 18-65 years of age
  • ADPKD diagnosis based on the modified Pei-Ravine criteria
  • Body-mass index of ≥27 kg/m^2
  • Estimated glomerular filtration rate ≥ 30 mL/min/1.73m^2
  • Mayo Classification of C, D, or E, calculated from a previous kidney ultrasound or MRI performed within the last 12 months
  • Not currently participating in or planning to participate in any formal weight loss or physical activity program, or another interventional study
  • Ability to provide informed consent

Who cannot join

  • Diabetes mellitus
  • Tolvaptan usage or plans to initiate tolvaptan
  • History of hospitalization or major surgery within the last 3 months
  • Uncontrolled hypertension (systolic blood pressure > 160 or diastolic blood pressure >100 mm Hg)
  • Pregnancy, lactation, or unwillingness to use adequate birth control
  • Regular use of prescription or over-the-counter medications that may affect weight, appetite, food intake, or energy metabolism
Show all 13Show fewer
  • History of clinically diagnosed eating disorder including: anorexia nervosa, bulimia, binge eating disorder
  • Weight change of >5% in the past 3 months for any reason except post-partum weight loss
  • Inability to cooperate with or clinical contraindication for MRI including: severe claustrophobia, implants, devices, or non-removable body piercings
  • Presence or personal history of malignant neoplasm within 5 years prior to the day of screening
  • Personal or family history of medullary thyroid carcinoma, thyroid nodule, or multiple endocrine neoplasia type 2
  • Prior history of pancreatitis
  • Weight ≥450 lb

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

United States1 site, 1 recruiting
  • University of Colorado - Anschutz Medical Campus

    Aurora, Colorado, 80045

    Kristen Nowak, PhD, MPH, 303-724-4842, Kristen.Nowak@cuanschutz.edu

    Kristen Nowak, PhD, MPH

    Recruiting

Other trials in United States

About this study

Official title: Advancing ADPKD Treatment With GLP-1RA: A Study of Glucagon-Like Peptide-1 Receptor Agonists' Efficacy, Safety, and Mechanism

The proposed clinical trial aims to assess if a year of treatment with a glucagon-like peptide 1 receptor agonist, a medication approved for weight management that also improves the body's response to glucose and insulin, can slow kidney growth in adults with autosomal dominant polycystic kidney disease who are overweight or obese. The study will also evaluate changes in abdominal fat and kidney metabolism using cutting-edge images techniques. Blood and urine samples will provide further insight into biological changes that may be linked to the benefits of the intervention, while ensuring careful monitoring of safety and tolerability.

Read the detailed description

Autosomal dominant polycystic kidney disease (ADPKD) is a common inherited disorder that leads to kidney failure. The only approved treatment to decelerate kidney disease progression in patients with ADPKD is tolvaptan, but its usage is limited due to frequent side effects affecting adherence. Thus, alternative interventions that may slow ADPKD progression hold considerable clinical importance. In line with the general population, body-mass index and insulin resistance have been increasing in patients with ADPKD. The investigators have shown that visceral adiposity associates strongly with accelerated progression of early-stage ADPKD. Pilot study suggested that diet-induced weight loss may slow kidney growth (% in height-adjusted total kidney volume [htTKV] by magnetic resonance imaging), and the study team is currently evaluating the efficacy of daily caloric restriction-induced weight loss for slowing ADPKD progression in a phase IIa clinical trial. However, the long-term adherence to lifestyle interventions is challenging, making pharmacological interventions a compelling adjunct or alternative. Moreover, the study team recently demonstrated that adults with ADPKD and preserved kidney function exhibited insulin resistance (via the gold-standard hyperinsulinemic-euglycemic clamps) and impaired kidney oxidative metabolism (via 11C-acetate PET), which were strongly associated with htTKV. These novel data suggest that targeting improvements in insulin sensitivity and kidney oxidative metabolism, in addition to weight loss, may slow ADPKD progression. Glucagon-like peptide 1 receptor agonists (GLP-1RAs) were recently FDA-approved for the treatment of obesity and show promise in substantially reducing adiposity and improving insulin sensitivity. Additionally, evidence indicates that GLP-1RAs may transform CKD management by reducing kidney events in patients with and without diabetes, via effects extending beyond glycemic modulation, and in part via attenuated kidney inflammation and oxidative stress. However, GLP-1RAs have not yet been evaluated as a novel therapy for slowing ADPKD progression in patients with overweight/obesity. Thus, the current study is a 12-month, phase II, randomized, placebo-controlled, double-blind clinical trial using a GLP-1RA in 126 adults with ADPKD and overweight or obesity to slow kidney growth (primary outcome). The trial will also evaluate changes in total body weight, adipose volume and function, insulin resistance, kidney oxidative metabolism, and inflammation, and carefully monitor safety and tolerability. As a novel therapeutic in ADPKD, GLP-1RAs could transform the treatment landscape for patients.

Being tested
Tirzepatide, Placebo
Keywords
GLP1RA
Medical subject headings
Polycystic Kidney, Autosomal Dominant, Obesity

What participants receive

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

  • TirzepatideDrug

    Also called Zepbound

    Titrated to dose of 5 mg once weekly subcutaneous

  • PlaceboOther

    Titrated to dose of 5 mg once weekly subcutaneous

Study groups in NCT06582875
Study groupRoleWhat they receive
TirzepatideExperimentalTo minimize the risk of gastrointestinal adverse events, we will use a standard dose-escalation regimen for tirzepatide (placebo-matched), starting at 2.5 mg once weekly (OW) at randomization. After 4 weeks of treatment at 2.5 mg, the dose will be escalated to 5 mg OW, which will be maintained for another 4 weeks and then continued as the target dose for 10 months until the end of treatment. As with other nutrient stimulating hormone (NuSH) therapies, dose reductions and extensions of dose-escalation intervals will be permitted if participants experience unacceptable adverse events. The minimum tolerated dose required for continued study participation is 2.5 mg/week. All dose changes will be documented in the study records.
Receives: Drug: Tirzepatide
PlaceboPlacebo comparatorTo minimize the risk of gastrointestinal adverse events, we will use a standard dose-escalation regimen for tirzepatide (placebo-matched), starting at 2.5 mg once weekly (OW) at randomization. After 4 weeks of treatment at 2.5 mg, the dose will be escalated to 5 mg OW, which will be maintained for another 4 weeks and then continued as the target dose for 10 months until the end of treatment. As with other nutrient stimulating hormone (NuSH) therapies, dose reductions and extensions of dose-escalation intervals will be permitted if participants experience unacceptable adverse events. The minimum tolerated dose required for continued study participation is 2.5 mg/week. All dose changes will be documented in the study records.
Receives: Other: Placebo

What is being measured

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

  1. Change in height-Adjusted Total kidney volume

    To assess kidney growth,height-adjusted total kidney volume will be measured by magnetic resonance imaging at baseline and 12 months to determine annual percent change.

    Measured: Baseline, 12-months

Secondary outcomes (15)
  1. Change in body weight

    Change in body weight over the 12-month period will be measured using a calibrated digital scale.

    Measured: Baseline, 12-months

  2. Change in abdominal adiposity

    Abdominal adiposity (subcutaneous, visceral, and total) will be assessed by magnetic resonance imaging.

    Measured: Baseline, 12-months

  3. Change in adiponectin (circulating)

    Venous blood samples will be analyzed for this mechanistic biomarker

    Measured: Baseline, 6-months, 12-months

  4. Change in leptin (circulating)

    Venous blood samples will be analyzed for this mechanistic biomarker

    Measured: Baseline, 6-months, 12-months

  5. Change in interleukin-6 (circulating)

    Venous blood samples will be analyzed for this mechanistic biomarker

    Measured: Baseline, 6-months, 12-months

  6. Change in tumor necrosis-factor-alpha (circulating)

    Venous blood samples will be analyzed for this mechanistic biomarker

    Measured: Baseline, 6-months, 12-months

  7. Change in high-sensitivity C-reactive protein (circulating)

    Venous blood samples will be analyzed for this mechanistic biomarker

    Measured: Baseline, 6-months, 12-months

  8. Change in 8-isoprostane (circulating)

    Venous blood samples will be analyzed for this mechanistic biomarker

    Measured: Baseline, 6-months, 12-months

  9. Change in copeptin (circulating)

    Venous blood samples will be analyzed for this mechanistic biomarker

    Measured: Baseline, 6-months, 12-months

  10. Change in HOMA-IR

    The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) will use fasting glucose and insulin to calcuate insulin sensitivity

    Measured: Baseline, 6-months, 12-months

  11. Change in HOMA-β

    The Homeostatic Model Assessment of β-cell function (HOMA-β) will use fasting glucose and insulin to calcuate insulin secretion.

    Measured: Baseline, 6-months, 12-months

  12. Change in 8-isoprostane (urinary)

    Sport urine samples will be analyzed for this mechanistic biomarker

    Measured: Baseline, 6-months, 12-months

  13. Change in copeptin (urinary)

    Sport urine samples will be analyzed for this mechanistic biomarker

    Measured: Baseline, 6-months, 12-months

  14. Change in renal oxygen consumption

    Renal oxygen consumption will be assessed by a PET/CT scan using 11-C acetate in a sub-set of participants

    Measured: Baseline, 12-months

  15. Change in gut microbiota

    16S rRNA gene sequencing will be used for taxonomic characterization of the gut microbiota in a subset of participants.

    Measured: Baseline, 12-months

Timeline

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

  1. First posted3 Sep 2024
  2. Study start6 Mar 2025
  3. Primary completion30 Jun 2029 (estimated)
  4. Study completion30 Jun 2029 (estimated)

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
126 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06582875
Sponsor's protocol ID
24-0594
Other IDs
R01DK138915-01A1
Status last verified
May 2025
First submitted
26 Aug 2024
Last updated
6 May 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Data obtained through this study may be provided to qualified researchers with academic interest in ADPKD. Data shared will be coded, with no PHI included. Approval of the request and execution of all applicable agreements (i.e. data use agreement) are prerequisites to the sharing of data with the requesting party.

Publications

  • Nowak KL, Chonchol M. Cardiovascular-Kidney-Metabolic Syndrome in Autosomal Dominant Polycystic Kidney Disease. J Am Soc Nephrol. 2026 Sep 25. doi: 10.1681/ASN.0000001291. Online ahead of print. No abstract available.

    PubMed 42789922
  • Chen CY, Hadla M, Khambati I, Kashyap S, Westerfield V, Fedeles S, Besse W, Hopp K, Harris PC, Patel V, Chini E, Salih M, Barry MA, Chebib FT. Emerging Therapies in Autosomal Dominant Polycystic Kidney Disease. Kidney360. 2026 Jul 1;7(7):1662-1676. doi: 10.34067/KID.0000001109. Epub 2025 Dec 12.

    PubMed 41385299
  • Cortinovis M, Perico N, Remuzzi G. The Need for Novel Therapeutic Directions in Autosomal Dominant Polycystic Kidney Disease Patient Care. Clin J Am Soc Nephrol. 2025 Dec 5. doi: 10.2215/CJN.0000000975. Online ahead of print.

    PubMed 41348481

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Tirzepatide in people with Autosomal Dominant Polycystic Kidney and Obesity, run by University of Colorado, Denver at 1 site 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 7 inclusion and 13 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: looking for participants now, as of the sponsor's last update on 6 May 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Kristen Nowak, PhD, MPH (3037244842, Kristen.Nowak@cuanschutz.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in height-Adjusted Total kidney volume (time frame: Baseline, 12-months). 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 NCT06582875, 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 6 May 2025.

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