Study to Observe Disease Progession In Alport Syndrome Patients

  • Research type

    Research Study

  • Full title

    A Natural History Study to Observe Disease Progression, Standard of Care and Investigate Biomarkers in Alport Syndrome Patients

  • IRAS ID

    164690

  • Contact name

    Neil Turner

  • Contact email

    neil.turner@ed.ac.uk

  • Sponsor organisation

    Regulus Therapeutics

  • Duration of Study in the UK

    2 years, 9 months, 12 days

  • Research summary

    Alport syndrome is an inherited form of kidney disease caused by mutations in genes coding for the capillary basement membrane collagen IV. The prevalence of mutations in the collagen IV family of genes is estimated to be 1 in 5,000 individuals. Multiple mutations have been identified in each of 3 distinct collagen IV alpha genes. Each chain is a key component of the collagen IV network, which is critical for maintaining the structure and integrity of the glomerular basement membrane. Alport syndrome is characterized by progressive glomerulonephritis, leading to glomerulosclerosis, tubulo-interstitial disease and organ failure.

    Regardless of the category of mutation, patients with Alport syndrome all progress, and eventually develop end-stage renal disease (ESRD), requiring dialysis or renal transplantation.

    Although renal transplantation has been shown to increase the survival of patients with Alport syndrome, it is associated with significant morbidity, even if successful in preventing death. In the U.S. there are no approved agents to delay time to ESRD for patients with Alport syndrome. Numerous agents have been investigated for their ability to reduce proteinuria and improve other symptoms associated with Alport syndrome. These agents include cyclosporine, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II type I receptor blockers (ARBs) and mineralocorticoid receptor antagonists. Only ACE inhibitors have been shown to reduce the time to dialysis in treated patients as compared to family relatives with Alport syndrome
    who were not receiving ACE inhibitors.

    Thus an urgent need remains for the development of new therapeutics that can reduce the degree of fibrosis and renal inflammation, improve renal function and delay the time to dialysis for patients with Alport syndrome.

    The study will collect data to characterize the progression of renal dysfunction in Alport syndrome patients.

    The sequential sampling of subjects' urine and/or blood will allow an assessment of the rate of change of established clinical endpoints, such as GFR and/or the rate of change of other renal biomarkers (proteinuria and β-2 microglobulin) in subjects whose renal function is steadily declining.

    The identification of surrogate markers that track the decline of renal function and could correlate with time to end-stage renal disease (ESRD) is a key goal of the natural history study.

  • REC name

    West Midlands - Black Country Research Ethics Committee

  • REC reference

    15/WM/0010

  • Date of REC Opinion

    24 Feb 2015

  • REC opinion

    Further Information Favourable Opinion