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A multicenter randomized trial to evaluate the efficacy of pioglitazone to improve renal outcome in ANCA-associated vasculitis - RENATO
EU CTIS ID: 2022-501057-36-00
What this study is testing
To demonstrate a reduction of renal damage (reflected by the early improvement of proteinuria and serum creatinine), in ANCA-associated renal vasculitis, by pioglitazone add-on treatment on top of Standard Of Care (SOC) standardized immunosuppressive regimen with glucocorticoids and rituximab, after six months
- Therapeutic confirmatory (Phase III)
A plain-language read of the study's public EU CTIS listing. The study team confirms the details.
Who can take part
You may be able to join if
- Newly-diagnosed or relapsing ANCA-associated vasculitis, i.e. granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA), according to ACR 1990 criteria and/or revised Chapel Hill Consensus Conference definitions and/or European Medical Agency algorithm, with an active vasculitis defined as a BVAS ≥ 3
- Presence of proteinuria (uPCR >300 mg/g), haematuria (>10 RBC/hpf), and eGFR ≥15 mL/min/1.73 m² (CKD-EPI formula) at inclusion (<1month)
- Recent (<4 weeks) renal biopsy that confirms renal involvement of ANCA-associated vasculitis
- Patients aged of 18 to 80 years
- Participant written informed consent prior to participation in the study
- Participants affiliated to a French health insurance system (registered or being a beneficiary of such a scheme)
You likely can't join if
- Alveolar haemorrhage requiring pulmonary ventilation support at inclusion
- Patients who have been taking an oral daily dose of a glucocorticoid of more than 10 mg prednisone-equivalent for more than 6 weeks continuously prior to screening
- Current participation in another research study involving a therapeutic intervention. Participation to an observational research, or a non-interventional research is allowed
- Patients with eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss
- Patients under guardianship or curatorship and protected adults
- Patients not able to understand and follow study procedures
See the full eligibility criteria
Who can join
- Newly-diagnosed or relapsing ANCA-associated vasculitis, i.e. granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA), according to ACR 1990 criteria and/or revised Chapel Hill Consensus Conference definitions and/or European Medical Agency algorithm, with an active vasculitis defined as a BVAS ≥ 3
- Presence of proteinuria (uPCR >300 mg/g), haematuria (>10 RBC/hpf), and eGFR ≥15 mL/min/1.73 m² (CKD-EPI formula) at inclusion (<1month)
- Recent (<4 weeks) renal biopsy that confirms renal involvement of ANCA-associated vasculitis
- Patients aged of 18 to 80 years
- Participant written informed consent prior to participation in the study
- Participants affiliated to a French health insurance system (registered or being a beneficiary of such a scheme)
What rules you out
- Alveolar haemorrhage requiring pulmonary ventilation support at inclusion
- Patients who have been taking an oral daily dose of a glucocorticoid of more than 10 mg prednisone-equivalent for more than 6 weeks continuously prior to screening
- Current participation in another research study involving a therapeutic intervention. Participation to an observational research, or a non-interventional research is allowed
- Patients with eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss
- Patients under guardianship or curatorship and protected adults
- Patients not able to understand and follow study procedures
- Patients on AME (Aide Médicale de l’Etat = State Medical Assistance)
- Active cancer (except non-melanoma skin cancer) within the past 24 months
- Active severe bacterial, viral or fungal infectious disease
- Past history of bladder or urinary tract cancer
- History of Class 3/4 congestive heart failure symptoms, any time
- Presence of neutropenia <1000 cells/µl (<1 month)
- History of Class 2 heart failure symptoms within the past 3 months and/or ejection fraction <40% on recent echocardiography (<1 month)
- Transaminases levels above 2 times the normal range value (<1 month) or any severe chronic liver disease
- Positive serology for HIV, HBV (Ag HBs positivity) or active HCV infection at inclusion
- A pre-existing or an important risk of new-onset macular edema (confirmed by an ophthalmological examination)
- History of intolerance to any thiazolidinedione (including Pioglitazone), to rituximab or any excipient listed in SmPc
- Diabetic ketoacidosis, any time
- Pregnant or breast-feeding women, or desire to become pregnant within 24 months. All women of childbearing potential (WOCBP) are required to have a negative pregnancy test before treatment and must agree to maintain highly effective contraception by practicing abstinence or by using an effective method of birth control from the date of consent through the end of the study and another 12 months after (or 12 months after the last rituximab infusion in case of premature termination): Combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation (Oral, Intravaginal, Transdermal); Progestogen-only hormonal contraception associated with inhibition of ovulation (Oral, Injectable, Implantable); Intrauterine device (IUD); Intrauterine hormone-releasing system (IUS); Bilateral tubal occlusion; Vasectomised partner
- Severe neurologic or psychiatric disease (e.g., dementia or schizophrenia)
- Kidney transplant recipients
- Cyclophosphamide or rituximab (dose > 375 mg/m2) use within 26 weeks prior to screening; if on azathioprine, mycophenolate mofetil or methotrexate at the time of screening, these drugs must be withdrawn prior to receiving the first rituximab dose. Patients that have initiated induction therapy with rituximab for the actual flare, can be included in the present study within 48h following the first rituximab infusion
- Intravenous glucocorticoids, >3000 mg methylprednisolone equivalent, within 4 weeks prior to screening
The study team makes the final eligibility decision.
Questions & answers
Do participants get paid in this trial?
This listing doesn't specify compensation. Many trials still reimburse travel or offer a stipend, so it's worth asking the study team when you connect.
Is it free to join, and do I need insurance?
Searching and applying through BridgeMD is free. In clinical trials the study-related treatment and visits are generally provided at no cost to you. You usually don't need insurance to take part - confirm specifics with the study team.
How long does this study last?
The listing doesn't state an exact length. The study team walks you through the schedule and number of visits before you decide to enroll.
Who can join this trial?
This study is enrolling all sexes, 18-64 years, 65+ years. The study team makes the final eligibility decision.
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BridgeMD is an information and trial-matching tool - not medical advice, and not the study sponsor. Details come from EU CTIS; the study team decides eligibility.