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Updated June 2026 · ClinicalTrials.gov

RECRUITINGPhase 3INTERVENTIONAL

A Trial to Evaluate the Efficacy of Pioglitazone to Promote Renal Tolerance in ANCA-associated Vasculitis - RENATO Trial

A Multicenter Randomized Trial to Evaluate the Efficacy of Pioglitazone to Promote Renal Tolerance in ANCA-associated Vasculitis - RENATO

A Trial to Evaluate the Efficacy of Pioglitazone to Promote Renal Tolerance in ANCA-associated Vasculitis - RENATO Trial (NCT05946564) is a Phase 3 interventional studying ANCA Associated Vasculitis and Rapidly Progressive Glomerulonephritis, sponsored by Assistance Publique - Hôpitaux de Paris. RECRUITING as of the most recent ClinicalTrials.gov update. Talk to your doctor before contacting the trial site.

Important: This information is not medical advice. Talk to your doctor about whether a clinical trial is right for you.

About This Trial

The RENATO trial is a multicenter randomized controlled trial that evaluates the efficacy of pioglitazone to improve renal outcomes in ANCA-associated vasculitis. Patients with biopsy-proven kidney involvement of ANCA vasculitis will be included in this trial at diagnosis. All patients will receive a standard of care immunosuppressive (SOC) therapy combining corticosteroids and rituximab (375 mg/m2/week for 4 consecutive weals followed by 500 mg re-infusion every 6 months). They will be randomized 1:1 to receive either pioglitazone 30 mg/day or placebo for 6 months, on top of SOC. The primary objective of this trial is to demonstrate that pioglitazone reduces kidney damage, reflected by the early improvement of proteinuria and serum creatinine levels. The secondary objectives will be to assess the efficacy of this drug on the reduction of hypertension and metabolic effects of glucocorticoids, to measure its impact on vasculitis activity and to evaluate the safety profile of pioglitazone in this population.

What Stage of Research Is This?

Phase 3 trials confirm efficacy and safety in large patient groups (often 300–3,000+) and form the evidence base for an FDA approval submission. For ANCA Associated Vasculitis, Phase 3 studies typically randomize participants between the investigational treatment and either a placebo or current standard of care. A successful Phase 3 result is the threshold most treatments need to clear before regulatory approval.

This trial is currently recruiting participants. The sponsor has registered the study with ClinicalTrials.gov as actively enrolling, which means new applicants who meet the eligibility criteria can be considered for screening. Trial status can change between updates — confirm current recruiting status with the study contact before traveling for a screening visit.

Target enrollment of 126 participants puts this in the typical range for a Phase 2-style efficacy study or a moderate Phase 3 trial in a focused ANCA Associated Vasculitis subpopulation. At this scale, the study has enough statistical power to detect a clear treatment effect but is not the largest cohort in the field.

Who May Be Eligible (Plain English)

Who May Qualify: - Newly-diagnosed or relapsing ANCA-associated vasculitis, i.e. granulomatosis with polyangitis (GPA) or microscopic polyangiitis (MPA), according to ACR 1990 criteria and/or revised Chapel Hill Consensus Conference definitions and/or European Medical Agency algorithm, with an active disease defined as a BVAS ≥3 - Presence of proteinuria (UPCR \>300 mg/g), haematuria (\>10 RBC/hpf), and eGFR ≥15 mL/min/1.73 m2 (CKD-EPI formula) at inclusion (\<1 month) - Recent (\<4 weeks) renal biopsy that confirms active renal involvement of ANCA-associated vasculitis - Patients aged of 18 to 80 years - Participant written willing to sign a consent form prior to participation in the study - Participants affiliated to a French health insurance system (registered or being a beneficiary of such a scheme) Who Should NOT Join This Trial: - Alveolar haemorrhage requiring pulmonary ventilation support at inclusion - Patients with eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss) - Active cancer (except non-melanoma skin cancer) within the past 24 months - Active severe bacterial, viral or fungal infectious disease - Past history of bladder or urinary tract cancer - History of Class 3/4 congestive heart failure symptoms, any time - History of Class 2 heart failure symptoms within the past 3 months and/or ejection fraction \<40% on recent echocardiography (\<1 month) - Transaminases levels above 2 times the normal range value (\<1 month) or any severe chronic liver disease - Positive serology for HIV, HBV (Ag HBs positivity) or active HCV infection at inclusion - Presence of neutropenia \<1000 cells/l (\<1 month) - History of intolerance to any thiazolidinedione (including Pioglitazone), to rituximab or any excipient listed in SmPc - Diabetic ketoacidosis, any time - A pre-existing or an important risk of new-onset macular edema (confirmed by an ophthalmological examination) ...See full criteria on ClinicalTrials.gov Always talk to your doctor about whether this trial is right for you.

These are translations of the protocol\'s inclusion and exclusion criteria, simplified for patients and caregivers. The original clinical text appears below. Eligibility is ultimately confirmed by the trial site\'s screening process — this summary is a starting point for a conversation with your doctor, not a final determination.

Original Eligibility Criteria

View original clinical language
Inclusion Criteria: * Newly-diagnosed or relapsing ANCA-associated vasculitis, i.e. granulomatosis with polyangitis (GPA) or microscopic polyangiitis (MPA), according to ACR 1990 criteria and/or revised Chapel Hill Consensus Conference definitions and/or European Medical Agency algorithm, with an active disease defined as a BVAS ≥3 * Presence of proteinuria (UPCR \>300 mg/g), haematuria (\>10 RBC/hpf), and eGFR ≥15 mL/min/1.73 m2 (CKD-EPI formula) at inclusion (\<1 month) * Recent (\<4 weeks) renal biopsy that confirms active renal involvement of ANCA-associated vasculitis * Patients aged of 18 to 80 years * Participant written informed consent prior to participation in the study * Participants affiliated to a French health insurance system (registered or being a beneficiary of such a scheme) Exclusion Criteria: * Alveolar haemorrhage requiring pulmonary ventilation support at inclusion * Patients with eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss) * Active cancer (except non-melanoma skin cancer) within the past 24 months * Active severe bacterial, viral or fungal infectious disease * Past history of bladder or urinary tract cancer * History of Class 3/4 congestive heart failure symptoms, any time * History of Class 2 heart failure symptoms within the past 3 months and/or ejection fraction \<40% on recent echocardiography (\<1 month) * Transaminases levels above 2 times the normal range value (\<1 month) or any severe chronic liver disease * Positive serology for HIV, HBV (Ag HBs positivity) or active HCV infection at inclusion * Presence of neutropenia \<1000 cells/l (\<1 month) * History of intolerance to any thiazolidinedione (including Pioglitazone), to rituximab or any excipient listed in SmPc * Diabetic ketoacidosis, any time * A pre-existing or an important risk of new-onset macular edema (confirmed by an ophthalmological examination) * Pregnant or breast-feeding women, or desire to become pregnant within 24 months All women of childbearing potential (WOCBP) are required to have a negative pregnancy test before treatment and must agree to maintain highly effective contraception by practicing abstinence or by using an effective method of birth control from the date of consent through the end of the study and another 12 months after (or 12 months after the last rituximab infusion in case of premature termination): Combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation (Oral, Intravaginal, Transdermal); Progestogen-only hormonal contraception associated with inhibition of ovulation (Oral, Injectable, Implantable); Intrauterine device (IUD); Intrauterine hormone-releasing system (IUS); Bilateral tubal occlusion; Vasectomised partner * Severe neurologic or psychiatric disease (e.g., dementia or schizophrenia) * Kidney transplant recipients * Cyclophosphamide or rituximab (dose \> 375 mg/m2) use within 26 weeks prior to screening; if on azathioprine, mycophenolate mofetil or methotrexate at the time of screening, these drugs must be withdrawn prior to receiving the first rituximab dose. Patients that have initiated induction therapy with rituximab for the actual flare, can be included in the present study within 48h following the first rituximab infusion * Intravenous glucocorticoids, \>3000 mg methylprednisolone equivalent, within 4 weeks prior to screening * Patients who have been taking an oral daily dose of a glucocorticoid of more than 10 mg prednisone-equivalent for more than 6 weeks continuously prior to screening * Current participation in another research study involving a therapeutic intervention. Participation to an observational research, or a non-interventional research is allowed * Patients under guardianship or curators and protected adults * Patients not able to understand and follow study procedures * Patients on AME (Aide Médicale de l'Etat = State Medical Assistance)

Treatments Being Tested

DRUG

Pioglitazone (ACTOS®)

Patient will be randomize in the intervention group receive treatment by pioglitazone (30 mg/day orally) for 26 weeks on top of a SOC immunosuppressive treatment.

DRUG

Placebo of Pioglitazone

Patient will be randomize in the intervention group receive treatment by placebo of pioglitazone (30 mg/day orally) for 26 weeks on top of a SOC immunosuppressive treatment.

Locations (20)

Trial sites listed on ClinicalTrials.gov for this study. Site activation status can vary — confirm with the specific site before traveling for a screening visit.

CHU Amiens
Amiens, France
CHU d'Angers
Angers, France
CH de Boulogne sur Mer
Boulogne-sur-Mer, France
CHU Brest - Hôpital de la Cavale Blanche
Brest, France
CHU de Dijon
Dijon, France
CHU de Grenoble - Hôpital Michalon site nord
Grenoble, France
Centre Hospitalier Départemental Vendée
La Roche-sur-Yon, France
Hopital Le Kremlin Bicetre - Aphp
Le Kremlin-Bicêtre, France
AP-HM - Hôpital la Conception
Marseille, France
CHU de Nantes - Hotel Dieu
Nantes, France
CHU Pasteur 2 - Nice
Nice, France
CHU Nîmes - Hôpital universitaire Caremeau
Nîmes, France
AP-HP - Hôpital Cochin
Paris, France
AP-HP - Necker enfants malades
Paris, France
HEGP
Paris, France
AP-HP - Hôpital Bichat
Paris, France
AP-HP - Tenon
Paris, France
AP-HP - Henri Mondor
Paris, France
CHU de Rouen
Rouen, France
CHU de Strasbourg
Strasbourg, France

How to Talk to Your Doctor About This Trial

Bring the printable summary of this trial — including the NCT ID (NCT05946564), the sponsor (Assistance Publique - Hôpitaux de Paris), and the key eligibility criteria — to your next appointment. Your doctor can review the inclusion and exclusion criteria against your medical history, lab values, and current treatments to assess whether you are likely to qualify. They can also help you weigh whether trial participation makes sense alongside your existing care plan.

Useful questions to walk through together: What does the trial protocol require beyond standard care? How long is the active treatment phase, and how long is follow-up? Are there study visits at sites I can reach? Who pays for the trial-specific procedures, and who pays for standard-of-care portions? See our 25 questions to ask about clinical trials guide for a more complete checklist.

Authoritative Sources

The official record for this trial lives on ClinicalTrials.gov — the federal registry maintained by the National Library of Medicine at NIH. For background on how this trial fits into the FDA approval pathway, see the FDA drug approval process. For oncology-specific guidance for patients considering trials, the National Cancer Institute publishes patient-oriented overviews. International trial registries are aggregated by the WHO ICTRP.

Frequently Asked Questions

What is the NCT05946564 clinical trial studying?

The RENATO trial is a multicenter randomized controlled trial that evaluates the efficacy of pioglitazone to improve renal outcomes in ANCA-associated vasculitis. Patients with biopsy-proven kidney involvement of ANCA vasculitis will be included in this trial at diagnosis. All patients will receive a standard of care immunosuppressive (SOC) therapy combining corticosteroids and rituximab (375 mg/m2/week for 4 consecutive weals followed by 500 mg re-infusion every 6 months). They will be randomized 1:1 to receive either pioglitazone 30 mg/day or placebo for 6 months, on top of SOC. The primary… The full protocol is registered on ClinicalTrials.gov and includes the primary outcome measures, eligibility criteria, and study endpoints.

Who can participate in NCT05946564?

Eligibility for this trial depends on the specific inclusion and exclusion criteria set by the sponsor. The plain-English summary above translates the most important criteria into accessible language; the official clinical text is preserved in the collapsible section underneath. Whether you fit any specific trial is a medical decision your doctor needs to confirm — bring the trial information to your treating physician for a full review against your medical history.

How do I contact the trial site for NCT05946564?

Contact information registered with ClinicalTrials.gov is shown in the sidebar of this page. Before reaching out, confirm with your treating physician that this trial is appropriate for your situation. The trial site will then walk you through the screening process to determine final eligibility.

Is participating in a clinical trial safe?

Clinical trials in the United States are regulated by the FDA and overseen by Institutional Review Boards (IRBs) that review the protocol for safety. Risk varies by trial — Phase 1 studies test new treatments in humans for the first time, while Phase 3 trials use treatments that have already passed earlier safety screening. The informed consent document for any specific trial details the known risks and what to expect. Discuss those risks with your physician before deciding whether to participate.

Where can I verify the data on this page?

Every detail on this page comes directly from the ClinicalTrials.gov API. Click "View on ClinicalTrials.gov" in the sidebar to see the official, unmodified record. The federal record is always authoritative; this page is a structured presentation with a plain-English eligibility translation. For background on how clinical trials are regulated, see the FDA drug approval process documentation.

How This Page Is Built

Every field on this page is pulled directly from the ClinicalTrials.gov API v2 — no estimates, no proxies. The plain-English eligibility translation is generated from the original protocol text and reviewed for fidelity to the underlying clinical criteria. The original clinical text remains visible in the collapsible section above so users and clinicians can verify the translation. Read the full methodology for the data pipeline and known limitations.

Source: ClinicalTrials.gov API v2 record for NCT05946564. Maintained by the National Library of Medicine at NIH. Public domain. Cite as: "TrialFinderData. NCT05946564. Data: ClinicalTrials.gov."

Medical disclaimer: This page is informational, not medical advice. Talk to your doctor about whether a clinical trial is right for you.

Last updated 2026-06-26 · Data from ClinicalTrials.gov.