A Study of PEG-EPO Injection (CHO Cells) for Maintenance Therapy of Patients With Renal Anemia .

Phase 2

Recruiting

• Conditions: Renal Anemia
• Interventions: Biological: Recombinant human erythropoietin injection; Biological: Human erythropoietin injection

• Registration Number: NCT05629598
• Lead Sponsor: Angde Biotech Pharmaceutical Co., Ltd.

Brief Summary

The purpose of the study is to explore the optimal dose and administration of the experimental drug, and to evaluate the safety and efficacy of the drug in patients with renal anemia. Patients with renal anemia on regular dialysis treatment are expected to be enrolled in this study.

Detailed Description

This study is a multi-center, randomized, open-label, positive controlled phase II clinical study. A total of 125 to 150 patients with renal anemia receiving regular dialysis were enrolled in this study. Those patients were randomly allocated to 5 treatment groups in a ratio of 1:1:1:1:1, with 25 to 30 patients in each group.

Study Timeline

• Study Start: 2022-04-13
• Study First Submitted: 2022-06-27
• Status Verified: 2022-11
• Study First Submitted QC: 2022-11-17
• Last Update Submitted: 2022-11-17
• Study First Posted: 2022-11-29
• Last Update Posted: 2022-11-29
• Primary Completion: 2023-03-17
• Study Completion: 2023-08-16

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 150

Inclusion Criteria

1. Male and female patients at the age of 18~75 (including critical value).
2. Patients clinically diagnosed with renal anemia who have received dialysis for at least 12 weeks (hemodialysis≥3 times/week, total urea clearance index (Kt/V) ≥1.2 or urea reduction rate (URR) ≥65%; peritoneal dialysis≥4 times/day, weekly Kt/V≥1.7);
3. Hb in screening period should be within the range of 100~130g/L (including both ends), and the deviation should not exceed 10g/L;
4. Iron status (TSAT ≥20% or SF ferritin ≥100μg/L) during screening.
5. Have been stably treated with short-acting EPO 1-3 times per week for at least 12 weeks before baseline;
6. Consent to use reliable contraceptive methods and no family planning from the screening period to 3 months after the last administration；
7. Voluntarily participate in the trial and sign the informed consent form.

Exclusion Criteria

1. Patients with a history of severe allergies (including drug allergies), especially allergic to erythropoietin, or to any component of the test drug (e.g. polyethylene glycol);

2. Have a history of kidney transplantation or plan to undergo kidney transplantation during the trial；

3. Have any other disease that causes chronic anemia (e.g., sickle cell anemia, myelodysplastic syndrome, hematologic malignancy, myeloma, hemolytic anemia, pure red cell aplastic anemia) or PRCA following therapy of erythropoietin protein;

4. Suffered from acute or chronic blood loss (such as gastrointestinal bleeding) or undergwent surgical procedures due to massive bleeding within 3 months before screening, or plan to have a surgery during the clinical trial (except for arteriovenous fistula or peritoneal dialysis tube adjustment);

5. Have a history of malignant tumors within the past 5 years (excluding non-melanoma skin cancer or excised carcinoma in situ);

6. Suffer from autoimmune diseases (such as rheumatoid arthritis or systemic lupus erythematosus) or diseases of endocrine system (such as poorly controlled diabetes mellitus complicated with peripheral vascular diseases, severe secondary hyperparathyroidism [parathyroid hormone > 800ng/L]);

7. Received systemic antibiotic treatment or C-reactive protein ≥30mg/L within 4 weeks due to severe infection before screening;

8. The following conditions occur during screening period:

   Hepatic dysfunction (AST or ALT>3 times ULN); Coagulation dysfunction (activated partial thrombin time > 1.5 times ULN); Folic acid or vitamin B12 deficiency (serum folic acid level <LLN, vitamin B12 <LLN); Positive for HBsAg, HBcAb, HIV-ABb, HCV-AbB or TP-Ab;

9. Suffer from severe thromboembolic disease, poorly controlled severe hypertension (SBP before dialysis > 170mmHg or DBP ≥100mmHg) or hypotension (SBP before dialysis <90mmHg);

10. Suffer from severe cardiovascular and cerebrovascular disease, severe or unstable coronary artery disease, heart failure (NYHA CLASS III or IV), or those who received coronary artery bypass grafting or percutaneous coronary intervention within 6 months, or those who had a history of myocardial infarction or stroke within 3 months;

11. Received androgen therapy or blood transfusion within 8 weeks before screening period;

12. Received long-acting ESAs within 3 months or HIF-PHI (e.g., rosalat) within 2 weeks before initial administration;

13. Participated in other clinical trials as a subject within 4 weeks before screening period or the duration from the last administration to enrollment was shorter than the 5 half-lives of the drug;

14. Have a history of epileptic seizures or mental illness;

15. Alcoholism, drug abuse or drug addiction

16. Pregnant or breastfeeding;

17. Investigator considers not suitable to enter this trial.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
A2	Recombinant human erythropoietin injection	Recombinant human erythropoietin injection; Weekly dose of short-acting EPO (IU/kg)\* 0.004 (conversion coefficient), Q4W for administration.
C	Human erythropoietin injection	Human erythropoietin injection；Refer to the product instructions.
A1	Recombinant human erythropoietin injection	Recombinant human erythropoietin injection; Weekly dose of short-acting EPO (IU/kg)\* 0.004 (conversion coefficient), Q2W for administration.
B1	Recombinant human erythropoietin injection	Recombinant human erythropoietin injection; Weekly dose of short-acting EPO (IU/kg)\* 0.008 (conversion coefficient), Q2W for administration.
B2	Recombinant human erythropoietin injection	Recombinant human erythropoietin injection; Weekly dose of short-acting EPO (IU/kg)\* 0.008 (conversion coefficient), Q4W for administration.

Primary Outcome Measures

Name	Time	Method
Change of mean hemoglobin during dose adjustment period	Day85-Day126	Change of mean hemoglobin compared to baseline from week 13 to 18 during dose adjustment period (dose adjustment period: week 7 to week 18/week 20).
Change of mean hemoglobin compared to baseline during fixed treatment	Day1-Day42	Change of mean hemoglobin (Hb) content from baseline during fixed treatment (fixed treatment：week 1 to week 6)

Secondary Outcome Measures

Name	Time	Method
Proportion of patients receiving red blood cell transfusion and number of transfusions during the trial.	Day1-Day126/140
Cmax	Day1-Day126/140	Maximum observed plasma concentration of EPO.
Tmax	Day1-Day126/140	Time to maximum observed plasma concentration of EPO.
AUC 0-t	Day1-Day126/140	Area under the plasma concentration-time curve from time 0 to the time of the last measurable concentration of EPO.
Emax	Day1-Day126/140	Maximal effect concentriation
Reticulocyte count, Hematocrit, Erythrocyte count	Day1-Day42、Day85-Day126	Changes of mean values of other evaluation indexes (including HCT, RET, RBC) between baseline and different stages of treatment (fixed treatment period, week 13 to 18 of dose adjustment period).
The number and proportion of patients with dose adjustments during the trial	Day1-Day126/140
Anti-drug antibody	1,5, 9, 13, 17 weeks (before administration) and 28±2 days after the last administration (A2/B2group ,A1/B1 patients with intensive blood collection) or 14±2 days after the last administration (A1/B1 patients with sparse blood collection)	The incidence of ADA and Nab
Tmax of Emax	Day1-Day126/140	Time to maximal effect concentriation
Proportion of patients with hemoglobin keeping within the target range	Day1-Day42、Day85-Day126	Proportion of patients with hemoglobin keeping within the target range (target range: the variation from baseline Hb is within ±10g/L, and HB is in the range of 100-130g/L) during treatment period (fixed treatment, week 13 to 18 during dose adjustment period).
Adverse events	Day1-Day126/140	Any adverse event that occurred during the clinical trials of all patients.
AUC 0-∞	Day1-Day126/140	Area under the plasma concentration-time curve from time 0 to infinity.
Number of iron deficiency, number of patients and proportion of patients with iron deficiency during the trial	Day1-Day126/140	Iron deficiency was defined as SF≤100μg/L and TSAT≤20% in peritoneal dialysis subjects; SF≤200μg/L and TSAT≤20% in hemodialysis subjects.
AUE0-t	Day1-Day126/140	Area under the plasma effect-concentriation curve from time 0 to the time of the last measurable concentration of EPO.

Trial Locations

Locations (1)

The First Affiliated Hospitial,College of Medicine,Zhejiang University; 🇨🇳 Hanzhou, Zhejiang, China