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Treatment of Autonomous Hyperparathyroidism in Post Renal Transplant Recipients

Primary Purpose

Chronic Allograft Nephropathy, Chronic Kidney Disease, Chronic Renal Failure

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Cinacalcet
Placebo
Sponsored by
Amgen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Allograft Nephropathy focused on measuring Intervention, Cinacalcet, Sensipar, Mimpara, hyperparathyroidism, calcium, osteodystrophy, hypercalcemia, renal, transplant, acute rejection, kidney transplant failure, hypophosphatemia

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Received a kidney transplant ≥ 9 weeks at time of Screening and ≤ 24 months before first dose
  • May be the first kidney transplant or a repeat kidney transplant.
  • Subjects with a functional, stable kidney transplant, defined as MDRD estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73 m² (chromic kidney disease stage 3 or better) at Screening.
  • Men or women ≥ 18 years at the start of Screening (ie, time of informed consent).
  • Corrected total serum calcium > 10.5 mg/dL (2.63 mmol/L), defined as the mean of 2 values in Screening period.
  • iPTH > 100 pg/mL (10.6 pmol/L), during the Screening period (obtained at either Screen 1 or Screen 2).

Exclusion Criteria:

  • Received cinacalcet therapy post-transplant for more than 14 days cumulatively post-transplant. If cinacalcet therapy was received for a total of 14 days or less post-transplant, there must be a 4-week washout before subject is eligible for screening (Note: This does not exclude pre-transplant use of cinacalcet).
  • Anticipated parathyroidectomy within 6 to12 months after Randomization.
  • Ongoing therapy with bisphosphonates or use within 6 months prior to Screening.
  • Ongoing use of 1,25-dihydroxyvitamin D3 (including other active vitamin D metabolites or analogues) or use within 30 days prior to Screening.
  • Ongoing use of calcium supplements or use within 30 days prior to Screening.
  • Ongoing use of phosphate binders (calcium or non-calcium containing) or use within 30 days prior to Screening.
  • Ongoing use of a thiazide diuretic.
  • Subjects with a history of seizures who had a seizure within the 3 months prior to Randomization, which required adjustments to the seizure medication.
  • Acute Kidney Injury (AKI) or renal biopsy within 6 weeks prior to Screening, unless it is an institutional protocol-driven biopsy.

Sites / Locations

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Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Cinacalcet

Placebo

Arm Description

Participants received cinacalcet at a starting dose of 30 mg orally once daily for 52 weeks. Cinacalcet dose was titrated every 4 weeks during the dose-titration phase and during study visits in the maintenance phase based on intact parthyroid hormone (iPTH) values, corrected total serum calcium values, and safety assessments.

Participants received placebo orally once daily for 52 weeks.

Outcomes

Primary Outcome Measures

Percentage of Participants With a Mean Corrected Total Serum Calcium Value < 10.2 mg/dL (2.55 mmol/L) During the Efficacy Assessment Phase (EAP)

Secondary Outcome Measures

Percent Change From Baseline to Week 52 in Bone Mineral Density at the Femoral Neck
Bone mineral density (BMD) was measured using dual X-ray absorptiometry (DXA).
Change From Baseline to the EAP in Mean Serum Phosphorus
Change From Baseline to Week 52 in eGFR
eGFR was calculated using the Modification of Diet in Renal Disease (MDRD) formula.
Change From Baseline to the EAP in Corrected Total Calcium
Change From Baseline to the EAP in Intact Parathyroid Hormone (iPTH)
Change From Baseline to the EAP in Urine Phosphorus
Percentage of Participants With a Parathyroidectomy
Time to Parathyroidectomy

Full Information

First Posted
September 10, 2009
Last Updated
September 20, 2018
Sponsor
Amgen
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1. Study Identification

Unique Protocol Identification Number
NCT00975000
Brief Title
Treatment of Autonomous Hyperparathyroidism in Post Renal Transplant Recipients
Official Title
A Randomized, Double-blind, Placebo-controlled Study to Evaluate the Efficacy and Safety of Using Cinacalcet to Correct Hypercalcemia in Renal Transplant Recipients With Autonomous Hyperparathyroidism
Study Type
Interventional

2. Study Status

Record Verification Date
September 2018
Overall Recruitment Status
Completed
Study Start Date
December 3, 2009 (Actual)
Primary Completion Date
September 13, 2012 (Actual)
Study Completion Date
April 16, 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Amgen

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Hyperparathyroidism (HPT) is common in people with a kidney transplant. Patients with HPT often have high parathyroid hormone (PTH) levels and may have large parathyroid glands in the neck. Patients with HPT can develop bone disease (osteodystrophy). This bone disease can cause bone pain, fractures, and poor formation of red blood cells. Other problems from HPT may include increases in blood levels of calcium (hypercalcemia) and low blood levels of phosphorus (hypophosphatemia). The high calcium levels may cause calcium to deposit in body tissues. Calcium deposits can cause arthritis (joint pain and swelling), muscle inflammation, itching, gangrene (death of soft tissue), heart and lung problems or kidney transplant dysfunction (worsening of kidney transplant function). The purpose of this study is to evaluate the effects of cinacalcet (Sensipar/Mimpara) on high calcium levels in the blood in patients with HPT after a kidney transplant.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Allograft Nephropathy, Chronic Kidney Disease, Chronic Renal Failure, Disordered Mineral Metabolism, End Stage Renal Disease, Hyperparathyroidism, Hypophosphatemia, Kidney Disease, Kidney Transplantation, Post Renal Transplantation
Keywords
Intervention, Cinacalcet, Sensipar, Mimpara, hyperparathyroidism, calcium, osteodystrophy, hypercalcemia, renal, transplant, acute rejection, kidney transplant failure, hypophosphatemia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
114 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cinacalcet
Arm Type
Experimental
Arm Description
Participants received cinacalcet at a starting dose of 30 mg orally once daily for 52 weeks. Cinacalcet dose was titrated every 4 weeks during the dose-titration phase and during study visits in the maintenance phase based on intact parthyroid hormone (iPTH) values, corrected total serum calcium values, and safety assessments.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Participants received placebo orally once daily for 52 weeks.
Intervention Type
Drug
Intervention Name(s)
Cinacalcet
Other Intervention Name(s)
Mimpara, Sensipar
Intervention Description
Possible sequential doses are 30, 60, 90, 120, and 180 mg.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Administered orally following the same dosing regimen as the experimental arm.
Primary Outcome Measure Information:
Title
Percentage of Participants With a Mean Corrected Total Serum Calcium Value < 10.2 mg/dL (2.55 mmol/L) During the Efficacy Assessment Phase (EAP)
Time Frame
Weeks 21 to 26 (EAP)
Secondary Outcome Measure Information:
Title
Percent Change From Baseline to Week 52 in Bone Mineral Density at the Femoral Neck
Description
Bone mineral density (BMD) was measured using dual X-ray absorptiometry (DXA).
Time Frame
Baseline and Week 52
Title
Change From Baseline to the EAP in Mean Serum Phosphorus
Time Frame
Baseline and the EAP (mean of Weeks 22, 24, and 26)
Title
Change From Baseline to Week 52 in eGFR
Description
eGFR was calculated using the Modification of Diet in Renal Disease (MDRD) formula.
Time Frame
Baseline and Week 52
Title
Change From Baseline to the EAP in Corrected Total Calcium
Time Frame
Baseline and the EAP (mean of Weeks 22, 24, and 26)
Title
Change From Baseline to the EAP in Intact Parathyroid Hormone (iPTH)
Time Frame
Baseline and the EAP (mean of Weeks 22, 24, and 26)
Title
Change From Baseline to the EAP in Urine Phosphorus
Time Frame
Baseline and the EAP (mean of Weeks 22, 24, and 26)
Title
Percentage of Participants With a Parathyroidectomy
Time Frame
56 weeks
Title
Time to Parathyroidectomy
Time Frame
56 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Received a kidney transplant ≥ 9 weeks at time of Screening and ≤ 24 months before first dose May be the first kidney transplant or a repeat kidney transplant. Subjects with a functional, stable kidney transplant, defined as MDRD estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73 m² (chromic kidney disease stage 3 or better) at Screening. Men or women ≥ 18 years at the start of Screening (ie, time of informed consent). Corrected total serum calcium > 10.5 mg/dL (2.63 mmol/L), defined as the mean of 2 values in Screening period. iPTH > 100 pg/mL (10.6 pmol/L), during the Screening period (obtained at either Screen 1 or Screen 2). Exclusion Criteria: Received cinacalcet therapy post-transplant for more than 14 days cumulatively post-transplant. If cinacalcet therapy was received for a total of 14 days or less post-transplant, there must be a 4-week washout before subject is eligible for screening (Note: This does not exclude pre-transplant use of cinacalcet). Anticipated parathyroidectomy within 6 to12 months after Randomization. Ongoing therapy with bisphosphonates or use within 6 months prior to Screening. Ongoing use of 1,25-dihydroxyvitamin D3 (including other active vitamin D metabolites or analogues) or use within 30 days prior to Screening. Ongoing use of calcium supplements or use within 30 days prior to Screening. Ongoing use of phosphate binders (calcium or non-calcium containing) or use within 30 days prior to Screening. Ongoing use of a thiazide diuretic. Subjects with a history of seizures who had a seizure within the 3 months prior to Randomization, which required adjustments to the seizure medication. Acute Kidney Injury (AKI) or renal biopsy within 6 weeks prior to Screening, unless it is an institutional protocol-driven biopsy.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
MD
Organizational Affiliation
Amgen
Official's Role
Study Director
Facility Information:
Facility Name
Research Site
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85012
Country
United States
Facility Name
Research Site
City
Tempe
State/Province
Arizona
ZIP/Postal Code
85284
Country
United States
Facility Name
Research Site
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Facility Name
Research Site
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Research Site
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32610
Country
United States
Facility Name
Research Site
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Research Site
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
Research Site
City
Evanston
State/Province
Illinois
ZIP/Postal Code
60201
Country
United States
Facility Name
Research Site
City
Springfield
State/Province
Massachusetts
ZIP/Postal Code
01107
Country
United States
Facility Name
Research Site
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48202
Country
United States
Facility Name
Research Site
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Research Site
City
Bethlehem
State/Province
Pennsylvania
ZIP/Postal Code
18017
Country
United States
Facility Name
Research Site
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
Facility Name
Research Site
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Facility Name
Research Site
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Research Site
City
Camperdown
State/Province
New South Wales
ZIP/Postal Code
2050
Country
Australia
Facility Name
Research Site
City
Westmead
State/Province
New South Wales
ZIP/Postal Code
2145
Country
Australia
Facility Name
Research Site
City
Woodville South
State/Province
South Australia
ZIP/Postal Code
5011
Country
Australia
Facility Name
Research Site
City
Parkville
State/Province
Victoria
ZIP/Postal Code
3050
Country
Australia
Facility Name
Research Site
City
Wien
ZIP/Postal Code
1090
Country
Austria
Facility Name
Research Site
City
Brussels
ZIP/Postal Code
1200
Country
Belgium
Facility Name
Research Site
City
Gent
ZIP/Postal Code
9000
Country
Belgium
Facility Name
Research Site
City
Leuven
ZIP/Postal Code
3000
Country
Belgium
Facility Name
Research Site
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T2N 2T9
Country
Canada
Facility Name
Research Site
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V6Z 1Y6
Country
Canada
Facility Name
Research Site
City
London
State/Province
Ontario
ZIP/Postal Code
N6A 5A5
Country
Canada
Facility Name
Research Site
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1H 7W9
Country
Canada
Facility Name
Research Site
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5C 2T2
Country
Canada
Facility Name
Research Site
City
Bordeaux Cedex
ZIP/Postal Code
33076
Country
France
Facility Name
Research Site
City
Montpellier cedex 05
ZIP/Postal Code
34295
Country
France
Facility Name
Research Site
City
Nantes Cedex 1
ZIP/Postal Code
44093
Country
France
Facility Name
Research Site
City
Paris Cedex 15
ZIP/Postal Code
75743
Country
France
Facility Name
Research Site
City
Toulouse Cedex 09
ZIP/Postal Code
31403
Country
France
Facility Name
Research Site
City
Berlin
ZIP/Postal Code
13353
Country
Germany
Facility Name
Research Site
City
Kiel
ZIP/Postal Code
24105
Country
Germany
Facility Name
Research Site
City
Genova
ZIP/Postal Code
16132
Country
Italy
Facility Name
Research Site
City
Milano
ZIP/Postal Code
20122
Country
Italy
Facility Name
Research Site
City
Padova
ZIP/Postal Code
35128
Country
Italy
Facility Name
Research Site
City
Gdansk
ZIP/Postal Code
80-952
Country
Poland
Facility Name
Research Site
City
Katowice
ZIP/Postal Code
40-027
Country
Poland
Facility Name
Research Site
City
Lodz
ZIP/Postal Code
90-153
Country
Poland
Facility Name
Research Site
City
Poznan
ZIP/Postal Code
60-539
Country
Poland
Facility Name
Research Site
City
Szczecin
ZIP/Postal Code
70-111
Country
Poland
Facility Name
Research Site
City
Málaga
State/Province
AndalucÃ-a
ZIP/Postal Code
29010
Country
Spain
Facility Name
Research Site
City
Barcelona
State/Province
Cataluña
ZIP/Postal Code
08025
Country
Spain
Facility Name
Research Site
City
Barcelona
State/Province
Cataluña
ZIP/Postal Code
08036
Country
Spain
Facility Name
Research Site
City
L'Hospitalet de Llobregat
State/Province
Cataluña
ZIP/Postal Code
08907
Country
Spain
Facility Name
Research Site
City
Madrid
ZIP/Postal Code
28041
Country
Spain
Facility Name
Research Site
City
Bern
ZIP/Postal Code
3010
Country
Switzerland
Facility Name
Research Site
City
Geneva 14
ZIP/Postal Code
1211
Country
Switzerland
Facility Name
Research Site
City
Zurich
ZIP/Postal Code
8091
Country
Switzerland

12. IPD Sharing Statement

Links:
URL
http://www.amgentrials.com
Description
AmgenTrials clinical trials website

Learn more about this trial

Treatment of Autonomous Hyperparathyroidism in Post Renal Transplant Recipients

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