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A 58-Week Safety and Efficacy Trial of Ferric Citrate in Patients With ESRD on Dialysis

Phase 3
Completed
Conditions
Kidney Failure
Hyperphosphatemia
Interventions
Drug: ferric citrate, ca acetate, sevelamer carbonate, placebo
Registration Number
NCT01191255
Lead Sponsor
Keryx Biopharmaceuticals
Brief Summary

This is up to a 58 week study comparing ferric citrate to active control for 52 weeks in ESRD dialysis patients, and subsequently comparing ferric citrate to placebo for 4 weeks.

Detailed Description

This trial is a three-period, multicenter, safety and efficacy clinical trial. The first period is a two-week Washout Period, the second period is a 52-week randomized, open-label, active control Safety Assessment Period, and the third period is a four-week, randomized, open-label, placebo-controlled Efficacy Assessment Period in only the patients who were randomized to treatment with ferric citrate during the Safety Assessment Period. The primary objectives of this trial are to determine the long-term safety over 52 weeks of up to twelve (12) caplets/day of KRX-0502 (ferric citrate) in patients with ESRD undergoing either hemodialysis or peritoneal dialysis and to determine the efficacy of KRX-0502 (ferric citrate) in the four-week, randomized, open-label, placebo-controlled Efficacy Assessment Period.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
441
Inclusion Criteria
  1. Males or non-pregnant, non-breast-feeding females
  2. Age ≥18 years
  3. On thrice-weekly hemodialysis or on peritoneal dialysis for at least the previous three months prior to Screening
  4. Serum phosphorus ≥6.0 mg/dL for study entry
  5. Taking less than 3-18 pills/day of current phosphate binder
  6. Willing to be discontinued from current phosphate binder(s) and initiated on ferric citrate
  7. Willing and able to give informed consent
  8. Life expectancy >1 year
Exclusion Criteria
  1. Parathyroidectomy within six months prior to Screening
  2. Actively symptomatic gastrointestinal bleeding or inflammatory bowel disease
  3. History of multiple drug allergies or intolerances
  4. History of malignancy in the last five years (treated cervical or non-melanomatous skin cancer may be permitted if approved by CCC)
  5. Previous intolerance to oral ferric citrate
  6. Intolerance to oral iron-containing products
  7. Psychiatric disorder that interferes with the patient's ability to comply with the study protocol
  8. Inability to tolerate oral drug intake
  9. Intolerance to calcium acetate and sevelamer carbonate
  10. Any other medical condition that renders the patient unable to or unlikely to complete the trial or that would interfere with optimal participation in the trial or produce significant risk to the patient
  11. Receipt of any investigational drug within 30 days of Screening Visit (Visit 0)
  12. Inability to cooperate with study personnel or history of noncompliance
  13. Unsuitable for this trial per Investigator's clinical judgment.

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Arm && Interventions
GroupInterventionDescription
Active Controlferric citrate, ca acetate, sevelamer carbonate, placeboPhosLo (calcium acetate) Renvela (sevelamer carbonate)
Placeboferric citrate, ca acetate, sevelamer carbonate, placeboPlacebo
KRX-0502 (Ferric Citrate)ferric citrate, ca acetate, sevelamer carbonate, placeboferric citrate
Primary Outcome Measures
NameTimeMethod
Change in Mean Serum Phosphorus From Baseline (Week 52) to the End of the Efficacy Assessment Period (EAP; Week 56)4 weeks

Patients who completed the 52-week Safety Assessment Period (SAP) on KRX-0502 (ferric citrate) were randomized in a 1:1 ratio to receive either KRX-0502 (ferric citrate) or Placebo for 4 weeks.

Secondary Outcome Measures
NameTimeMethod
Change in Mean Serum Ferritin From Baseline to Week 5252 weeks
Change in Mean Serum Transferrin Saturation (TSAT) From Baseline to the End of the Safety Assessment Period (Week 52)52 weeks
IV Iron Analysis52 weeks

Full Analysis Population, cumulative IV Iron administration from Baseline to the end of the Safety Assessment Period (Week 52)

ESA Analysis52 weeks

Full analysis population, cumulative Erythropoiesis-stimulating agent (ESA) administration from baseline to the end of the Safety Assessment Period (Week 52)

Trial Locations

Locations (56)

Circle Medical Management

🇺🇸

Chicago, Illinois, United States

Cleveland Clinic Foundation Q7-150 Nephrology

🇺🇸

Cleveland, Ohio, United States

Nephrology, PA

🇺🇸

Houston, Texas, United States

Veterans Administration Greater Los Angeles Healthcare System, West Los Angeles

🇺🇸

Los Angeles, California, United States

PAB Clinical Research

🇺🇸

Brandon, Florida, United States

Western Nephrology

🇺🇸

Westminster, Colorado, United States

Apex Research of Riverside

🇺🇸

Riverside, California, United States

Nephrology Hypertension Clinic

🇺🇸

Southgate, Michigan, United States

Tufts Medical Center

🇺🇸

Boston, Massachusetts, United States

Brookdale Physician's Dialysis Associates

🇺🇸

Brooklyn, New York, United States

Southeast Renal Research Institute Nephrology Associates

🇺🇸

Chattanooga, Tennessee, United States

The Ohio State University Division of Nephrology

🇺🇸

Columbus, Ohio, United States

Nephrology Clinical Research Center

🇺🇸

Charlottesville, Virginia, United States

Clinical Research & Consulting Center, LLC

🇺🇸

Fairfax, Virginia, United States

Peninsula Kidney Associates

🇺🇸

Hampton, Virginia, United States

Puerto Rico Renal Health & Research Center, Inc/ Atlantic Healthcare Group, Inc

🇵🇷

Trujillo Alto, Puerto Rico

DaVita

🇺🇸

Oklahoma City, Oklahoma, United States

Nephrology Associates, PC

🇺🇸

Nashville, Tennessee, United States

Vanderbilt University Medical Center Clinical Trials Center

🇺🇸

Nashville, Tennessee, United States

University of Utah Health Sciences Center

🇺🇸

Salt Lake City, Utah, United States

Medical College of Wisconsin Froedert Memorial Lutheran Hospital Division of Nephrology

🇺🇸

Milwaukee, Wisconsin, United States

Southwest Clinical Research Institute, LLC

🇺🇸

Tempe, Arizona, United States

Clinical Research Limited

🇺🇸

Canton, Ohio, United States

Wake Forest University School of Medicine

🇺🇸

Winston Salem, North Carolina, United States

Tower Nephrology Medical Group

🇺🇸

Los Angeles, California, United States

Kidney Care Associates, LLC

🇺🇸

Augusta, Georgia, United States

Nephrology Specialists, PC

🇺🇸

Michigan City, Indiana, United States

LSU Health Sciences Center Section of Nephrology and Hypertension Department of Internal Medicine

🇺🇸

New Orleans, Louisiana, United States

American Institute of Research

🇺🇸

Whittier, California, United States

Rockville Dialysis Center

🇺🇸

Rockville, Maryland, United States

Western New England Renal & Transplant Associates

🇺🇸

Springfield, Massachusetts, United States

Mountain Kidney and Hypertension Associates, PA

🇺🇸

Asheville, North Carolina, United States

Duke University Medical Center Division of Nephrology

🇺🇸

Durham, North Carolina, United States

Trial Management Associates

🇺🇸

Wilmington, North Carolina, United States

UT Southwestern Medical Center at Dallas

🇺🇸

Dallas, Texas, United States

McGuire VA Medical Center

🇺🇸

Richmond, Virginia, United States

Kidney Specialists of North Houston, PLLC

🇺🇸

The Woodlands, Texas, United States

Nephrology Associates of Northern Virginia, Inc.

🇺🇸

Fairfax, Virginia, United States

Kidney Associates

🇺🇸

Houston, Texas, United States

Tel Aviv Sourasky Medical Center Nephrology Department

🇮🇱

Tel Aviv, Israel

RCMI-Clinical Research Center Medical Sciences Campus University of Puerto Rico

🇵🇷

Rio Piedras, Puerto Rico

ASA Clinical Research, LLC

🇺🇸

Jupiter, Florida, United States

Ocala Kidney Group

🇺🇸

Ocala, Florida, United States

Mayo Clinic

🇺🇸

Jacksonville, Florida, United States

Atlanta Nephrology Referral Center

🇺🇸

Decatur, Georgia, United States

Pines Clinical Research, Inc.

🇺🇸

Pembroke Pines, Florida, United States

Pioneer Valley Nephrology

🇺🇸

Holyoke, Massachusetts, United States

Division of Nephrology and Hypertension Department of Internal Medicine University of Cincinnati College of Medicine

🇺🇸

Cincinnati, Ohio, United States

University of Pennsylvania Health System

🇺🇸

Philadelphia, Pennsylvania, United States

Metrolina Nephrology Associates, PA

🇺🇸

Charlotte, North Carolina, United States

Michigan Kidney Consultants, PC

🇺🇸

Pontiac, Michigan, United States

Henry Ford Hospital

🇺🇸

Detroit, Michigan, United States

Department of Nephrology and Hypertension Brazilai Medical Center

🇮🇱

Ashkelon, Israel

University of Vermont/ Fletcher Allen Health Care; Renal Services

🇺🇸

Burlington, Vermont, United States

University of Colorado Denver

🇺🇸

Aurora, Colorado, United States

Kansas City VA Medical Center

🇺🇸

Kansas City, Missouri, United States

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