36 Participants Needed

PB for Nephrogenic Diabetes Insipidus

(SerendipityPB1 Trial)

Recruiting at 1 trial location
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Overseen ByTaylor Cunningham
Age: 18+
Sex: Any
Trial Phase: Phase 2
Sponsor: Mayo Clinic
Must be taking: Tolvaptan
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a medication called PB to determine its effectiveness in managing frequent urination in individuals with certain kidney-related conditions. It aims to improve life for those with inherited or lithium-induced nephrogenic diabetes insipidus, which causes excessive urination, or those with autosomal dominant polycystic kidney disease treated with tolvaptan. Individuals with one of these conditions who experience frequent urination might be suitable for this trial. As a Phase 2 trial, the research focuses on measuring the treatment's effectiveness in an initial, smaller group, offering participants a chance to contribute to important medical advancements.

Will I have to stop taking my current medications?

The trial protocol does not specify if you need to stop taking your current medications. However, if you have high blood pressure, it must be controlled with medication for at least 30 days before starting the trial.

Is there any evidence suggesting that PB is likely to be safe for humans?

Research is investigating the safety and effectiveness of PB for treating conditions like nephrogenic diabetes insipidus and polyuria, which involves frequent urination due to other health issues. Although detailed information about PB remains limited, the study's early phase suggests it has shown promise for safety in initial tests. Early-phase studies typically assess whether a treatment is generally safe and free from major side effects.

If PB has been tested for other conditions, some safety information might be available from those uses. However, specific safety details about PB are not yet available. It is important to discuss any concerns with a healthcare provider and consider all information before deciding to join the trial.12345

Why do researchers think this study treatment might be promising for nephrogenic diabetes insipidus?

Researchers are excited about PB for nephrogenic diabetes insipidus because it offers a new approach compared to standard treatments like thiazide diuretics and nonsteroidal anti-inflammatory drugs. PB is unique as it specifically targets the mechanisms causing excessive urination in different patient groups, including those with lithium-induced polyuria, hereditary nephrogenic diabetes insipidus, and autosomal dominant polycystic kidney disease. Unlike current treatments that generally aim to reduce urine output indirectly, PB may more precisely address the underlying causes, such as loss of function in specific receptors or channels like AVPR2 or AQP2. This targeted approach could lead to improved effectiveness and fewer side effects, making it a promising option for patients who have limited choices today.

What evidence suggests that PB might be an effective treatment for frequent urination in nephrogenic diabetes insipidus?

Research has shown that PB may help treat nephrogenic diabetes insipidus (NDI), a condition causing frequent urination. In this trial, participants with hereditary NDI, NDI due to lithium treatment, or autosomal dominant polycystic kidney disease (ADPKD) treated with tolvaptan will receive PB. Studies have found PB effective in reducing frequent urination, particularly in inherited cases. Early findings suggest that PB could ease daily life by reducing bathroom visits, offering a promising option for those facing these challenging conditions.678910

Who Is on the Research Team?

FC

Fouad Chebib, MD

Principal Investigator

Mayo Clinic

Are You a Good Fit for This Trial?

This trial is for adults who can consent and have been diagnosed with nephrogenic diabetes insipidus (inherited or from lithium/tolvaptan use), ADPKD, or severe polyuria. They must have a GFR ≥ 30 ml/min, low morning urine concentration, and controlled blood pressure if hypertensive. Excluded are those with chronic diseases like heart failure or liver disease, urinary issues, recent gout attacks, uncontrolled gout/hyperuricemia, drug allergies to PB, or past hepatotoxicity from tolvaptan.

Inclusion Criteria

Only females are eligible for this study.
You have been diagnosed with nephrogenic diabetes insipidus (NDI), which can be either genetic or caused by certain medications.
You have kidney problems caused by taking lithium.
See 7 more

Exclusion Criteria

You have a history of low sodium levels in your blood that has lasted for a long time.
You have a significant long-term health condition like heart failure, diabetes, liver disease, or consistently high liver enzyme levels.
You have trouble controlling your bladder or have problems with urination.
See 4 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive PB to assess its efficacy in decreasing urine output and increasing urine osmolality

90 days
Visits at baseline, day 15, day 45, day 75

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • PB
Trial Overview The study tests the medication PB's effectiveness in reducing excessive urination in patients with inherited nephrogenic diabetes insipidus (NDI), NDI due to long-term treatment of ADPKD with tolvaptan, or NDI caused by previous lithium therapy.
How Is the Trial Designed?
3Treatment groups
Experimental Treatment
Group I: Polyuric subjects with Hereditary Nephrogenic Diabetes InsipidusExperimental Treatment1 Intervention
Group II: Polyuric subjects with Autosomal Dominant Polycystic Kidney Disease treated with TolvaptanExperimental Treatment1 Intervention
Group III: Polyuric subject secondary to lithium administrationExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Mayo Clinic

Lead Sponsor

Trials
3,427
Recruited
3,221,000+

Otsuka America Pharmaceutical

Industry Sponsor

Trials
67
Recruited
28,400+

Tarek Rabah

Otsuka America Pharmaceutical

Chief Executive Officer since 2022

BS in Biology and BA in Business from the American University of Beirut, MBA from McGill University

John Kraus

Otsuka America Pharmaceutical

Chief Medical Officer since 2021

MD and PhD in Neurobiology from Duke University

Hopital du Sacre-Coeur de Montreal

Collaborator

Trials
52
Recruited
12,100+

Published Research Related to This Trial

Parathyroidectomy (PTX) significantly reduced blood lead (Pb) levels in 30 patients with refractory secondary hyperparathyroidism (SHPT) undergoing long-term hemodialysis, indicating a beneficial effect on lead release from bone stores.
The study found that after PTX, there was a marked decrease in serum intact parathyroid hormone (iPTH) and a progressive increase in bone-specific alkaline phosphatase (BAP), suggesting that PTX effectively alters bone remodeling and may help mitigate lead exposure in these patients.
Parathyroidectomy leads to decreased blood lead levels in patients with refractory secondary hyperparathyroidism.Chu, P., Wu, CC., Chen, CC., et al.[2016]
Teriparatide, a treatment for postmenopausal osteoporosis and osteoporosis in men, has been used for over 5 years, providing substantial data on its long-term safety, particularly regarding its registered dose of 20 microg/day.
While teriparatide is effective, there are important safety considerations, including the potential for hypercalcemia, hypercalciuria, and hyperuricemia, as well as a 'black-box' warning from the FDA about the risk of osteogenic sarcoma observed in rat studies.
Safety of parathyroid hormone for the treatment of osteoporosis.Miller, PD.[2021]
In a study of 28 patients with secondary hyperparathyroidism undergoing hemodialysis, intravenous calcitriol therapy for 16 weeks significantly reduced blood lead levels and markers of bone remodeling, indicating its efficacy in managing these conditions.
The therapy led to a notable decrease in serum intact parathyroid hormone (iPTH) levels and a positive correlation was found between blood lead levels and both serum iPTH and TRAP, suggesting that hyperparathyroidism may enhance lead mobilization from bones.
Decreased blood lead levels after calcitriol treatment in hemodialysis patients with secondary hyperparathyroidism.Lu, KC., Wu, CC., Ma, WY., et al.[2016]

Citations

Diagnosis, Treatment, and Outcomes in Children With ...Diagnosis, treatment, and outcomes in children with congenital nephrogenic diabetes insipidus: a pediatric nephrology research consortium study.
PB to Treat Hereditary Nephrogenic Diabetes Insipidus, ...The objectives of this study are to evaluate the effectiveness and safety of PB in the treatment of patients with hereditary nephrogenic diabetes insipidus.
Probenecid (PB) to Treat Hereditary Nephrogenic Diabetes ...The purpose of this research is to study the effectiveness and safety of the medication PB in slowing the frequent urination related to ...
4.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/33367818/
Treatment and long-term outcome in primary nephrogenic ...This large NDI cohort shows an overall favourable outcome with normal adult height and only mild to moderate CKD in most.
PB for Nephrogenic Diabetes InsipidusTrial Overview The study tests the medication PB's effectiveness in reducing excessive urination in patients with inherited nephrogenic diabetes insipidus (NDI) ...
Hereditary Nephrogenic Diabetes Insipidus - NCBI - NIHHereditary nephrogenic diabetes insipidus (NDI) is characterized by inability to concentrate the urine, which results in polyuria (excessive urine production) ...
Nephrogenic Diabetes Insipidus - Symptoms, Causes, ...NDI is a rare kidney disorder that may be inherited or acquired. NDI is not related to the more common diabetes mellitus (sugar diabetes).
Nephrogenic Diabetes Insipidus (NDI)Nephrogenic diabetes insipidus is a rare genetic renal tubular disease characterized by polyuria, polydipsia, fever, constipation, and acute hypernatremic ...
Diabetes insipidusDiabetes insipidus (DI) is a disorder characterized by a high hypotonic urinary output of more than 50ml per kg body weight per 24 hours, with associated ...
Nephrogenic Diabetes Insipidus: Symptoms & TreatmentNephrogenic diabetes insipidus is a kidney condition. Your body fails to respond properly to a natural hormone called antidiuretic hormone (ADH).
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