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Evaluate the Efficacy and Safety of Multiple Roxadustat Dosing Regimens for the Treatment of Anemia in Dialysis Participants With Chronic Kidney Disease

Phase 4
Completed
Conditions
CKD Anemia in Dialysis Participants
Interventions
Registration Number
NCT04059913
Lead Sponsor
FibroGen
Brief Summary

This is a randomized, open-label, multi-center study in dialysis chronic kidney disease (CKD) participants to evaluate the efficacy and relative safety of different dosing regimens of roxadustat over a 36-week treatment period.

There are 3 study periods:

* Screening Period (up to 4 weeks)

* Treatment Period (36 weeks)

Part 1: Correction/Conversion Period (Weeks 1-20)

Part 2: Hemoglobin (Hb) Maintenance Period (Weeks 21-36)

* Follow-up Period (4 weeks)

Detailed Description

Approximately 102 erythropoiesis stimulating agents (ESA)-naïve participants and 204 ESA-treated participants will be enrolled and randomized respectively in a 1:1 ratio to receive roxadustat at one of 2 starting doses as below:

* Low weight-based dosing: 70 milligrams (mg) 3 times a week (TIW) for body weight \<60 kilograms (kg) or 100 mg TIW for body weight ≥60 kg

* Standard weight-based dosing: 100 mg TIW for body weight \<60 kg or 120 mg TIW for body weight ≥60 kg

After 20 weeks of treatment, all eligible participants whose last 2 Hb levels ≥105 grams (g)/liter (L) and change in Hb over the most recent 4 weeks is \> - 10 g/L will switch to receive roxadustat for another 16 weeks to evaluate the efficacy and safety of new dosing regimens.

At the end of Week 36, all participants will discontinue roxadustat and enter a 4-week Follow-up Period.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
318
Inclusion Criteria
  1. CKD with end-stage renal disease (ESRD) on either hemodialysis (HD) or peritoneal dialysis (PD)
Exclusion Criteria
  1. Positive for any of the following: human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), or anti-hepatitis C virus antibody (anti-HCV Ab).
  2. Myocardial infarction, acute coronary syndrome, stroke, seizure, or a thromboembolic event (for example, deep venous thrombosis or pulmonary embolism) within 26 weeks prior to Day 1.
  3. History of malignancy, myelodysplastic syndrome, and multiple myeloma.
  4. Chronic inflammatory disease other than glomerulonephritis that could impact erythropoiesis (for example, systemic lupus erythematosis [SLE], rheumatoid arthritis, celiac disease).
  5. Clinically significant gastrointestinal bleeding.
  6. Women of childbearing potential and men with sexual partners of child bearing potential who are not using adequate contraception.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Part 1: ESA-Naïve Participants - Low Weight Based DosingRoxadustatESA-naïve participants will receive roxadustat 70 mg TIW for body weight 45 to \<60 kg or 100 mg TIW for body weight ≥60 kg.
Part 1: ESA-Naïve Participants - Standard Weight Based DosingRoxadustatESA naïve participants will receive roxadustat 100 mg TIW for body weight 45 to \<60 kg or 120 mg TIW for body weight ≥60 kg.
Part 1: ESA-Treated Participants - Low Weight Based DosingRoxadustatESA-treated participants will receive roxadustat 70 mg TIW for body weight 45 to \<60 kg or 100 mg TIW for body weight ≥60 kg.
Part 2: Roxadustat QWRoxadustatParticipants will receive roxadustat once a week (QW). Roxadustat dose will be 2-dose step increase from originally planned week 21 TIW per dose amount.
Part 1: ESA-Treated Participants - Standard Weight Based DosingRoxadustatESA treated participants will receive roxadustat 100 mg TIW for body weight 45 to \<60 kg or 120 mg TIW for body weight ≥60 kg.
Part 2: Roxadustat BIWRoxadustatParticipants will receive roxadustat twice a week (BIW). Roxadustat dose will be 1-dose step increase from originally planned week 21 TIW per dose amount.
Part 2: Roxadustat TIWRoxadustatParticipants will receive roxadustat TIW. Roxadustat dose will continue per dose adjustment guideline.
Primary Outcome Measures
NameTimeMethod
Part 1 (ESA Naïve): Percentage of Participants who Achieved Hb ≥110 g/L in the First 20 WeeksWeeks 1 to 20
Part 1 (ESA Treated): Percentage of Participants who Achieved Mean Hb ≥100 g/L Averaged Over Weeks 17 to 21 VisitsWeeks 17 to 21
Part 2: Mean Hb Value Averaged Over Weeks 33 to 37 VisitsWeeks 33 to 37
Secondary Outcome Measures
NameTimeMethod
Part 1: Mean Change in Hb Level From Baseline to Average Over Weeks 17 to 21 VisitsBaseline, Weeks 17 to 21
Part 1 (ESA-Naïve): Percentage of Participants With Mean Hb (Averaged Weeks 17 to 21 Visits) ≥100 g/LWeeks 17 to 21
Part 2: Percentage of Participants With Mean Hb (Averaged Weeks 33 to 37 Visits) ≥100 g/LWeeks 33 to 37

Trial Locations

Locations (1)

Investigational Site

🇨🇳

Tianjin, China

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