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CSP #2008 - Pentoxifylline in Diabetic Kidney Disease


Description

Pentoxifylline (PTX) is a medication that has been on the market since 1984 for use in disease in the blood vessels of the legs. There is some preliminary information that it may protect the kidneys from damage due to diabetes and other diseases. "Pentoxifylline in Diabetic Kidney Disease" is a study to bee conducted in 40 VA hospitals across the nation to determine definitively whether or not PTX can prevent worsening of kidney disease and delay death in patients with diabetic kidney disease.Diabetic kidney disease (DKD) is the most frequent cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) in the U.S. and in U.S. Veterans. Control of blood pressure and reduction in proteinuria, for instance by blockade of the renin-angiotensin-aldosterone system (RAAS) with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptors blockers (ARBs), have led to some improvement in outcomes in recent years. However, many patients continue to progress to ESRD, requi

Trial Eligibility

Inclusion Criteria: A. Inclusion Criteria: 1. Type 2 diabetes. 2. Meet one of the following categories at a time that is greater than 90 days prior to randomization * Group I: eGFR 15 to less than 30 mL/min/1.73 m2, or * Group II: eGFR 30 to less than 45 mL/min/1.73 m2 with UACR \> 30 mg/g or UPCR \> 150 mg/g, or * Group III: eGFR 45 to less than 60 mL/min/1.73 m2 with UACR \> 300 mg/g or UPCR \> 500 mg/g 3. Participants need to be in one of the following categories at the time of randomization: * Group I: eGFR 15 to less than 30 mL/min/1.73 m2 , or * Group II: eGFR 30 to less than 45 mL/min/1.73 m2 with UACR \> 30 mg/g, or * Group III: eGFR 45 to less than 60 mL/min/1.73 m2 with UACR \> 300 mg/g Participants must be a United States Veteran, currently receiving care at a VA hospital with a local study team. Exclusion Criteria: 1. Type 1 diabetes 2. History of non-diabetic kidney disease 3. Severe comorbid conditions expected to reduce life expectancy to less than 1 year, as determined by LSI 4. Active substance abuse, homelessness, or other condition that is likely to result in participant non,ompliance as determined by the LSI 5. Previous organ or bone marrow transplant 6. Pregnancy, breast feeding or female of child-bearing potential unwilling to use a reliable form of contraception 7. A recent (within 3 months) cerebral hemorrhage 8. Current use of oral pentoxifylline 9. Hypersensitivity to pentoxifylline or any of the components of the formulation 10. Current use of systemic ketorolac, oral or IV (contraindicated with pentoxifylline) 11. Current use of riociguat (contraindicated with pentoxifylline) 12. Current use of dialysis 13. Unable to provide informed consent 14. or any condition that in the opinion of the LSI would make the potential participant non-compliant

Study Info

Organization

VA Office of Research and Development


Primary Outcome

Time to ESRD or death


Outcome Timeframe 5 to 9 years

NCTID NCT03625648

Phases PHASE4

Primary Purpose TREATMENT

Start Date 2019-11-18

Completion Date 2028-01-03

Enrollment Target 2510

Interventions

DRUG Pentoxifylline

DRUG Placebo

Locations Recruiting

Phoenix VA Health Care System, Phoenix, AZ

United States, Arizona, Phoenix


Central Arkansas Veterans Healthcare System, Little Rock, AR

United States, Arkansas, Little Rock


VA Loma Linda Healthcare System, Loma Linda, CA

United States, California, Loma Linda


VA Long Beach Healthcare System, Long Beach, CA

United States, California, Long Beach


VA Palo Alto Health Care System, Palo Alto, CA

United States, California, Palo Alto


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