Clinical trial

Urinary Proteomics to Guide Early Intervention to Prevent Complications in Type 2 Diabetes - a Feasibility Study

Invitation only · Phase 4 · 1 countries · Registry ID NCT06954090

Invitation onlyPhase 4Interventional

What this study is about

Title: Body fluid proteome SIGnatures for persoNALised intervention to prevent cardiovascular and renal complications in diabetes. Aim: To explore the feasibility of using urinary proteomic risk scores in clinical practice to identify patients at risk of developing end organ damage and identify which patients should receive additional renocardiovascular protective treatment.

A promising-looking record is not the same as confirmed eligibility. The study team must review the full criteria and current recruitment status.

Basic eligibility

Age18 Years to Not listed
SexAll
Healthy volunteersNot accepted
ConditionType 2 DM, Type 2 DM /Diabetic Nephropathy, Albuminuria

Full registry criteria

Inclusion Criteria: 1. Men and women over 18 years of age. 2. Type 2 diabetes with no clinical signs of HF NYHA Class IV 3. Able to understand the written participant information and give informed consent. Exclusion Criteria: 1. Heart failure NYHA class IV at screening 2. Moderately - or severely increased albuminuria with a UACR ≥ 200 mg/g or CKD with an eGFR \< 30 ml/min/1.73m2 at the screening visit. 3. A female who is pregnant, breastfeeding, or intends to become pregnant, or women of childbearing potential (WOCBP) who are not using highly effective contraceptive methods. 4. Receiving therapy with all three of the study medication prior to enrolment. 5. Myocardial infarction, unstable angina, stroke, or transient ischemic attack within 12 weeks prior to enrolment 6. Known or suspected hypersensitivity to the study medications or related products 7. History of pancreatitis at the screening visit 8. Body mass index \< 18.5 kg/m2 at the screening visit 9. Type 1 diabetes 10. Serum potassium \> 5.0 mmol/L at the screening visit 11. Addison's Disease 12. Concomitant treatment with strong CYP3A4 inhibitors (e.g., itraconazole, ketoconazole, ritonavir, nelfinavir, cobicistat, clarithromycin, telithromycin, nefazodone) 13. Treatment with a potassium-sparing diuretic (amiloride, triamterene) 14. Treatment with other mineralocorticoid receptor antagonist than finerenone (e.g., spironolactone, eplerenone, esaxerenone, canrenone) 15. Elevated Alanine Aminotransferase (ALT) \> 3x upper normal limit, autoimmune hepatitis, and/or severe hepatic impairment (including but not limited to a history of hepatic encephalopathy, a history of oesophageal varices or a history of portocaval shunt.) 16. Autosomal dominant or autosomal recessive polycystic kidney disease 17. Lupus nephritis or ANCA-associated vasculitis, or any other primary or secondary kidney disease requiring immunosuppressive therapy within 6 months prior to screening 18. Kidney transplant or dialysis 19. Presence or history of malignant neoplasms (except basal cell skin cancer or squamous cell skin cancer) within five years before screening. 20. Any other history, condition, therapy, or uncontrolled intercurrent illness that could, as judged by the investigator, affect participant safety or compliance with study requirements. 21. Known or suspected abuse of narcotics. 22. Participant in another intervention study, 23. Vulnerable (i.e., under guardianship) or mentally incapacitated subjects (i.e., not able to understand and sign the informed consent)

Treatments and study arms

Semaglutide, 1.34 mg/mL

Drug

Semaglutide will be introduced at a dose of 0.25 mg/week subcutaneous injection, escalated to 0.5 and 1.0 mg/week after 4 and 8 weeks if tolerated.

Finerenone Oral Tablet

Drug

Finerenone will be introduced at a dose of 10 mg/day in patients with a serum potassium level \< 4.8 mmol/l and eGFR \< 60 ml/min/1.73 m2 and escalated to 20 mg/day after 4 weeks if the serum potassium level is still \< 4.8 mmol/l. Starting dose is 20 mg/day if eGFR ≥ 60 ml/min/1.73 m2. The dosage will be reduced or discontinued in patients who develop hyperkalemia (serum potassium \> 5.5 mmol/l).

Dapagliflozin (DAPA)

Drug

Dapagliflozin will be introduced at a dose of 10 mg/day. The dose can be reduced at any time during the trial if required by the subject's tolerance to the product.

Primary outcomes

Proteomic feasibility2 weeks from sampling

Achieve urine proteomic results within 2 weeks of sampling for at least 90% of the participants in clinical practice.

Evaluation of medical treatment3 weeks from sampling

Ensure that urine proteomic results are interpreted for evaluating medical treatment in at least 90% of participants.

Study locations

1 locations were listed when this page was built. The first 40 are shown.

Steno Diabetes Center Copenhagen🇩🇰 Herlev, Hajdú-Bihar, Denmark