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DialysisPhase 2NCT01414075

Study of Roxadustat (FG-4592) to Correct Anemia in Newly Initiated Dialysis Participants Not on Erythropoiesis-Stimulating Agent Treatment

A Phase 2 study testing Roxadustat, Oral Iron and IV Iron in people with Dialysis and Anemia, run by Kyntra Bio at 7 sites in 4 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The purpose of this study is to evaluate efficacy and safety of roxadustat in the correction of anemia in participants with end-stage renal disease who recently started dialysis. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Dialysis, Anemia
What is being tested?
Roxadustat, Oral Iron and IV Iron
Could I receive a placebo?
No, everyone receives an active treatment
How many people
60 participants
Where
7 sitesin 4 countries
Study dates
21 Jul 2011to 10 Jan 2013
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Receiving HD or PD for native kidney end-stage renal disease (ESRD) for 2 weeks to 4 months, prior to randomization
  • Mean of the 2 most recent Hb values during the screening period, obtained at least 7 days apart, must be <10.0 grams (g)/deciliter (dL), with a difference of ≤1.0 g/dL between the 2 values
  • Body weight 40 to 140 kilograms (kg)

Who cannot join

  • Previously received erythropoiesis-stimulating agents
  • Received IV iron within 4 weeks of randomization
  • Received red blood cell transfusion within 8 weeks prior to randomization or anticipated need for transfusion during the treatment period
  • Positive for any of the following: human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), or anti-hepatitis C virus antibody (anti-HCV Ab)
  • History of chronic liver disease
  • Clinically significant infection
Show all 17Show fewer
  • New York Heart Association Class III or IV congestive heart failure
  • History of malignancy, except the following: cancers determined to be cured or in remission for ≥5 years, curatively resected basal cell or squamous cell skin cancers, cervical cancer in situ, or resected colonic polyps
  • Chronic inflammatory disease that could impact erythropoiesis (for example, systemic lupus erythematosis, rheumatoid arthritis, celiac disease) even if it is currently in remission
  • History of other blood disorders
  • Active hemolysis or diagnosis of hemolytic syndrome
  • Known bone marrow fibrosis
  • Uncontrolled or symptomatic secondary hyperparathyroidism
  • History of alcohol or drug abuse within a year prior to randomization, or anticipated inability to avoid consumption of more than 3 alcoholic beverages per day
  • History of allergy or sensitivity to oral or IV iron therapy
  • Seizure disorder or receiving anti-epilepsy medication for seizure disorder within 12 weeks prior to randomization
  • Pregnant or breast-feeding females

Trial locations and contacts

7 sites in 4 countries.

7 sites in 4 countries

United States3 sites
  • Study site

    Detroit, Michigan

  • Study site

    Northridge, California

  • Study site

    Yuba City, California

Other trials in United States

Russia2 sites
  • Study site

    Moscow

  • Study site

    Saint Petersburg

Other trials in Russia

Hong Kong1 site
  • Study site

    Hong Kong

Other trials in Hong Kong

Singapore1 site
  • Study site

    Singapore

Other trials in Singapore

About this study

Official title: A Phase 2, Randomized, Open-Label, Dose Titration, Safety and Efficacy Study of FG-4592 for the Correction of Anemia in Newly Initiated Dialysis Patients Not on Erythropoiesis-Stimulating Agent Treatment

The purpose of this study is to evaluate efficacy and safety of roxadustat in the correction of anemia in participants with end-stage renal disease who recently started dialysis.

Read the detailed description

Participants on hemodialysis (HD) will be randomized to 3 treatment arms (A, B, and C) of in a 1:1:1 ratio to receive no iron supplementation, oral iron supplementation, and IV iron supplementation, respectively, in addition to roxadustat. At the same time, participants on peritoneal dialysis (PD) will be enrolled into Arm D. Arm E will enroll either HD or PD participants, and is an optional, confirmatory/supplemental treatment arm with flexible dosing and flexible iron supplementation based on the evaluation of data from the previous 4 treatment arms.

Initial roxadustat dose will be based on a tiered, weight-based dosing scheme (low weight [40 to 60 kilograms {kg}], medium weight [>60 to 90 kg], and heavy weight [>90 to 140 kg] participants will receive 60, 100, and 140 milligrams [mg] roxadustat, respectively). Dose adjustments will be implemented (up to a maximum roxadustat dose of 140, 200, and 300 mg for low, medium, and high weight participants, respectively) during Weeks 5 and 9, depending on the hemoglobin (Hb) level and rate of Hb rise in the previous 4 weeks.

Conditions
Dialysis, Anemia
Being tested
Roxadustat, Oral Iron, IV Iron
Keywords
Kidney, ESRD, Renal, End-Stage Renal Disease, Anemia, Oral anemia treatment, Hemoglobin levels, Hemodialysis, Peritoneal, HD, PD, Hb, Erythropoietin, Blood count
Medical subject headings
Anemia, Kidney Failure, Chronic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • RoxadustatDrug

    Also called FG-4592

    Tiered, weight-based dosing per schedule specified in the arm.

  • Oral IronDrug

    Administered per oral dose and schedule specified in the arm.

  • IV IronDrug

    Administered per IV dose and schedule specified in the arm.

Study groups in NCT01414075
Study groupRoleWhat they receive
Arm A + E (Participants on HD): Roxadustat Only, No IronExperimentalParticipants on HD will receive roxadustat capsules at the applicable dose (up to a maximum roxadustat dose of 140, 200, and 300 mg) based on weight and Hb level, administered orally 3 times weekly (TIW) for 12 weeks.
Receives: Drug: Roxadustat
Arm B (Participants on HD): PO Iron (Ferrous Fumarate or Ferrous Gluconate) Between 50 and 195 mgExperimentalParticipants on HD will receive roxadustat capsules at the applicable dose (up to a maximum roxadustat dose of 140, 200, and 300 mg) based on weight and Hb level, administered orally TIW with iron (ferrous fumarate or ferrous gluconate) PO at doses containing elemental iron between 50 and 195 mg daily (depending on the type of iron formulation available in their countries) for 12 weeks.
Receives: Drug: Roxadustat; Drug: Oral Iron
Arm C (Participants on HD): IV Iron (Ferric Gluconate Complex in Sucrose or Equivalent) 60 mgExperimentalParticipants on HD will receive roxadustat capsules at the applicable dose (up to a maximum roxadustat dose of 140, 200, and 300 mg) based on weight and Hb level, administered orally TIW with approximately 60 mg IV iron (ferric gluconate complex in sucrose injection [for example, Ferrlecit®] or equivalent) once a week for 12 weeks.
Receives: Drug: Roxadustat; Drug: IV Iron
Arm D (Participants on PD): PO Iron (Ferrous Fumarate or Ferrous Gluconate) Between 50 and 195 mgExperimentalParticipants on PD will receive roxadustat capsules at the applicable dose (up to a maximum roxadustat dose of 140, 200, and 300 mg) based on weight and Hb level, administered orally TIW with iron (ferrous fumarate or ferrous gluconate) PO at doses containing elemental iron between 50 and 195 mg daily (depending on the type of iron formulation available in their countries) for 12 weeks.
Receives: Drug: Roxadustat; Drug: Oral Iron

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Maximum Change From Baseline in Hb During Weeks 3-13

    Baseline Hb was defined as the mean of the last 3 central laboratory Hb values prior to the first dose administration. This outcome measure is derived from the maximum change from baseline during Weeks 3-13, without last observation carried forward (LOCF) imputation.

    Measured: Baseline, Weeks 3-13

Secondary outcomes (25)
  1. Mean Change From Baseline in Hb During Weeks 2-5, 6-9, and 10-13

    Baseline Hb was defined as the mean of the last 3 central laboratory Hb values prior to the first dose administration.

    Measured: Baseline, Weeks 2-5, 6-9, and 10-13

  2. Number of Participants Whose Maximum Hb Achieved During Treatment Was at Least 1.0 g/dL Increase From Baseline and Was ≥11.0 g/dL

    Baseline Hb was defined as the mean of the last 3 central laboratory Hb values prior to the first dose administration.

    Measured: Week 3 to 13

  3. Number of Participants Whose Maximum Hb Achieved During Treatment Was at Least 1.0 g/dL Increase From Baseline and Was ≥10.0 g/dL

    Baseline Hb was defined as the mean of the last 3 central laboratory Hb values prior to the first dose administration.

    Measured: Week 3 to 13

  4. Number of Participants With a Hb Response, Defined as an Increase in Hb by ≥1.0 g/dL From Baseline, by Weeks 5, 9, and 13

    Baseline Hb was defined as the mean of the last 3 central laboratory Hb values prior to the first dose administration.

    Measured: Weeks 5, 9, and 13

  5. Number of Participants Who Achieved Maximum Hb During Weeks 3-13

    Measured: Weeks 3-13

  6. Number of Participants With a Maximum Change From Baseline in Hb During Weeks 3-13

    Baseline Hb was defined as the mean of the last 3 central laboratory Hb values prior to the first dose administration. The number of participants who fall within the following categories of maximum change are reported: <1 g/dL, ≥1 g/dL, 1 to <2 g/dL, 2 to <3 g/dL, >3 to <4 g/dL, ≥4 g/dL.

    Measured: Baseline, Weeks 3-13

  7. Median Time to Hb Response (Increase in Hb by ≥1.0 g/dL From Baseline)

    Baseline Hb was defined as the mean of the last 3 central laboratory Hb values prior to the first dose administration.

    Measured: Baseline up to Week 13

  8. Weekly Dose at First Hb Response (Increase in Hb by ≥1.0 g/dL From Baseline)

    Baseline Hb was defined as the mean of the last 3 central laboratory Hb values prior to the first dose administration.

    Measured: Baseline up to Week 13

  9. Number of Participants Requiring Dose Increase at Weeks 5 and 9

    Number of participants requiring dose increase due to any reasons is reported.

    Measured: Weeks 5 and 9

  10. Number of Participants Requiring Dose Reduction or Dose Discontinuation Due to Excessive Erythropoiesis

    Number of participants requiring dose reduction or dose discontinuation due to excessive erythropoiesis is reported.

    Measured: Weeks 5 and 9

  11. Change From Baseline in Ferritin at Week 13

    Baseline was defined as the average of the last 2 values prior to the first dose administration.

    Measured: Baseline, Week 13

  12. Change From Baseline in Transferrin Saturation (TSAT) at Week 13

    Measured: Baseline, Week 13

  13. Change From Baseline in Reticulocyte Hemoglobin Content at Week 13

    Measured: Baseline, Week 13

  14. Number of Participants With Mean Hb Values 11.0-13.0 g/dL at Weeks 6-9 and 10-13

    Measured: Weeks 6-9 and 10-13

  15. Number of Participants With Mean Hb Values Within 11.0-13.0 g/dL During Weeks 10-13 Among Those With Maximum Hb ≥11.0 g/dL and Change of Hb ≥1 g/dL

    Measured: Weeks 10-13

  16. Number of Participants With Mean Hb Values Within 10.0-13.0 g/dL During Weeks 10-13 Among Those With Maximum Hb ≥10.0 g/dL and Change of Hb ≥1 g/dL

    Measured: Weeks 10-13

  17. Number of Participants With Mean Hb Values in Excess of 13.0 and 14.0 g/dL at Weeks 6-9 and 10-13

    Measured: Weeks 6-9 and 10-13

  18. Number of Participants With Mean Hb Values <10.0 g/dL at Weeks 6-9 and 10-13

    Measured: Weeks 6-9 and 10-13

  19. Number of Participants Requiring Rescue Treatment With an Erythropoiesis-Stimulating Agent (ESA), Red Blood Cells (RBC) Transfusion, or IV Iron (Excluding Arm C)

    Number of participants requiring rescue treatment with an ESA, RBC transfusion, or IV Iron (Excluding Arm C) was reported.

    Measured: Baseline up to Week 13

  20. Number of Participants Requiring Therapeutic Phlebotomy

    Number of participants who required therapeutic phlebotomy due to TEAE of abnormal erythropoiesis is reported.

    Measured: Baseline up to Week 13

  21. Number of Participants Withdrawn From the Study Due to Inadequate Efficacy

    Number of participants withdrawn from the study due to inadequate efficacy is reported.

    Measured: Baseline up to Week 16

  22. Change From Baseline in Short Form 36 (SF-36) Version 2 Physical Functioning Subscore and Vitality Subscore at Weeks 9 and 13

    The SF-36 V2 consists of 36 questions covering 8 health domains: physical functioning, bodily pain, role limitations due to physical problems, role limitations due to emotional problems, general health perceptions, mental health, social function, and vitality. The physical functioning subscore and vitality subscore are reported. The scores ranged from 0 (worst) to 100 (Best). Higher score indicated a better health state. Baseline is defined as the last non-missing value prior to the first dose administration.

    Measured: Baseline, Weeks 9 and 13

  23. Change From Baseline in Functional Assessment of Cancer Therapy-Anemia (FACT-An) Total Score at Weeks 9 and 13

    FACT-An is composed of 27 core items which assess participant's function in 4 domains and 20 anemia-related items, grouped into 5 subscales as follows: Physical well-being (PWB): 7 items; Social/family well-being (SWB): 7 items; Emotional well-being (EWB): 6 items; Functional well-being (FWB): 7 items; and Anemia: 20 items. All FACT-An items were rated as: 0=not at all; 1=a little bit; 2=somewhat; 3=quite a bit; 4=very much. Each subscale score was the sum of scores for the items in the subscale. The FACT-An total score was the sum of all 5 subscale scores, ranging from 0 (worst) - 188 (best). Higher scores represented better quality of life. Baseline is defined as the last non-missing value prior to the first dose administration.

    Measured: Baseline, Weeks 9 and 13

  24. Number of Participants With Potentially Clinically Significant Laboratory Tests

    Criteria for the potential clinical significance included: bilirubin (µmol/L) >1.5 * upper limit of normal (ULN), potassium (mmol/L) >1.2 * ULN, neutrophils (*10^9/L) ≤1, protein (g/L) >1.1 * ULN, leukocytes (*10^9/L) ≤2.5 or ≥15.

    Measured: Baseline up to Week 16

  25. Number of Participants With TEAEs

    An adverse event (AE) was any untoward medical event in a participant who received study drug whether or not the event is considered drug related. TEAEs were defined as any event that either began or worsened after the first administration of study drug and within 28 days of the last dose. A summary of other nonserious AEs and all serious AEs, regardless of causality is located in Reported AE section.

    Measured: Baseline up to Week 16

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Aug 2011 (estimated)
  2. Study start21 Jul 2011
  3. Primary completion10 Jan 2013
  4. Study completion10 Jan 2013

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
60 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01414075
Sponsor's protocol ID
FGCL-4592-053
Status last verified
Sep 2021
First submitted
9 Aug 2011
Last updated
1 Oct 2021
Data monitoring committee
Yes

Publications

  • Natale P, Palmer SC, Jaure A, Hodson EM, Ruospo M, Cooper TE, Hahn D, Saglimbene VM, Craig JC, Strippoli GF. Hypoxia-inducible factor stabilisers for the anaemia of chronic kidney disease. Cochrane Database Syst Rev. 2022 Aug 25;8(8):CD013751. doi: 10.1002/14651858.CD013751.pub2.

    PubMed 36005278

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Roxadustat, Oral Iron and IV Iron in people with Dialysis and Anemia, run by Kyntra Bio at 7 sites in 4 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 1 Oct 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites in United States, Russia, Hong Kong, Singapore. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 1 Oct 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Maximum Change From Baseline in Hb During Weeks 3-13 (time frame: Baseline, Weeks 3-13). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01414075, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Oct 2021.

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