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A Safety Study of Pentoxifylline for the Treatment of Anemia

Primary Purpose

End Stage Renal Disease

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Erythropoietin
Erythropoietin
Pentoxifylline
Sponsored by
Fresenius Medical Care North America
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for End Stage Renal Disease focused on measuring Anemia, ESRD

Eligibility Criteria

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

Inclusion Criteria:

  • Male or female, aged ≥18 years;
  • Able to comply with the study procedures and medication;
  • Written informed consent given;
  • On a stable in-center hemodialysis regimen (at least 3 times per week) for ≥ 12 weeks prior to screening;
  • Subject must have been on a stable (< 25% change) erythropoietin dose with an average of ≥ 15,000 and <55,000 units/week of treatment for ≥ 14 days prior to screening visit;
  • Two hemoglobin measurements must meet the following criteria: (1) Taken ≥ 2 weeks apart; (2) Between 10 and 12 g/dL, inclusive; (3) Within 1 g/dL of each other; and (4) Occurred within 30 days prior to screening visit;
  • If subject is a female and of childbearing potential (pre-menopausal and not surgically sterile), subject is willing to use an effective contraceptive method throughout study, which includes abstinence, barrier methods, hormones, or IUDs;
  • Life expectancy of 12 months or greater;
  • Most recent single pool Kt/V ≥1.2, taken within 45 days prior to screening visit;
  • Stable nutrition status with all albumin levels ≥ 3.0 g/dL within the 30 days prior to screening visit.

Exclusion Criteria:

  • Participation in any clinical trial using an investigational product or device during the 30 days preceding the Screening Visit;
  • Currently undergoing nocturnal hemodialysis;
  • A significant history of alcohol, drug or solvent abuse in the opinion of the investigator;
  • Serum iPTH > 800 pg/mL within 90 days prior to screening visit;
  • Dysrhythmia or severe cardiac disease: CHF Class III-IV; unstable cardiovascular diagnosis (for example MI, CABG, PTCA, CVA, and TIA) within 90 days prior to screening visit;
  • Significant concurrent liver disorder [Aspartate transaminase (AST) or alanine transaminase (ALT) values > 3 times upper limit of normal (ULN) within 30 days prior to screening];
  • Platelet count < 130x109 within 30 days prior to screening visit or on the day of the screening visit;
  • Known hypersensitivity to, or intolerance of, Pentoxifylline or other methylxanthines, such as caffeine, theophylline or theobromine;
  • Currently taking pentoxifylline, warfarin, theophylline, aminophylline, dyphylline, or oxtriphylline;
  • Absolute or functional iron deficiency [transferrin saturation (TSAT) <20%] within 45 days prior to screening;
  • Recent or severe hemorrhage per PI discretion;
  • Significant bleeding episode or prolonged bleeding from dialysis access per PI judgment within the 3 months prior to screening;
  • Melatonin treatment, androgen therapy or blood transfusion within 30 days prior to screening;
  • Vitamin C therapy at dose greater than 100 mg/day or at a dose which has changed within the last 3 months;
  • Current active cancer (excluding basal cell carcinoma of the skin);
  • Poorly controlled hypertension per PI judgment within 4 weeks prior to screening;
  • Known HIV positive status;
  • Significant GI disorders where absorption of an oral medication might, in the opinion of the Investigator, be impaired;
  • Anticipated live donor kidney transplant or any other planned major surgery over the study duration;
  • History of poor adherence to hemodialysis or medical regimen;
  • Any active clinically significant infection or evidence of an underlying infection;
  • Currently on immunosuppressive drug regimen other than a stable, low dose of steroids, per PI judgment;
  • Any disease or condition, physical or psychological that, in the opinion of the investigator, would compromise the safety of the subject or the likelihood of achieving reliable results or increase the likelihood of the subject being withdrawn.

Sites / Locations

  • Fresenius Medical Care North America
  • Fresenius Medical Care North America
  • Fresenius Medical Care North America
  • Fresenius Medical Care North America
  • Fresenius Medical Care North America
  • Fresenius Medical Care North America
  • Fresenius Medical Care North America
  • Fresenius Medical Care North America
  • Fresenius Medical Care North America
  • Fresenius Medical Care North America

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

erythropoietin plus pentoxifylline

erythropoietin alone

Arm Description

Outcomes

Primary Outcome Measures

Change in Erythropoietin Dose
Erythropoietin dose is amount needed to maintain a hemoglobin between 11 and 12 mg/dL.

Secondary Outcome Measures

Examine the EPO Resistance Index (Erythropoietin Dose/kg/Week/Hgb) or ERI Over Time
Observe Changes in Markers of Inflammation Including But Not Limited to TNF-α and IL-6

Full Information

First Posted
April 9, 2010
Last Updated
March 26, 2012
Sponsor
Fresenius Medical Care North America
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1. Study Identification

Unique Protocol Identification Number
NCT01102218
Brief Title
A Safety Study of Pentoxifylline for the Treatment of Anemia
Official Title
A Randomized Multi-Center Study to Determine the Safety and Efficacy of Erythropoietin Plus Pentoxifylline Versus Erythropoietin Alone for the Treatment of Anemia in Subjects With End Stage Renal Disease on Maintenance Hemodialysis
Study Type
Interventional

2. Study Status

Record Verification Date
March 2012
Overall Recruitment Status
Terminated
Why Stopped
Lack of statistical difference between both arms of the trial.
Study Start Date
August 2010 (undefined)
Primary Completion Date
January 2012 (Actual)
Study Completion Date
January 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Fresenius Medical Care North America

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Chronic kidney disease (CKD) patients have increased levels of inflammation and oxidative stress, which in turn contribute to anemia and cardiovascular disease. Pentoxifylline is known to have anti-inflammatory and anti-oxidant properties, and has shown promise in improving the treatment of patients with anemia. This study will examine the use of pentoxifylline for the treatment of anemia in chronic kidney disease.
Detailed Description
Treatment of the anemia of renal failure has been revolutionized by the use of erythropoietin and other ESAs (erythropoiesis-stimulating agent). Concerns with ESA use include a substantial number of End Stage Renal Disease (ESRD) patients with ESA-resistant anemia, and a growing body of evidence of potential negative effects of high doses of ESA use, including increased mortality and increased rate of tumor growth in cancer patients. There are only a couple of small studies in the literature examining the effects of pentoxifylline on anemia in patients with renal failure. The results are limited by the very small number of patients. There is clearly a need for a larger, prospective, clinical trial of pentoxifylline in ESRD patients, not limited to those with ESA-resistant anemia. This would be the first prospective, randomized clinical trial of this size to study pentoxifylline for the treatment of anemia in chronic kidney disease.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
End Stage Renal Disease
Keywords
Anemia, ESRD

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
48 (Actual)

8. Arms, Groups, and Interventions

Arm Title
erythropoietin plus pentoxifylline
Arm Type
Experimental
Arm Title
erythropoietin alone
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
Erythropoietin
Intervention Description
Standard of Care
Intervention Type
Drug
Intervention Name(s)
Erythropoietin
Intervention Description
Standard of Care
Intervention Type
Drug
Intervention Name(s)
Pentoxifylline
Other Intervention Name(s)
brand name is Trental
Intervention Description
400 mg qd po for 6 months
Primary Outcome Measure Information:
Title
Change in Erythropoietin Dose
Description
Erythropoietin dose is amount needed to maintain a hemoglobin between 11 and 12 mg/dL.
Time Frame
Baseline and 6 months
Secondary Outcome Measure Information:
Title
Examine the EPO Resistance Index (Erythropoietin Dose/kg/Week/Hgb) or ERI Over Time
Time Frame
6 months
Title
Observe Changes in Markers of Inflammation Including But Not Limited to TNF-α and IL-6
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female, aged ≥18 years; Able to comply with the study procedures and medication; Written informed consent given; On a stable in-center hemodialysis regimen (at least 3 times per week) for ≥ 12 weeks prior to screening; Subject must have been on a stable (< 25% change) erythropoietin dose with an average of ≥ 15,000 and <55,000 units/week of treatment for ≥ 14 days prior to screening visit; Two hemoglobin measurements must meet the following criteria: (1) Taken ≥ 2 weeks apart; (2) Between 10 and 12 g/dL, inclusive; (3) Within 1 g/dL of each other; and (4) Occurred within 30 days prior to screening visit; If subject is a female and of childbearing potential (pre-menopausal and not surgically sterile), subject is willing to use an effective contraceptive method throughout study, which includes abstinence, barrier methods, hormones, or IUDs; Life expectancy of 12 months or greater; Most recent single pool Kt/V ≥1.2, taken within 45 days prior to screening visit; Stable nutrition status with all albumin levels ≥ 3.0 g/dL within the 30 days prior to screening visit. Exclusion Criteria: Participation in any clinical trial using an investigational product or device during the 30 days preceding the Screening Visit; Currently undergoing nocturnal hemodialysis; A significant history of alcohol, drug or solvent abuse in the opinion of the investigator; Serum iPTH > 800 pg/mL within 90 days prior to screening visit; Dysrhythmia or severe cardiac disease: CHF Class III-IV; unstable cardiovascular diagnosis (for example MI, CABG, PTCA, CVA, and TIA) within 90 days prior to screening visit; Significant concurrent liver disorder [Aspartate transaminase (AST) or alanine transaminase (ALT) values > 3 times upper limit of normal (ULN) within 30 days prior to screening]; Platelet count < 130x109 within 30 days prior to screening visit or on the day of the screening visit; Known hypersensitivity to, or intolerance of, Pentoxifylline or other methylxanthines, such as caffeine, theophylline or theobromine; Currently taking pentoxifylline, warfarin, theophylline, aminophylline, dyphylline, or oxtriphylline; Absolute or functional iron deficiency [transferrin saturation (TSAT) <20%] within 45 days prior to screening; Recent or severe hemorrhage per PI discretion; Significant bleeding episode or prolonged bleeding from dialysis access per PI judgment within the 3 months prior to screening; Melatonin treatment, androgen therapy or blood transfusion within 30 days prior to screening; Vitamin C therapy at dose greater than 100 mg/day or at a dose which has changed within the last 3 months; Current active cancer (excluding basal cell carcinoma of the skin); Poorly controlled hypertension per PI judgment within 4 weeks prior to screening; Known HIV positive status; Significant GI disorders where absorption of an oral medication might, in the opinion of the Investigator, be impaired; Anticipated live donor kidney transplant or any other planned major surgery over the study duration; History of poor adherence to hemodialysis or medical regimen; Any active clinically significant infection or evidence of an underlying infection; Currently on immunosuppressive drug regimen other than a stable, low dose of steroids, per PI judgment; Any disease or condition, physical or psychological that, in the opinion of the investigator, would compromise the safety of the subject or the likelihood of achieving reliable results or increase the likelihood of the subject being withdrawn.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Raymond M. Hakim, MD, PhD
Organizational Affiliation
Fresenius Medical Care North America
Official's Role
Principal Investigator
Facility Information:
Facility Name
Fresenius Medical Care North America
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60616
Country
United States
Facility Name
Fresenius Medical Care North America
City
Kalamazoo
State/Province
Michigan
ZIP/Postal Code
49007
Country
United States
Facility Name
Fresenius Medical Care North America
City
Brookhaven
State/Province
Mississippi
ZIP/Postal Code
39601
Country
United States
Facility Name
Fresenius Medical Care North America
City
Tupelo
State/Province
Mississippi
ZIP/Postal Code
38801
Country
United States
Facility Name
Fresenius Medical Care North America
City
St. Ann
State/Province
Missouri
ZIP/Postal Code
63074
Country
United States
Facility Name
Fresenius Medical Care North America
City
St. Peters
State/Province
Missouri
ZIP/Postal Code
63376
Country
United States
Facility Name
Fresenius Medical Care North America
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89120
Country
United States
Facility Name
Fresenius Medical Care North America
City
Columbia
State/Province
Tennessee
ZIP/Postal Code
38478
Country
United States
Facility Name
Fresenius Medical Care North America
City
Irving
State/Province
Texas
ZIP/Postal Code
75039
Country
United States
Facility Name
Fresenius Medical Care North America
City
Tyler
State/Province
Texas
ZIP/Postal Code
75701
Country
United States

12. IPD Sharing Statement

Learn more about this trial

A Safety Study of Pentoxifylline for the Treatment of Anemia

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