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Research Study to demonstrate that intravenous iron isomaltoside 1000 (Monofer®) is non-inferior to oral iron sulphate in reducing renal related anemia in subjects with non-dialysis dependent chronic kidney disease (NDD-CKD), determined as ability to increase Hb.

Phase 3
Completed
Conditions
non-dialysis dependent chronic kidney disease Subjects
Registration Number
CTRI/2010/091/000417
Lead Sponsor
Pharmacosmos AS
Brief Summary

**Study Design:**

Prospective, Open-label, Randomized, Comparative, Multi-centre Study with Two Treatment Groups:

A. Iron isomaltoside 1000 (Monofer®)

  - Administered as intravenous infusions (A1)

·         Maximum 1000 mg iron each week until full replacement dose is achieved (if the subject weight is between 35.1-45 kg maximum 750 mg iron/infusion or if the subject weight is between 30-35 kg maximum 500 mg iron/infusion).

·         The infusion is diluted in 100 mL 0.9% sodium chloride and given over approximately 15 minutes.

  - Administered as intravenous bolus injections (A2)

·         The full iron replacement dose of iron isomaltoside 1000 (Monofer®) listed in the dosing table is administered as bolus injections of 500 mg administered undiluted over approximately 2 minutes, once per week until full replacement dose is achieved.

·         In some cases the remaining dose on the last dosing day may be 250 mg e.g., on visit 4 if the full replacement dose is 1250mg,

·         In these situations remaining 250 mg should be administered undiluted over approximately 2 minutes

  -Iron sulphate administered orally (B)

·         100 mg elementary iron b.i.d. (200 mg daily) for 8 weeks.

  **Prohibited concomitant medication and therapy:**

1. Blood transfusion.

2. Any iron supplementation other than investigational drugs.

3. Erythropoeisis-Stimulating Agents (ESA).

4. Medications which potentially yield a decrease in oral iron absorption, e.g. tetracycline, antacids, cholestyramine etc.

Detailed Description

Not available

Recruitment & Eligibility

Status
Completed
Sex
All
Target Recruitment
350
Inclusion Criteria
  • Men and women, aged more than 18 years.
  • Subjects diagnosed with NDD-CKD with MDRD calculated eGFR between 15-59 mL/min.
  • Hb 11.0 g/dL (6.80 mmol/L) 4.
  • Either or both of the following iron stores indicators below target {Serum ferritin < 200 ug/l and Transferrin saturation (TfS)<20%}.
  • Life expectancy beyond 12 months by Principal Investigator?s judgement.
  • Willingness to participate after informed consent and any authorization as required by local law ( e.g. Protected Health Information [PHI] for North America).
Exclusion Criteria
  • Anaemia predominantly caused by factors other than renal impairment or iron deficiency (according to Principal Investigator s?
  • Iron overload or disturbances in utilisation of iron (e.g. haemochromatosis and haemosiderosis).
  • Drug hypersensitivity (i.e. previous hypersensitivity to Iron Dextran or iron mono- or disaccharide complexes or to iron sulphate or any excipients of the study drug.
  • Subjects with history of multiple allergies.
  • Decompensated liver cirrhosis and hepatitis (alanine aminotransferase (ALT) > 3 times upper normal limit) 6.
  • Diagnosis of Hepatitis B and/or C confirmed by appropriate lab test.
  • Active acute or chronic infections ((assessed by clinical judgment), supplied with white blood cells (WBC) and C-reactive protein (CRP)).
  • Rheumatoid arthritis with symptoms or signs of active joint inflammation.
  • Pregnancy and nursing (To avoid pregnancy, women have to be postmenopausal (at least 12 months must have elapsed since last menstruation), surgically sterile, or women of child bearing potential must use one of the following contraceptives during the whole study period and after the study has ended for at least 5 times plasma biological half-life of the investigational medicinal product (5 days): Contraceptive pills, Intrauterine Devices (IUD), contraceptive depot injections (prolonged-release gestagen), subdermal implantation, vaginal ring, and transdermal patches).
  • Extensive active bleeding necessitating blood transfusion.
  • Planned elective surgery during the study.
  • Participation in any other clinical study within 3 months prior to screening.
  • Known intolerance to oral iron treatment.
  • Untreated B12 or folate deficiency.
  • I.V. or oral iron treatment or blood transfusion within 4 weeks prior to screening visit.
  • ESA treatment within 8 weeks prior to screening visit.
  • Serum ferritin > 500 μg/L.
  • Any other medical condition that, in the opinion of Principal Investigator, may cause the subject to be unsuitable for the completion of the study or place the subject at potential risk from being in the study or interfere with study drug evaluation.
  • Example, Uncontrolled Hypertension, Unstable Ischemic Heart Disease or Uncontrolled Diabetes Mellitus.
  • History of immunodeficiency, including positive HIV test result.
  • Body weight < 30 kilograms.

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Intravenous iron isomaltoside 1000 (Monofer®) is non-inferior to oral iron sulphate in reducing renal related anemia in subjects with non-dialysis dependent chronic kidney disease (NDD-CKD), determined as ability to increase Hb.Wk 1, 2, 3, 4, and 8
Secondary Outcome Measures
NameTimeMethod
1. To assess other relevant haematology and biochemical parameters during the study.2. Quality of Life assessment (QoL) by Linear Analog Scale Assessment (LASA).

Trial Locations

Locations (17)

Apex Kidney Care Pvt Ltd,

🇮🇳

Mumbai, MAHARASHTRA, India

Ajanta Research Centre,

🇮🇳

Lucknow, UTTAR PRADESH, India

Deenanath Mangeshkar Hospital & Research Centre

🇮🇳

Pune, MAHARASHTRA, India

Department of Nephrology,Osmania General Hospital

🇮🇳

Hyderabad, ANDHRA PRADESH, India

Department of Nephrology,SMS Medical College and Hospital, Jawahar Lal Nehru Marg ,Jaipur-302004, India

🇮🇳

Jaipur, RAJASTHAN, India

Dr. Hargovind Laxmishanker Trivedi Institute of Kidney Disease & Research Centre

🇮🇳

Hospital, India

Gujarat Kidney Foundation

🇮🇳

Ahmadabad, GUJARAT, India

Krishna Institute of Medical Sciences

🇮🇳

Hyderabad, ANDHRA PRADESH, India

M S Ramaiah Memorial hospital

🇮🇳

Bangalore, KARNATAKA, India

Maulana Azad Medical College & Associated Lok Nayak Hospital

🇮🇳

Delhi, DELHI, India

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Apex Kidney Care Pvt Ltd,
🇮🇳Mumbai, MAHARASHTRA, India
Dr. Rajesh Kumar
Principal investigator
9821267704
rajkbasudeo@yahoo.com

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