At a glance
ClinicalIndex Comparison Record- ✓Biopsy-proven FSGS (focal segmental glomerulosclerosis)
- ✓Age ≥18 years
- ✓GFR between 25–80 mL/min by MDRD equation
- ✓Documented renal decline ≥0.4 mL/min/month over ≥6 months baseline period
- ✕Known intolerance to pirfenidone
- ✕FSGS associated with additional primary or secondary glomerular disease (e.g., diabetes, membranous nephropathy, IgA nephropathy)
- ✕Myocardial infarction within 6 months
- ✕Peptic ulcer within 6 months
Standardized by ClinicalIndex from the ClinicalTrials.gov record · verify against the source.
Pirfenidone in Focal Segmental Glomerulosclerosis:Phase II Study
In Brief
A Phase 2 clinical trial evaluating Pirfenidone for Fibrosis and 4 related conditions. Completed, enrolled 21 participants across 1 site.
Detailed Summary
This study will examine the effectiveness of the drug pirfenidone in treating focal segmental glomerulosclerosis (FSGS). Patients with this disease have kidney fibrosis (scarring) and proteinuria (excessive excretion of protein in the urine). About half of patients with FSGS eventually require kidney dialysis or transplant. Steroids, which are currently used to treat the disease, are effective in only a minority of patients. Other drugs, such as cyclosporin and cyclophosphamide, improve proteinuria in a very small percentage of patients and have serious side effects. Patients with FSGS who wish to participate in this study will undergo pre-study evaluation with blood and urine tests. Patients must be on a stable dose of an ACE inhibitor (a drug that lowers blood pressure and reduces proteinuria) for at list 6 months before starting pirfenidone therapy. (Patients who are not already taking an ACE inhibitor will be started on the drug; those who cannot tolerate ACE inhibitors will be given a different drug.) Patients with elevated cholesterol will take a cholesterol-lowering drug. A diet containing approximately 1 gram of protein per kilogram of body weight per day will be recommended. Patients will take pirfenidone by mouth 3 times a day for 12 months. Blood and urine will be tested once a month, either at NIH or by the patient's local kidney specialist. They will collect two 24-hour urine samples at the beginning of the treatment period, at 2-month intervals throughout the study, and at a 6-month follow-up. Patients will also be asked to give three to five tubes of blood and urine samples for analysis during the study. In animal studies, pirfenidone improved kidney function and proteinuria and reduced kidney scarring in rats with a disease similar to FSGS. In human studies, pirfenidone improved breathing and survival in patients with lung fibrosis.
Study Details
Timeline
Interventions
During the study drug period of 12 months, patients will receive oral pirfenidone daily. For patients whose initial renal function is 50-80 ml/min as assessed by the MDRD equation, the initial pirfenidone dosage will be calculated at 40 mg/kg/d, with a maximum dose of 800 mg TID. For patients whose initial renal function is 30-50 ml/min, the initial dose will be 30 mg/kg/d. For patients whose initial renal function is between 15 and 30 ml/min, the initial dose will be 20 mg/kg/d.