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A Study to Evaluate Efficacy and Safety of Daprodustat Compared to Darbepoetin Alfa in Japanese Hemodialysis (HD)-Dependent Subjects With Anemia Associated With Chronic Kidney Disease (CKD)

Registration Number
NCT02969655
Lead Sponsor
GlaxoSmithKline
Brief Summary

Daprodustat is a drug that is currently being developed as a treatment for renal anemia . This study is to evaluate the efficacy and safety of daprodustat following a switch from erythropoiesis-stimulating agent (ESA) in Japanese HD subjects with renal anemia who are currently treated with ESA. The primary objective is to demonstrate non-inferiority of daprodustat to darbepoetin alfa. This study is a 52-week, Phase III, double-blind, active-controlled, parallel-group, multi-center study. The total duration of the study will be approximately 58 weeks including screening and follow-up.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
271
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
DaprodustatDaprodustat smallSubjects will receive oral daprodustat once daily and intravenous (IV) darbepoetin alfa placebo once weekly for 52 weeks
DaprodustatDaprodustat largeSubjects will receive oral daprodustat once daily and intravenous (IV) darbepoetin alfa placebo once weekly for 52 weeks
DaprodustatDarbepoetin alfa placeboSubjects will receive oral daprodustat once daily and intravenous (IV) darbepoetin alfa placebo once weekly for 52 weeks
Darbepoetin alfaDaprodustat small placeboSubjects will receive IV darbepoetin alfa once weekly and oral daprodustat placebo once daily for 52 weeks
Darbepoetin alfaDaprodustat large placeboSubjects will receive IV darbepoetin alfa once weekly and oral daprodustat placebo once daily for 52 weeks
Darbepoetin alfaDarbepoetin alfaSubjects will receive IV darbepoetin alfa once weekly and oral daprodustat placebo once daily for 52 weeks
Primary Outcome Measures
NameTimeMethod
Mean Hemoglobin (Hgb) During the Primary Efficacy Evaluation Period (Weeks 40 to 52)Weeks 40 to 52

The mean hemoglobin during the Evaluation Period was estimated by a statistical model.

Secondary Outcome Measures
NameTimeMethod
Number of Dose Adjustments for DaprodustatUp to Week 52

Number of dose adjustments has been presented only for daprodustat.

Percentage of Participants With Mean Hgb in the Target Range (10.0-12.0 g/dL) During the Primary Efficacy Evaluation Period (Weeks 40 to 52)Weeks 40 to 52

The percentage of participants with observed mean Hgb within the target range during the primary efficacy evaluation period was summarized. Odds ratio was estimated using a logistic regression and provided along with its 95% CI and a one-sided p-value.

Change From Baseline in Hgb (Hgb Increase Rate) at Week 4Baseline and Week 4

Change from Baseline was calculated as the post-dose Week 4 visit value minus the Baseline value.

Percentage of Participants by Hgb Change From Baseline Category at Week 4Week 4

Percentage of participants within each category were provided only for daprodustat and the categories were classified into 6 (i.e., \<=-2, \>-2 to -1, \>-1 to 0, \>0 to 1, \>1 to 2, \>2 grams per deciliter \[g/dL\]). In addition, 'within 1.0 g/dL (i.e., \<=-1 and \>=1) and over 2.0 g/dL (i.e., \<-2 and \>2) categories were provided.

Distribution of Daprodustat Dose Level by VisitDay 1, Weeks 4,8,12,16,20,24,28,32,36,40,44, and 48)

Distribution of dose level by visit for hemodialysis-dependent participants with anemia associated with chronic kidney disease who were currently ESA users has been presented for Daprodustat. Median along with the interquartile range (25th and 75th percentile) has been presented.

Distribution of Darbepoetin Alfa Dose Level by VisitDay 1, Weeks 2,4,6,8,10,12,14,16,18,20,22,24,26,28,30,32,34,36,38,40,42,44,46,48, and 50

Distribution of dose level by visit for hemodialysis-dependent participants with anemia associated with chronic kidney disease who were currently ESA users has been presented for Darbepoetin Alfa. Median along with the interquartile range (25th and 75th percentile) has been presented.

Duration of Treatment Interruption Due to Hgb >13 g/dLUp to Week 52

Duration of treatment interruption due to Hgb \>13 g/dL for hemodialysis-dependent participants with anemia associated with chronic kidney disease who were currently ESA users has been presented for the daprodustat group.

Hgb Values at Each Assessment VisitBaseline (Day 1), Weeks 4,8,12,16,20,24,28,32,36,40,44,48 and Week 52

Hgb values at each assessment visit for hemodialysis-dependent participants with anemia associated with chronic kidney disease who were currently ESA users has been presented.

Change From Baseline in Hgb Values at Each Assessment VisitBaseline (Day 1) and Weeks 4,8,12,16,20,24,28,32,36,40,44,48 and Week 52

Baseline Hgb value was the value from the Day 1 visit. Change from Baseline was calcuated as the post-dose visit value minus the Baseline value. Change from Baseline Hgb values at each assessment visit for hemodialysis-dependent participants with anemia associated with chronic kidney disease who were currently ESA users has been presented.

Percentage of Participants Who Had Hgb Level Within the Target Range (10.0-12.0 g/dL) at Each Assessment VisitBaseline (Day 1) and Weeks 4,8,12,16,20,24,28,32,36,40,44,48 and Week 52

Percentage of participants with Hgb within the target range was summarized at each assessment visit by treatment group have been presented.

Percentage of Time in Hgb Target Range (10.0 to 12.0 g/dL) During the Primary Efficacy Evaluation Period (Weeks 40 to 52)Weeks 40 to 52

Percentage of time in Hgb target range (10.0 to 12.0 g/dL) during the primary efficacy evaluation period (Weeks 40 to 52) for hemodialysis-dependent participants with anemia associated with chronic kidney disease who were currently ESA users has been presented.

Number of Participants Who Had an Hgb Level of Less Than 7.5 g/dLUp to Week 52

If an initial Hgb value was less than 7.5 g/dL, measurement was repeated at the same study visit (using the same sample) to calculate the average. If the average met the Hgb stopping criteria, study treatment was permanently discontinued. Number of participants who had an Hgb level of less than 7.5 g/dL has been presented.

Number of Participants Who Had an Hgb Increase of More Than 2 g/dL Over Any 4 WeeksUp to Week 52

Number of participants who had an Hgb increase of more than 2 g/dL over any 4 weeks for hemodialysis-dependent participants with anemia associated with chronic kidney disease who were currently ESA users have been presented.

Number of Participants Who Had an Hgb Level of More Than 13.0 g/dLUp to Week 52

Number of participants who had an Hgb increase of more than 13 g/dL for hemodialysis-dependent participants with anemia associated with chronic kidney disease who were currently ESA users have been presented.

Number of Episodes With Hgb Level of More Than 13.0 g/dLUp to Week 52

Number of episodes with Hgb level of more than 13.0 g/dL for hemodialysis-dependent participants with anemia associated with chronic kidney disease who were currently ESA users have been presented.

Area Under Plasma Concentration Curve From Time Zero to 4 Hours (AUC [0 - 4]) of Plasma Daprodustat0, 1, 2, 3, and 4 hours post-dose at Week 12 and Week 24

Blood samples for Pharmacokinetic (PK) analysis of daprodustat were collected as the time points provided. PK parameters were calculated by standard non-compartmental analysis according to current working practices and using the currently supported version of WinNonlin (version 6.3 or higher). NA indicates geometric co-efficient of variation could not be calculated as a single participant was analyzed. Data has been provided as a consolidated values for at all time-points (0,1,2,3,and 4 hours post-dose) as provided for a single value at Weeks 12 and 24 respectively. PK population comprised of all daprodustat-treated participants from whom PK samples were collected and analyzed. Data was not calculated for darbepoetin alfa group as the primary interest of analysis was Daprodustat and not comparator drug (darbepoetin alfa). Data is combined from Week 12 and Week 24 data.

Maximum Concentration (Cmax) of Plasma Daprodustat0, 1, 2, 3, and 4 hours post-dose at Week 12 and Week 24

Blood samples for PK analysis of daprodustat were collected as the time points provided. PK parameters were calculated by standard non-compartmental analysis according to current working practices and using the currently supported version of WinNonlin (version 6.3 or higher). Data has been provided as a consolidated values for at all time-points (0,1,2,3,and 4 hours post-dose) as provided for a single value at Weeks 12 and 24 respectively. Data was not calculated for darbepoetin alfa group as the primary interest of analysis was Daprodustat and not comparator drug (darbepoetin alfa). Data is combined from Week 12 and Week 24 data.

Trial Locations

Locations (1)

GSK Investigational Site

🇯🇵

Yamaguchi, Japan

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