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NCT04702997: MERLIN

A Trial of Bardoxolone Methyl in Patients With CKD at Risk of Rapid Progression (MERLIN)

Completed Phase 2 Results posted Last updated 3 June 2025
What this trial tests

Phase 2 trial testing Bardoxolone methyl oral capsule in Chronic Kidney Diseases in 81 participants. Completed in 23 November 2021.

Timeline
9 February 2021
Primary endpoint
20 October 2021
23 November 2021

Quick facts

Lead sponsorBiogen
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingtriple
Primary purposetreatment
Enrollment81
Start date9 February 2021
Primary completion20 October 2021
Estimated completion23 November 2021
Sites12 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Biogen — full company profile →

Who can join

Adults 18 to 70, any sex, with Chronic Kidney Diseases. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Change From Baseline in Estimated Glomerular Filtration Rate (eGFR) at Week 12 Primary · Baseline through 12 weeks after participant receives the first dose

To assess the change in eGFR from baseline to week 12. eGFR is a measure of kidney function assessed through blood/serum. Higher eGFRs represent better/improved kidney function. Lower eGFRs represent poorer/decreased kidney function.

GroupValue95% CI
Bardoxolone Methyl6.79± 0.925
Placebo-0.92± 0.868

Adverse events — posted to ClinicalTrials.gov

Time frame: 17 weeks. Reporting threshold: 2%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Bardoxolone Methyl
Serious: 3/39 (8%)
Deaths: 0/39
Placebo
Serious: 1/42 (2%)
Deaths: 0/42

Serious adverse events (4 terms)

ReactionSystemBardoxolone MethylPlacebo
Gastrooesophageal reflux diseaseGastrointestinal disorders
Small intestinal obstructionGastrointestinal disorders
Biliary dyskinesiaHepatobiliary disorders
Acute kidney injuryRenal and urinary disorders
Other adverse events (119 terms — click to expand)

ReactionSystemBardoxolone MethylPlacebo
Muscle spasmsMusculoskeletal and connective tissue disorders
NauseaGastrointestinal disorders
Weight decreasedInvestigations
DiarrhoeaGastrointestinal disorders
VomitingGastrointestinal disorders
HyperkalaemiaMetabolism and nutrition disorders
Abdominal painGastrointestinal disorders
Oedema peripheralGeneral disorders
Type 2 diabetes mellitusMetabolism and nutrition disorders
HeadacheNervous system disorders
ConstipationGastrointestinal disorders
Alanine aminotransferase increasedInvestigations
Gamma-glutamyltransferase increasedInvestigations
Decreased appetiteMetabolism and nutrition disorders
GoutMetabolism and nutrition disorders
Gastrooesophageal reflux diseaseGastrointestinal disorders
FatigueGeneral disorders
BronchitisInfections and infestations
FuruncleInfections and infestations
SinusitisInfections and infestations
Urinary tract infectionInfections and infestations
Aspartate aminotransferase increasedInvestigations
Blood alkaline phosphatase increasedInvestigations
Fluid overloadMetabolism and nutrition disorders
DysgeusiaNervous system disorders
HaematuriaRenal and urinary disorders
Renal painRenal and urinary disorders
HypertensionVascular disorders
AnaemiaBlood and lymphatic system disorders
Cardiac septal hypertrophyCardiac disorders
Diastolic dysfunctionCardiac disorders
Left ventricular hypertrophyCardiac disorders
Mitral valve incompetenceCardiac disorders
Pulmonary valve incompetenceCardiac disorders
Sinus bradycardiaCardiac disorders
TachycardiaCardiac disorders
Tricuspid valve incompetenceCardiac disorders
Ear painEar and labyrinth disorders
VertigoEar and labyrinth disorders
CataractEye disorders

Most-reported serious reactions: Gastrooesophageal reflux disease, Small intestinal obstruction, Biliary dyskinesia, Acute kidney injury.

Data from ClinicalTrials.gov NCT04702997 adverse events section.

Sponsor's own description

This multi-center, randomized, double-blind, placebo-controlled, Phase 2 trial will study the safety, tolerability, and efficacy of bardoxolone methyl in qualified patients with CKD due to multiple etiologies at risk of rapid disease progression. Approximately 70 patients will be enrolled and randomized 1:1 to either bardoxolone methyl or placebo. Patients with CKD secondary to varying etiologies will be enrolled from age 18-70 years with eGFR ≥ 20 to \< 60 mL/min/1.73 m2, and other risk factors for rapid progression of kidney disease. The maximum target dose will be determined by baseline proteinuria status. Patients with baseline urine albumin to creatinine ratio (UACR) ≤ 300 mg/g will be titrated to a maximum dose of 20 mg, and patients with baseline UACR \> 300 mg/g will be titrated to a maximum dose of 30 mg. Qualified patients will be randomized 1:1 to receive either bardoxolone methyl or placebo once daily (preferably in the morning) throughout a 12-week dosing period. Patients in the study will follow the same visit and assessment schedule. Patients will be assessed during treatment at Day 1, Weeks 1, 2, 4, 6, 8, and 12 and by telephone contact on Days 3, 10, 21, 31, 35, and 45. Date of last dose and the end-of-treatment assessments mark the end of the treatment period. Patients will not receive study drug during a 5-week off-treatment period between Weeks 12 and 17. The off-treatment (OT) period includes 5 visits requiring various assessments to characterize eGFR from the time of study drug discontinuation through Day 35 off-treatment.

Publications & conference data

6 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Kidney fibrosis: from mechanisms to therapeutic medicines.
    Huang R, Fu P, Ma L. · · 2023 · cited 453× · PMID 36932062 · DOI 10.1038/s41392-023-01379-7
  2. Recent Advances in Understanding Nrf2 Agonism and Its Potential Clinical Application to Metabolic and Inflammatory Diseases.
    Kim MJ, Jeon JH. · · 2022 · cited 60× · PMID 35269986 · DOI 10.3390/ijms23052846
  3. Targeting the mitochondrial unfolded protein response in cancer: opportunities and challenges.
    Inigo JR, Kumar R, Chandra D. · · 2021 · cited 16× · PMID 34580036 · DOI 10.1016/j.trecan.2021.08.008
  4. Triple combination of BET plus PI3K and NF-κB inhibitors exhibit synergistic activity in adult T-cell leukemia/lymphoma.
    Daenthanasanmak A, Bamford RN, Yoshioka M, Yang SM, et al · · 2022 · cited 12× · PMID 35030628 · DOI 10.1182/bloodadvances.2021005948
  5. Health position paper and redox perspectives - Bench to bedside transition for pharmacological regulation of NRF2 in noncommunicable diseases.
    Cuadrado A, Cazalla E, Bach A, Bathish B, et al · · 2025 · cited 9× · PMID 40059038 · DOI 10.1016/j.redox.2025.103569
  6. Research progress in anti-renal fibrosis drugs.
    Huang H, Peng Z, Yuan Q. · · 2024 · cited 2× · PMID 39788524 · DOI 10.11817/j.issn.1672-7347.2024.240284

Verify or expand the search:

Other trials of Bardoxolone methyl oral capsule

Trials testing the same drug.

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Other Biogen trials

Trials by the same sponsor.

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