BACKGROUND AND OBJECTIVES: Patients with primary focal segmental glomerulosclerosis (FSGS) who are resistant to standard therapy are at high risk for progressive chronic kidney disease. Prevention of renal fibrosis represents a promising strategy to slow or halt kidney function decline. This paper presents the results of a Phase I clinical trial of rosiglitazone, a thiazolidinedione, that exerts antifibrotic effects in animal models of FSGS. The primary goal was assessment of safety, tolerability, and pharmacokinetics (PK) of rosiglitazone. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Eleven patients, including eight boys/men and three girls/women, with mean age 15 +/- 6 yr and estimated GFR 131 +/- 62 ml/min/1.73 m(2), received rosiglitazone, 3 mg/m(2)/d for 16 wk. PK was assessed twice, after the initial dose and after attaining steady state, in a General Clinical Research Center. RESULTS: There were no serious adverse events or cardiovascular complications. Rosiglitazone was well tolerated by all patients, as judged by the Treatment Satisfaction Questionnaire for Medication. The PK studies indicated that the area under the curve was decreased by 40 to 50% and oral clearance of rosiglitazone was increased by 250 to 300% in patients with resistant FSGS compared with healthy controls and patients with nonproteinuric stage 2 chronic kidney disease. CONCLUSIONS: Rosiglitazone therapy was safe and well tolerated. PK assessment of potential novel therapies for resistant FSGS is necessary to define appropriate dosing regimens. There is rationale to evaluate the efficacy of rosiglitazone as an antifibrotic agent for resistant FSGS in Phase II/III clinical trials.
BACKGROUND AND OBJECTIVES:Patients with primary focal segmental glomerulosclerosis (FSGS) who are resistant to standard therapy are at high risk for progressive chronic kidney disease. Prevention of renal fibrosis represents a promising strategy to slow or halt kidney function decline. This paper presents the results of a Phase I clinical trial of rosiglitazone, a thiazolidinedione, that exerts antifibrotic effects in animal models of FSGS. The primary goal was assessment of safety, tolerability, and pharmacokinetics (PK) of rosiglitazone. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Eleven patients, including eight boys/men and three girls/women, with mean age 15 +/- 6 yr and estimated GFR 131 +/- 62 ml/min/1.73 m(2), received rosiglitazone, 3 mg/m(2)/d for 16 wk. PK was assessed twice, after the initial dose and after attaining steady state, in a General Clinical Research Center. RESULTS: There were no serious adverse events or cardiovascular complications. Rosiglitazone was well tolerated by all patients, as judged by the Treatment Satisfaction Questionnaire for Medication. The PK studies indicated that the area under the curve was decreased by 40 to 50% and oral clearance of rosiglitazone was increased by 250 to 300% in patients with resistant FSGS compared with healthy controls and patients with nonproteinuric stage 2 chronic kidney disease. CONCLUSIONS:Rosiglitazone therapy was safe and well tolerated. PK assessment of potential novel therapies for resistant FSGS is necessary to define appropriate dosing regimens. There is rationale to evaluate the efficacy of rosiglitazone as an antifibrotic agent for resistant FSGS in Phase II/III clinical trials.
Authors: Thomas D Nolin; Kofi Appiah; Scott A Kendrick; Phuong Le; Ellen McMonagle; Jonathan Himmelfarb Journal: J Am Soc Nephrol Date: 2006-08-09 Impact factor: 10.121
Authors: Stephen Zafiriou; Scott R Stanners; Sonia Saad; Tania S Polhill; Philip Poronnik; Carol A Pollock Journal: J Am Soc Nephrol Date: 2005-02-02 Impact factor: 10.121
Authors: Thomas C Dowling; Andrew E Briglia; Jeffrey C Fink; Donna S Hanes; Paul D Light; Lucy Stackiewicz; Chetan S Karyekar; Natalie D Eddington; Matthew R Weir; William L Henrich Journal: Clin Pharmacol Ther Date: 2003-05 Impact factor: 6.875
Authors: Mark J Atkinson; Anusha Sinha; Steven L Hass; Shoshana S Colman; Ritesh N Kumar; Meryl Brod; Clayton R Rowland Journal: Health Qual Life Outcomes Date: 2004-02-26 Impact factor: 3.186
Authors: Melanie S Joy; Tammy Boyette; Yichun Hu; Jinzhao Wang; Mary La; Susan L Hogan; Paul W Stewart; Ronald J Falk; Mary Anne Dooley; Philip C Smith Journal: Eur J Clin Pharmacol Date: 2010-06-22 Impact factor: 2.953
Authors: Melanie S Joy; Debbie S Gipson; Leslie Powell; Jacqueline MacHardy; J Charles Jennette; Suzanne Vento; Cynthia Pan; Virginia Savin; Allison Eddy; Agnes B Fogo; Jeffrey B Kopp; Daniel Cattran; Howard Trachtman Journal: Am J Kidney Dis Date: 2009-11-22 Impact factor: 8.860
Authors: David Ternant; Gilles Paintaud; Howard Trachtman; Debbie S Gipson; Melanie S Joy Journal: Eur J Clin Pharmacol Date: 2015-10-31 Impact factor: 2.953