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A Study of Intermittent Oral Dosing of ASP1517 in Peritoneal Dialysis Chronic Kidney Disease Patients With Anemia

Phase 3
Completed
Conditions
Peritoneal Dialysis Chronic Kidney Disease Patients With Anemia
Interventions
Registration Number
NCT02780726
Lead Sponsor
Astellas Pharma Inc
Brief Summary

The objective of this study is to evaluate the safety and efficacy of ASP1517 in peritoneal dialysis chronic kidney disease patients with anemia.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
56
Inclusion Criteria
  • Female subject must either:

Be of non-childbearing potential:

  • post-menopausal (defined as at least 1 year without any menses) prior to Screening, or

  • documented surgically sterile Or, if of childbearing potential,

  • Agree not to try to become pregnant during the study and for 28 days after the final study drug administration

  • And have a negative pregnancy test at Screening

  • And, if heterosexually active, agree to consistently use two forms of highly effective form of birth control (at least one of which must be a barrier method) starting at Screening and throughout the study period and continued for 28 days after the final study drug administration.

    • Female subject must agree not to breastfeed starting at Screening and throughout the study period, and continued for 28 days after the final study drug administration.
    • Female subject must not donate ova starting at Screening and throughout the study period, and continued for 28 days after the final study drug administration.
    • Male subject and their female spouse/partners who are of childbearing potential must be using two forms of highly effective form of birth control (at least one of which must be a barrier method) starting at Screening and continue throughout the study period, and for 12 weeks after the final study drug administration
    • Male subject must not donate sperm starting at Screening and throughout the study period and, for 12 weeks after the final study drug administration
    • Subjects who have not received Erythropoieses Stimulating Agents (ESAs):
  • Subjects who have been receiving peritoneal dialysis for more than 4 weeks before the screening assessment

  • Subjects who have never received ESAs after starting peritoneal dialysis, or subjects who have not received ESAs within 6 weeks before the screening assessment.

  • Mean of the subject's two most recent Hb values before randomization during the Screening Period must be <10.5 g/dL with an absolute difference ≤1.3 g/dL between the two values

  • Either transferrin saturation (TSAT) ≥ 5% or serum ferritin ≥ 30 ng/mL during the screening period

    • Subjects who have been receiving ESAs:
  • Subjects with renal anemia who have been receiving ESA within the doses approved in Japan for more than 8 weeks after starting peritoneal dialysis, before the screening assessment

  • Mean of the subject's two most recent Hb values before randomization during the Screening Period must be ≥10.0 g/dL and ≤12.0 g/dL

  • TSAT ≥ 20% or serum ferritin ≥ 100 ng/mL during the screening period

Exclusion Criteria
  • Subjects who had trouble with continuing peritoneal dialysis due to peritonitis, development of catheter trouble (e.g. tunnel infection) within 4 weeks before the screening assessment
  • Concurrent retinal neovascular lesion requiring treatment and macular edema requiring treatment
  • Concurrent autoimmune disease with inflammation that could impact erythropoiesis
  • History of gastric/intestinal resection considered influential on the absorption of drugs in the gastrointestinal tract (excluding resection of gastric or colon polyps) or concurrent gastro-paresis
  • Uncontrolled hypertension
  • Concurrent congestive heart failure (NYHA Class III or higher)
  • History of hospitalization for treatment of stroke, myocardial infarction, or pulmonary embolism within 12 weeks before the screening assessment
  • Positive for hepatitis B surface antigen (HBsAg) or anti-hepatitis C virus (HCV) antibody at the screening assessment, or positive for human immunodeficiency virus (HIV) in a past test
  • Concurrent other form of anemia than renal anemia
  • Having received treatment with protein anabolic hormone, testosterone enanthate, or mepitiostane within 6 weeks before the screening assessment
  • Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), total bilirubin, or Alkaline Phosphatase (ALP) that is greater than the criteria below, or previous or concurrent another serious liver disease at screening assessment
  • Previous or current malignant tumor (no recurrence for at least 5 years is eligible.)
  • Having undergone blood transfusion and/or a surgical procedure considered to promote anemia (excluding shunt reconstruction surgery for access to the blood) within 4 weeks before the screening assessment
  • Having undergone a kidney transplantation
  • Having a previous history of treatment with ASP1517
  • History of serious drug allergy including anaphylactic shock
  • Participation in another clinical study or post-marketing clinical study (including that of a medical device) within 12 weeks before informed consent acquisition

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ASP1517 ESAs Treated GrouproxadustatThis group includes subjects who have received ESAs. The treatment was converted from ESAs to study drug. Study drug will be dosed three times weekly and dose adjustments will be made during the study.
ASP1517 Low Dose Group (ESA Untreated)roxadustatThis group includes subjects who have not received Erythropoieses Stimulating Agents (ESAs). Study drug will be dosed three times weekly and dose adjustments will be made during the study.
ASP1517 High Dose Group (ESA Untreated)roxadustatThis group includes subjects who have not received ESAs. Study drug will be dosed three times weekly and dose adjustments will be made during the study.
Primary Outcome Measures
NameTimeMethod
Hemoglobin (Hb) Response Rate from Week 18 to Week 24Up to Week 24

Hb response defined as average Hb within the target range in this outcome

Secondary Outcome Measures
NameTimeMethod
Hb Response rateUp to Week 24

Hb response is defined as reaching target values for Hb and change of Hb from baseline in this outcome.

Proportion of participants who achieve the target Hb level at each weekUp to Week 24
Efficacy assessed by total iron binding capacityUp to Week 24

Total iron binding capacity will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.

Efficacy assessed by soluble transferrin receptorUp to Week 24

Soluble transferrin receptor will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.

Average Hb levels from week 18 to week 24Up to week 24
Change from baseline in the average Hb levels of week 18 to week 24Baseline and up to Week 24
Rate of rise in Hb levels (g/dL/week)Up to Week 4
Proportion of time points with target Hb levelsUp to Week 24
Change from baseline in Hb level at each weekBaseline and Up to Week 24
Proportion of participants who achieve the lower limit of the target Hb levelUp to Week 24
Time to achieve the lower limit of the target Hb levelUp to Week 24
Number of participants with abnormal Laboratory values and/or adverse events related to treatmentUp to Week 24
Plasma concentration of unchanged ASP1517Up to Week 24
Efficacy assessed by hematocritUp to Week 24

Hematocrit will be summarized by ASP1517 low dose Erythropoieses Stimulating Agent (ESA) untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.

Efficacy assessed by reticulocytes/ erythrocytesUp to Week 24

Reticulocytes/Erythrocytes will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.

Efficacy assessed by Iron (Fe)Up to Week 24

Fe will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.

Efficacy assessed by ferritinUp to Week 24

Ferritin will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.

Efficacy assessed by transferrinUp to Week 24

Transferrin will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.

Efficacy assessed by transferrin saturationUp to Week 24

Transferrin saturation will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.

Efficacy assessed by reticulocyte hemoglobin contentUp to Week 24

Reticulocyte hemoglobin content will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.

Quality of life assessed by SF-36Up to Week 24

SF-36: Medical Outcomes Study 36-Item Short-Form Health Survey

Quality of life assessed by EQ-5DUp to Week 24

EQ-5D: EuroQol 5 Dimension

Quality of life assessed by FACT-AnUp to Week 24

FACT-An: Functional Assessment of Cancer Therapy-Anemia

Occurrence of hospitalizationsUp to Week 24
Safety assessed by incidence of adverse eventsUp to Week 24
Number of participants with abnormal Vital signs and/or adverse events related to treatmentUp to Week 24
Safety assessed by standard 12-lead electrocardiogramUp to Week 24

Trial Locations

Locations (15)

Site JP00005

🇯🇵

Fukuoka, Japan

Site JP00004

🇯🇵

Aichi, Japan

Site JP00003

🇯🇵

Nagano, Japan

Site JP00002

🇯🇵

Aichi, Japan

Site JP00010

🇯🇵

Aichi, Japan

Site JP00013

🇯🇵

Aichi, Japan

Site JP00001

🇯🇵

Fukuoka, Japan

Site JP00012

🇯🇵

Hokkaido, Japan

Site JP00006

🇯🇵

Ishikawa, Japan

Site JP00014

🇯🇵

Hokkaido, Japan

Site JP00008

🇯🇵

Kanagawa, Japan

Site JP00011

🇯🇵

Toyama, Japan

Site JP00007

🇯🇵

Tokushima, Japan

SIte JP00015

🇯🇵

Okayama, Japan

Site JP00009

🇯🇵

Osaka, Japan

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