A Randomized, Double-blind, Placebo Controlled Study to Assess the Efficacy and Safety of Cinacalcet HCl in Pediatric Subjects With Chronic Kidney Disease and Secondary Hyperparathyroidism Receiving Dialysis
试验速览
- 阶段
- 3 期
- 状态
- 终止
- 发起方
- Amgen
- 入组人数
- 43
- 试验地点
- 1
- 主要终点
- Percentage of Participants Achieving ≥ 30% Reduction in Mean iPTH From Baseline to the Efficacy Assessment Phase
研究概览
简要总结
The purpose of this study is to assess the safety and efficacy of adding cinacalcet to the current treatment of secondary hyperparathyroidism in children currently receiving dialysis compared to a treatment regimen that does not include cinacalcet.
详细描述
Secondary hyperparathyroidism (SHPT) is a condition that can develop early in patients with chronic kidney disease (CKD), usually gets worse over time, and is known to cause problems for patients on dialysis. Children on dialysis can have a wide range of bone and growth issues, and common treatments have a chance of making these things worse by increasing serum calcium and serum phosphorus. Cinacalcet has been shown to be effective in controlling parathyroid hormone (PTH), calcium and phosphorus in adults. The purpose of this study is to show that including cinacalcet in the treatment of SHPT will lower the levels of intact parathyroid hormone (iPTH) in a larger number of pediatric patients with CKD who are receiving dialysis, compared to a treatment regimen that does not include cinacalcet.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 6 Years 至 17 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age 6 to less than 18 years at screening
- •Diagnosed with CKD and SHPT receiving hemodialysis or peritoneal dialysis for ≥ 2 months before randomization
- •Dry weight ≥ 12.5 kg at screening
- •iPTH obtained from the central laboratory must be > 300 pg/mL (31.8 pmol/L)
- •Serum calcium (corrected) obtained from the central laboratory must be ≥ 8.8 mg/dL (2.2 mmol/L)
- •Serum phosphorus obtained from the central laboratory ≥ 4.0 mg/dL (1.3 mmol/L) for children 6 to less than 12 years old, or ≥ 3.5 mg/dL (1.1 mmol/L) for children 12 to less than 18 years old
- •Subjects already receiving vitamin D sterols (either calcitriol or a synthetic analog), a stable dose within the last 2 months prior to randomization
- •Subjects taking growth hormone, a stable dose defined as no change > than 20% in the last 2 months prior to randomization
- •Subjects on anti-convulsant medication must be on a stable dose for 3 months, and have a therapeutic blood level of the anti-convulsant at the time of randomization
- •Subjects must be on a dialysate calcium concentration of ≥ 2.5 mEq/L (1.25 mmol/L) for at least 2 months prior to randomization
排除标准
- •Underwent parathyroidectomy in the last 6 months
- •Anticipated parathyroidectomy within 6 months after randomization
- •Received therapy with cinacalcet (sensipar/mimpara) within the last month
- •A new onset of seizure or worsening of a pre-existing seizure disorder within the last 3 months
- •Scheduled date for kidney transplant from a known living donor that makes completion of the study unlikely
研究组 & 干预措施
Cinacalcet
Participants received standard of care and cinacalcet once daily for 30 weeks during the double-blind phase. The starting dose of cinacalcet was ≤ 0.20 mg/kg based on dry weight, and could be titrated up according to plasma iPTH and serum calcium levels every 4 weeks until Week 24 to a maximum dose of 4.2 mg/kg. During the open-label phase participants continued to receive cinacalcet with standard of care for an additional 30 weeks.
干预措施: Standard of Care (Drug)
Placebo
Participants received standard of care and placebo once daily for 30 weeks during the double-blind phase. During the open-label phase, participants received cinacalcet with standard of care for an additional 30 weeks. The starting dose of cinacalcet was ≤ 0.20 mg/kg based on dry weight, and could be titrated up according to plasma iPTH and serum calcium levels every 4 weeks up to Week 54 to a maximum dose of 4.2 mg/kg.
干预措施: placebo (Drug)
Placebo
Participants received standard of care and placebo once daily for 30 weeks during the double-blind phase. During the open-label phase, participants received cinacalcet with standard of care for an additional 30 weeks. The starting dose of cinacalcet was ≤ 0.20 mg/kg based on dry weight, and could be titrated up according to plasma iPTH and serum calcium levels every 4 weeks up to Week 54 to a maximum dose of 4.2 mg/kg.
干预措施: Standard of Care (Drug)
Cinacalcet
Participants received standard of care and cinacalcet once daily for 30 weeks during the double-blind phase. The starting dose of cinacalcet was ≤ 0.20 mg/kg based on dry weight, and could be titrated up according to plasma iPTH and serum calcium levels every 4 weeks until Week 24 to a maximum dose of 4.2 mg/kg. During the open-label phase participants continued to receive cinacalcet with standard of care for an additional 30 weeks.
干预措施: cinacalcet capsule (Drug)
结局指标
主要结局
Percentage of Participants Achieving ≥ 30% Reduction in Mean iPTH From Baseline to the Efficacy Assessment Phase
时间窗: From Baseline to the Efficacy Assessment Phase, Weeks 25-30
The efficacy assessment value is based on the scheduled assessment(s) taken during the efficacy assessment phase (EAP; Weeks 25 - 30). When multiple assessments were available, the average of those was used. If an efficacy measurement during the EAP was missing, the mean of the last 2 available post-baseline values in the dose-titration phase was used. If only one post-baseline value was available, this single value was used.
次要结局
- Percent Change From Baseline in Mean Ionized Calcium During the Efficacy Assessment Phase(From Baseline to the Efficacy Assessment Phase, Weeks 25-30.)
- Growth Velocity From Baseline to End of Double-blind Phase(From Baseline to end of Efficacy Assessment at Week 30)
- Growth Velocity From End of Double-blind Phase to End of Open-label Phase(End of double-blind phase (Week 30) until end of the open-label phase (Week 60))
- Percent Change From Baseline in Mean Phosphorous Product (Ca x P) During the Efficacy Assessment Phase(From Baseline to end of Efficacy Assessment Period, assessed up to 30 weeks)
- Percentage of Participants Achieving Mean iPTH ≤ 300 pg/mL (31.8 Pmol/L) During the Efficacy Assessment Phase(From Baseline to the Efficacy Assessment Phase (EAP), Weeks 25-30)
- Percent Change From Baseline in Mean Serum Phosphorus During the Efficacy Assessment Phase(From Baseline to the Efficacy Assessment Phase, Weeks 25-30.)
- Percent Change From Baseline in Mean Corrected Total Serum Calcium During the Efficacy Assessment Period(From Baseline to the Efficacy Assessment Phase, Weeks 25-30.)