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Clinical Trial
. 2021 Jul;36(7):1765-1774.
doi: 10.1007/s00467-020-04873-0. Epub 2021 Feb 26.

Safety, efficacy, and acceptability of ADV7103 during 24 months of treatment: an open-label study in pediatric and adult patients with distal renal tubular acidosis

Aurélia Bertholet-Thomas  1 , Catherine Guittet  2 , Maria A Manso-Silván  2 , Sophie Joukoff  2 , Victor Navas-Serrano  2 , Véronique Baudouin  3 , Mathilde Cailliez  4 , Massimo Di Maio  5 , Olivia Gillion-Boyer  6 , Emilija Golubovic  7 , Jérôme Harambat  8 , Bertrand Knebelmann  9 , François Nobili  10 , Robert Novo  11 , Ludmila Podracka  12 , Gwenaëlle Roussey-Kesler  13 , Luc-André Granier  2
Affiliations
Clinical Trial

Safety, efficacy, and acceptability of ADV7103 during 24 months of treatment: an open-label study in pediatric and adult patients with distal renal tubular acidosis

Aurélia Bertholet-Thomas et al. Pediatr Nephrol. 2021 Jul.

Abstract

Background: A new prolonged-release formulation of potassium citrate and potassium bicarbonate, ADV7103, has been shown to improve metabolic control, palatability, and gastrointestinal safety in patients with distal renal tubular acidosis (dRTA) when compared to standard of care (SoC) treatments. The present work evaluates safety and efficacy of ADV7103 during 24 months.

Methods: Thirty pediatric and adult patients were included in an open-label extension study after a phase II/III trial. Safety and tolerability were assessed. Plasma bicarbonate and potassium levels, as well as urine parameters, were evaluated over time. Acceptability, adherence, and quality of life were also assessed. The evolution of clinical consequences of dRTA in the cohort was explored.

Results: There were 104 adverse events (AEs) reported, but only 9 gastrointestinal events observed in five patients (17%) were considered to be related to ADV7103 treatment. There were no AEs leading to treatment discontinuation. Plasma bicarbonate and potassium levels were in the normal ranges at the different visits, respectively, in 69-86% and 83-93% of patients. Overall adherence rates were ≥ 75% throughout the whole study in 79% patients. An average improvement of quality of life of 89% was reported at 24 months of study.

Conclusions: Common AEs concerned metabolism and gastrointestinal disorders; the former being related to the disease. Less than half of the gastrointestinal AEs were related to ADV7103 treatment and they were mostly mild in severity. Metabolic parameters were maintained in the normal ranges in most patients. Patient satisfaction was high and adherence to treatment was good and remained stable.

Trial registration number: Registered as EudraCT 2013-003828-36 on the 3rd of September 2013.

Keywords: Acceptability; Adherence to treatment; Plasma bicarbonate; Safety; dRTA.

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Conflict of interest statement

C. Guittet, M.A. Manso-Silván and L.A. Granier are employees of Advicenne and hold stock options or shares in the company. S. Joukoff and V. Navas-Serrano are also employees of Advicenne.

A. Bertholet received support from Advicenne for traveling to meetings and/or funding for lectures.

Figures

Fig. 1
Fig. 1
Study design
Fig. 2
Fig. 2
Mean (SEM) overall values of a plasma bicarbonate and b plasma potassium with ADV7103 at baseline and after 3, 6, 12, 18, and 24 months of treatment
Fig. 3
Fig. 3
Mean (SEM) overall values of a urine citrate/creatinine ratio, b urine calcium/creatinine ratio, and c urine calcium/citrate ratio with ADV7103 at baseline and after 3, 6, 12, 18, and 24 months of treatment
Fig. 4
Fig. 4
Improvement of a quality of life at 6 and 24 months, and b number of intakes, taste, formulation, efficacy, and gastrointestinal tolerability at 24 months after change of alkalizing treatment from SoC to ADV7103 in the different age groups and overall
See this image and copyright information in PMC

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