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Berger DiseasePhase 3ADVANCENCT07498335

Study to Assess the Efficacy, Pharmacokinetics, Safety and Tolerability of Atrasentan in Pediatric Patients With Primary IgAN

A Phase 3 study testing Drug: Atrasentan in people with Berger Disease and Bergers Disease, run by Novartis Pharmaceuticals at 23 sites in 8 countries.

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

A Phase III, single-arm, multicenter pediatric clinical study evaluating atrasentan in children and adolescents aged 2 to <18 years with primary immunoglobulin A nephropathy (IgAN). Read more about this study

Who is it for?
Ages 2 to 18 years
Conditions the study is for
Berger Disease, Bergers Disease, IgA Nephropathy
What is being tested?
Drug: Atrasentan
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
28 participants
Where
23 sitesin 8 countries
Study dates
6 Aug 2026to 13 Dec 2032
Phase
Phase 3
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 2 to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Signed informed consent by parent(s)/legal guardian(s) for the pediatric patient must be obtained before any study-specific assessment is performed. A consent or assent may also be required for some participants depending upon their age and local requirement.
  • Male and female participants 2 to < 18 years of age as of Day 1.
  • eGFR ≥ 30 mL/min/1.73m2 where eGFR is calculated using the modified Schwartz formula at Screening and confirmed during the Run-in Period.
  • Kidney biopsy-proven primary IgAN*, with biopsy performed within 3 years of Screening with < 50% tubulointerstitial fibrosis and < 25% crescents. In case a kidney biopsy within 3 years from Screening is not available, a kidney biopsy may be performed if it is part of the planned diagnostic approach and clinical management of the participant.
  • Proteinuria due to primary diagnosis of IgAN as assessed by UPCR ≥ 1 g/g (113 mg/mmoL) sampled from FMV at Screening on Day -90 and Day -60 as well as during the Run-in Period despite treatment with maximum tolerated dose of ACE inhibitor/ARB for at least 120 days prior to Day 1. Note: UPCR will be assessed based on one FMV sample at Day -90 and based on the geometric mean of 2 FMV samples for the Day -60 visit and during the Run-in Period.
  • All participants must have been on supportive care including stable dose regimen of ACE inhibitor or ARB at either the locally approved maximal daily dose per body weight, or the maximally tolerated dose (per Investigator's judgment for pediatric use), for at least 120 days before first study drug administration. In addition, if participants are taking diuretics, other antihypertensive medication, or other background medication for IgAN (such as SGLT2 inhibitors), the doses should also be stabilized for at least 120 days prior to the first dosing of study treatment. Note: Participants with allergies or intolerance to ACE inhibitors and ARBs are eligible for the study. Participants with allergies or intolerance to RAS inhibitors are eligible but will not exceed ~5% of the total population treated (maximum of 2 participants).
  • The minimum body weight of enrolled pediatric participants is 10 kg at Screening and confirmed on Day 1.
  • Parent(s)/guardian(s) are to be able to communicate well with the investigator and to understand and comply with the study's requirements for their child.

Who cannot join

  • Participation in any other investigational drug trial or use of other investigational drugs at the time of enrollment, or within 5 elimination half-lives of enrollment, or within 30 days of enrollment, whichever is longer; or longer if required by local regulations.
  • History of hypersensitivity to any of the study drugs or its excipients or to drugs of similar chemical classes.
  • Any secondary IgAN as defined by the investigator; secondary IgAN can be associated with cirrhosis, celiac disease, Human Immunodeficiency Virus (HIV) infection, Herpes Simplex virus infection, dermatitis herpetiformis, seronegative arthritis, small-cell carcinoma, lymphoma, disseminated tuberculosis, bronchiolitis obliterans, inflammatory bowel disease, and familial mediterranean fever before treatment.
  • A clinical diagnosis of IgA vasculitis (IgAV or Henoch-Schoenlein purpura) based on typical palpable purpura with or without arthralgia and abdominal pain.
  • Evidence of significant urinary obstruction or difficulty in voiding, any urinary tract disorder causing significant urinary obstruction or difficulty in voiding at Screening and confirmed at Baseline/Day 1.
  • Concurrent diagnosis of CKD other than IgAN at Screening and before first study drug administration.
Show all 42Show fewer
  • Current acute kidney injury (AKI) defined by Acute Kidney Injury Network (AKIN) criteria within 4 weeks of Screening.
  • Presence of rapidly progressive glomerulonephritis (RPGN) as defined by 50% decline in eGFR within 3 months prior to Screening or during Screening and Run-in periods.
  • Presence of nephrotic syndrome at Screening based on the investigator's judgement.
  • BNP value of >200 pg/mL at Screening.
  • Hemoglobin below 9 g/dL at Screening or prior history of blood transfusion for anemia within 3 months of Screening.
  • Platelet count <80,000/μL at Screening.
  • On Day 1 participants' body weight falls below the lower limit of the cohort in which the participant was initially screened and lower body weight cohort is not open for enrollment.
  • Known history of congenital heart disease, heart failure or clinically significant fluid retention such as pulmonary edema, uncontrolled peripheral edema, pleural effusion, or ascites before treatment.
  • Current use of any homeopathic and/or herbal medications for the treatment of IgAN disease , such as but not limited to Tripterygium wilfordii (Lei Gong Teng), Caulis sinomenii and Sinomenium acutum before treatment.
  • History of an alcohol or illicit drug-related disorder within the past 3 years at Screening.
  • Confirmed blood pressure >150 mmHg systolic or >95 mmHg diastolic for 12 to <18 years of age; >140 mmHg systolic or >90 mmHg diastolic for 6 to <12 years of age; >120 mmHg systolic or >80 mmHg diastolic for 2 to <6 years of age; based on the mean of 3 measurements obtained at Screening; or clinically significant hypotension at screening.
  • Participants previously treated with immunosuppressive or other immunomodulatory agents such as but not limited to cyclophosphamide, rituximab, infliximab, canakinumab, mycophenolate mofetil (MMF) or mycophenolate sodium (MPS), calcineurin inhibitors, complement inhibitors, oral budesonide in any dose, systemic corticosteroid exposure ≥0.5 mg/kg/day or > 7.5 mg total exposure in a single day of prednisone/prednisolone equivalent within 120 days (or 180 days for rituximab) prior to first study drug administration.
  • Participants treated with endothelin (receptor) antagonists (including sparsentan) within 120 days prior to first study drug administration.
  • History of organ transplantation (subjects with history of corneal transplant are not excluded) before treatment.
  • Major concurrent comorbidities before treatment including but not limited to advanced cardiac disease (e.g., NYHA class III (for ages 6 to <18 years), Ross class III (for ages 2 to <6years)), severe pulmonary disease (e.g., WHO class III (for age 17 years); Pulmonary Vascular Research Institute (PVRI) class III (for 2-<17 years)), or hepatic disease (e.g., active hepatitis) that in the opinion of the investigator precludes subject's participation in the study.
  • Any medical condition deemed likely to interfere with the subject's participation in the study before treatment.
  • Active systemic bacterial, viral (including COVID-19) or fungal infection within 14 days prior to study drug administration.
  • Presence of fever ≥ 38°C (100.4°F) within 7 days prior to study drug administration.
  • Human immunodeficiency virus (HIV) infection (known history of HIV or test positive for HIV antibody at Screening).
  • Liver disease, such as active hepatitis B virus (HBV) or hepatitis C virus (HCV) infection defined as Hepatitis B surface antigen (HBsAg) positive or Hepatitis C virus ribonucleic acid (HCV-RNA) positive at Screening, or liver injury as indicated by abnormal liver function tests at Screening and Baseline as defined below:
  • Any single parameter of ALT, AST, GGT, alkaline phosphatase must not exceed 3X upper limit of normal (ULN)
  • Serum bilirubin must not exceed 2X ULN
  • History of malignancy of any organ system (other than localized basal cell carcinoma of the skin or in situ cervical cancer treated with curative intent), treated or untreated, within the past 5 years, regardless of whether there is evidence of local recurrence or metastases; for children aged 2 to <5 years of age, history of malignancy of any organ system (other than localized basal cell carcinoma of the skin or in situ cervical cancer), treated or untreated, inclusive of malignancies diagnosed at birth and during the neonatal and childhood time, regardless of whether there is evidence of local recurrence or metastases.
  • Pregnant or nursing (lactating) female participants (of childbearing potential), where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive human chorionic gonadotropin (hCG) laboratory test at Screening.
  • Subjects taking prohibited therapies before treatment.
  • Women of childbearing potential, defined as all women physiologically capable of becoming pregnant from menarche until becoming post-menopausal, unless they are using highly effective methods of contraception (failure rate < 1% per year) while taking study treatment and for 1 month after stopping study treatment.
  • Highly effective contraception methods include:
  • Total abstinence (when this is in line with the preferred and usual lifestyle of the participant). Note that periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception.
  • Bilateral oophorectomy with or without hysterectomy, total hysterectomy or bilateral salpingectomy at least six weeks before taking study treatment. In case of oophorectomy alone, only when the reproductive status of the woman has been confirmed by follow up hormone level assessment are they considered to be not of childbearing potential.
  • Bilateral tubal occlusion, Bilateral tubal ligation (at least six weeks before taking study treatment).
  • Sterilization (vasectomy) of male partner(s) of the female participant at least 6 months prior to screening provided partner(s) has(have) received medical confirmation of surgical success.
  • Use of hormonal contraception methods:
  • Combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation; oral, intravaginal or transdermal.
  • Progestogen-only hormonal contraception (where inhibition of ovulation is not the primary or only mode of action): oral, injectable or implantable.
  • Intrauterine device (IUD) or intrauterine hormone-releasing system (IUS) In case of use of hormonal contraception, women should have been stable on the same method for a minimum of 3 months before taking study treatment. If local regulations are more stringent than the contraception methods listed above, local regulations apply and will be described in the ICF. 30. For fertile male participants, participants must not intend to father a child or donate sperm while taking study treatment and at least 1 month afterward for males.
  • All fertile male participants in a sexual relationship with a WOCBP must agree to the use of a condom during the trial and for up to one month after last study drug administration. A male participant is considered fertile after puberty unless permanently sterile by bilateral orchidectomy/orchiectomy.

Trial locations and contacts

23 sites in 8 countries. Contact the study team or a site near you to ask about taking part.

Novartis Pharmaceuticals contact

1-888-669-6682

novartis.email@novartis.com

Novartis Pharmaceuticals contact

+41613241111

23 sites in 8 countries

United States4 sites, 4 recruiting
  • Cincinnati Childrens Hospital MC

    Cincinnati, Ohio, 45229

    Not yet recruiting
  • University of Tennessee Health Science Center- Le Bonheur Research Center

    Memphis, Tennessee, 38105

    Not yet recruiting
  • Hackensack Meridian Health

    Neptune City, New Jersey, 07753

    Not yet recruiting
  • University of Oklahoma Health Science Center

    Oklahoma City, Oklahoma, 73104

    Not yet recruiting

Other trials in United States

France4 sites, 4 recruiting
  • Novartis Investigative Site

    Bron, 69677

    Recruiting
  • Novartis Investigative Site

    Nantes, 44093

    Recruiting
  • Novartis Investigative Site

    Paris, 75019

    Recruiting
  • Novartis Investigative Site

    Toulouse, 31059

    Recruiting

Other trials in France

Japan4 sites, 4 recruiting
  • Novartis Investigative Site

    Chiba, 2608712

    Recruiting
  • Novartis Investigative Site

    Fukuoka, 8158555

    Recruiting
  • Novartis Investigative Site

    Kanazawa, Ishikawa-ken, 9208650

    Recruiting
  • Novartis Investigative Site

    Nagoya, Aichi-ken, 4578510

    Recruiting

Other trials in Japan

Spain4 sites, 4 recruiting
  • Novartis Investigative Site

    Barcelona, 08035

    Recruiting
  • Novartis Investigative Site

    Cadiz, Andalusia, 11009

    Recruiting
  • Novartis Investigative Site

    Madrid, 28041

    Recruiting
  • Novartis Investigative Site

    Madrid, 28046

    Recruiting

Other trials in Spain

China2 sites, 2 recruiting
  • Novartis Investigative Site

    Beijing, 100034

    Recruiting
  • Novartis Investigative Site

    Xi'an, 710054

    Recruiting

Other trials in China

Colombia2 sites, 2 recruiting
  • Novartis Investigative Site

    Barranquilla, Atlántico, 080020

    Recruiting
  • Novartis Investigative Site

    Medellín, Antioquia, 050001

    Recruiting

Other trials in Colombia

Taiwan2 sites, 2 recruiting
  • Novartis Investigative Site

    Taipei, 10002

    Recruiting
  • Novartis Investigative Site

    Taoyuan, 33305

    Recruiting

Other trials in Taiwan

South Korea1 site, 1 recruiting
  • Novartis Investigative Site

    Seoul, Seoul, 03080

    Recruiting

Other trials in South Korea

About this study

Official title: A Single-arm, Multicenter, Phase III Study to Assess Efficacy, Pharmacokinetics, Safety and Tolerability of Atrasentan in Pediatric Patients of 2 to <18 Years of Age With Primary Immunoglobulin A Nephropathy (IgAN)

A Phase III, single-arm, multicenter pediatric clinical study evaluating atrasentan in children and adolescents aged 2 to <18 years with primary immunoglobulin A nephropathy (IgAN).

Read the detailed description

This Phase III study aims to address the unmet medical need in pediatric primary IgAN by assessing the efficacy, pharmacokinetics, safety, and tolerability of atrasentan in patients aged 2 to <18 years. Pediatric patients with biopsy-confirmed IgAN will receive atrasentan (0.75 mg or a body-weight-adjusted dose) for up to 104 weeks while taking the maximally tolerated and stable dose of a RAS (renin-angiotensin system) inhibitor [such as angiotensin converting enzyme inhibitor (ACEi) or angiotensin-receptor antagonist (ARB)] as part of standard of care, if possible.

The primary objective of the study is to evaluate the effect of atrasentan in reducing proteinuria from Baseline to Week 36. UPCR will be measured based on the geometric mean of 2 FMVs obtained during the Run-in period and preceding each scheduled visit.

The study will enroll pediatric patients in a staggered approach. The approach will be to first enroll a subset of Cohort 1 (≥40 kg of body weight) patients to collect safety data, tolerability data, PK data and biomarker data for up to 104 weeks (EOS). Confirmatory PK and safety review will be held at multiple timepoints throughout the trial. There is a data monitoring committee (DMC) which will function independently of all other individuals associated with the conduct of this clinical trial, including the site investigators participating in the study. The DMC will assess at defined intervals the progress of a clinical trial, safety data and recommend to the study team whether to continue, modify, or terminate the trial.

Subjects who complete treatment through Week 104 and complete the study may be eligible to enroll in the open label extension of the study to receive atrasentan 0.75 mg or a body-weight adjusted appropriate dose.

Being tested
Drug: Atrasentan
Keywords
Kidney Diseases, Kidney Disease, Chronic, Glomerulonephritis, Urologic Diseases, Glomerular Disease, Glomerulonephritis, IGA, Glomerulopathy, Immunoglobulin Disease, Atrasentan
Medical subject headings
Glomerulonephritis, IGA, Kidney Diseases, Renal Insufficiency, Chronic, Glomerulonephritis, Urologic Diseases

What participants receive

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

  • Drug: AtrasentanDrug

    • 104 Weeks - Film-coated tablet
    • Other Names:

    Atrasentan Hydrochloride ABT-627

Study groups in NCT07498335
Study groupRoleWhat they receive
Cohort 1 (≥40 kg of body weight)ExperimentalOnce daily oral administration of 0.75 mg atrasentan for 104 weeks
Receives: Drug: Drug: Atrasentan
Cohort 2 (30 to <40 kg of body weight)ExperimentalOral administration of weight-based appropriate dose(s) (that may be modified based on emerging data) for 104 weeks
Receives: Drug: Drug: Atrasentan
Cohort 3 (20 to <30 kg of body weight)ExperimentalOral administration of weight-based appropriate dose(s) (that may be modified based on emerging data) for 104 weeks
Receives: Drug: Drug: Atrasentan
Cohort 4 (10 to <20kg of body weight)ExperimentalOral administration of weight-based appropriate dose(s) (that may be modified based on emerging data) for 104 weeks
Receives: Drug: Drug: Atrasentan

What is being measured

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

  1. Change From Baseline in Proteinuria at Week 36

    The change in urine protein: creatinine ratio (UPCR) from baseline to Week 36

    Measured: Baseline and 36 weeks

Secondary outcomes (6)
  1. Change from Baseline in Proteinuria at Week 36 in participants who experienced ≤ 30% decrease in proteinuria during the 60-day period prior to atrasentan initiation

    All cohorts combined

    Measured: Baseline and 36 weeks

  2. PK parameters: Cmaxss

    Cmaxss: The maximum (peak) observed plasma concentration (mass x volume-1)

    Measured: Baseline and week 104

  3. PK parameters: AUCss

    AUCss: The AUC calculated during a dosing interval at steady state (amount x time x volume-1)

    Measured: Baseline and week 104

  4. PK parameters: CLss/F

    CLss/F: Apparent total plasma clearance of after extravascular administration at steady state. (volume x time-1)

    Measured: Baseline and week 104

  5. PK parameters: Ctrough

    Ctrough: The pre-dose plasma concentration observed during a dosing interval (mass x volume-1)

    Measured: Baseline and week 104

  6. Number of participants with AEs

    Number of participants with AEs and SAEs including abnormal laboratory parameters, and vital signs

    Measured: Baseline and week 104

Timeline

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

  1. First posted27 Mar 2026
  2. Study start6 Aug 2026
  3. Primary completion15 Sep 2031 (estimated)
  4. Study completion13 Dec 2032 (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 3
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Sequential
Masking
None (open label)
Enrolment
28 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07498335
Sponsor's protocol ID
CEXV811B12301
Acronym
ADVANCE
Status last verified
Nov 2026
First submitted
23 Mar 2026
Last updated
6 Nov 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent expert panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data is currently available according to the process described on www.clinicalstudydatarequest.com.

Publications

  • Heerspink HJL, Jardine M, Kohan DE, Lafayette RA, Levin A, Liew A, Zhang H, Lodha A, Gray T, Wang Y, Renfurm R, Barratt J; ALIGN Study Investigators. Atrasentan in Patients with IgA Nephropathy. N Engl J Med. 2025 Feb 6;392(6):544-554. doi: 10.1056/NEJMoa2409415. Epub 2024 Oct 25.

    PubMed 39460694

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Drug: Atrasentan in people with Berger Disease and Bergers Disease, run by Novartis Pharmaceuticals at 23 sites in 8 countries.

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 8 inclusion and 42 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 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 23 sites in United States, France, Japan, Spain, China and 3 more countries. 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. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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 Novartis Pharmaceuticals (1-888-669-6682, novartis.email@novartis.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change From Baseline in Proteinuria at Week 36 (time frame: Baseline and 36 weeks). 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 NCT07498335, which also lists 1 linked publication.

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 Nov 2026.

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