This is a multi-center, two-part study; Part A and Part B. Part A of the study is an open-label, single-dose pharmacokinetic (PK) evaluation of 100 mg RVX000222 on dialysis and non-dialysis days in eight (8) End Stage Renal Disease (ESRD) patients who receive hemodialysis as standard of care. Part B of the study is a double-blind, placebo-controlled study in up to thirty six (36) ESRD patients receiving hemodialysis using a sequential cross-over design with RVX000222 at a daily oral dose of 100 mg b.i.d. (200 mg per day) or matching placebo in combination with SoC. The primary objective of the study is to evaluate if treatment with RVX000222 in combination with standard of care (SoC) decreases plasma alkaline phosphatase in comparison to placebo and SoC.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
44
RVX000222 oral (apabetalone), 100 mg capsule
matching placebo capsule
Percent change in alkaline phosphatase (ALP) concentration (Part B)
The primary endpoint of the study is the comparison of the RVX000222 treatment period to the placebo period in the percent change in ALP concentration. Percent change is computed relative to the beginning of each period.
Time frame: Percent change is computed relative to the beginning of each period (6 weeks)
Single Dose Cmax of RVX000222 (apabetalone) and the Metabolites RVX000288 and RVX000404
Primary PK comparison between dialysis (test) and non-dialysis (reference) days for Cmax of RVX000222 and its two principal metabolites, RVX000288 and RVX000404
Time frame: 48 hours
Single Dose AUC of RVX000222 (apabetalone) and the Metabolites RVX000288 and RVX000404
Primary PK comparison between dialysis (test) and non-dialysis (reference) days for AUC of RVX000222 and its two principal metabolites, RVX000288 and RVX000404
Time frame: 48 hours
Changes in high-sensitivity C-Reactive Protein (hsCRP)
Changes in hsCRP in dialysis patients at the end of the RVX000222 treatment period relative to the end of the placebo period
Time frame: 6 weeks
Changes in Interleukin-13 (IL-13)
Changes in IL-13 in dialysis patients at the end of the RVX000222 treatment period relative to the end of the placebo period
Time frame: 6 weeks
Changes in Interleukin-6 (IL-6)
Changes in IL-6 in dialysis patients at the end of the RVX000222 treatment period relative to the end of the placebo period
Time frame: 6 weeks
Changes in Interleukin-8 (IL-8)
Changes in IL-8 in dialysis patients at the end of the RVX000222 treatment period relative to the end of the placebo period
Time frame: 6 weeks
Changes in Monocyte Chemoattractant Protein-1 (MCP-1)
Changes in MCP-1 in dialysis patients at the end of the RVX000222 treatment period relative to the end of the placebo period
Time frame: 6 weeks
Change in key markers of vascular mineralization
Change in key markers of vascular mineralization i.e. RANKL and osteoprotegerin at the end of the RVX000222 treatment period relative to the end of the placebo period
Time frame: 6 weeks
Changes in ALP isoenzymes
Changes in ALP isoenzymes at the end of the RVX000222 treatment period relative to the end of the placebo period
Time frame: 6 weeks
Changes in Parathyroid hormone (PTH)
Changes in parathyroid hormone at the end of the RVX000222 treatment period relative to the end of the placebo period
Time frame: 6 weeks
Change in apolipoprotein A1 (apoA-I), HDL-C, LDL-C, apolipoprotein B (apoB), and triglycerides
Change in apoA-I, HDL-C, LDL-C, apoB, and triglycerides at the end of the RVX000222 treatment period relative to the end of the placebo period
Time frame: 6 weeks
Change in Analyzing Data, Recognizing Excellence and Optimizing Outcomes All-Cause Mortality Risk Score For Patients on Chronic Hemodialysis (ARO Score)
Change in ARO Score at the end of the RVX000222 treatment period relative to the end of the placebo period
Time frame: 6 weeks
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