A Phase 3 Study Comparing the Effects of Subcutaneous Epoetin Hospira and Epoetin Alfa [Epogen] (Amgen) in Patients With Chronic Renal Failure Requiring Hemodialysis and Receiving Epoetin Maintenance Treatment. AiME - Anemia Management With Epoetin

Phase 3

Completed

• Conditions: Chronic Renal Failure; Chronic Kidney Disease
• Interventions: Biological: Epoetin Hospira; Biological: Epogen Amgen

• Registration Number: NCT01473420
• Lead Sponsor: Pfizer

Brief Summary

The purpose of this study is to demonstrate therapeutic equivalence of subcutaneous (SC) Epoetin Hospira compared to SC Epogen (Amgen), based on maintenance of hemoglobin (Hb) levels and study drug dose requirements in patients treated for anemia associated with chronic renal failure and on hemodialysis.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2011-11-02
• Study First Submitted QC: 2011-11-16
• Study First Posted: 2011-11-17
• Study Start: 2012-01-17
• Primary Completion: 2014-02-28
• Study Completion: 2014-02-28
• Disposition First Submitted: 2015-02-23
• Disposition First Submitted QC: 2015-02-23
• Disposition First Posted: 2015-03-11
• Results First Submitted: 2018-05-16
• Results First Submitted QC: 2018-05-21
• Results First Posted: 2018-06-20
• Status Verified: 2018-07
• Last Update Submitted: 2018-07-12
• Last Update Posted: 2018-08-09

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 320

Inclusion Criteria

1. Patient is able to provide written informed consent after risks and benefits of the study have been explained prior to any study related activities

2. Hemodialysis patients with chronic renal failure and renal anemia currently on stable Epogen (Amgen) dose administered IV or SC, 1 to 3 times per week for whom the following apply:

   • A change in Epogen dosing of no more than 10% from the mean
   • Mean hemoglobin between 9.0 and 11.0 g/dL
   • No more than one hemoglobin result outside of range from 9.0-11.0 g/dL
   • No hemoglobin result more than ±1 g/dL from the mean hemoglobin level

3. Patients on stable, adequate dialysis for at least 12 weeks prior to randomization, defined as no clinically relevant changes of dialysis regimen and/or dialyzer

4. Patients with adequate iron stores, defined as plasma ferritin > 100 μg/L and TSAT >20%, prior to randomization

5. Male or female patients aged 18 to 80 years (both inclusive)

6. If female, patient must be postmenopausal for at least one year prior to randomization, surgically sterile (bilateral tubal ligation, bilateral oophorectomy or hysterectomy), or practicing at least one of the following methods of birth control:

   • hormonal contraceptives (oral, parenteral or transdermal) for at least 3 months prior to randomization
   • intrauterine device (IUD)
   • double-barrier method (condoms, contraceptive sponge, diaphragm or vaginal ring with spermicidal jellies or cream)

If hormonal contraceptives are used, the specific contraceptive must have been used for at least 3 months prior to randomization. If the patient is currently using a hormonal contraceptive, she should also use a barrier method during this study and for at least 30 days following the administration of the patient's last dose

Exclusion Criteria

1. Maintenance epoetin dosage >600 U/kg per week (1-3 times per week)

2. Treatment with long-acting epoetin analogues such as Aranesp ® within 12 weeks prior to randomization

3. Any of the following within 3 months prior to randomization:

   • Myocardial infarction
   • Stroke (cerebrovascular accident)/cerebrovascular insult (minor stroke) or transient ischemic attack/intracerebral bleeding/cerebral infarction
   • Severe/unstable angina
   • Coronary angioplasty, bypass surgery, or peripheral artery bypass graft
   • Decompensated congestive heart failure (New York Heart Association [NYHA] class IV)
   • Pulmonary embolism
   • Deep vein thrombosis or other thromboembolic event
   • Received live or attenuated vaccination (except flu vaccination)

4. Uncontrolled hypertension within the 4 weeks prior to randomization defined as more than 10% of post-dialysis blood pressures >170 mmHg systolic and/or >110 mmHg diastolic, based on blood pressure readings obtained when the patient's post-dialysis body weight was not more than 0.5 kg above their listed dry weight

5. Known, clinically manifested deficiency of folic acid and/or vitamin B12 (irrespective of whether currently treated or not)

6. A patient with any active, uncontrolled systemic, inflammatory or malignant disease that in the Investigator's opinion may be significant to exclude participation in the study, including but not limited to demyelinating diseases such as multiple sclerosis, microbial, viral or fungal infection or mental disease

7. Contraindication for the test drug or have been previously treated with Epoetin Hospira

8. Relative or absolute iron deficiency prior to randomization into the Maintenance Period

9. Platelet count below 100 x 10^9/L

10. Clinically relevant increase of CRP (>10 mg/dL) for at least 2 weeks

11. Significant drug sensitivity or a significant allergic reaction to any drug, as well as known hypersensitivity or idiosyncratic reaction to epoetin (or its excipients, including albumin) or any other related drugs that in the judgment of the Investigator is exclusionary for the study participation

12. History of any of the following:

    • Detectable anti-rhEPO antibodies
    • Clinically relevant malnutrition
    • Confirmed aluminum intoxication
    • Myelodysplastic syndrome
    • Known bone marrow fibrosis (osteitis fibrosa cystica)
    • Known seizure disorder
    • Liver cirrhosis with clinical evidence of complications (portal hypertension, splenomegaly, ascites)

13. A female patient who is pregnant, lactating or planning a pregnancy during the study

14. History of drug abuse or alcohol abuse within 2 years prior to randomization as determined by the Investigator

15. Current participation or participation in a drug or other investigational research study within 30 days prior to randomization

16. May not be able to comply with the requirements of this clinical study, communicate effectively with study personnel, or is considered by the Investigator, for any reason, to be an unsuitable candidate for the study

17. Donated or lost >475 mL (i.e., 1 pint) blood volume (including plasmapheresis) or had a transfusion of any blood product within 3 months prior to randomization

18. A patient who in the Investigator's opinion, has any clinically significant abnormal laboratory evaluations, including liver function taken at Screening Visit

19. Positive laboratory test for human immunodeficiency virus (HIV) or hepatitis B surface antigen (HBsAg)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Epoetin Hospira	Epoetin Hospira	Epoetin Hospira
Epogen (Amgen)	Epogen Amgen	Epogen (Amgen)

Primary Outcome Measures

Name	Time	Method
Mean Weekly Hemoglobin Level From Week 30 to Week 34: Maintenance Period	Week 30 up to Week 34
Mean Weekly Dosage of Study Medication From Week 30 to Week 34: Maintenance Period	Week 30 up to Week 34

Secondary Outcome Measures

Name	Time	Method
Percentage of Participants Who Required Permanent Dose Changes: Maintenance Period	Week 19 up to Week 34
Percentage of Participants With Any Transient Change of Hemoglobin Level Greater Than (>) 1.0 Gram Per Deciliter (g/dL): Maintenance Period	Week 19 up to Week 34
Percentage of Participants With Mean Weekly Hemoglobin Level Outside the Target Range: Maintenance Period	Week 26, 34	Percentage of participants who had hemoglobin level outside the target range of 9 to 11 g/dL for the specified weeks were reported.
Percentage of Participants With Mean Weekly Hemoglobin Level Within the Target Range: Maintenance Period	Week 26, 34	Percentage of participants who had hemoglobin level within the target range of 9 to 11 g/dL for the specified weeks were reported.
Percentage of Participants Who Received Blood Transfusions: Maintenance Period	Week 19 up to Week 34
Mean Weekly Hemoglobin Level From Week 19 to Week 34: Maintenance Period	Week 19 up to Week 34
Number of Participants With Change in Mean Dose of Study Medication Based on Hemoglobin Level: Maintenance Period	Week 19 up to Week 34	In this outcome measure number of participants with change (increase and decrease) in mean dose of Epoetin Hospira and Epogen were categorized and reported according to their mean hemoglobin levels. Hemoglobin levels were divided in following classes: \>11.0 g/dL, from 9.0 to 11.0 g/dL and \<9.0 g/dL
Percentage of Participants With Any Transient Change of Hemoglobin Level Greater Than (>) 2.0 Gram Per Deciliter (g/dL) in Hemoglobin Level: Maintenance Period	Week 19 up to Week 34
Mean Weekly Dosage of Study Medication From Week 19 to Week 34: Maintenance Period	Week 19 up to Week 34
Total Dose of Study Medication Administered: Maintenance Period	Week 19 up to Week 34	In this outcome measure mean of total dose of study medication administered in maintenance period was reported.
Percentage of Participants Who Required Temporary Dose Changes: Maintenance Period	Week 19 up to Week 34
Percentage of Participants Who Qualified as Optimally Titrated and Stable: Titration Period	Week 1 up to Week 18

Trial Locations

Locations (70)

National Institute of Clinical Research; 🇺🇸 Bakersfield, California, United States

North America Research Institute; 🇺🇸 Azusa, California, United States

Valley Renal Medical Group; 🇺🇸 Northridge, California, United States

Pleasanton Dialysis Center; 🇺🇸 Pleasanton, California, United States

Sunset Dialysis Center; 🇺🇸 Rancho Cordova, California, United States

Research Management Inc.; 🇺🇸 Paramount, California, United States

Intercommunity Dialysis Center; 🇺🇸 Whittier, California, United States

American Institute of Research; 🇺🇸 Whittier, California, United States

Whittier Kidney Dialysis Center; 🇺🇸 Whittier, California, United States

Kidney Center of Westminster, LLC; 🇺🇸 Westminster, Colorado, United States

New York Harbor Health Care System; 🇺🇸 New York, New York, United States

Clinical Research Consultants, LLC; 🇺🇸 Kansas City, Missouri, United States

Metro Hypertension and Kidney Center; 🇺🇸 Saint Louis, Missouri, United States

Parker Jewish Institute for Health Care and Rehabilitation; 🇺🇸 New Hyde Park, New York, United States

Newtown Dialysis Center; 🇺🇸 Astoria, New York, United States

New York Hospital Medical Center Queens Institutional Review Board; 🇺🇸 Flushing, New York, United States

Private Practice of Kenneth Lempert; 🇺🇸 Toledo, Ohio, United States

Northwest Physicians Associates, PC; 🇺🇸 Meadville, Pennsylvania, United States

Fresenius Medical Care - Austin North Dialysis; 🇺🇸 Austin, Texas, United States

Research Management, Inc.; 🇺🇸 Austin, Texas, United States

Dallas Veterans Affairs Medical Center; 🇺🇸 Dallas, Texas, United States

Research Management, Inc; 🇺🇸 Austin, Texas, United States

Research Across America; 🇺🇸 Houston, Texas, United States

Grand Prairie Dialysis Center; 🇺🇸 Grand Prairie, Texas, United States

Mission Bend Dialysis; 🇺🇸 Houston, Texas, United States

East Texas Nephrology Associates; 🇺🇸 Lufkin, Texas, United States

Southwest Houston Research, Ltd.; 🇺🇸 Houston, Texas, United States

Renal Care Partners of Pentagon City; 🇺🇸 Arlington, Virginia, United States

Clinical Research and Consulting Center, LLC; 🇺🇸 Fairfax, Virginia, United States

Renal Care Partners of Fairfax; 🇺🇸 Fairfax, Virginia, United States

Western Institutional Review Board; 🇺🇸 Olympia, Washington, United States

Westminster Dialysis; 🇺🇸 Houston, Texas, United States

Pines Clinical Research Inc.; 🇺🇸 Pembroke Pines, Florida, United States

Research Nurse Specialists, LLC; 🇺🇸 Lafayette, Louisiana, United States

Westbank Nephrology Associates; 🇺🇸 Marrero, Louisiana, United States

Northwest Louisiana Nephrology; 🇺🇸 Shreveport, Louisiana, United States

FMC Opelousas; 🇺🇸 Opelousas, Louisiana, United States

Fresenius Medical Care-Kalamazoo East; 🇺🇸 Kalamazoo, Michigan, United States

Fresenius Medical Care-Gull Road; 🇺🇸 Kalamazoo, Michigan, United States

Fresenius Medical Care-Kalamazoo; 🇺🇸 Kalamazoo, Michigan, United States

Fresenius Medical Care-Oshtemo; 🇺🇸 Kalamazoo, Michigan, United States

Nephrology Center DBA Paragon Health PC; 🇺🇸 Kalamazoo, Michigan, United States

University of Cincinnati College of Medicine.; 🇺🇸 North Brunswick, New Jersey, United States

Nephrology & Hypertension Associates of NJ; 🇺🇸 Voorhees, New Jersey, United States

CSRA Renal Services, LLC; 🇺🇸 Aiken, South Carolina, United States

Fresenius Medical Care Midtown JV; 🇺🇸 Columbia, South Carolina, United States

Columbia Nephrology Associates, PA; 🇺🇸 Columbia, South Carolina, United States

Fresenius Medical Care Irmo JV; 🇺🇸 Irmo, South Carolina, United States

Knoxville Kidney Center, PLLC; 🇺🇸 Knoxville, Tennessee, United States

Academic Medical Research Institute; 🇺🇸 Los Angeles, California, United States

Neomedica Marquette Park; 🇺🇸 Chicago, Illinois, United States

Long Beach Dialysis Center; 🇺🇸 Modesto, California, United States

Innovative Dialysis Center of Northridge, LLC; 🇺🇸 Northridge, California, United States

Renal Consultants Medical Group; 🇺🇸 Santa Clarita, California, United States

Dialysis Clinic, Inc. - Albany; 🇺🇸 Albany, Georgia, United States

Renal Physicians of Georgia, PC; 🇺🇸 Dublin, Georgia, United States

Kidney Care Associates; 🇺🇸 Augusta, Georgia, United States

Research by Design, LLC; 🇺🇸 Evergreen Park, Illinois, United States

Kansas City Renal Center; 🇺🇸 Kansas City, Missouri, United States

Wake Nephrology Associates, PA; 🇺🇸 Raleigh, North Carolina, United States

Nephrology Specialists, PC; 🇺🇸 Mechanicsville, Virginia, United States

Kansas Nephrology Physicians, PA; 🇺🇸 Wichita, Kansas, United States

Western Nephrology and Metabolic Bone Disease, PC; 🇺🇸 Westminster, Colorado, United States

Chabot Nephrology Medical Group; 🇺🇸 San Leandro, California, United States

San Leandro Dialysis; 🇺🇸 San Leandro, California, United States

University of Cincinnati College of Medicine; 🇺🇸 Cincinnati, Ohio, United States

San Antonio Kidney Disease Center; 🇺🇸 San Antonio, Texas, United States

Capital Nephrology Medical Group; 🇺🇸 Sacramento, California, United States

Renal Advantage, Inc.; 🇺🇸 Kansas City, Missouri, United States

South Carolina Nephrology and Hypertension Center, Inc.; 🇺🇸 Orangeburg, South Carolina, United States