Hemodialysis Access FailureNCT06034691
Exploratory Research of PCSK9 Inhibitor on Patency of aAVF After PTA With PCB
A study testing pcsk9 inhibitor in people with Hemodialysis Access Failure, run by RenJi Hospital at 1 site in China.
Trial summary
Autologous arteriovenous fistula (AVF) is the preferred vascular pathway type for maintenance hemodialysis (MHD) patients. The K/DOQI guidelines suggest that the use of percutaneous transluminal angioplasty (PTA) as the primary treatment for AVF stenosis is reasonable. However, the durability of PTA is limited. Read more about this study
- Who is it for?
- Ages 17 to 76 years
- Conditions the study is for
- Hemodialysis Access Failure
- What is being tested?
- pcsk9 inhibitor
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 1 siteChina
- Study dates
- 10 Sep 2023to 1 Oct 2024
- Phase
- Interventional
- 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 17 to 76 years
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Agree to join this study and sign an informed consent form
- Age ≥ 18 years old and ≤ 75 years old, regardless of gender
- Maintenance hemodialysis patients using autologous arteriovenous fistula (AVF), with a dialysis frequency of three times a week
- AVF venous stenosis: The local stenosis rate exceeds 50% of the normal diameter of nearby blood vessels and is accompanied by at least one of the following conditions:
- The natural blood flow of the internal fistula is less than 500ml/min or has decreased by more than 25% compared to the previous examination result
- Unable to meet the required blood flow for dialysis prescription (blood flow<200ml/min, and cannot be corrected after adjusting the puncture needle position)
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- Decreased arterial pressure or increased venous pressure during dialysis (monitoring arterial pressure<-120mmHg for more than 2 consecutive times or monitoring venous pressure>120mmHg while maintaining 200ml/min blood flow)
- Difficulty in puncture: A qualified nurse who has difficulty puncturing for 3 consecutive days of hemodialysis (blood can only be drawn out after more than two punctures)
- Decreased dialysis adequacy [arteriovenous fistula recirculation rate (RA)>10%, or an increase of more than 25% compared to the previous examination result] [RA=(SA-A)/(SA-V) * 100, dialysis to 1 hour: SA=blood flow adjusted to 20ml/min, ultrafiltration and dialysate flow stopped, after 2 minutes, artery Blood urea nitrogen concentration A=artery Blood urea nitrogen concentration V=vein Blood urea nitrogen concentration]
- Abnormal signs of fistula.
- Patients with primary Hypercholesterolemia [LDL-C ≥ 130 mg/dl (≥ 3.4 mmol/L), and/or non-HDL-C≥ 160 mg/dl (≥ 4.1 mmol/L)] or combine cardiovascular disease or assess patients with a high risk of cardiovascular disease
Who cannot join
- MHD with AVG
- Breastfeeding or Pregnant Women
- Patients with central venous reflux obstruction
- Patients with AVF feeding artery disease
- Patients with severe Hypotension (systolic blood pressure<90mmHg or diastolic blood pressure<60mmHg, at least three times within one month before signing the informed consent)
- Left ventricular Ejection fraction less than 30% or hemodynamic instability
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- Patients receiving immunotherapy or suspected/confirmed Vasculitis
- Patients with coagulation dysfunction or a history of Thrombocytopenic purpura
- Patients with vascular access infections or systemic active infections
- Patients who are known to be allergic to PCSK9 inhibitors or paclitaxel
- Patient's life expectancy is less than 12 months
- Patients who are planning kidney transplantation or switching to Peritoneal dialysis
- Patients participating in other intervention studies
- The researcher judged that the subject's condition was not suitable for participation in this study
Trial locations and contacts
1 site in 1 country.
China1 site, 1 recruiting
- Recruiting
Yuanyuan Xie
Shanghai, Pudong, 200127
Yuanyuan Xie, +86 13601852981, xieyuanyuan@renji.com
About this study
Official title: Exploratory Research of PCSK9 Inhibitor on Patency of Autogenous Arteriovenous Fistula After Percutaneous Transluminal Angioplasty With Paclitaxel Releasing Balloon
Autologous arteriovenous fistula (AVF) is the preferred vascular pathway type for maintenance hemodialysis (MHD) patients. The K/DOQI guidelines suggest that the use of percutaneous transluminal angioplasty (PTA) as the primary treatment for AVF stenosis is reasonable. However, the durability of PTA is limited. In order to reduce the risk of dysfunction recurrence after the intervention, there have been reports in recent years that drug-coated balloons (DCB) are used in the treatment of vascular stenosis in hemodialysis. Multiple factors have limited the efficacy of DCB. Previous studies on the related factors of hemodialysis access stenosis showed that Dyslipidemia was significantly related to the short initial patency rate, and Dyslipidemia was an important predictor of secondary patency loss. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are a new type of lipid-lowering drug that can prevent vascular calcification. Previous studies have shown that PCSK9 inhibitors have good lipid-lowering effects in both MHD patients and nondialysis patients, and the use of PSK9 inhibitors at the same dose as nondialysis patients is safe in MHD patients. There are currently few studies on the use of paclitaxel-releasing balloon dilation combined with PCSK9 inhibitors to improve autologous internal fistula. Therefore, the investigators applied a prospective, randomized, and controlled study method to preliminarily explore the effect of paclitaxel releasing balloon combined with PCSK9 inhibitor on improving the postoperative patency rate of AVF and the safety of the combined application.
- Conditions
- Hemodialysis Access Failure
- Being tested
- pcsk9 inhibitor
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
pcsk9 inhibitorBiological
The treatment group received postoperative use of 140 mg of Ribavirin, administered every two weeks, with 140 mg administered subcutaneously for a total of 48 weeks. There was no additional intervention with lipid-lowering drugs in the control group.
| Study group | Role | What they receive |
|---|---|---|
| PCSK9i group | Experimental | treatment group Receives: Biological: pcsk9 inhibitor |
| control group | No intervention | control group |
What is being measured
The primary outcome is the main question the study is designed to answer.
Value of vessel diameter
ultrasonic measurement
Measured: 24 week, 48 week
Value of volume of blood flow
ultrasonic measurement
Measured: 24 week, 48 week
Value of peak systolic velocity ratio(PSVR)
ultrasonic measurement
Measured: 24 week, 48 week
Incidence of Re intervention of fistula
Event recording
Measured: 48 week
Secondary outcomes (9)
Endometrium
Ultrasonic measurement of changes in thickness of vascular intima , expressed in millimeters
Measured: 24 week, 48 week
RA
Arteriovenous fistula recirculation rate
Measured: 24 week, 48 week
BTM
Blood temperature monitoring, testing of specific modules of the hemodialysis machine. Expressed as a percentage.
Measured: 24 week, 48 week
Adequacy of dialysis
spKT/V
Measured: 24 week, 48 week
Blood routine
Concentration of hemoglobin, white blood cell count, platelet
Measured: 12 week, 24 week, 48 week
liver function
Concentration of GPT, GOT
Measured: 12 week, 24 week, 48 week
Concentration of blood sugar
Measured: 12 week, 24 week, 48 week
Concentration of CRP
Measured: 12 week, 24 week, 48 week
blood lipids
Concentration of cholesterol, triglyceride, LDL-c, HDL
Measured: 12 week, 24 week, 48 week
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Sep 2023
- Study start10 Sep 2023 (estimated)
- Primary completion6 Sep 2024 (estimated)
- Study completion1 Oct 2024 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Hemodialysis Access FailureStudies of the same condition, open and under way.
- More trials run by RenJi HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 40 participants (estimated)
Sponsor and investigators
- Lead sponsor
- RenJi Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06034691
- Sponsor's protocol ID
- LY2023-113-A
- Status last verified
- Sep 2023
- First submitted
- 14 Aug 2023
- Last updated
- 13 Sep 2023
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 13 Sep 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Exploratory Research of PCSK9 Inhibitor on Patency of Autogenous Arteriovenous Fistula After Percutaneous Transluminal Angioplasty With Paclitaxel Releasing Balloon
- ClinicalTrials.gov ID
- NCT06034691
- Acronym / sponsor ID
- LY2023-113-A
- Conditions
- Hemodialysis Access Failure
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 40 participants (estimated)
- Lead sponsor
- RenJi HospitalUniversity, hospital or other
- Study start
- 10 Sep 2023 (estimated)
- Primary completion
- 6 Sep 2024 (estimated)
- Study completion
- 1 Oct 2024 (estimated)
- First posted
- 13 Sep 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Autologous arteriovenous fistula (AVF) is the preferred vascular pathway type for maintenance hemodialysis (MHD) patients. The K/DOQI guidelines suggest that the use of percutaneous transluminal angioplasty (PTA) as the primary treatment for AVF stenosis is reasonable. However, the durability of PTA is limited. In order to reduce the risk of dysfunction recurrence after the intervention, there have been reports in recent years that drug-coated balloons (DCB) are used in the treatment of vascular stenosis in hemodialysis. Multiple factors have limited the efficacy of DCB. Previous studies on the related factors of hemodialysis access stenosis showed that Dyslipidemia was significantly related to the short initial patency rate, and Dyslipidemia was an important predictor of secondary patency loss. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are a new type of lipid-lowering drug that can prevent vascular calcification. Previous studies have shown that PCSK9 inhibitors have good lipid-lowering effects in both MHD patients and nondialysis patients, and the use of PSK9 inhibitors at the same dose as nondialysis patients is safe in MHD patients. There are currently few studies on the use of paclitaxel-releasing balloon dilation combined with PCSK9 inhibitors to improve autologous internal fistula. Therefore, the investigators applied a prospective, randomized, and controlled study method to preliminarily explore the effect of paclitaxel releasing balloon combined with PCSK9 inhibitor on improving the postoperative patency rate of AVF and the safety of the combined application.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| PCSK9i group | Experimental | Biological: pcsk9 inhibitortreatment group |
| control group | No intervention | –control group |
Who may qualify
- Ages
- 17 to 76 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (11 listed)
- Agree to join this study and sign an informed consent form
- Age ≥ 18 years old and ≤ 75 years old, regardless of gender
- Maintenance hemodialysis patients using autologous arteriovenous fistula (AVF), with a dialysis frequency of three times a week
- AVF venous stenosis: The local stenosis rate exceeds 50% of the normal diameter of nearby blood vessels and is accompanied by at least one of the following conditions:
- Patients with primary Hypercholesterolemia [LDL-C ≥ 130 mg/dl (≥ 3.4 mmol/L), and/or non-HDL-C≥ 160 mg/dl (≥ 4.1 mmol/L)] or combine cardiovascular disease or assess patients with a high risk of cardiovascular disease
Key exclusion criteria (14 listed)
- MHD with AVG
- Breastfeeding or Pregnant Women
- Patients with central venous reflux obstruction
- Patients with AVF feeding artery disease
- Patients with severe Hypotension (systolic blood pressure<90mmHg or diastolic blood pressure<60mmHg, at least three times within one month before signing the informed consent)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| pcsk9 inhibitorThe treatment group received postoperative use of 140 mg of Ribavirin, administered every two weeks, with 140 mg administered subcutaneously for a total of 48 weeks. There was no additional intervention with lipid-lowering drugs in the control group. | Biological | PCSK9i group |
Primary outcome
Value of vessel diameter
Time frame: 24 week, 48 week
ultrasonic measurement
Value of volume of blood flow
Time frame: 24 week, 48 week
ultrasonic measurement
Value of peak systolic velocity ratio(PSVR)
Time frame: 24 week, 48 week
ultrasonic measurement
Incidence of Re intervention of fistula
Time frame: 48 week
Event recording
9 secondary outcomes
Endometrium
Time frame: 24 week, 48 week
RA
Time frame: 24 week, 48 week
BTM
Time frame: 24 week, 48 week
Adequacy of dialysis
Time frame: 24 week, 48 week
Blood routine
Time frame: 12 week, 24 week, 48 week
liver function
Time frame: 12 week, 24 week, 48 week
Concentration of blood sugar
Time frame: 12 week, 24 week, 48 week
Concentration of CRP
Time frame: 12 week, 24 week, 48 week
blood lipids
Time frame: 12 week, 24 week, 48 week
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Sep 2023.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing pcsk9 inhibitor in people with Hemodialysis Access Failure, run by RenJi Hospital at 1 site in China.
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 11 inclusion and 14 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: status not confirmed, as of the sponsor's last update on 13 Sep 2023. 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 China. 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.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Value of vessel diameter (time frame: 24 week, 48 week). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 13 Sep 2023.