Full Text View
Tabular View
No Study Results Posted
Related Studies
Efficacy and Safety of Using MPC-5971 in Subjects Undergoing Shock Wave Lithotripsy
This study is enrolling participants by invitation only.
First Received: March 10, 2009   No Changes Posted
Sponsored by: Mission Pharmacal
Information provided by: Mission Pharmacal
ClinicalTrials.gov Identifier: NCT00860093
  Purpose

To evaluate the efficacy of MP-5971 in facilitating stone passage after Shock Wave Lithotripsy treatment.


Condition Intervention Phase
Nephrolithiasis
Other: placebo
Drug: MPC-5971
Phase II

MedlinePlus related topics: Kidney Stones
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Double Blind (Subject, Investigator, Outcomes Assessor), Parallel Assignment, Safety/Efficacy Study
Official Title: A Multi-Site Placebo-Controlled Randomized Double-Blind Study to Evaluate the Efficacy and Safety of Using MPC-5971 as Adjuvant Therapy in Subjects Undergoing Shock Wave Lithotripsy

Further study details as provided by Mission Pharmacal:

Primary Outcome Measures:
  • stone free rate after SWL treatment [ Time Frame: 3 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • increase in urine inhibitors [ Time Frame: 1 month and 3 month ] [ Designated as safety issue: No ]

Estimated Enrollment: 100
Study Start Date: June 2009
Estimated Study Completion Date: June 2010
Estimated Primary Completion Date: April 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1: Experimental
MPC-5971
Drug: MPC-5971
After SWL treatment subjects will be randomized to receive either MPC-5971 or placebo. Two tablets of MPC-5971 or placebo will be taken orally twice a day (bid). This will give a daily dosage equal to 40 mEq of potassium, 20 mEq of magnesium and 60 mEq of citrate. MPC-5971 or placebo will be taken bid for 90 days beginning immediately after SWL treatment.
2: Placebo Comparator
placebo identical in appearance to study drug
Other: placebo
After SWL treatment subjects will be randomized to receive either MPC-5971 or placebo. Two tablets of MPC-5971 or placebo will be taken orally twice a day (bid). This will give a daily dosage equal to 40 mEq of potassium, 20 mEq of magnesium and 60 mEq of citrate. MPC-5971 or placebo will be taken bid for 90 days beginning immediately after SWL treatment.

Detailed Description:

Shock Wave Lithotripsy (SWL) is widely utilized as a first line therapy in patients with renal calculi. SWL is associated with limited morbidity, however, complications relating to stone fragment passage after treatment can occur, the most serious being ureter obstruction. In addition, the growth and agglomeration of residual fragments after SWL treatment, in approximately 40% of patients, will lead to another stone episode within 12 months.

Adjunct therapy with MPC-5971 should reduce the risk of complications of residual stone fragments by facilitating passage, preventing blockage and inhibiting growth and enlargement of residual fragments. This is based on MPC-5971's ability to increase urinary inhibitors against growth and agglomeration of stone fragments and by reducing urinary saturation of calcium oxalate and uric acid. The objective is to see a decrease in fragment complications and a significant increase in the stone free rate at 3 months following SWL treatment in combination with MPC-5971.

  Eligibility

Ages Eligible for Study:   18 Years to 70 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Subject aged 18 yr to 70 yr.
  • Unilateral renal calculus, presumed to be of calcium composition and/or uric acid composition.
  • Stone size between 5 and 15 mm in diameter, determined by low dose non- contrast computerized tomography (CT).
  • Anatomically normal kidney.
  • An appropriate candidate for SWL, determined by treating physician.
  • Female subjects with negative pregnancy test, hysterectomy, tubal ligation or non-bearing potential (post-menopausal).
  • Urine is pyuria negative and nitrate negative on dipstick.
  • Subject must voluntarily consent to participate in this study and provide their written informed consent prior to start of any study-specific procedures.

Exclusion Criteria:

  • Current or past history of cystine stones or infection stones.
  • Renal insufficiency, defined as serum creatinine value 2 SD above the normal laboratory range.
  • Currently has or had hyperkalemia over the past six months, defined as outside of the normal reference range.
  • Has or had hypermagnesemia over the past six months, defined as outside of the normal reference range.
  • Active urinary tract infection.
  • Stones in an anatomically abnormal kidney; horseshoe shape, ureteropelvic junction obstruction or calyceal diverticulum.
  • Altered anatomy such as a transplant kidney, urinary reconstruction or congenital anomaly.
  • Blood coagulopathies and or taking anticoagulants (warfarin, coumarin, heparin).
  • History of complications with SWL; pyelonephritis, perinephric hematoma.
  • Unsuccessful SWL for previous stone within the past six months.
  • Currently has or previously had ulcers of the esophageal, stomach and/or small intestines.
  • Chronic diarrhea or has a history of diarrhea.
  • Inflammatory bowel disease such as Crohn's, celiac disease, fat malabsorption or Sprue.
  • Undergone any bariatric surgery procedures.
  • Obese, BMI >30.
  • Uncontrolled hypertension.
  • Adrenal insufficiency.
  • Taking potassium-sparing diuretics (triamterene, amiloride, spironolactone Midamor, Aldactone, Dyrenium, Eplerenone)
  • Taking potassium supplements (Rx or OTC)within the past 15 days.
  • Taking magnesium supplements (Rx or OTC) within the past 15 days.
  • Taken potassium citrate (Rx or OTC) within past 30 days.
  • Subject is taking anticholinergic medications (dicyclomine, atropine, scopolamine, oxybutynin, Cogentin®, Sinemit®, Robinal®, Kenadrin®, Artane®, Enablex®, Detrol®, Vesicare®, Sanctura®, Ditropan®, Oxytrol®, Bentyl®, Byclomine®, Dibent®, Di-Sap Dilomine®, Tolterodine®, Propiverine®, Pirenzepine®, Mebeverine®)
  • Subject is taking gastrointestinal enzyme inducers or proton pump inhibitors within past 30 days (Ultrase®, Creon®, Viokase®, Pancrease® MT, pancrelipase agents, Aciphex®, Nexium®, Prevacid®, Protonix®, Zegerid® Prilosec OTC®, rabeprazole, esomeprazole, lansoprazole, pantoprazole, omeprazole)
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00860093

Locations
Canada, British Columbia
Jim Pattison Pavilion (station 5, ground floor), Vancouver General Hospital
Vancouver, British Columbia, Canada, V5Z 1M9
Sponsors and Collaborators
Mission Pharmacal
  More Information

Publications:
Koenig K, Padalino P, Alexandrides G, Pak CY. Bioavailability of potassium and magnesium, and citraturic response from potassium-magnesium citrate. J Urol. 1991 Feb;145(2):330-4.
Pak CY, Koenig K, Khan R, Haynes S, Padalino P. Physicochemical action of potassium-magnesium citrate in nephrolithiasis. J Bone Miner Res. 1992 Mar;7(3):281-5.
Ettinger B, Pak CY, Citron JT, Thomas C, Adams-Huet B, Vangessel A. Potassium-magnesium citrate is an effective prophylaxis against recurrent calcium oxalate nephrolithiasis. J Urol. 1997 Dec;158(6):2069-73.
Gonzalez GB, Pak CY, Adams-Huet B, Taylor R, Bilhartz LE. Effect of potassium-magnesium citrate on upper gastrointestinal mucosa. Aliment Pharmacol Ther. 1998 Jan;12(1):105-10.
Ruml LA, Wuermser LA, Poindexter J, Pak CY. The effect of varying molar ratios of potassium-magnesium citrate on thiazide-induced hypokalemia and magnesium loss. J Clin Pharmacol. 1998 Nov;38(11):1035-41.
Ruml LA, Gonzalez G, Taylor R, Wuermser LA, Pak CY. Effect of varying doses of potassium-magnesium citrate on thiazide-induced hypokalemia and magnesium loss. Am J Ther. 1999 Jan;6(1):45-50.
Ruml LA, Pak CY. Effect of potassium magnesium citrate on thiazide-induced hypokalemia and magnesium loss. Am J Kidney Dis. 1999 Jul;34(1):107-13.
Wuermser LA, Reilly C, Poindexter JR, Sakhaee K, Pak CY. Potassium-magnesium citrate versus potassium chloride in thiazide-induced hypokalemia. Kidney Int. 2000 Feb;57(2):607-12.
Jaipakdee S, Prasongwatana V, Premgamone A, Reungjui S, Tosukhowong P, Tungsanga K, Suwantrai S, Noppawinyoowong C, Maskasame S, Sriboonlue P. The effects of potassium and magnesium supplementations on urinary risk factors of renal stone patients. J Med Assoc Thai. 2004 Mar;87(3):255-63.
Tosukhowong P, Tungsanga K, Phongudom S, Sriboonlue P. Effects of potassium-magnesium citrate supplementation on cytosolic ATP citrate lyase and mitochondrial aconitase activity in leukocytes: a window on renal citrate metabolism. Int J Urol. 2005 Feb;12(2):140-4.
Sriboonlue P, Jaipakdee S, Jirakulsomchok D, Mairiang E, Tosukhowong P, Prasongwatana V, Savok S. Changes in erythrocyte contents of potassium, sodium and magnesium and Na, K-pump activity after the administration of potassium and magnesium salts. J Med Assoc Thai. 2004 Dec;87(12):1506-12.
Odvina CV, Mason RP, Pak CY. Prevention of thiazide-induced hypokalemia without magnesium depletion by potassium-magnesium-citrate. Am J Ther. 2006 Mar-Apr;13(2):101-8.
Zerwekh JE, Odvina CV, Wuermser LA, Pak CY. Reduction of renal stone risk by potassium-magnesium citrate during 5 weeks of bed rest. J Urol. 2007 Jun;177(6):2179-84.

Responsible Party: Mission Pharmacal Company, San Antonio, TX ( Mary Walter, PhD, Chief Scientific Officer, VP Research and Development )
Study ID Numbers: MPC-5971
Study First Received: March 10, 2009
Last Updated: March 10, 2009
ClinicalTrials.gov Identifier: NCT00860093     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by Mission Pharmacal:
Kidney Calculi
Urolithiasis
Lithotripsy
potassium compounds
magnesium compounds

Study placed in the following topic categories:
Urologic Diseases
Shock
Urolithiasis
Citric Acid
Adjuvants, Immunologic
Kidney Diseases
Calculi
Nephrolithiasis
Kidney Calculi

Additional relevant MeSH terms:
Urologic Diseases
Urolithiasis
Kidney Diseases
Nephrolithiasis

ClinicalTrials.gov processed this record on May 07, 2009