Peginesatide for Maintenance Treatment of Anemia in Participants on Hemodialysis
Information source: Affymax
ClinicalTrials.gov processed this data on August 23, 2015 Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Anemia; Chronic Kidney Disease; Chronic Renal Failure
Intervention: peginesatide (Drug); peginesatide (Drug); peginesatide (Drug); peginesatide (Drug); peginesatide (Drug); peginesatide (Drug)
Phase: Phase 2
Status: Completed
Sponsored by: Affymax Official(s) and/or principal investigator(s): Vice President, Clinical Development, Study Director, Affiliation: Affymax, Inc.
Summary
The purpose of this study was to determine the dose ranges of peginesatide administered
intravenously or subcutaneously that maintained hemoglobin in participants on dialysis whose
hemoglobin values were stable on epoetin (alfa or beta).
Clinical Details
Official title: A Phase 2, Open-Label, Multi-Center, Dose Finding Study of the Safety, Pharmacodynamics, and Pharmacokinetics of Peginesatide for the Maintenance Treatment of Anemia in Hemodialysis Patients Previously Treated With Epoetin
Study design: Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Primary outcome: Mean Hemoglobin Throughout the Trial and Mean Hemoglobin Change From Baseline Throughout the Trial.
Detailed description:
Anemia associated with chronic kidney disease is due to several factors, primarily the
inability of the diseased kidneys to produce adequate amounts of endogenous erythropoietin.
Ancillary factors include the shortened lifespan of red blood cells, iron and other
nutritional deficiencies, infection, and inflammation. The presence and severity of anemia
are related to the duration and extent of kidney failure. Anemia is associated with
increased mortality, increased likelihood of hospitalization, reduced cognitive function,
and increased left ventricular hypertrophy and heart failure.
Erythropoiesis stimulating agents have been established as a treatment for anemia in
subjects with chronic kidney disease, and have improved the management of anemia over
alternatives such as transfusion. Peginesatide is a parenteral formulation developed for the
treatment of anemia associated with chronic kidney disease. Peginesatide binds to and
activates the human erythropoietin receptor, and stimulates erythropoiesis in human red cell
precursors in a manner similar to other known erythropoiesis-stimulating agents.
Six dose cohorts of 15 participants each were evaluated in this study. Participants received
peginesatide injection once every 4 weeks administered intravenously or subcutaneously for a
total of 7 doses.
Eligibility
Minimum age: 18 Years.
Maximum age: N/A.
Gender(s): Both.
Criteria:
Inclusion Criteria:
- Participant is informed of the investigational nature of this study and has given
written, witnessed informed consent in accordance with institutional, local, and
national guidelines
- Males or females ≥ 18 years of age. Pre-menopausal females (with the exception of
those who are surgically sterile) must have a negative pregnancy test at screening;
those who are sexually active must practice a highly effective method of birth
control for at least 4 weeks prior to study start, and must be willing to continue
contraception until at least 4 weeks after the last dose of study drug
- Clinically stable on hemodialysis for ≥ 3 months prior to study start
- Epoetin (alfa or beta) maintenance therapy, ≥ 50 and ≤ 200 Units/kg/week, at the same
dosing frequency, continuously prescribed for 8 weeks prior to study start
- Three mid- or end-of-week hemoglobin values of ≥ 10. 0 and ≤ 12. 5 grams per deciliter
(g/dL) in the 4 weeks prior to study start, with ≤ 1. 2 g/dL difference between any of
the three values
- One transferrin saturation (TSAT) > 20% within 4 weeks prior to study start
- One ferritin level ≥ 100 ng/mL within 4 weeks prior to study start
- One serum or red cell folate level ≥ lower limit of normal during the 4 weeks prior
to study start
- One vitamin B12 level ≥ lower limit of normal during the 4 weeks prior to study start
- One C-reactive protein (CRP) level ≤ 30 mg/L within 4 weeks prior to study start
- Urea clearance/volume (Kt/V) ≥ 1. 2 within 4 weeks prior to study start
- One white blood cell count (WBC) ≥ 3. 0 x 10^9/L within 4 weeks prior to study start
- One platelet count ≥ 100 x 10^9/L and ≤ 500 x 10^9/L within 4 weeks prior to study
start
Exclusion Criteria:
- Pregnant or breast-feeding participants
- Known intolerance to any erythropoiesis stimulating agent, parenteral iron
supplementation or pegylated molecules
- History of antibodies to any erythropoiesis stimulating agent or history of pure red
cell aplasia (PRCA)
- Known bleeding or coagulation disorder
- Known hematologic disease (e. g., homozygous sickle-cell disease, thalassemia of all
types, multiple myeloma, hemolytic anemia)
- Uncontrolled or symptomatic inflammatory disease (e. g., rheumatoid arthritis,
systemic lupus erythematosus, etc.)
- Known history of seizure disorder or received anti-epileptic medication within the
previous 6 months
- Uncontrolled or symptomatic secondary hyperparathyroidism, per Investigator's
clinical judgment
- Poorly controlled hypertension within 4 weeks prior to study start, per
Investigator's clinical judgment
- Chronic congestive heart failure of New York Heart Association class III or IV
- High likelihood of early withdrawal or interruption of the study (e. g., myocardial
infarction, severe or unstable coronary artery disease, stroke, respiratory,
autoimmune, neuropsychiatric, or neurological abnormalities, liver disease including
active hepatitis B or C, active HIV disease, or any other clinically significant
medical diseases or conditions in the prior 6 months that may, in the Investigator's
opinion, interfere with safety, assessment, or follow-up of the participant)
- Evidence of malignancy within the past 5 years (except non-melanoma skin cancer
which is not an exclusion criterion)
- Life expectancy < 12 months
- Temporary (untunneled) dialysis access catheter
- Anticipated elective surgery during the study period, that may be expected to lead to
significant blood loss, including vascular access surgery such as an arteriovenous
fistula or graft, or a scheduled kidney transplant
- Red blood cell or whole blood transfusion within 12 weeks prior to study start
- Received antibiotics for systemic infection within 2 weeks prior to study start
- Previous exposure to any investigational agent within 6 weeks prior to study start,
or planned receipt of an investigational agent, other than as specified by this
protocol, during the study period
Locations and Contacts
Research Facility, Burgas 8000, Bulgaria
Research Facility, Pleven 5800, Bulgaria
Research Facility, Plovdiv 4003, Bulgaria
Research Facility, Rousse 7002, Bulgaria
Research Facility, Sofia 1527, Bulgaria
Research Facility, Sofia 1606, Bulgaria
Research Facility, Sofia 1709, Bulgaria
Research Facility, Varna 9010, Bulgaria
Research Facility, Veliko Tarnovo 5000, Bulgaria
Research Facility, Arad 310017, Romania
Research Facility, Bacau 600114, Romania
Research Facility, Bucuresti, Romania
Research Facility, Iasi 700503, Romania
Research Facility, Timisoara 300736, Romania
Research Facility, London SE5 9RS, United Kingdom
Additional Information
Starting date: December 2006
Last updated: June 22, 2012
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