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A Study of Mircera in Hemoglobin Control of Patients Transitioning to Dialysis.

Registration Number
NCT00454246
Lead Sponsor
Hoffmann-La Roche
Brief Summary

This study will assess the efficacy and safety of methoxy polyethylene glycol-epoetin beta (Mircera) in the maintenance of hemoglobin levels in patients who have previously received treatment with epoetin alfa or darbepoetin alfa, and who are transitioning from chronic kidney disease stage 4 through dialysis. Patients will be randomized either to receive Mircera or to remain on their existing therapy; the initial monthly dose of subcutaneous (sc) Mircera (120-360 micrograms) will be based on the average weekly dose of epoetin alfa or darbepoetin alfa administered in the week preceding the switch to Mircera. At the initiation of dialysis, patients in the Mircera group will receive monthly intravenous (iv) Mircera at a starting dose based on their previous (sc) dose, and those in the control group will receive weekly (iv) epoetin alfa. The anticipated time on study treatment is 1-2 years, and the target sample size is 500+ individuals.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
111
Inclusion Criteria
  • adult patients, >=18 years of age;
  • chronic kidney disease stage IV not requiring dialysis;
  • expected to initiate dialysis within 18 months;
  • 15<=Glomerular Filtration Rate (GFR)<=29.
Exclusion Criteria
  • failing renal allograft in place;
  • acute or chronic bleeding within 8 weeks prior to screening;
  • transfusion of red blood cells within 8 weeks prior to screening;
  • poorly controlled hypertension;
  • immunosuppressive therapy in the 12 weeks prior to screening.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Epoetin alfaepoetin alfaPatients randomized to the reference arm continued to receive their standard of care dose and regimen of epoetin alfa subcutaneous once per week for a minimum of 5 months to a maximum of 18 months. Subcutaneous injections were to be administered in the same part of the body (ie, thigh, abdomen or arm) throughout the study. Dosage was adjusted to maintain a hemoglobin target range of ≥10 g/dL to ≤12 g/dL.
methoxy polyethylene glycol-epoetin betamethoxy polyethylene glycol-epoetin beta120-360 micrograms methoxy polyethylene glycol-epoetin beta subcutaneous (sc) monthly starting dose, for a minimum of 5 months to a maximum of 18 months. Dosage was adjusted to maintain a hemoglobin target range of ≥10 g/dL to ≤12 g/dL.
Darbepoetin alfadarbepoetin alfaPatients randomized to the reference arm continued to receive their standard of care dose and regimen of darbepoetin subcutaneous once every two weeks for a minimum of 5 months and a maximum of 18 months. Subcutaneous injections were to be administered in the same part of the body (ie, thigh, abdomen or arm) throughout the study. Dosage was adjusted to maintain a hemoglobin target range of ≥10 g/dL to ≤12 g/dL.
Primary Outcome Measures
NameTimeMethod
Percentage of Patients Able to Maintain Hemoglobin (Hb) Within 10-12 g/dL6-7 months post initiation of dialysis

Efficacy analyses were not performed.

Secondary Outcome Measures
NameTimeMethod
Dose Adjustments5 months post-randomization through onset of dialysis, and post-dialysis initiation through study end.

Efficacy analyses were not performed.

Number of Participants Assessed for AEs and SAEsFirst dose of medication through 15 days post last dose (up to 8 months)

The adverse events are captured in the adverse event and serious adverse event section of this database.

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