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Study to Evaluate the Efficacy and Safety of GX-E2 in the Anemic Patients Diagnosed With Chronic Kidney Disease (CKD)

Primary Purpose

Anemia, Chronic Kidney Disease

Status
Completed
Phase
Phase 2
Locations
Korea, Republic of
Study Type
Interventional
Intervention
GX-E2
GX-E2
GX-E2
NESP
MIRCERA
Sponsored by
Genexine, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Anemia focused on measuring Phase 2

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Written informed consent
  • ≥18 yr of age
  • Chronic Kidney diseases with hemodialysis, peritoneal dialysis with Kt/V ≥ 1.2 (hemodialysis) or Kt/V ≥ 1.7 (peritoneal dialysis) within a year
  • Adequate transferrin saturation (≥20%), serum ferritin (≥100ug/L)
  • Should have received Vitamine B12 ≥ 3 months before the first dose of study agent
  • Should have received Folate ≥3 months before the first dose of study agent
  • No erythropoietin (EPO) therapy within 2 months before the planned first dose of GX-E2 and Hb<10g/dL or No EPO therapy within a month (peritoneal dialysis) or 2 weeks (hemodialysis) before the planned first dose of GX-E2 and Hb<10g/dL.

Exclusion Criteria:

  • Refractory to erythropoiesis stimulating agent (ESA) treatment
  • History of blood transfusion within 3 months
  • Donation or loss of blood for more than 400 milliliters (mL) within 8 weeks
  • History of a known or suspected hypersensitivity, shock, or past history to the investigational drug or to similar ESA drugs
  • Acute or chronic organ seizure disorder (including asthma and chronic obstructive pulmonary disease) which may be clinically deteriorated by the drug administration
  • Active infection or history of infection that required intravenous injection of antibiotics in the last two months
  • Grand Mal epilepsy
  • Major surgery within 3 months other than access surgery
  • Malignant tumor within 5 years other than successfully treated skin cancer that is not melanoma
  • Ischemic stroke within 3 years
  • Chest x-ray findings determined that they cannot participate in the study for clinically abnormal findings by the baseline chest x-ray findings or previously taken chest x-ray findings
  • Uncontrolled hypertension
  • Congestive heart failure more severe than NYHA functional class III; unstable Coronary artery disease (CAD); myocardial infraction within 3 months
  • Uncontrolled arrhythmia
  • High risk of thrombosis and embolism
  • Systemic blood diseases (e.g. Pure red cell anemia, sickle cell anemia, myelodysplastic syndromes, hematologic malignancy, myeloma, hemolytic anemia)
  • Absolute neutrophil count below 1,500 per microliter (uL) within screening periods
  • Platelet count less than 5e10 per liter (L) within screening periods
  • Hyperparathyrodism / hypothyrodism
  • Splenomegaly caused by anemia or severe splenomegaly (>20cm)
  • Blood aspartate aminotransferase/alanine aminotransferase (ALT/AST) concentration exceeds three times Upper Normal Limit of Normal (UNL)
  • Blood total bilirubin concentration exceeds 1.5 times Upper Normal Limit of Normal (UNL)
  • Blood albumin concentration below 3g per deciliter (dl)
  • History of drug or alcohol abuse in the 6 months prior to the screening
  • History of psychotropic or narcotic analgesic drugs dependence within 6 months prior to the screening
  • Mental disorder or other central nervous system disorder determined that the study evaluation cannot be conducted
  • Lack of understanding of the study and cooperation (one with no intention to give efforts to perform each evaluation visit and extend previously planned elective surgery)
  • Female subjects with childbearing potential who are pregnant, breastfeeding or intends to become pregnant
  • Participation in any drug study within 30 days prior to dosing
  • Any other ineligible condition at the direction of the investigator that would be ineligible to participate the study

Sites / Locations

  • Bucheon St. Mary's Hospital
  • Bundang Seoul National University College of Medicine
  • The Catholic University of Korea Incheon St.Mary's Hospital
  • Gangnam severance hospital
  • Seoul St.Mary's Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm 9

Arm 10

Arm 11

Arm 12

Arm 13

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Active Comparator

Experimental

Experimental

Experimental

Active Comparator

Arm Label

Group A (Part A)

Group B (Part A)

Group C (Part A)

Group D (Part A)

Group E (Part A)

Group F (Part A)

Group G (Part B)

Group H (Part B)

Group I (Part B)

Group J (Part B)

Group K (Part B)

Group L (Part B)

Group M (Part B)

Arm Description

GX-E2 : Subcutaneously injection every 2 weeks (Q2W) at dose 3ug/kg

GX-E2 : Subcutaneously injection every 2 weeks (Q2W) at dose 5ug/kg

GX-E2 : Subcutaneously injection every 2 weeks (Q2W) at dose 8ug/kg

GX-E2 : Subcutaneously injection every 4 weeks (Q4W) at dose 3ug/kg

GX-E2 : Subcutaneously injection every 4 weeks (Q4W) at dose 5ug/kg

GX-E2 : Subcutaneously injection every 4 weeks (Q4W) at dose 8ug/kg

GX-E2 : Subcutaneously injection every 2 weeks (Q2W) at dose 5ug/kg

GX-E2 : Subcutaneously injection every 2 weeks (Q2W) at dose 8ug/kg

MIRCERA : Subcutaneously injection every 2 weeks (Q2W) at dose 0.6ug/kg

GX-E2 : Intravenously injection every week (Q1W) at dose 5ug/kg

GX-E2 : Intravenously injection every week (Q1W) at dose 8ug/kg

GX-E2 : Intravenously injection every 2 weeks (Q2W) at dose 8ug/kg

NESP : Intravenously injection every week (Q1W) at dose 30ug

Outcomes

Primary Outcome Measures

average change of Hemoglobin level
change from baseline in Hemoglobin level

Secondary Outcome Measures

change of red blood cell indices
change from baseline in red blood cell indices
change of reticulocyte indices
change from baseline in reticulocyte indices
incidence, degree, outcome of adverse event
Incidence of adverse events
incidence, frequency, amount of blood transfusion
Incidence of adverse events
immunogenicity: ratio of neutralizing antibody & binding antibody in subjects
comparison from pre-treatment to post-treatment

Full Information

First Posted
January 9, 2014
Last Updated
October 13, 2017
Sponsor
Genexine, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02044653
Brief Title
Study to Evaluate the Efficacy and Safety of GX-E2 in the Anemic Patients Diagnosed With Chronic Kidney Disease (CKD)
Official Title
Phase II Clinical Trial to Explore the Optimal Fixed Starting Dose & Dosing Interval and to Evaluate the Safety of GX-E2 in the Anemic Patients Diagnosed With Chronic Kidney Disease and Receiving Hemodialysis (HD) / Peritoneal Dialysis (PD)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2017
Overall Recruitment Status
Completed
Study Start Date
April 15, 2014 (Actual)
Primary Completion Date
April 20, 2017 (Actual)
Study Completion Date
April 20, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Genexine, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The primary objective of study is Part A : To explore the optimal fixed starting dose and dosing interval of GX-E2 Part B : To evaluate the proof of concept (POC) of GX-E2
Detailed Description
The secondary objective of study is to evaluate: change of red blood cell indices in anemic patients with chronic kidney disease receiving hemodialysis/peritoneal dialysis when administering GX-E2 intravenously/subcutaneously change of reticulocyte indices in anemic patients with chronic kidney disease receiving hemodialysis/peritoneal dialysis when administering GX-E2 intravenously/subcutaneously safety of GX-E2 when administering intravenously/subcutaneously incidence of blood transfusion in anemic patients with chronic kidney disease receiving hemodialysis/peritoneal dialysis when administering GX-E2 intravenously/subcutaneously Immunogenicity in anemic patients with chronic kidney disease receiving hemodialysis/peritoneal dialysis when administering GX-E2 intravenously/subcutaneously

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Anemia, Chronic Kidney Disease
Keywords
Phase 2

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
257 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group A (Part A)
Arm Type
Experimental
Arm Description
GX-E2 : Subcutaneously injection every 2 weeks (Q2W) at dose 3ug/kg
Arm Title
Group B (Part A)
Arm Type
Experimental
Arm Description
GX-E2 : Subcutaneously injection every 2 weeks (Q2W) at dose 5ug/kg
Arm Title
Group C (Part A)
Arm Type
Experimental
Arm Description
GX-E2 : Subcutaneously injection every 2 weeks (Q2W) at dose 8ug/kg
Arm Title
Group D (Part A)
Arm Type
Experimental
Arm Description
GX-E2 : Subcutaneously injection every 4 weeks (Q4W) at dose 3ug/kg
Arm Title
Group E (Part A)
Arm Type
Experimental
Arm Description
GX-E2 : Subcutaneously injection every 4 weeks (Q4W) at dose 5ug/kg
Arm Title
Group F (Part A)
Arm Type
Experimental
Arm Description
GX-E2 : Subcutaneously injection every 4 weeks (Q4W) at dose 8ug/kg
Arm Title
Group G (Part B)
Arm Type
Experimental
Arm Description
GX-E2 : Subcutaneously injection every 2 weeks (Q2W) at dose 5ug/kg
Arm Title
Group H (Part B)
Arm Type
Experimental
Arm Description
GX-E2 : Subcutaneously injection every 2 weeks (Q2W) at dose 8ug/kg
Arm Title
Group I (Part B)
Arm Type
Active Comparator
Arm Description
MIRCERA : Subcutaneously injection every 2 weeks (Q2W) at dose 0.6ug/kg
Arm Title
Group J (Part B)
Arm Type
Experimental
Arm Description
GX-E2 : Intravenously injection every week (Q1W) at dose 5ug/kg
Arm Title
Group K (Part B)
Arm Type
Experimental
Arm Description
GX-E2 : Intravenously injection every week (Q1W) at dose 8ug/kg
Arm Title
Group L (Part B)
Arm Type
Experimental
Arm Description
GX-E2 : Intravenously injection every 2 weeks (Q2W) at dose 8ug/kg
Arm Title
Group M (Part B)
Arm Type
Active Comparator
Arm Description
NESP : Intravenously injection every week (Q1W) at dose 30ug
Intervention Type
Drug
Intervention Name(s)
GX-E2
Other Intervention Name(s)
GC1113
Intervention Description
Each Group of Peritoneal dialysis patients (n=10) will be administered GX-E2 3ug/kg to 8ug/kg
Intervention Type
Drug
Intervention Name(s)
GX-E2
Other Intervention Name(s)
GC1113
Intervention Description
Each Group of Peritoneal dialysis patients (n=24) will be administered GX-E2 5ug/kg to 8ug/kg
Intervention Type
Drug
Intervention Name(s)
GX-E2
Other Intervention Name(s)
GC1113
Intervention Description
Each Group of Hemodialysis patients (n=30) will be administered GX-E2 5ug/kg to 8ug/kg
Intervention Type
Drug
Intervention Name(s)
NESP
Other Intervention Name(s)
Aranesp, Darbepoetin alfa
Intervention Description
Each Group of Hemodialysis (n=30) will be administered NESP 30ug
Intervention Type
Drug
Intervention Name(s)
MIRCERA
Other Intervention Name(s)
Methoxy Polyethylene glycol-epoetin beta
Intervention Description
Each Group of Peritoneal dialysis (n=24) will be administered MIRCERA 0.6ug/kg
Primary Outcome Measure Information:
Title
average change of Hemoglobin level
Description
change from baseline in Hemoglobin level
Time Frame
6 weeks (Part A) & 14 weeks (Part B)
Secondary Outcome Measure Information:
Title
change of red blood cell indices
Description
change from baseline in red blood cell indices
Time Frame
6 weeks (Part A) & 14 weeks (Part B)
Title
change of reticulocyte indices
Description
change from baseline in reticulocyte indices
Time Frame
6 weeks (Part A) & 14 weeks (Part B)
Title
incidence, degree, outcome of adverse event
Description
Incidence of adverse events
Time Frame
6 weeks (Part A) & 14 weeks (Part B)
Title
incidence, frequency, amount of blood transfusion
Description
Incidence of adverse events
Time Frame
6 weeks (Part A) & 14 weeks (Part B)
Title
immunogenicity: ratio of neutralizing antibody & binding antibody in subjects
Description
comparison from pre-treatment to post-treatment
Time Frame
6 weeks (Part A) & 14 weeks (Part B)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Written informed consent ≥18 yr of age Chronic Kidney diseases with hemodialysis, peritoneal dialysis with Kt/V ≥ 1.2 (hemodialysis) or Kt/V ≥ 1.7 (peritoneal dialysis) within a year Adequate transferrin saturation (≥20%), serum ferritin (≥100ug/L) Should have received Vitamine B12 ≥ 3 months before the first dose of study agent Should have received Folate ≥3 months before the first dose of study agent No erythropoietin (EPO) therapy within 2 months before the planned first dose of GX-E2 and Hb<10g/dL or No EPO therapy within a month (peritoneal dialysis) or 2 weeks (hemodialysis) before the planned first dose of GX-E2 and Hb<10g/dL. Exclusion Criteria: Refractory to erythropoiesis stimulating agent (ESA) treatment History of blood transfusion within 3 months Donation or loss of blood for more than 400 milliliters (mL) within 8 weeks History of a known or suspected hypersensitivity, shock, or past history to the investigational drug or to similar ESA drugs Acute or chronic organ seizure disorder (including asthma and chronic obstructive pulmonary disease) which may be clinically deteriorated by the drug administration Active infection or history of infection that required intravenous injection of antibiotics in the last two months Grand Mal epilepsy Major surgery within 3 months other than access surgery Malignant tumor within 5 years other than successfully treated skin cancer that is not melanoma Ischemic stroke within 3 years Chest x-ray findings determined that they cannot participate in the study for clinically abnormal findings by the baseline chest x-ray findings or previously taken chest x-ray findings Uncontrolled hypertension Congestive heart failure more severe than NYHA functional class III; unstable Coronary artery disease (CAD); myocardial infraction within 3 months Uncontrolled arrhythmia High risk of thrombosis and embolism Systemic blood diseases (e.g. Pure red cell anemia, sickle cell anemia, myelodysplastic syndromes, hematologic malignancy, myeloma, hemolytic anemia) Absolute neutrophil count below 1,500 per microliter (uL) within screening periods Platelet count less than 5e10 per liter (L) within screening periods Hyperparathyrodism / hypothyrodism Splenomegaly caused by anemia or severe splenomegaly (>20cm) Blood aspartate aminotransferase/alanine aminotransferase (ALT/AST) concentration exceeds three times Upper Normal Limit of Normal (UNL) Blood total bilirubin concentration exceeds 1.5 times Upper Normal Limit of Normal (UNL) Blood albumin concentration below 3g per deciliter (dl) History of drug or alcohol abuse in the 6 months prior to the screening History of psychotropic or narcotic analgesic drugs dependence within 6 months prior to the screening Mental disorder or other central nervous system disorder determined that the study evaluation cannot be conducted Lack of understanding of the study and cooperation (one with no intention to give efforts to perform each evaluation visit and extend previously planned elective surgery) Female subjects with childbearing potential who are pregnant, breastfeeding or intends to become pregnant Participation in any drug study within 30 days prior to dosing Any other ineligible condition at the direction of the investigator that would be ineligible to participate the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Chul-Woo Yang, MD
Organizational Affiliation
222 Banpo-daero, Seocho-gu, Seoul, Korea
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Seok Joon Shin, MD
Organizational Affiliation
56 Dongsuro, Pupyung-Gu, Incheon, Korea
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Ki Young Na, MD
Organizational Affiliation
82 Gumi-ro, 173 Beon-gil, Bundnag-gu, Seongnam-si, Gyeonggi-do, Korea
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Ho cheol Song, MD
Organizational Affiliation
327 sosaro, onemi-Gu, bucheon, Korea
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Hyeong cheoon Park, MD
Organizational Affiliation
211 Eonju-ro, Gangnam-gu, Seoul, Korea
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Young Sun Kang, MD
Organizational Affiliation
123 Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, Korea
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Eun Young Seong, MD
Organizational Affiliation
176 Gudeok-ro, Seo-gu, Busan, Korea
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Yong-Lim Kim, MD
Organizational Affiliation
130 Dongdeok-ro, Jung-gu, Dae-gu, Korea
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Sangho Lee, MD
Organizational Affiliation
892 Dongnam-ro, Gangdong-gu, Seoul, Korea
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Byung Chul Shin, MD
Organizational Affiliation
365 Pilmun-daero, Dong-gu, Gwangju Metropolitan City
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Su-Hyun Kim, MD
Organizational Affiliation
102 Heukseok-ro, Dongjak-gu, Seoul, Korea
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Hyung Wook Kim, MD
Organizational Affiliation
93 Jungbu-daero, Paldal-gu, Suwon, Gyeonggi-do, Korea
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Won Kim, MD
Organizational Affiliation
20 Geonjiro Deokjin-gu, Jeonju-si, Jeollabuk-do, Korea
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Young-il Jo, MD
Organizational Affiliation
4-12 Hwayang-dong, Gwangjin-gu, Seoul, Korea
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Sug Kyun Shin, MD
Organizational Affiliation
100 Ilsan-ro, Ilsan-donggu, Goyang-si, Gyeonggi-do, Korea
Official's Role
Principal Investigator
Facility Information:
Facility Name
Bucheon St. Mary's Hospital
City
Bucheon
Country
Korea, Republic of
Facility Name
Bundang Seoul National University College of Medicine
City
Gumi
Country
Korea, Republic of
Facility Name
The Catholic University of Korea Incheon St.Mary's Hospital
City
Incheon
Country
Korea, Republic of
Facility Name
Gangnam severance hospital
City
Seoul
Country
Korea, Republic of
Facility Name
Seoul St.Mary's Hospital
City
Seoul
Country
Korea, Republic of

12. IPD Sharing Statement

Learn more about this trial

Study to Evaluate the Efficacy and Safety of GX-E2 in the Anemic Patients Diagnosed With Chronic Kidney Disease (CKD)

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