IMPEDE-PKD

Implementation of Metformin theraPy to Ease DEcline of kidney function in PKD (IMPEDE-PKD)

The IMPEDE-PKD trial is studying whether a drug called metformin can slow down the rate at which kidney disease progresses in people with Autosomal Dominant Polycystic Kidney Disease (ADPKD). ADPKD is the 4th most common reason for starting dialysis in Australia, but there is a lack of affordable and effective treatment options for people with ADPKD.
Metformin is not a new drug; it has been used to treat patients with diabetes for many years and is also used for the treatment of polycystic ovarian syndrome. Animal studies have shown that metformin could change how ADPKD disease progresses. Recent clinical studies in people with ADPKD have shown that metformin is safe to use in people with ADPKD.
This is the first clinical study to test if metformin therapy is effective in treating people with ADPKD. If successful, this study could change the future clinical care of people with ADPKD.

Diabetes drug could prevent kidney failure (UQ News, July 2020).

In this trial, we are evaluating the potential efficacy and role of a common and repurposed medicine, Metformin, in slowing the loss of kidney function in the most common genetic kidney disease – Autosomal Dominant Polycystic Kidney Disease. It has been designed and led by a group of passionate clinicians, researchers and patients over the past several years and involves leading global experts in ADPKD. At the end of the trial and in conjunction with our international partners, we aim to generate data which helps us to more definitely understand whether an effective treatment for ADPKD might already be within reach. Further, our partnership across stakeholders will realise opportunities to ensure rapid translation of those findings, both into practice and future research, seeking to improve the lives of those affected by ADPKD.

Professor Andrew Mallett, Coordinating Principal Investigator
What does the IMPEDE-PKD trial involve for participants?

The IMPEDE-PKD trial is a prospective, multicentre, double blind randomised controlled trial. Study participants are randomised to receive either metformin or a placebo (inactive pill). All study participants receive standard care and complete some trial questionnaires and blood and urine tests.

“Any safe drug that can slow the progression of kidney cysts and decline is a major win for PKD patients. Especially if the drug is effective enough to prevent having to endure a kidney transplant and the life-long use of immunosuppressant anti rejection medication.”

PKD Consumer
How is the IMPEDE-PKD trial outcome being measured?

The IMPEDE-PKD trial looks at changes in study participants’ estimated Glomerular Filtration Rate (eGFR). eGFR measures how well kidneys can filter toxins or waste from blood. A lower eGFR means a reduction in kidney function. This is measured through a routine blood test.

Where is the IMPEDE-PKD trial being conducted?

The IMPEDE-PKD trial is an international trial, including Australia, New Zealand, United Kingdom, Europe, India and North America. Australia was the first country to start the IMPEDE-PKD trial and has completed its recruitment phase, thanks to many hospitals across the country. Australian participants are now in the follow-up phase of the trial.

When is the IMPEDE-PKD trial starting?

The trial is currently recruiting at:

New Zealand
Hauora a Toi Bay of Plenty – Te Whatu Ora
Southern – Te Whatu Ora
Te Tai Tokerau Northland – Te Whatu Ora
Taranaki – Te Whatu Ora
Te Pae Hauora o Ruahine o Tararua Mid Central – Te Whatu Ora

The trial has completed recruitment at these Australian sites:

QLD
Princess Alexandra Hospital 
Royal Brisbane & Women’s Hospital
Townsville University Hospital
Bundaberg Hospital

NSW
Renal Research Gosford
Westmead Hospital
Royal Prince Alfred Hospital
Royal North Shore Hospital

VIC
Austin Health
Monash Health
Royal Melbourne Hospital

SA
Royal Adelaide Hospital

WA
Sir Charles Gairdner Hospital


Who can take part in the IMPEDE-PKD trial?

Adults with ADPKD aged 18 to 70 years who meet the study eligibility criteria.

Study team and funding:

Professor Andrew Mallett (the University of Queensland) is the Coordinating Principal Investigator.

Pushparaj Velayudham is the Clinical Project Manager and Misa Matsuyama is the Clinical Research Associate.

The Medical Research Future Fund (Australian government) is funding this research.

Trial Number: AKTN 16.01

“IMPEDE-PKD is a really important trial that will prove whether the cheap, safe and already available medication, metformin, is effective at slowing kidney function loss and painful kidney cyst growth in people with ADPKD. It offers hope to the many people and families affected by this profoundly painful, progressive and perilous disease that currently has limited treatment options.”

Professor David Johnson, Deputy Chair AKTN

Publications:

Implementation of Metformin Therapy to Ease Decline of Kidney Function in Polycystic Kidney Disease (IMPEDE-PKD): study protocol for a phase III, multi-centre, randomized, placebo-controlled trial evaluating the long-term efficacy of metformin in slowing the rate of kidney function decline in patients with autosomal dominant polycystic kidney disease.