Lupus NephritisPhase 1/2NCT06113900
Assessment of Safety and Efficacy of SGLT2is Among LN Patients
A Phase 1/2 study testing Dapagliflozin 10mg Tab orally once daily in people with Lupus Nephritis, run by Ain Shams University at 1 site in Egypt.
Trial summary
The aim of this study is to assess the safety and efficacy of SGLT2is among LN patients. Read more about this study
- Who is it for?
- Ages 18 to 75 yearsHealthy volunteers can take part
- Conditions the study is for
- Lupus Nephritis
- What is being tested?
- Dapagliflozin 10mg Tab orally once daily
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 50 participants
- Where
- 1 siteEgypt
- Study dates
- 1 Dec 2023to 30 Jan 2025
- Phase
- Phase 1/2
- 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 75 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Patients aged more than 18 year.
- Patients with confirmed SLE according to EULAR/ACR classification criteria.
- Patients with LN ( persistent proteinuria > 2 gm per day or greater than 3+ by dipstick, and/or cellular casts including red cell, hemoglobin, granular, tubular or mixed \& "active urinary sediment" (>5 RBC/hpf, >5 WBC/hpf in the absence of infection, or cellular casts limited to RBC or WBC casts )
- Patient with e GFR > 25 ml/min/1.73m2 by CKD-EPI equation.
Who cannot join
- Patients with an allergy or intolerance to Dapagliflozin or any prior SGLT2i exposure within 1 month before screening.
- Medical history of chronic disease (Severe respiratory distress, gastrointestinal tract lesions \& chronic liver disease)
- Patients with recurrent genitourinary infections.
- Patient with proteinuria < 2gm.
- Patient who show response to immune therapy in proteinuria reduction > 50%.
- Patient with Lupus in induction phase.
Show all 12Show fewer
- Patient on steroids > 30 mg daily dose.
- Patients with diabetes mellitus.
- Patients with severe infection requiring antibiotics within 1 month before screening.
- Patients with malignant diseases.
- Pregnant or breast-feeding women.
- Patients with eGFR < 25 ml/min/1.73m2 or undergoing dialysis therapy
Trial locations and contacts
1 site in 1 country.
Marwa Abdel Samie, Lecturer contact
Egypt1 site
Ain Shams University
Alexandria
Howida Al Shennawi, Professor, 01223429592
About this study
Official title: Assessment of Safety and Efficacy of Sodium Glucose Co-transporter 2 Inhibitors Among Lupus Nephritis Patients
The aim of this study is to assess the safety and efficacy of SGLT2is among LN patients.
Read the detailed description
SLE is a chronic debilitating autoimmune disorder that involves multiple organ systems either simultaneously or sequentially with relapsing and remitting course. The word 'Lupus' is a Latin term which means wolf.
Lupus nephritis (LN) is one of the common complications in patients with SLE and influences overall outcome of these patients. About two-thirds of patients with SLE have renal disease at some stage which is a leading cause of mortality in these patients.
Manifestations of LN vary from asymptomatic urinary abnormalities to rapidly progressive crescentic glomerulonephritis to end-stage renal disease (ESRD).
Recently, metabolic modulation approach has become a hot spot in the management of SLE. Increased glucose metabolism in immune cells has been reported in patients with SLE.
Repurposing metformin, an old anti diabetic drug, has the potential to reduce the risk of lupus flare in randomized controlled trials. A recent crossover study implied that peroxisome proliferator-activated receptor-gamma agonists might decrease cardiovascular risk in patients with SLE.
Dapagliflozin, SGLT2i, is a new therapy for type 2 diabetes. The Dapagliflozin mode of action is to reduce glucose reabsorption in the epithelial cells of the proximal renal tubule of the kidney, which results in decreased blood glucose and glycated hemoglobin levels.
Strikingly, four cardiovascular outcome trials demonstrated that treatment with SGLT2is (empagliflozin, canagliflozin and dapagliflozin) in patients with type 2 diabetes had prominent effects on slowing the decline rate of eGFR and decreasing albuminuria, as well as a significant reduction in cardiovascular events.
Furthermore, the nephroprotective efficacy of SGLT2is was extended to non-diabetic CKD, such as IgA nephropathy.
The net gain of SGLT2 inhibition is to reduce renal workload and to modulate weight loss and blood pressure.
The paradigm for CKD and congestive heart failure management has been shifted accordingly
Interestingly, all researchers have reported that SGLT2is could block lipopolysaccharide-induced and NLRP3-mediated inflammatory responses and regulate macrophage polarization via interplay with mammalian target of rapamycin (mTOR) and AMP-activated protein kinase pathway thereby, SGLT2is might further contribute to reducing inflammation, modulating endothelial dysfunction and decelerating atherosclerosis which are all relevant to the pathophysiology of SLE.
Here, the investigators initiated this study aiming to assess the safety and efficacy of dapagliflozin among patients with LN.
- Conditions
- Lupus Nephritis
- Being tested
- Dapagliflozin 10mg Tab orally once daily
- Medical subject headings
- Lupus Nephritis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Dapagliflozin 10mg Tab orally once dailyDrug
Also called Empagliflozin 10 mg tab orally once daily
Sodium glucose co-transporter 2 inhibitors
| Study group | Role | What they receive |
|---|---|---|
| Drug as Dapagliflozin 10 mg orally for 6 months is given | Experimental | 25 lupus nephritis patients will receive SGLT2is as dapagliflozin 10mg beside there usual treatment of lupus for 6 months Receives: Drug: Dapagliflozin 10mg Tab orally once daily |
| On there conventional lupus nephritis treatment | No intervention | 25 lupus nephritis patients didn't receive SGLT2i and continue on their conventional lupus nephritis treatment |
What is being measured
The primary outcome is the main question the study is designed to answer.
Renal Function Tests:
- Measurement of serum urea level in mg/dl at 3 month's interval, that is, at 0, 3 and 6 months.
- Measurement of serum creatinine level in mg/dl at 3 month's interval, that is, at 0, 3 and 6 months.
- Measurement of serum uric acid level in mg/dl at 3 month's interval, that is, at 0, 3 and 6 months.
Measured: 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Nov 2023
- Study start1 Dec 2023 (estimated)
- Primary completion1 Dec 2024 (estimated)
- Study completion30 Jan 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (7)Papers the sponsor has linked to this study.
- Other trials for Lupus NephritisStudies of the same condition, open and under way.
- More trials run by Ain Shams UniversityThe 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 1/2
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 50 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Ain Shams University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Marwa Ahmed Mohamed Ahmed Waly, Ain Shams University
- Investigators
- Howaida Al-Shennawi, Professor, Principal investigator, Professor of internal medicine and NephrologyCherry Kamel, Professor, Study director, Professor of internal medicine and Nephrology
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06113900
- Sponsor's protocol ID
- SGLT2I among LN patients
- Status last verified
- Oct 2023
- First submitted
- 20 Sep 2023
- Last updated
- 2 Nov 2023
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Abdollahi E, Keyhanfar F, Delbandi AA, Falak R, Hajimiresmaiel SJ, Shafiei M. Dapagliflozin exerts anti-inflammatory effects via inhibition of LPS-induced TLR-4 overexpression and NF-kappaB activation in human endothelial cells and differentiated macrophages. Eur J Pharmacol. 2022 Mar 5;918:174715. doi: 10.1016/j.ejphar.2021.174715. Epub 2022 Jan 11.
PubMed 35026193Braunwald E. Gliflozins in the Management of Cardiovascular Disease. N Engl J Med. 2022 May 26;386(21):2024-2034. doi: 10.1056/NEJMra2115011. No abstract available.
PubMed 35613023Gounden V, Bhatt H, Jialal I. Renal Function Tests. 2024 Jul 27. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK507821/
PubMed 29939598Ma Y, Zhao Q, Peng H, Nalisa DL, Shan P, Jiang H. SGLT2i in Patients with Type 1 Diabetes: Benefits, Risks, and Preventive Strategies. Front Biosci (Landmark Ed). 2023 May 22;28(5):98. doi: 10.31083/j.fbl2805098.
PubMed 37258468Parodis I, Gomez A, Lindblom J, Chow JW, Sjowall C, Sciascia S, Gatto M. B Cell Kinetics upon Therapy Commencement for Active Extrarenal Systemic Lupus Erythematosus in Relation to Development of Renal Flares: Results from Three Phase III Clinical Trials of Belimumab. Int J Mol Sci. 2022 Nov 11;23(22):13941. doi: 10.3390/ijms232213941.
PubMed 36430417Sada K, Kurita N, Noma H, Matsuki T, Quasny H, Levy RA, Jones-Leone AR, Gairy K, Yajima N. MOONLIGHT study: the design of a comparative study of the effectiveness of belimumab in patients with a history of lupus nephritis from the post-Marketed effectiveness of belimumab cOhOrt and JapaN Lupus NatIonwide reGistry (LUNA) coHorT. Lupus Sci Med. 2022 Sep;9(1):e000746. doi: 10.1136/lupus-2022-000746.
PubMed 37017254Desai SB, Ahdoot R, Malik F, Obert M, Hanna R. New guidelines and therapeutic updates for the management of lupus nephritis. Curr Opin Nephrol Hypertens. 2024 May 1;33(3):344-353. doi: 10.1097/MNH.0000000000000969. Epub 2024 Feb 9.
PubMed 38334499
Study at a glance
From the registry record, last updated by the sponsor on 2 Nov 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Assessment of Safety and Efficacy of Sodium Glucose Co-transporter 2 Inhibitors Among Lupus Nephritis Patients
- ClinicalTrials.gov ID
- NCT06113900
- Acronym / sponsor ID
- SGLT2I among LN patients
- Conditions
- Lupus Nephritis
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 50 participants (estimated)
- Lead sponsor
- Ain Shams UniversityUniversity, hospital or other
- Study start
- 1 Dec 2023 (estimated)
- Primary completion
- 1 Dec 2024 (estimated)
- Study completion
- 30 Jan 2025 (estimated)
- First posted
- 2 Nov 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.
The aim of this study is to assess the safety and efficacy of SGLT2is among LN patients.
Detailed description
SLE is a chronic debilitating autoimmune disorder that involves multiple organ systems either simultaneously or sequentially with relapsing and remitting course. The word 'Lupus' is a Latin term which means wolf.
Lupus nephritis (LN) is one of the common complications in patients with SLE and influences overall outcome of these patients. About two-thirds of patients with SLE have renal disease at some stage which is a leading cause of mortality in these patients.
Manifestations of LN vary from asymptomatic urinary abnormalities to rapidly progressive crescentic glomerulonephritis to end-stage renal disease (ESRD).
Recently, metabolic modulation approach has become a hot spot in the management of SLE. Increased glucose metabolism in immune cells has been reported in patients with SLE.
Repurposing metformin, an old anti diabetic drug, has the potential to reduce the risk of lupus flare in randomized controlled trials. A recent crossover study implied that peroxisome proliferator-activated receptor-gamma agonists might decrease cardiovascular risk in patients with SLE.
Dapagliflozin, SGLT2i, is a new therapy for type 2 diabetes. The Dapagliflozin mode of action is to reduce glucose reabsorption in the epithelial cells of the proximal renal tubule of the kidney, which results in decreased blood glucose and glycated hemoglobin levels.
Strikingly, four cardiovascular outcome trials demonstrated that treatment with SGLT2is (empagliflozin, canagliflozin and dapagliflozin) in patients with type 2 diabetes had prominent effects on slowing the decline rate of eGFR and decreasing albuminuria, as well as a significant reduction in cardiovascular events.
Furthermore, the nephroprotective efficacy of SGLT2is was extended to non-diabetic CKD, such as IgA nephropathy.
The net gain of SGLT2 inhibition is to reduce renal workload and to modulate weight loss and blood pressure.
The paradigm for CKD and congestive heart failure management has been shifted accordingly
Interestingly, all researchers have reported that SGLT2is could block lipopolysaccharide-induced and NLRP3-mediated inflammatory responses and regulate macrophage polarization via interplay with mammalian target of rapamycin (mTOR) and AMP-activated protein kinase pathway thereby, SGLT2is might further contribute to reducing inflammation, modulating endothelial dysfunction and decelerating atherosclerosis which are all relevant to the pathophysiology of SLE.
Here, the investigators initiated this study aiming to assess the safety and efficacy of dapagliflozin among patients with LN.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Drug as Dapagliflozin 10 mg orally for 6 months is given | Experimental | Drug: Dapagliflozin 10mg Tab orally once daily25 lupus nephritis patients will receive SGLT2is as dapagliflozin 10mg beside there usual treatment of lupus for 6 months |
| On there conventional lupus nephritis treatment | No intervention | –25 lupus nephritis patients didn't receive SGLT2i and continue on their conventional lupus nephritis treatment |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Patients aged more than 18 year.
- Patients with confirmed SLE according to EULAR/ACR classification criteria.
- Patients with LN ( persistent proteinuria > 2 gm per day or greater than 3+ by dipstick, and/or cellular casts including red cell, hemoglobin, granular, tubular or mixed \& "active urinary sediment" (>5 RBC/hpf, >5 WBC/hpf in the absence of infection, or cellular casts limited to RBC or WBC casts )
- Patient with e GFR > 25 ml/min/1.73m2 by CKD-EPI equation.
Key exclusion criteria (12 listed)
- Patients with an allergy or intolerance to Dapagliflozin or any prior SGLT2i exposure within 1 month before screening.
- Medical history of chronic disease (Severe respiratory distress, gastrointestinal tract lesions \& chronic liver disease)
- Patients with recurrent genitourinary infections.
- Patient with proteinuria < 2gm.
- Patient who show response to immune therapy in proteinuria reduction > 50%.
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 |
|---|---|---|
| Dapagliflozin 10mg Tab orally once dailyAlso: Empagliflozin 10 mg tab orally once dailySodium glucose co-transporter 2 inhibitors | Drug | Drug as Dapagliflozin 10 mg orally for 6 months is given |
Primary outcome
Renal Function Tests:
Time frame: 6 months
1. Measurement of serum urea level in mg/dl at 3 month's interval, that is, at 0, 3 and 6 months. 2. Measurement of serum creatinine level in mg/dl at 3 month's interval, that is, at 0, 3 and 6 months. 3. Measurement of serum uric acid level in mg/dl at 3 month's interval, that is, at 0, 3 and 6 months.
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Nov 2023.
- Background: PubMed 35026193Abdollahi E, Keyhanfar F, Delbandi AA, Falak R, Hajimiresmaiel SJ, Shafiei M. Dapagliflozin exerts anti-inflammatory effects via inhibition of LPS-induced TLR-4 overexpression and NF-kappaB activation in human endothelial cells and differentiated macrophages. Eur J Pharmacol. 2022 Mar 5;918:174715. doi: 10.1016/j.ejphar.2021.174715. Epub 2022 Jan 11.
- Background: PubMed 35613023Braunwald E. Gliflozins in the Management of Cardiovascular Disease. N Engl J Med. 2022 May 26;386(21):2024-2034. doi: 10.1056/NEJMra2115011. No abstract available.
- Background: PubMed 29939598Gounden V, Bhatt H, Jialal I. Renal Function Tests. 2024 Jul 27. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK507821/
- Background: PubMed 37258468Ma Y, Zhao Q, Peng H, Nalisa DL, Shan P, Jiang H. SGLT2i in Patients with Type 1 Diabetes: Benefits, Risks, and Preventive Strategies. Front Biosci (Landmark Ed). 2023 May 22;28(5):98. doi: 10.31083/j.fbl2805098.
- Background: PubMed 36430417Parodis I, Gomez A, Lindblom J, Chow JW, Sjowall C, Sciascia S, Gatto M. B Cell Kinetics upon Therapy Commencement for Active Extrarenal Systemic Lupus Erythematosus in Relation to Development of Renal Flares: Results from Three Phase III Clinical Trials of Belimumab. Int J Mol Sci. 2022 Nov 11;23(22):13941. doi: 10.3390/ijms232213941.
- Background: PubMed 37017254Sada K, Kurita N, Noma H, Matsuki T, Quasny H, Levy RA, Jones-Leone AR, Gairy K, Yajima N. MOONLIGHT study: the design of a comparative study of the effectiveness of belimumab in patients with a history of lupus nephritis from the post-Marketed effectiveness of belimumab cOhOrt and JapaN Lupus NatIonwide reGistry (LUNA) coHorT. Lupus Sci Med. 2022 Sep;9(1):e000746. doi: 10.1136/lupus-2022-000746.
- Derived from this study: PubMed 38334499Desai SB, Ahdoot R, Malik F, Obert M, Hanna R. New guidelines and therapeutic updates for the management of lupus nephritis. Curr Opin Nephrol Hypertens. 2024 May 1;33(3):344-353. doi: 10.1097/MNH.0000000000000969. Epub 2024 Feb 9.
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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.
Marwa Abdel Samie, Lecturer contact
Howaida Al-Shennawi, Professor principal investigator
Professor of internal medicine and Nephrology
Cherry Kamel, Professor study director
Professor of internal medicine and Nephrology
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing Dapagliflozin 10mg Tab orally once daily in people with Lupus Nephritis, run by Ain Shams University at 1 site in Egypt.
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 4 inclusion and 12 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 2 Nov 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 Egypt. 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 combined phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
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?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Marwa Ahmed Waly, MD (01288264247, Dr.marwa_waly@outlook.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Renal Function Tests: (time frame: 6 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 NCT06113900, which also lists 7 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 2 Nov 2023.