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Chronic Kidney DiseasesPhase 3NCT05342623

A Study to Evaluate the Safety and Efficacy of Difelikefalin in Advanced Chronic Kidney Disease Patients With Moderate-to-Severe Pruritus

A Phase 3 study testing Difelikefalin 1 mg Oral Tablet in people with Chronic Kidney Diseases and Pruritus, run by Cara Therapeutics, Inc. at 83 sites in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This is a multicenter, double-blind, randomized, placebo-controlled study to evaluate the safety and efficacy of oral difelikefalin administered as a 1 mg tablet once daily compared to placebo in reducing the intensity of itch in advanced chronic kidney disease (CKD) patients with moderate-to-severe pruritus. Read more about this study

Who is it for?
Ages 18 to 85 years
Conditions the study is for
Chronic Kidney Diseases, Pruritus
What is being tested?
Difelikefalin 1 mg Oral Tablet
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
286 participants
Where
83 sitesUnited States
Study dates
17 May 2022to 29 Feb 2024
Phase
Phase 3
Are there results?
None posted in the registry

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

Who may be able to join

  • To be eligible for inclusion into the study, a patient must meet the following criteria:
  • Advanced stage 4 and 5 CKD and end stage renal disease on hemodialysis
  • Subject self-reports experiencing at least near-daily (eg, most days of a week) pruritus for at least 6 months prior to screening.
  • Inadequate response to current or prior treatments (including emollients/moisturizers, topical medications, or systemic treatments) for pruritus prior to screening.
  • Prior to randomization on Day 1 of Treatment Period 1:
  • Has recorded at least 4 WI-NRS scores during the 7-day Run-in Period; and
  • Has a mean baseline WI-NRS score ≥ 5, defined as the average of all non-missing scores reported during the 7-day Run-in Period.

Who cannot join

  • A patient will be excluded from the study if any of the following criteria are met:
  • Scheduled to receive a renal replacement therapy (dialysis or kidney transplant) during the study.
  • Has a concomitant disease, significant medical condition or physical/laboratory/ECG/vital signs abnormality that, in the opinion of the investigator, puts the subject at undue risk or interferes with interpretation of study results, impedes completion of the study procedures, or compromises the validity of the study measurements.
  • New or change of treatment received for itch, including antihistamines and corticosteroids (oral, intravenous, or topical), within 14 days prior to the start of run-in.

Trial locations and contacts

83 sites in 1 country.

83 sites in 1 country

United States83 sites
  • Cara Therapeutics Study Site

    Albany, Georgia, 31701

  • Cara Therapeutics Study Site

    Anaheim, California, 92801

  • Cara Therapeutics Study Site

    Ardmore, Oklahoma, 73401

  • Cara Therapeutics Study Site

    Arvada, Colorado, 80002

  • Cara Therapeutics Study Site

    Atlantis, Florida, 33462

  • Cara Therapeutics Study Site

    Austin, Texas, 78751

  • Cara Therapeutics Study Site

    Bakersfield, California, 93308

  • Cara Therapeutics Study Site

    Baton Rouge, Louisiana, 70808

  • Cara Therapeutics Study Site

    Bethlehem, Pennsylvania, 18107

  • Cara Therapeutics Study Site

    Beverly Hills, California, 90211

  • Cara Therapeutics Study Site

    Boston, Massachusetts, 02111

  • Cara Therapeutics Study Site

    Cape Coral, Florida, 33914

  • Cara Therapeutics Study Site

    Chattanooga, Tennessee, 37404

  • Cara Therapeutics Study Site

    Chula Vista, California, 91910

  • Cara Therapeutics Study Site

    Columbus, Ohio, 43215

  • Cara Therapeutics Study Site

    Coral Gables, Florida, 33134

  • Cara Therapeutics Study Sites

    Corsicana, Texas, 75110

  • Cara Therapeutics Study Site

    Denver, Colorado, 80230

  • Cara Therapeutics Study Site

    Durham, North Carolina, 27704

  • Cara Therapeutics Study Site

    East Point, Georgia, 30344

  • Cara Therapeutics Study Site

    East Providence, Rhode Island, 02914

  • Cara Therapeutics Study Site

    El Centro, California, 92243

  • Cara Therapeutics Study Site

    El Paso, Texas, 79902

  • Cara Therapeutics Study Site

    Flint, Michigan, 48504

  • Cara Therapeutics Study Site

    Fort Lauderdale, Florida, 33308

  • Cara Therapeutics Study Site

    Garden Grove, California, 92844

  • Cara Therapeutics Study Site

    Greenville, Texas, 75402

  • Cara Therapeutics Study Site

    Hampton, Virginia, 23666

  • Cara Therapeutics Study Site

    Hialeah, Florida, 33010

  • Cara Therapeutics Study Site

    Houston, Texas, 77079

  • Cara Therapeutics Study Site

    Houston, Texas, 77081

  • Cara Therapeutics Study Site 2

    Houston, Texas, 77099

  • Cara Therapeutics Study Site

    Huntley, Illinois, 60142

  • Cara Therapeutics Study Site

    Huntsville, Alabama, 35805

  • Cara Therapeutics Study Site

    Jackson, Tennessee, 38305

  • Cara Therapeutics Study Site

    Kalamazoo, Michigan, 49007

  • Cara Therapeutics Study Site

    Kansas City, Kansas, 48504

  • Cara Therapeutics Study Site

    Kansas City, Missouri, 64131

  • Cara Therapeutics Study Site

    Knoxville, Tennessee, 37924

  • Cara Therapeutics Study Site

    La Mesa, California, 91942

  • Cara Therapeutics Study Site

    Las Vegas, Nevada, 89128

  • Cara Therapeutics Study Site

    Laurelton, New York, 11413

  • Cara Therapeutics Study Site

    Lewisville, Texas, 75057

  • Cara Therapeutics Study Site

    Lima, Ohio, 45805

  • Cara Therapeutics Study Site

    Louisville, Kentucky, 40205

  • Cara Therapeutics Study Site

    McAllen, Texas, 78503

  • Cara Therapeutics Study Site

    McKinney, Texas, 75069

  • Cara Therapeutics Study Site

    Metairie, Louisiana, 70006

  • Cara Therapeutics Study Site

    Miami, Florida, 33143

  • Cara Therapeutics Study Site

    Miami, Florida, 33173

  • Cara Therapeutics Study Site

    Nampa, Idaho, 83687

  • Cara Therapeutics Study Site

    New Haven, Connecticut, 06511

  • Cara Therapeutics Study Site

    Northridge, California, 91324

  • Cara Therapeutics Study Site

    Ontario, California, 91762

  • Cara Therapeutics Study Site

    Orange City, Florida, 32763

  • Cara Therapeutics Study Site 2

    Orlando, Florida, 32806

  • Cara Therapeutics Study Site

    Orlando, Florida, 32808

  • Cara Therapeutics Study Site

    Palos Hills, Illinois, 60465

  • Cara Therapeutics Study Site

    Pasadena, Texas, 77504

  • Cara Therapeutics Study Site

    Pembroke Pines, Florida, 33024

  • Cara Therapeutics Study Site

    Phoenix, Arizona, 85016

  • Cara Therapeutics Study Site

    Providence, Rhode Island, 02904

  • Cara Therapeutics Study Site

    Riverside, California, 92505

  • Cara Therapeutics Study Site

    Riverview, Florida, 33578

  • Cara Therapeutics Study Site

    Roseville, Michigan, 48066

  • Cara Therapeutics Study Site

    Saint Clair, Michigan, 48081

  • Cara Therapeutics Study Site

    Saint Joseph, Michigan, 49085

  • Cara Therapeutics Study Site

    Santa Clara, California, 91351

  • Cara Therapeutics Study Site

    Sherman, Texas, 75090

  • Cara Therapeutics Study Site

    Shreveport, Louisiana, 71101

  • Cara Therapeutics Study Site

    South Gate, California, 90280

  • Cara Therapeutics Study Site

    Spartanburg, South Carolina, 29302

  • Cara Therapeutics Study Site

    Surprise, Arizona, 85374

  • Cara Therapeutics Study Site

    Tampa, Florida, 33603

  • Cara Therapeutics Study Site

    Tarzana, California, 91356

  • Cara Therapeutics Study Site

    The Bronx, New York, 10455

  • Cara Therapeutics Study Site

    Tupelo, Mississippi, 38801

  • Cara Therapeutics Study Site

    Upland, Pennsylvania, 19013

  • Cara Therapeutics Study Site

    Vacaville, California, 95687

  • Cara Therapeutics Study Site

    Valencia, California, 91355

  • Cara Therapeutics Study Site

    Victorville, California, 92392

  • Cara Therapeutics Study Site

    West Palm Beach, Florida, 33401

  • Cara Therapeutics Study Site

    Zachary, Louisiana, 70791

Other trials in United States

About this study

Official title: A Multicenter, Randomized, Double-blind, Placebo-controlled 12-Week Study to Evaluate the Safety and Efficacy of Oral Difelikefalin in Advanced Chronic Kidney Disease Subjects With Moderate-to-Severe Pruritus With an up to 52-Week Long-term Extension

This is a multicenter, double-blind, randomized, placebo-controlled study to evaluate the safety and efficacy of oral difelikefalin administered as a 1 mg tablet once daily compared to placebo in reducing the intensity of itch in advanced chronic kidney disease (CKD) patients with moderate-to-severe pruritus. This study is comprised of an Efficacy Assessment Phase and a Long-term Extension Phase. The Efficacy Assessment Phase includes a double-blind 12-week Treatment Period (Treatment Period 1), and the Long-term Extension Phase includes a double-blind Treatment Period (Treatment Period 2) of up to 52 weeks.

Read the detailed description

This study will consist of a Screening Period, a 7-day Run-in Period, a 12 week double-blind Efficacy Assessment Phase (Treatment Period 1), a double-blind Long-term Extension Phase (Treatment Period 2) of up to 52 weeks, and a Follow-up Visit (7 to 10 days after the End of Treatment (EOT)/Early Termination (ET) Visit).

If patients continue to meet all inclusion and no exclusion criteria at the end of the 7-day Run-in Period, they will be randomized in a 1:1 ratio to receive once daily oral difelikefalin tablets at a dose of 1 mg or placebo for 12 weeks. Subjects will be stratified according to their use or nonuse of medications to treat pruritus prior to randomization as well as the presence or absence of specific medical conditions. During the Long-term Extension Phase, patients will be re-randomized on Day 1 of Treatment Period 2 to receive either oral difelikefalin 1 mg or placebo, once daily for up to an additional 52 weeks. A final safety Follow-up Visit will be conducted 7 to 10 days after the EOT/ET.

Informed consent will be obtained prior to performing any study-specific procedures. Screening will occur within 7 to 28 days prior to randomization to assess eligibility.

Being tested
Difelikefalin 1 mg Oral Tablet, Placebo Oral Tablet
Keywords
difelikefalin, CR845, Pruritus, Chronic Itch, Itch, Itching, uremic pruritus, CKD, CKD-aP, CKD-associated pruritus, Chronic Kidney Disease, Kidney dysfunction, Generalized pruritus, Hemodialysis, Dialysis, ESRD (end stage renal disease), Kidney failure, chronic
Medical subject headings
Renal Insufficiency, Chronic, Pruritus, Kidney Failure, Chronic

What participants receive

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

  • Difelikefalin 1 mg Oral TabletDrug

    Also called CR845

    Difelikefalin 1 mg medication taken orally 1 time/day

  • Placebo Oral TabletDrug

    Placebo tablet taken orally 1 time/day

Study groups in NCT05342623
Study groupRoleWhat they receive
Difelikefalin 1 mg Oral TabletExperimentalPatients receive oral difelikefalin 1 mg once daily
Receives: Drug: Difelikefalin 1 mg Oral Tablet
Placebo Oral TabletPlacebo comparatorPatients receive oral placebo once daily
Receives: Drug: Placebo Oral Tablet

What is being measured

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

  1. Efficacy Assessment Phase (Treatment Period 1): Proportion of subjects achieving at least a 4-point improvement from baseline with respect to the weekly mean of the daily 24-hour WI-NRS score at Week 12 of Treatment Period 1

    Intensity of itch will be measured using an NRS used to indicate the intensity of the worst itching over the past 24 hours using a 0 to 10 numeric rating scale, where "0" represents "no itching" and "10" represents "worst itching imaginable".

    Measured: Week 12 of Treatment Period 1

Secondary outcomes (4)
  1. Efficacy Assessment Phase (Treatment Period 1): Proportion of subjects achieving at least a 4-point improvement from baseline with respect to the weekly mean of the WI-NRS at Week 8 of Treatment Period 1.

    Intensity of itch will be measured using an NRS used to indicate the intensity of the worst itching over the past 24 hours using a 0 to 10 numeric rating scale, where "0" represents "no itching" and "10" represents "worst itching imaginable".

    Measured: Week 8 of Treatment Period 1

  2. Efficacy Assessment Phase (Treatment Period 1): Proportion of subjects achieving at least a 4-point improvement from baseline with respect to the weekly mean of the WI-NRS at Week 4 of Treatment Period 1.

    Intensity of itch will be measured using an NRS used to indicate the intensity of the worst itching over the past 24 hours using a 0 to 10 numeric rating scale, where "0" represents "no itching" and "10" represents "worst itching imaginable".

    Measured: Week 4 of Treatment Period 1

  3. Efficacy Assessment Phase (Treatment Period 1): Proportion of subjects who are "complete itch responders" defined as subjects with ≥ 70% of the non-missing 24-hour WI-NRS scores equal to 0 or 1 at Week 12 of Treatment Period 1.

    Intensity of itch will be measured using an NRS used to indicate the intensity of the worst itching over the past 24 hours using a 0 to 10 numeric rating scale, where "0" represents "no itching" and "10" represents "worst itching imaginable".

    Measured: Week 12 of Treatment Period 1

  4. Efficacy Assessment Phase (Treatment Period 1): Change from baseline in Sleep Quality Questionnaire score at the end of Week 12 of Treatment Period 1.

    Sleep Quality will be measured using an NRS used to indicate how much itch has interfered with sleep during the past 24 hours using a 0 to 10 numeric rating scale, where "0" represents "did not interfere" and "10" represents "completely interfered".

    Measured: Week 12 of Treatment Period 1

Timeline

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

  1. First posted22 Apr 2022
  2. Study start17 May 2022
  3. Primary completion29 Feb 2024
  4. Study completion29 Feb 2024

Why it stopped: Corporate decision to discontinue work in advanced chronic kidney disease.

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
Randomised
Intervention model
Parallel groups
Model description
Randomized, double-blind, placebo controlled study
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
286 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05342623
Sponsor's protocol ID
CR845-310301
Status last verified
May 2024
First submitted
18 Apr 2022
Last updated
7 May 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Wulczyn KE, Shafi T. CKD-Associated Pruritus: Updates on Management and Future Directions. Kidney360. 2026 Jul 1;7(7):1658-1661. doi: 10.34067/KID.0000001172. Epub 2026 Feb 13. No abstract available.

    PubMed 41686509
  • Didik S, Golosova D, Xu B, Staruschenko A. Opioids and the Kidney: A Compendium. Kidney360. 2023 Dec 1;4(12):1816-1823. doi: 10.34067/KID.0000000000000291. Epub 2023 Nov 6.

    PubMed 37927032

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Difelikefalin 1 mg Oral Tablet in people with Chronic Kidney Diseases and Pruritus, run by Cara Therapeutics, Inc. at 83 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 7 inclusion and 4 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: stopped early, as of the sponsor's last update on 7 May 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 83 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 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?

The study was stopped early (reason given: Corporate decision to discontinue work in advanced chronic kidney disease.). Results are not available in the source record.

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?

Efficacy Assessment Phase (Treatment Period 1): Proportion of subjects achieving at least a 4-point improvement from baseline with respect to the weekly mean of the daily 24-hour WI-NRS score at Week 12 of Treatment Period 1 (time frame: Week 12 of Treatment Period 1). 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 NCT05342623, which also lists 2 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 7 May 2024.

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