A Prospective Interventional Study Assessing the Clinical and Operational Effectiveness of Transitioning From Mircera to Daprodustat for the Treatment of Anemia in End Stage Kidney Disease

Phase 4

Completed

• Conditions: Renal Insufficiency, Chronic; Anemia; Renal Anemia
• Interventions: Drug: Daprodustat

• Registration Number: NCT05951192
• Lead Sponsor: USRC Kidney Research

Brief Summary

Investigator-initiated, interventional, prospective study to assess the clinical and operational effectiveness of daprodustat in adult patients receiving in center hemodialysis or peritoneal home dialysis who are transitioning from Mircera to daprodustat.

Detailed Description

Investigator-initiated, multicenter, prospective, interventional study to determine the clinical and operational effectiveness of transitioning from intravenous or subcutaneous Mircera to oral daily daprodustat as assessed by change in hemoglobin. This trial will be conducted at up to 40 United States Renal Care sites in the United States and will enroll approximately 200 patients (\~150 in-center hemodialysis and \~50 home dialysis patients).

Participants who are prescribed daprodustat by their treating physician and have taken at least a single dose of daprodustat will be considered enrolled into the clinical trial. After the prescription of daprodustat by the treating physician, each subject will be followed prospectively for a treatment period of approximately 120 days.

Subjects taking daprodustat will not have any in-person study related visits and will follow their usual schedule with regard to standard of care. Standard of care laboratory assessments as ordered by the primary nephrologist will be utilized. Twice monthly hemoglobin collection and monitoring will be required as part of the standard of care laboratory assessments.

Study Timeline

• Study First Submitted: 2023-06-02
• Study Start: 2023-07-01
• Study First Submitted QC: 2023-07-14
• Study First Posted: 2023-07-18
• Primary Completion: 2024-02-14
• Study Completion: 2024-02-14
• Status Verified: 2024-05
• Last Update Submitted: 2024-05-22
• Last Update Posted: 2024-05-24

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 161

Inclusion Criteria

1. Adult patients ≥18 years old.
2. Diagnosis of end stage kidney disease and receiving maintenance dialysis (in-center hemodialysis or peritoneal dialysis) for ≥ 4 months.
3. Has received at least a single dose of Mircera within 45 days prior to prescription of Daprodustat by treating physician.
4. Understands the procedures and requirements of the study and provides written informed consent and authorization for protected health information disclosure.

Exclusion Criteria

1. A known allergy or intolerance to daprodustat or any of its constituents.
2. Uncontrolled hypertension.
3. Active malignancy as documented in electronic medical record.
4. Concomitant use of a strong CYP2C8 inhibitor such as gemfibrozil.
5. Severe hepatic impairment as documented in the electronic medical record.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Commercial daprodustat	Daprodustat	Prescription of oral daprodustat in accordance with the FDA approved package label.

Primary Outcome Measures

Name	Time	Method
Change in hemoglobin from baseline to the effectiveness evaluation period	120 days	Change in hemoglobin from baseline (defined as the mean of all available hemoglobin values obtained in the 30 days prior to Day 1) to the effectiveness evaluation period (mean of all available hemoglobin values obtained in the 30 days prior to Day 120).

Secondary Outcome Measures

Name	Time	Method
The number/proportion of subjects with a hemoglobin in target range of 10-11 g/dL from baseline to effectiveness evaluation period	120 days	The number/proportion of subjects with a hemoglobin in target range of 10-11 g/dL from baseline to effectiveness evaluation period
Number of subjects retained on daprodustat therapy from Day 1 through Day 120	120 days	Number of subjects retained on daprodustat therapy from Day 1 through Day 120
Average monthly (percent) compliance with daprodustat daily dosing, per subject report.	120 days	The average monthly compliance will be calculated from individual subject reported verbal estimates of (percent) compliance with daprodustat daily administration.
Number of hemoglobin excursions that are < 8.5 g/dL or ≥ 12 g/dL during the treatment period.	120 days	Number of hemoglobin excursions that are \< 8.5 g/dL or ≥ 12 g/dL during the treatment period.
The number/proportion of subjects with a change in hemoglobin under 0.5 g/dL from baseline to effectiveness evaluation period	120 days	The number/proportion of subjects with a change in hemoglobin under 0.5 g/dL from baseline to effectiveness evaluation period
The time (in days) from initial and refill prescription to delivery to patient	120 days	The time (in days) from initial and refill prescription to delivery to patient
Number of dose adjustments in daprodustat per patient during the treatment period	120 days	Number of dose adjustments in daprodustat per patient during the treatment period
The number/proportion of subjects who receive a refill prescription with the correct prescribed dose with no gap (0 days) in drug supply from the previous prescription	120 days	The number/proportion of subjects who receive a refill prescription with the correct prescribed dose with no gap (0 days) in drug supply from the previous prescription

Trial Locations

Locations (1)

USRC Kidney Research; 🇺🇸 Lone Tree, Colorado, United States