The purpose of the study is to assess efficacy, safety and tolerability of treatment with zibotentan and dapagliflozin in combination and dapagliflozin 10 mg as monotherapy in participants with chronic kidney disease (CKD) with estimated glomerular filtration rate (eGFR) ≥ 20 mL/min/1.73 m\^2, and urinary albumin to creatinine ratio (UACR) ≥ 150 mg/g and ≤ 5000 mg/g.
The study will be conducted in approximately 220 sites in North America, South America, Africa, Asia/Pacific, and European countries. Participants will be randomized to 12 weeks of treatment plus 2 weeks follow-up. After screening, eligible participants will be stratified by diabetes (diabetic kidney disease \[DKD\] versus non-diabetes mellitus \[non-DM\] CKD) and baseline eGFR (below or equal versus above 45 mL/min/1.73m\^2). A total of 495 participants will be randomised into this study, including participants randomised under the earlier study design. Four hundred and fifteen (415) participants will be randomised to have 166 participants in zibotentan Dose A/dapagliflozin 10 mg combination arm and dapagliflozin 10 mg monotherapy arm, and 83 participants in the zibotentan Dose B/dapagliflozin 10 mg combination arm. * Zibotentan Dose A + Dapagliflozin 10 mg once daily. * Zibotentan Dose B + Dapagliflozin 10 mg once daily. * Placebo + Dapagliflozin 10 mg once daily Participants who were previously randomised cannot be re-randomised.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
542
Participants will receive zibotentan as per the arms they are randomized.
Participants will receive 10 mg dapagliflozin as per the arms they are randomized.
Participants will receive placebo as per the arms they are randomized to.
Change in Urinary Albumin to Creatinine Ratio (UACR) From Baseline to Week 12
The effect of zibotentan 1.5/dapagliflozin 10 mg versus dapagliflozin 10 mg on UACR was assessed.
Time frame: From baseline (Week 0 [Day 1]) until Week 12 (Day 84)
Change in UACR From Baseline to Week 12
The effect of zibotentan 0.25 mg/dapagliflozin 10 mg versus dapagliflozin 10 mg monotherapy on UACR was assessed.
Time frame: From baseline (Week 0 [Day 1]) until Week 12
Change in Office Systolic Blood Pressure From Baseline to Week 12
The change in office systolic blood pressure for doses of zibotentan combined with dapagliflozin 10 mg versus dapagliflozin 10 mg monotherapy was assessed.
Time frame: From baseline (Week 0 [Day 1]) until Week 12 (Day 84)
Change in Office Diastolic Blood Pressure From Baseline to Week 12
The change in office diastolic blood pressure for doses of zibotentan combined with dapagliflozin 10 mg versus dapagliflozin 10 mg monotherapy was assessed.
Time frame: From baseline (Week 0 [Day 1]) until Week 12 (Day 84)
Change in UACR From Baseline to Week 12
The assessment of dose-response and relationship across different dose of zibotentan/dapagliflozin and dapagliflozin alone on UACR reduction.
Time frame: From baseline (Week 0 [Day 1]) until Week 12 (Day 84)
Change in eGFR From Baseline to Week 1, Week 12, and Week 14
The effect of different doses of zibotentan and dapagliflozin 10 mg in combination versus dapagliflozin 10 mg monotherapy on eGFR was assessed.
Time frame: From baseline (Week 0 [Day 1]) until Week 1 (Day 8), Week 12 (Day 84), and Week 14 (Day 98)
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Research Site
Huntsville, Alabama, United States
Research Site
Beverly Hills, California, United States
Research Site
Downey, California, United States
Research Site
Fountain Valley, California, United States
Research Site
Laguna Hills, California, United States
Research Site
Los Angeles, California, United States
Research Site
Northridge, California, United States
Research Site
Ontario, California, United States
Research Site
South Gate, California, United States
Research Site
Tarzana, California, United States
...and 154 more locations
Number of Participants With Adverse Events (AE) and Serious Adverse Events (SAE)
The safety and tolerability of all doses of zibotentan combined with dapagliflozin 10 mg and dapagliflozin 10 mg monotherapy was assessed.
Time frame: From Screening (Day -28) until Follow-up visit (Day 98), up to 126 days
Change in eGFR From Week 1 to Week 12
The effect of different doses of zibotentan and dapagliflozin 10 mg in combination versus dapagliflozin 10 mg monotherapy on eGFR was assessed.
Time frame: From Week 1 (Day 8) to Week 12 (Day 84)