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A Randomized, Comparative, Open-label Study of IV Monofer® Administered as Maintenance Therapy by Single or Repeated Bolus Injections in Comparison With IV Iron Sucrose in Subjects With CKD-5D

Primary Purpose

Chronic Kidney Disease Stage 5 (Dialysis Dependent)

Status
Completed
Phase
Phase 3
Locations
India
Study Type
Interventional
Intervention
Monofer
Iron sucrose
Sponsored by
Pharmacosmos A/S
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Kidney Disease Stage 5 (Dialysis Dependent)

Eligibility Criteria

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

Inclusion Criteria:

Subjects with a diagnosis of CKD-5D, in dialysis therapy for at least 90 days prior to inclusion, will be included if they meet all of the following criteria:

  1. Men or women, aged 18 years or greater.
  2. Subjects diagnosed with CKD-5D and in haemodialysis therapy for at least 90 days.
  3. Life expectancy beyond 12 months by Principal Investigator's judgement.
  4. Willingness and ability to participate after Informed Consent.
  5. Hb concentrations between 9.5 g/dL and 12.5 g/dL (both values included) both at Screening Visit 1a and at Screening Visit 1b (screening Visit 1a and Visit 1b must be separated by at least 1 week).
  6. Serum ferritin < 800 ng/mL.
  7. Transferrin Saturation < 35%.
  8. Subjects receiving ESA treatment with dose stable for the previous 4 weeks prior to screening (with only 1 missed dose to be allowed. Dose to be kept stable during the study period).
  9. Subjects receiving no IV iron or an average of no more than 100 mg/week for the previous 4 weeks (with only 1 missed dose to be allowed).

Exclusion Criteria:

  1. Anaemia caused primarily by factors other than renal related anaemia.
  2. Iron overload or disturbances in utilization of iron (e.g. haemochromatosis and haemosiderosis).
  3. Patients currently undergoing treatment with immunosuppresives (low dose steroids are allowed during the study conduct for dosages no more than 10 mg prednisolone/day or equivalent. If possible the dosage should be kept constant through the study).
  4. Difference of Hb ≥ 1.0 g/dL between screening (Visits 1a and 1b).
  5. Patients with a history of multiple allergies.
  6. Decompensated liver cirrhosis or active hepatitis [Alanine Aminotransferase (ALT) > 3 times normal] or history of Hepatitis B or C.
  7. Active acute or chronic infections (assessed by clinical judgement), supplied with White Blood Cells (WBC) and C - reactive protein (CRP).
  8. Rheumatoid arthritis with symptoms or signs of active joint inflammation.
  9. Pregnancy or nursing. [To avoid pregnancy, women have to be postmenopausal (at least 12 months must have elapsed since last menstruation), surgically sterile, or women of child bearing potential must use one of the following contraceptives during the whole study period and after the study has ended for at least 5 times plasma biological half-life of the investigational medicinal product: Contraceptive pills, Intrauterine Devices (IUD), contraceptive depot injections (prolonged-release gestagen), subdermal implantation, vaginal ring, and transdermal patches]
  10. Blood transfusion within the previous 12 weeks.
  11. Planned elective surgery in the next 8 weeks.
  12. Participation in any other clinical trial within the past 30 days, or if longer, where the study drug has not passed five half-lives prior to screening.
  13. Untreated Vitamin B12 or folate deficiency.
  14. Any other medical condition that, in the opinion of Principal Investigator, may cause the subject to be unsuitable for the completion of the study or place the subject at potential risk from being in the study. Examples include Uncontrolled Hypertension, Unstable Ischemic Heart Disease or Uncontrolled Diabetes Mellitus.

Sites / Locations

  • Jatin Kothari

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Iron isomaltoside 1000

Iron sucrose

Arm Description

Iron isomaltoside 1000 (Monofer)administered as 500 mg intravenous single bolus injections OR administered as 500 mg fractionated (100mg+200mg+200mg) intravenous bolus injection

Iron sucrose administered as 500 mg fractionated (100mg+200mg+200mg) intravenous bolus injection

Outcomes

Primary Outcome Measures

Ability to Maintain Hemoglobin Level
The primary outcome measure was the proportion of subjects who were able to maintain haemoglobin between 9.5 and 12.5 g/dL (both values included) at week 6. Haemoglobin was measured by a blood sample at the different visits. All blood samples were taken before the dialysis from the dialysis catheter. Intravenous iron was administered during dialysis, at least 30 min after the start and at least 1 h before the end of dialysis.

Secondary Outcome Measures

Change in Hemoglobin Concentration

Full Information

First Posted
October 15, 2010
Last Updated
November 2, 2015
Sponsor
Pharmacosmos A/S
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1. Study Identification

Unique Protocol Identification Number
NCT01222884
Brief Title
A Randomized, Comparative, Open-label Study of IV Monofer® Administered as Maintenance Therapy by Single or Repeated Bolus Injections in Comparison With IV Iron Sucrose in Subjects With CKD-5D
Official Title
A Phase III, Randomized, Comparative, Open-label Study of Intravenous Iron Isomaltoside 1000 (Monofer®) Administered as Maintenance Therapy by Single or Repeated Bolus Injections in Comparison With Intravenous Iron Sucrose in Subjects With Stage 5 Chronic Kidney Disease on Dialysis Therapy (CKD-5D)
Study Type
Interventional

2. Study Status

Record Verification Date
June 2015
Overall Recruitment Status
Completed
Study Start Date
June 2011 (undefined)
Primary Completion Date
October 2013 (Actual)
Study Completion Date
December 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pharmacosmos A/S

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to compare the efficacy and safety of intravenous iron isomaltoside 1000 with intravenous iron sucrose in patients suffering from Stage 5 Chronic Kidney Disease on Dialysis Therapy (CKD-5D).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Kidney Disease Stage 5 (Dialysis Dependent)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
351 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Iron isomaltoside 1000
Arm Type
Active Comparator
Arm Description
Iron isomaltoside 1000 (Monofer)administered as 500 mg intravenous single bolus injections OR administered as 500 mg fractionated (100mg+200mg+200mg) intravenous bolus injection
Arm Title
Iron sucrose
Arm Type
Active Comparator
Arm Description
Iron sucrose administered as 500 mg fractionated (100mg+200mg+200mg) intravenous bolus injection
Intervention Type
Drug
Intervention Name(s)
Monofer
Intervention Description
Iron isomaltoside 1000 (Monofer®) administered as 500 mg intravenous single bolus injection over approximately 2 minutes
Intervention Type
Drug
Intervention Name(s)
Iron sucrose
Intervention Description
Iron sucrose is administered undiluted in doses of 100mg at baseline, 200mg at week 2 and 200 mg at week 4 as fractionated IV bolus injections according to local Summary of Product Characteristics
Primary Outcome Measure Information:
Title
Ability to Maintain Hemoglobin Level
Description
The primary outcome measure was the proportion of subjects who were able to maintain haemoglobin between 9.5 and 12.5 g/dL (both values included) at week 6. Haemoglobin was measured by a blood sample at the different visits. All blood samples were taken before the dialysis from the dialysis catheter. Intravenous iron was administered during dialysis, at least 30 min after the start and at least 1 h before the end of dialysis.
Time Frame
Baseline to 6 weeks
Secondary Outcome Measure Information:
Title
Change in Hemoglobin Concentration
Time Frame
6 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects with a diagnosis of CKD-5D, in dialysis therapy for at least 90 days prior to inclusion, will be included if they meet all of the following criteria: Men or women, aged 18 years or greater. Subjects diagnosed with CKD-5D and in haemodialysis therapy for at least 90 days. Life expectancy beyond 12 months by Principal Investigator's judgement. Willingness and ability to participate after Informed Consent. Hb concentrations between 9.5 g/dL and 12.5 g/dL (both values included) both at Screening Visit 1a and at Screening Visit 1b (screening Visit 1a and Visit 1b must be separated by at least 1 week). Serum ferritin < 800 ng/mL. Transferrin Saturation < 35%. Subjects receiving ESA treatment with dose stable for the previous 4 weeks prior to screening (with only 1 missed dose to be allowed. Dose to be kept stable during the study period). Subjects receiving no IV iron or an average of no more than 100 mg/week for the previous 4 weeks (with only 1 missed dose to be allowed). Exclusion Criteria: Anaemia caused primarily by factors other than renal related anaemia. Iron overload or disturbances in utilization of iron (e.g. haemochromatosis and haemosiderosis). Patients currently undergoing treatment with immunosuppresives (low dose steroids are allowed during the study conduct for dosages no more than 10 mg prednisolone/day or equivalent. If possible the dosage should be kept constant through the study). Difference of Hb ≥ 1.0 g/dL between screening (Visits 1a and 1b). Patients with a history of multiple allergies. Decompensated liver cirrhosis or active hepatitis [Alanine Aminotransferase (ALT) > 3 times normal] or history of Hepatitis B or C. Active acute or chronic infections (assessed by clinical judgement), supplied with White Blood Cells (WBC) and C - reactive protein (CRP). Rheumatoid arthritis with symptoms or signs of active joint inflammation. Pregnancy or nursing. [To avoid pregnancy, women have to be postmenopausal (at least 12 months must have elapsed since last menstruation), surgically sterile, or women of child bearing potential must use one of the following contraceptives during the whole study period and after the study has ended for at least 5 times plasma biological half-life of the investigational medicinal product: Contraceptive pills, Intrauterine Devices (IUD), contraceptive depot injections (prolonged-release gestagen), subdermal implantation, vaginal ring, and transdermal patches] Blood transfusion within the previous 12 weeks. Planned elective surgery in the next 8 weeks. Participation in any other clinical trial within the past 30 days, or if longer, where the study drug has not passed five half-lives prior to screening. Untreated Vitamin B12 or folate deficiency. Any other medical condition that, in the opinion of Principal Investigator, may cause the subject to be unsuitable for the completion of the study or place the subject at potential risk from being in the study. Examples include Uncontrolled Hypertension, Unstable Ischemic Heart Disease or Uncontrolled Diabetes Mellitus.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lars Lykke Thomsen, MD
Organizational Affiliation
Pharmacosmos A/S
Official's Role
Study Chair
Facility Information:
Facility Name
Jatin Kothari
City
Mumbai
Country
India

12. IPD Sharing Statement

Learn more about this trial

A Randomized, Comparative, Open-label Study of IV Monofer® Administered as Maintenance Therapy by Single or Repeated Bolus Injections in Comparison With IV Iron Sucrose in Subjects With CKD-5D

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