Tests dapagliflozin in adults with kidney AL amyloidosis

Who can take part

• Provision of signed and dated informed consent form
• Stated willingness to comply with study procedures, including remote telehealth consultations with the study team, confirming availability, and agreeing to use mobile/web applications for study purposes
• Age ≥18 years
• Histopathologic diagnosis of renal AL amyloidosis confirmed by biopsy of any tissue and evidence of >1.0 g/day proteinuria without any other identifiable cause
• Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) 0, 1 or 2
• Plateau in any renal response (i.e., reduction in proteinuria) for at least 3 months prior to enrollment, as determined by the enrolling physician
• Residence in the state of Michigan

Who cannot take part

• Either ongoing first line induction with anti-plasma cell therapy or ongoing post- induction maintenance for <6 months prior to enrollment
• Women of child-bearing potential (i.e., those who have not undergone chemical or surgical sterilization or are not postmenopausal) and who are unwilling to use a medically accepted and reliable form of contraception while participating in the study and for 2 weeks following the last dose of study medication, as determined by the investigator, or have a positive pregnancy test at the time of enrolment or are currently breastfeeding
• Current or previous use of any SGLT2i
• Initiation or dose modification of angiotensin converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs) <3 months prior to enrollment
• Diagnosis of symptomatic multiple myeloma, including presence of lytic bone disease, plasmacytomas, ≥60% plasma cells in the bone marrow, or hypercalcemia, either currently or in the past
• Known allergic reactions to components of the dapagliflozin
• Treatment requiring type 1 or type 2 diabetes mellitus
• Acute or chronic liver disease with severe impairment of liver function (e.g., ascites, esophageal varices or coagulopathy)
• Active malignancy requiring treatment (other than AL amyloidosis and non-melanoma skin cancers)
• Baseline eGFR <25 mL/min/1.73m2