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KRX-0502 (Ferric Citrate) in Subjects With NDD-CKD and IDA (The COMPASS Trial)

Phase 4
Completed
Conditions
Chronic Kidney Diseases
Iron Deficiency Anemia
Interventions
Registration Number
NCT03236246
Lead Sponsor
Keryx Biopharmaceuticals
Brief Summary

The objectives of this study are to assess the long-term efficacy and safety of different dose regimens of KRX-0502 in the treatment of iron deficiency anemia (IDA) in adult subjects with non-dialysis dependent chronic kidney disease (CKD).

Detailed Description

This is a Phase 4, 48-week, randomized, open-label, multicenter clinical study comprised of 2 periods: a 24-week Dose Titration Period, followed by a 24-week Dose Maintenance Period. The study will consist of 12 scheduled clinic visits over a period of 48 weeks and additional visits as needed.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
206
Inclusion Criteria
  • Estimated glomerular filtration rate ≥20 mL/min and <60 mL/min
  • Hgb ≥8.5 g/dL and ≤11.5 g/dL
  • Serum ferritin ≤500 ng/mL and transferrin saturation (TSAT) ≤25%
  • Serum intact parathyroid hormone ≤600 pg/mL
Exclusion Criteria
  • Serum phosphate <3.0 mg/dL
  • Intravenous (IV) iron administered within 4 weeks prior to Screening
  • Erythropoiesis-stimulating agents (ESA) administered within 4 weeks prior to Screening
  • Blood transfusion within 4 weeks prior to Screening

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group 1KRX-0502KRX-0502 1 tablet thrice daily (TID) with meals
Group 2KRX-0502KRX-0502 2 tablets twice daily (BID) with the largest 2 daily meals
Primary Outcome Measures
NameTimeMethod
Change From Baseline in Hemoglobin (Hgb) at Week 24Baseline; Week 24

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Estimates are from a mixed model of repeated measures (MMRM), including an intercept term and covariates for randomized treatment, visit, treatment by visit interaction, Baseline value, and Baseline value by visit interaction. The Kenward-Roger method was used along with an unstructured covariance matrix.

Secondary Outcome Measures
NameTimeMethod
Number of Hospitalizations for Participants Who Entered the Dose Maintenance Periodup to Week 48

A hospitalization is defined as admission to the hospital.

Change From Baseline in Hgb at Week 48Baseline; Week 48

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Estimates are from an MMRM, including an intercept term and covariates for randomized treatment, visit, treatment by visit interaction, Baseline value, and Baseline value by visit interaction. The Kenward-Roger method was used along with an unstructured covariance matrix.

Change From Baseline Scores for the WPAI Questionnaire Adapted for Anemia Associated With CKD at Week 24: Activity ImpairmentBaseline; Week 24

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. The WPAI is a questionnaire to evaluate the effect of anemia associated with Chronic Kidney Disease on the ability to work and perform regular activities. Scores are presented as percentages (multiplying the scores by 100), with 0% representing no impact and 100% representing complete impact.

Change From Baseline Scores for the WPAI Questionnaire Adapted for Anemia Associated With CKD at Week 48: Activity ImpairmentBaseline; Week 48

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. The WPAI is a questionnaire to evaluate the effect of anemia associated with Chronic Kidney Disease on the ability to work and perform regular activities. Scores are presented as percentages (multiplying the scores by 100), with 0% representing no impact and 100% representing complete impact.

Change From Baseline Scores for the WPAI Questionnaire Adapted for Anemia Associated With CKD at Week 48: Work-associated MeasuresBaseline; Week 48

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. The WPAI is a questionnaire to evaluate the effect of anemia associated with Chronic Kidney Disease on the ability to work and perform regular activities. Scores are presented as percentages (multiplying the scores by 100), with 0% representing no impact and 100% representing complete impact.

Change From Baseline Scores for the Work Productivity and Activity Impairment (WPAI) Questionnaire Adapted for Anemia Associated With Chronic Kidney Disease (CKD) at Week 24: Work-associated MeasuresBaseline; Week 24

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. The WPAI is a questionnaire to evaluate the effect of anemia associated with Chronic Kidney Disease on the ability to work and perform regular activities. Scores are presented as percentages (multiplying the scores by 100), with 0% representing no impact and 100% representing complete impact.

Number of Participants With Any Treatment-emergent Adverse Event (TEAE) for Participants Who Entered the Dose Maintenance Periodup to Week 48

Treatment-emergent adverse events are defined as adverse events that began after the first administration of study medication or pre-existing conditions that worsened after the first dose of study medication.

Change From Baseline in Ferritin at Week 24Baseline; Week 24

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Estimates are from an MMRM, including an intercept term and covariates for randomized treatment, visit, treatment by visit interaction, Baseline value, and Baseline value by visit interaction. The Kenward-Roger method was used along with an unstructured covariance matrix.

Change From Baseline in Ferritin at Week 48Baseline; Week 48

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Estimates are from an MMRM, including an intercept term and covariates for randomized treatment, visit, treatment by visit interaction, Baseline value, and Baseline value by visit interaction. The Kenward-Roger method was used along with an unstructured covariance matrix.

Change From Baseline in Serum Phosphate at Week 48Baseline; Week 48

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Estimates are from an MMRM, including an intercept term and covariates for randomized treatment, visit, treatment by visit interaction, Baseline value, and Baseline value by visit interaction. The Kenward-Roger method was used along with an unstructured covariance matrix.

Change From Baseline in TSAT at Week 48Baseline; Week 48

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Estimates are from an MMRM, including an intercept term and covariates for randomized treatment, visit, treatment by visit interaction, Baseline value, and Baseline value by visit interaction. The Kenward-Roger method was used along with an unstructured covariance matrix.

Change From Baseline in Serum Phosphate at Week 24Baseline; up to Week 24

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Estimates are from an MMRM, including an intercept term and covariates for randomized treatment, visit, treatment by visit interaction, Baseline value, and Baseline value by visit interaction. The Kenward-Roger method was used along with an unstructured covariance matrix.

Change From Baseline in Estimated Glomerular Filtration Rate (eGFR) at Week 24Baseline; Week 24

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Estimates are from an MMRM, including an intercept term and covariates for randomized treatment, visit, treatment by visit interaction, Baseline value, and Baseline value by visit interaction. The Kenward-Roger method was used along with an unstructured covariance matrix.

Change From Baseline in Bicarbonate at Week 24Baseline; Week 24

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Estimates are from an MMRM, including an intercept term and covariates for randomized treatment, visit, treatment by visit interaction, Baseline value, and Baseline value by visit interaction. The Kenward-Roger method was used along with an unstructured covariance matrix.

Change From Baseline in Bicarbonate at Week 48Baseline; Week 48

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Estimates are from an MMRM, including an intercept term and covariates for randomized treatment, visit, treatment by visit interaction, Baseline value, and Baseline value by visit interaction. The Kenward-Roger method was used along with an unstructured covariance matrix.

Change From Baseline in C-terminal Fibroblast Growth Factor 23 (FGF23) at Week 24Baseline; Week 24

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Estimates obtained using an uncommon slope ANCOVA model which includes the Baseline laboratory parameter as a covariate, randomized treatment group, randomized treatment group by Baseline interaction, and a random error term.

Change From Baseline in eGFR at Week 48Baseline; Week 48

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Estimates are from an MMRM, including an intercept term and covariates for randomized treatment, visit, treatment by visit interaction, Baseline value, and Baseline value by visit interaction. The Kenward-Roger method was used along with an unstructured covariance matrix.

Change From Baseline in Intact Parathyroid Hormone (iPTH) at Week 24Baseline; Week 24

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Estimates obtained using a common slope analysis of covariance (ANCOVA) model which includes the Baseline laboratory parameter as a covariate, randomized treatment group, and a random error term.

Change From Baseline in the Functional Assessment of Chronic Illness Therapy Fatigue Scale Score at Week 48Baseline; Week 48

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Participants were asked to respond to 13 statements (as they apply to the last 7 days) that other people with the same illness said are important with one of the following: 0, not at all; 1, a little bit; 2, somewhat; 3, quite a bit; 4, very much. All individual items were summed to create a single fatigue score ranging from 0 to 52. Higher scores indicate greater fatigue.

Change From Baseline in iPTH at Week 48Baseline; Week 48

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Estimates obtained using an uncommon slope ANCOVA model which includes the Baseline laboratory parameter as a covariate, randomized treatment group, randomized treatment group by Baseline interaction, and a random error term.

Change From Baseline in C-terminal FGF23 at Week 48Baseline; Week 48

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Estimates obtained using an uncommon slope ANCOVA model which includes the Baseline laboratory parameter as a covariate, randomized treatment group, randomized treatment group by Baseline interaction, and a random error term.

Change From Baseline in Intact Fibroblast Growth Factor 23 at Week 48Baseline; Week 48

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Estimates obtained using an uncommon slope ANCOVA model which includes the Baseline laboratory parameter as a covariate, randomized treatment group, randomized treatment group by Baseline interaction, and a random error term.

Duration of Hospitalizations for Participants Who Entered the Dose Maintenance Periodup to Week 48

A hospitalization is defined as admission to the hospital.

Time From Randomization to the First Increase From Baseline Hgb of at Least 0.5 Grams Per Deciliter (g/dL) During the Dose Titration Periodfrom Randomization to Week 24

The Kaplan-Meier estimator of the survival function of time from randomization to the first increase from Baseline Hgb of at least 0.5 g/dL for each of the two starting dose treatment groups were obtained.

Change From Baseline in Transferrin Saturation (TSAT) at Week 24Baseline; Week 24

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Estimates are from an MMRM, including an intercept term and covariates for randomized treatment, visit, treatment by visit interaction, Baseline value, and Baseline value by visit interaction. The Kenward-Roger method was used along with an unstructured covariance matrix.

Change From Baseline in Intact Fibroblast Growth Factor 23 at Week 24Baseline; Week 24

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Estimates obtained using a common slope ANCOVA model which includes the Baseline laboratory parameter as a covariate, randomized treatment group, and a random error term.

Change From Baseline in the Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale Score at Week 24Baseline; Week 24

Change from Baseline was calculated as the post-Baseline value minus the Baseline value. Participants were asked to respond to 13 statements (as they apply to the last 7 days) that other people with the same illness said are important with one of the following: 0, not at all; 1, a little bit; 2, somewhat; 3, quite a bit; 4, very much. All individual items were summed to create a single fatigue score ranging from 0 to 52. Higher scores indicate greater fatigue.

Trial Locations

Locations (24)

Miami Kidney Group

🇺🇸

Miami, Florida, United States

Renal Associates, LLC

🇺🇸

Columbus, Georgia, United States

Hypertension and Nephrology Association

🇺🇸

Eatontown, New Jersey, United States

Southeastern Nephrology Associates

🇺🇸

Jacksonville, North Carolina, United States

Metrolina Nephrology Associates, PA

🇺🇸

Charlotte, North Carolina, United States

California Institute of Renal Research

🇺🇸

Poway, California, United States

South Mississippi Medical Research, LLC

🇺🇸

Gulfport, Mississippi, United States

Sierra Nevada Nephrology Consultants

🇺🇸

Reno, Nevada, United States

Nephrology Associates, P.C.

🇺🇸

Nashville, Tennessee, United States

Southeastern Clinical Research Institute, LLC

🇺🇸

Augusta, Georgia, United States

Division of Kidney/HTN Research

🇺🇸

Great Neck, New York, United States

Mountain Kidney & Hypertension Associates

🇺🇸

Asheville, North Carolina, United States

Research by Design, LLC

🇺🇸

Chicago, Illinois, United States

Arizona Kidney Disease and Hypertension center: AKDHC Medical Research Services, LLC

🇺🇸

Phoenix, Arizona, United States

Kidney and Hypertension Specialists of Miami, P.A.

🇺🇸

Miami, Florida, United States

Eastern Nephrology Associates

🇺🇸

New Bern, North Carolina, United States

Columbia Nephrology Associates, PA

🇺🇸

Columbia, South Carolina, United States

Research Management, Inc.

🇺🇸

Austin, Texas, United States

Southeastern Nephrology

🇺🇸

Wilmington, North Carolina, United States

Clinical Advancement Center, PLLC

🇺🇸

San Antonio, Texas, United States

P & I Clinical Research, LLC

🇺🇸

Lufkin, Texas, United States

Denver Nephrologists, P.C.

🇺🇸

Denver, Colorado, United States

South Carolina Nephrology & Hypertension Center, Inc

🇺🇸

Orangeburg, South Carolina, United States

Clinical Research Consultants

🇺🇸

Kansas City, Missouri, United States

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