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Clinical Trial
. 2010 Jan 29:11:2.
doi: 10.1186/1471-2369-11-2.

Follow-up of phase I trial of adalimumab and rosiglitazone in FSGS: III. Report of the FONT study group

Alexandra Peyser  1 , Nathaniel Machardy, Freya Tarapore, Jacqueline Machardy, Leslie Powell, Debbie S Gipson, Virginia Savin, Cynthia Pan, Theresa Kump, Suzanne Vento, Howard Trachtman
Affiliations
Clinical Trial

Follow-up of phase I trial of adalimumab and rosiglitazone in FSGS: III. Report of the FONT study group

Alexandra Peyser et al. BMC Nephrol. .

Abstract

Background: Patients with resistant primary focal segmental glomerulosclerosis (FSGS) are at high risk of progression to chronic kidney disease stage V. Antifibrotic agents may slow or halt this process. We present outcomes of follow-up after a Phase I trial of adalimumab and rosiglitazone, antifibrotic drugs tested in the Novel Therapies in Resistant FSGS (FONT) study.

Methods: 21 patients--12 males and 9 females, age 16.0 +/- 7.5 yr, and estimated GFR (GFRe) 121 +/- 56 mL/min/1.73 m2--received adalimumab (n = 10), 24 mg/m2 every 14 days or rosiglitazone (n = 11), 3 mg/m2 per day for 16 weeks. The change in GFRe per month prior to entry and after completion of the Phase I trial was compared.

Results: 19 patients completed the 16-week FONT treatment phase. The observation period pre-FONT was 18.3 +/- 10.2 months and 16.1 +/- 5.7 months after the study. A similar percentage of patients, 71% and 56%, in the rosiglitazone and adalimumab cohorts, respectively, had stabilization in GFRe, defined as a reduced negative slope of the line plotting GFRe versus time without requiring renal replacement therapy after completion of the FONT treatment period (P = 0.63).

Conclusion: Nearly 50% of patients with resistant FSGS who receive novel antifibrotic agents may have a legacy effect with delayed deterioration in kidney function after completion of therapy. Based on this proof-of-concept preliminary study, we recommend long-term follow-up of patients enrolled in clinical trials to ascertain a more comprehensive assessment of the efficacy of experimental treatments.

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Figures

Figure 1
Figure 1
This graph illustrates the estimated GFR versus time (in months) prior to and after completion of the 6-month FONT Treatment Period in patients assigned to rosiglitazone.
Figure 2
Figure 2
This graph illustrates the estimated GFR versus time (in months) prior to and after completion of the 6-month FONT Treatment Period in patients assigned to adalimumab.
See this image and copyright information in PMC

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