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Multiple Dose Study to Evaluate the Safety of Multiple Doses of Denosumab 120 mg in Adults With Severe Chronic Kidney Disease (CKD) and CKD on Dialysis

Phase 1
Completed
Conditions
Renal Impairment
Interventions
Registration Number
NCT01464931
Lead Sponsor
Amgen
Brief Summary

The primary objective was to evaluate the incidence of clinically significant hypocalcemia following multiple 120 mg subcutaneous doses of denosumab in patients with severe chronic kidney disease (CKD) and CKD on dialysis

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
32
Inclusion Criteria
  • Subjects at least 18 years old with severe CKD (defined as creatinine clearance < 30 mL/min at both screening assessments) and CKD requiring hemodialysis
  • Additional inclusion criteria apply
Exclusion Criteria
  • Subjects must have calcium, phosphate, and magnesium levels appropriate for their condition and must not have other uncontrolled co-morbidities.
  • Additional exclusion criteria apply

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
DenosumabDenosumabParticipants received two 120 mg doses of denosumab administered subcutaneously on Day 1 and Day 29.
Primary Outcome Measures
NameTimeMethod
Number of Participants With Clinically Significant Hypocalcemia113 days

Clinically significant hypocalcemia is defined as albumin-adjusted calcium \< 7.0 mg/dL or symptomatic hypocalcemia. Symptomatic hypocalcemiais is defined as both a clinical adverse event of hypocalcemia and a concomitant symptom of hypocalcemia (e.g., hypoesthesia, paresthesia, muscle cramps, seizure, prolonged QT interval) that occurred along with the hypocalcemia event or decreased serum calcium levels.

Secondary Outcome Measures
NameTimeMethod
Number of Participants With Adverse Events113 days

The severity of each adverse event (AE) was graded using the Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0. The investigator assessed whether AEs were possibly related to study drug by answering the question: "Is there a reasonable possibility that the event may have been caused by the investigational product?" Abnormal laboratory findings without clinical significance (based on the investigator's judgment) were not recorded as AEs, however, laboratory value changes that required treatment or adjustment in current therapy were considered AEs. A serious adverse event is defined as an adverse event that meets at least 1 of the following serious criteria: • fatal, • life-threatening (places the participant at immediate risk of death), • requires in-patient hospitalization or prolongation of existing hospitalization, • results in persistent or significant disability/incapacity, • congenital anomaly/birth defect, and/or • other medically important serious event.

Area Under the Serum Concentration-time Curve From Time 0 to 4 Weeks (AUC0-4wks) After Dose 1Days 1, 8, 15, and 29 (predose)

Estimated using the linear trapezoidal method.

Number of Participants Who Developed Anti-denosumab AntibodiesFrom Day 1 (predose) to Day 113
Number of Participants With Hypomagnesemia Determined by CTCAE v.4.0 Criteria113 days

The severity of hypomagnesemia (a low concentration of magnesium in the blood) was graded according to the common terminology criteria for adverse events (CTCAE) v.4.0 criteria: Grade 1: \< LLN (1.5 mg/dL) - 1.2 mg/dL; Grade 2: \< 1.2 - 0.9 mg/dL; Grade 3: \< 0.9 - 0.7 mg/dL; Grade 4: \< 0.7 mg/dL.

Maximum Observed Serum Denosumab Concentration (Cmax)Days 1 and 29 (predose), and on Days 8, 15, 36, 43, 57, 71, 85, and 113

Serum concentrations of denosumab were measured by an enzyme-linked immunosorbent assay (ELISA). The lower limit of quantification (LLOQ) was 20 ng/mL.

Percent Change From Baseline in Serum Phosphorus Over TimeBaseline and Days 2, 3, 6, 8, 11, 15, 22, 29, 30, 31, 34, 36, 39, 43, 57, 71, 85, and 113
Number of Participants With Hypocalcemia Determined by CTCAE v.4.0 Criteria113 days

The severity of hypocalcemia (a low concentration of calcium, corrected for albumin, in the blood) was graded according to the common terminology criteria for adverse events (CTCAE) v.4.0 criteria: Grade 1: albumin-adjusted serum calcium \< lower limit of normal (LLN; 9.2 mg/dL) to 8.0 mg/dL; Grade 2: albumin-adjusted serum calcium \< 8.0 to 7.0 mg/dL; Grade 3: albumin-adjusted serum calcium \< 7.0 to 6.0 mg/dL; Grade 4: albumin-adjusted serum calcium \< 6.0 mg/dL.

Number of Participants With Hypophosphatemia Determined by CTCAE v.4.0 Criteria113 days

The severity of hypophosphatemia (a low concentration of phosphates in the blood) was graded according to the common terminology criteria for adverse events (CTCAE) v.4.0 criteria: Grade 1: \< LLN (3 mg/dL) - 2.5 mg/dL; Grade 2: \< 2.5 - 2.0 mg/dL; Grade 3: \< 2.0 - 1.0 mg/dL; Grade 4: \< 1.0 mg/dL.

Time to Maximum Observed Serum Denosumab Concentration (Tmax)Days 1 and 29 (predose), and on Days 8, 15, 36, 43, 57, 71, 85, and 113

Serum concentrations of denosumab were measured by an enzyme-linked immunosorbent assay (ELISA). The lower limit of quantification (LLOQ) was 20 ng/mL.

Area Under the Serum Concentration-time Curve From Time 0 to 12 Weeks (AUC0-12wks) After Dose 2Days 29 (predose), 36, 43, 57, 71, and 85

Estimated using the linear trapezoidal method.

Percent Change From Baseline in Albumin-adjusted Serum Calcium Over TimeBaseline and Days 2, 3, 6, 8, 11, 15, 22, 29, 30, 31, 34, 36, 39, 43, 57, 71, 85, and 113
Percent Change From Baseline in Serum Magnesium Over TimeBaseline and Days 2, 3, 6, 8, 11, 15, 22, 29, 30, 31, 34, 36, 39, 43, 57, 71, 85, and 113
Percent Change From Baseline in Serum C-Telopeptide Over TimeBaseline and Days 1 and 29 (predose), and on Days 8, 15, 36, 43, 57, 71, 85, and 113

Trial Locations

Locations (1)

Research Site

🇺🇸

San Antonio, Texas, United States

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