Clinical trial NCT02048904: Use of Sitagliptin to Decrease Microalbuminuria
Official title: Clinical Effect of Dipeptidyl Peptidase-4 (DPP-4) Inhibitors in Urinary Albumin to Creatinine Ratio in Patients With Overt Kidney Disease
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE4
Conditions: Type 2 Diabetes
Microalbuminuria
Keywords: microalbuminuria
type 2 diabetes
Lead sponsor: University of Missouri-Columbia
Sponsor class: OTHER
First posted: 2014-01-29
Enrollment: 142
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The people being asked to participate in this study have type 2 diabetes and abnormal levels of protein in their urine. This indicates that they are starting to develop diabetic kidney disease. The standard treatment for this is the use of one of two blood pressure medicines, either an angiotensin converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB). However, these medicines are not always completely effective in stopping/reversing the kidney disease. Some studies have previously suggested that another type of medicine, called sitagliptin, normal used to treat diabetes may also help prevent diabetic kidney disease from getting worse.

This study is being performed to test the effectiveness of sitagliptin as compared to a placebo, along with a stable dose of an ACE inhibitor or ARB, to determine whether or not it will reduce protein levels in their urine. Protein levels in the urine are a marker of the severity of kidney disease.

Detailed description: The people being asked to participate in this study have type 2 diabetes and abnormal levels of protein in their urine. This indicates that they are starting to develop diabetic kidney disease. The standard treatment for this is the use of one of two blood pressure medicines, either an ACE inhibitor or ARB. However, these medicines are not always completely effective in stopping/reversing the kidney disease. Some studies have previously suggested that another type of medicine, called sitagliptin, normal used to treat diabetes may also help prevent diabetic kidney disease from getting worse.

Eligibility criteria: Inclusion Criteria:

* Albumin/creatinine ratio between 30-299 mg/dl.
* type 2 diabetes mellitus (T2DM) with hemoglobin A1c between 7 and 9%.
* Stable BP control of less than 145/90 on treatment with ACE or ARB for more than three months prior and during the trial.
* Glomerular filtration rate (GFR) of 60 mL/min/1.73m2 or more.
* Age between 18-75 years old.
* For women: at least two years postmenopausal, surgically sterile, or using an acceptable contraceptive regiment to include oral contraceptive pill (OCP), intrauterine device (IUD), double barrier, depo-provera, or subcutaneous progestin implant and negative urine pregnancy test at trial start.

Exclusion Criteria:

* Pregnancy.
* GFR less than 60 mL/min/73m2.
* Have a history of malignancy other than basal cell or squamous cell skin cancer and have not yet been treated, are currently being treated, or were diagnosed less than 5 years prior to Visit 1.
* Advanced liver disease.
* Subjects cannot be on DPP-4 inhibitor or glycolipoprotein (GLP-1) agonist for at least 4 months before the study start.
* Psychiatric condition that would prevent subject from following directions. Per PI discretion.

Primary outcomes:
measure: Change in Microalbuminuria Level
timeFrame: Six months
Secondary outcomes:
Other outcomes:
Locations:
city: Columbia
country: United States
facility: University of Missouri-Columbia: Diabetes Center
state: Missouri
Study officials:
affiliation: University of Missouri-Columbia
name: Guido Lastra Gonzalez, MD
role: PRINCIPAL_INVESTIGATOR
References: