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KRX-0502 (Ferric Citrate) for the Treatment of IDA in Adult Subjects With NDD-CKD

Primary Purpose

Anemia of Chronic Kidney Disease

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
ferric citrate
Placebo
Sponsored by
Keryx Biopharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Anemia of Chronic Kidney Disease focused on measuring ferric citrate, Chronic kidney disease, Anemia

Eligibility Criteria

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

Inclusion Criteria:

  1. Men and non-lactating women with negative serum pregnancy test (for women of child-bearing potential) at Screening
  2. Age ≥18 years
  3. CKD with Estimated Glomerular Filtration Rate (eGFR) <60 mL/min at Screening using the 4-variable Modification of Diet in Renal Disease (MDRD) equation (with a limit of up to 20% of the target randomization of 230 subjects with eGFR <15 mL/min)
  4. Patients who were intolerant of or have had an inadequate therapeutic response to oral iron supplements (in the opinion of the investigator)
  5. Hgb ≥ 9.0 g/dL and ≤11.5 g/dL at Screening
  6. Serum ferritin ≤200 ng/mL and Transferrin Saturation (TSAT) ≤25% at Screening
  7. Serum Intact Parathyroid Hormone (iPTH) ≤600 pg/mL at Screening
  8. Must consume a minimum of 2 meals per day
  9. Willing and able to give written informed consent

Exclusion Criteria:

  1. Serum phosphate <3.5 mg/dL at Screening
  2. Liver enzymes (ALT/AST) >X3 times upper limit of normal at Screening
  3. Symptomatic gastrointestinal bleeding or inflammatory bowel disease within 12 weeks prior to Screening
  4. Evidence of acute kidney injury or requirement for dialysis within 12 weeks prior to Screening
  5. Scheduled kidney transplant or initiation of dialysis planned within 24 weeks of Screening
  6. IV iron administered within 4 weeks prior to Screening
  7. Erythropoiesis-stimulating agent (ESA) administered within 4 weeks prior to Screening
  8. Blood transfusion within 4 weeks prior to Screening
  9. Receipt of any investigational drug within 4 weeks prior to Screening
  10. Cause of anemia other than iron deficiency or chronic kidney disease
  11. Malignancy (except non-melanoma skin cancer or disease-free for ≥2 years after curative therapy)
  12. History of hemochromatosis
  13. Active drug or alcohol dependence or abuse (excluding tobacco use or medicinal marijuana) within the 12 months prior to Screening or evidence of such abuse (in the opinion of the PI)
  14. Subjects with known allergic reaction to previous oral iron therapy
  15. Previous intolerance to oral ferric citrate
  16. Psychiatric disorder that interferes with the subject's ability to comply with the study protocol
  17. Planned surgery or hospitalization (anticipated to last >72 hours) during the randomized period of the trial other than dialysis access related surgery.
  18. Any other medical condition that, in the opinion of the PI, renders the subject unable to or unlikely to complete the trial or that would interfere with optimal participation in the trial or produce significant risk to the subject
  19. Inability to cooperate with study personnel

Sites / Locations

  • AKDHC Medical Research Services, LLC
  • Southwest Kidney Institute
  • California Renal Research
  • Southern California Medical Research Center
  • Academic Medical Research Institute, Inc
  • Apex Research of Riverside
  • Capital Nephrology Medical Group
  • La Jolla Clinical Research, Inc
  • California Institute of Renal Research
  • Denver Nephrology
  • Creekside Medical Research
  • Riverside Clinical Research
  • Pines Clinical Research, Inc
  • Kidney Care Associates, LLC
  • Renal Physicians of Georgia, PC
  • Pacific Renal Research Institute
  • Advanced Renal Care
  • Kansas Nephrology Research Institute
  • Renal Associates of Baton Rouge
  • Western New England Renal & Transplant Associates
  • Renaissance Renal Research
  • Michigan Kidney Consultants, PC
  • Clinical Research Consultants
  • Lincoln Nephrology & Hypertension
  • Sierra Nevada Nephrology Asoociates
  • Mountain Kidney & Hypertension Associates
  • Metrolina Nephrology
  • Research Management, Inc
  • Research Management, Inc.
  • TAD Clinical Research
  • Kidney & Hypertension Specialists
  • Clinical Advancement Center
  • San Antonio Kidney Disease Center
  • Mendez Center for Clinical Research
  • Nephrology Associates of Northern VA, Inc.
  • Peninsula Kidney Associates

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

KRX-0502 (ferric citrate)

Placebo

Arm Description

1 g of KRX-0502 (ferric citrate) containing approximately 210 mg of ferric iron

Matching Placebo

Outcomes

Primary Outcome Measures

Percentage of Subjects Achieving an Increase in Hemoglobin of ≥1.0 g/dL at Any Time Point Between Baseline and the End of the 16-week Randomized Period
Efficacy analyses were performed for the Intention-to-treat (ITT) population, the population consisted of all subjects who were randomized, had a baseline laboratory value, took at least 1 dose of study drug, and had at least 1 post-baseline laboratory assessment during the randomized period.

Secondary Outcome Measures

Mean Change in Hemoglobin (Hgb) at the End of 16 Weeks Minus Baseline
The difference of Hgb at 16 weeks compared to the Hgb value at the time of study entry.
Mean Change in Transferrin Saturation (TSAT) at the End of 16 Weeks Minus Baseline
The difference of TSAT at 16 weeks compared to the TSAT value at the time of study entry was averaged.
Mean Change in Ferritin at the End of 16 Weeks Minus Baseline
The difference of ferritin at 16 weeks compared to the ferritin value at the time of study entry.
Percentage of Subjects Experiencing a Sustained Treatment Effect on Hemoglobin (Hgb)
Proportion of subjects that continued to maintain an increase in Hgb over a 4 week period, provided they had an increase of at least 1.0 g/dL during that 4-week period
Mean Change in Serum Phosphate at the End of 16 Weeks Minus Baseline
The difference of serum phosphate at 16 weeks compared to the serum phosphate value at the time of study entry.

Full Information

First Posted
October 11, 2014
Last Updated
February 22, 2018
Sponsor
Keryx Biopharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT02268994
Brief Title
KRX-0502 (Ferric Citrate) for the Treatment of IDA in Adult Subjects With NDD-CKD
Official Title
A Phase 3 Study of KRX-0502 (Ferric Citrate) for the Treatment of Iron Deficiency Anemia (IDA) in Adult Subjects With Non-Dialysis Dependent (NDD) Chronic Kidney Disease
Study Type
Interventional

2. Study Status

Record Verification Date
February 2018
Overall Recruitment Status
Completed
Study Start Date
October 2014 (undefined)
Primary Completion Date
January 2016 (Actual)
Study Completion Date
January 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Keryx Biopharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
a 24-week phase 3, multi-center clinical trial, comprised of a 16-week, randomized, double-blind, placebo-controlled period ("Randomized Period"), followed by an 8-week open-label safety extension period, where all subjects receive KRX-0502 (ferric citrate) ("Extension Period").
Detailed Description
a 24-week phase 3, multi-center clinical trial, comprised of a 16-week, randomized, double-blind, placebo-controlled period ("Randomized Period"), followed by an 8-week open-label safety extension period, where all subjects receive KRX-0502 (ferric citrate) ("Extension Period"). The study will consist of 14 clinic visits over a period of 24 weeks. There will be a screening period of up to 14 days; Approximately 230 subjects will be randomized into the Randomized Period in a 1:1 ratio to receive either KRX-0502 or matching placebo, at baseline

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Anemia of Chronic Kidney Disease
Keywords
ferric citrate, Chronic kidney disease, Anemia

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
KRX-0502 (ferric citrate)
Arm Type
Experimental
Arm Description
1 g of KRX-0502 (ferric citrate) containing approximately 210 mg of ferric iron
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Matching Placebo
Intervention Type
Drug
Intervention Name(s)
ferric citrate
Other Intervention Name(s)
KRX-0502
Intervention Description
1 g ferric citrate containing approximately 210 mg of ferric iron
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Matching placebo
Primary Outcome Measure Information:
Title
Percentage of Subjects Achieving an Increase in Hemoglobin of ≥1.0 g/dL at Any Time Point Between Baseline and the End of the 16-week Randomized Period
Description
Efficacy analyses were performed for the Intention-to-treat (ITT) population, the population consisted of all subjects who were randomized, had a baseline laboratory value, took at least 1 dose of study drug, and had at least 1 post-baseline laboratory assessment during the randomized period.
Time Frame
Week 16
Secondary Outcome Measure Information:
Title
Mean Change in Hemoglobin (Hgb) at the End of 16 Weeks Minus Baseline
Description
The difference of Hgb at 16 weeks compared to the Hgb value at the time of study entry.
Time Frame
Baseline and week 16
Title
Mean Change in Transferrin Saturation (TSAT) at the End of 16 Weeks Minus Baseline
Description
The difference of TSAT at 16 weeks compared to the TSAT value at the time of study entry was averaged.
Time Frame
Baseline and week 16
Title
Mean Change in Ferritin at the End of 16 Weeks Minus Baseline
Description
The difference of ferritin at 16 weeks compared to the ferritin value at the time of study entry.
Time Frame
Baseline and week 16
Title
Percentage of Subjects Experiencing a Sustained Treatment Effect on Hemoglobin (Hgb)
Description
Proportion of subjects that continued to maintain an increase in Hgb over a 4 week period, provided they had an increase of at least 1.0 g/dL during that 4-week period
Time Frame
Week 16
Title
Mean Change in Serum Phosphate at the End of 16 Weeks Minus Baseline
Description
The difference of serum phosphate at 16 weeks compared to the serum phosphate value at the time of study entry.
Time Frame
Baseline and week 16

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Men and non-lactating women with negative serum pregnancy test (for women of child-bearing potential) at Screening Age ≥18 years CKD with Estimated Glomerular Filtration Rate (eGFR) <60 mL/min at Screening using the 4-variable Modification of Diet in Renal Disease (MDRD) equation (with a limit of up to 20% of the target randomization of 230 subjects with eGFR <15 mL/min) Patients who were intolerant of or have had an inadequate therapeutic response to oral iron supplements (in the opinion of the investigator) Hgb ≥ 9.0 g/dL and ≤11.5 g/dL at Screening Serum ferritin ≤200 ng/mL and Transferrin Saturation (TSAT) ≤25% at Screening Serum Intact Parathyroid Hormone (iPTH) ≤600 pg/mL at Screening Must consume a minimum of 2 meals per day Willing and able to give written informed consent Exclusion Criteria: Serum phosphate <3.5 mg/dL at Screening Liver enzymes (ALT/AST) >X3 times upper limit of normal at Screening Symptomatic gastrointestinal bleeding or inflammatory bowel disease within 12 weeks prior to Screening Evidence of acute kidney injury or requirement for dialysis within 12 weeks prior to Screening Scheduled kidney transplant or initiation of dialysis planned within 24 weeks of Screening IV iron administered within 4 weeks prior to Screening Erythropoiesis-stimulating agent (ESA) administered within 4 weeks prior to Screening Blood transfusion within 4 weeks prior to Screening Receipt of any investigational drug within 4 weeks prior to Screening Cause of anemia other than iron deficiency or chronic kidney disease Malignancy (except non-melanoma skin cancer or disease-free for ≥2 years after curative therapy) History of hemochromatosis Active drug or alcohol dependence or abuse (excluding tobacco use or medicinal marijuana) within the 12 months prior to Screening or evidence of such abuse (in the opinion of the PI) Subjects with known allergic reaction to previous oral iron therapy Previous intolerance to oral ferric citrate Psychiatric disorder that interferes with the subject's ability to comply with the study protocol Planned surgery or hospitalization (anticipated to last >72 hours) during the randomized period of the trial other than dialysis access related surgery. Any other medical condition that, in the opinion of the PI, renders the subject unable to or unlikely to complete the trial or that would interfere with optimal participation in the trial or produce significant risk to the subject Inability to cooperate with study personnel
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Geoffrey Block, MD
Organizational Affiliation
Denver Nephrology
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Glenn Chertow, MD
Organizational Affiliation
Division of Nephrology at Stanford University School of Medicine
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Steven Fishbane, MD
Organizational Affiliation
Kidney Disease and Hypertension at North Shore University Hospital/Long Island Jewish Medical Center
Official's Role
Study Chair
Facility Information:
Facility Name
AKDHC Medical Research Services, LLC
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85027
Country
United States
Facility Name
Southwest Kidney Institute
City
Tempe
State/Province
Arizona
ZIP/Postal Code
85284
Country
United States
Facility Name
California Renal Research
City
Glendale
State/Province
California
ZIP/Postal Code
91204
Country
United States
Facility Name
Southern California Medical Research Center
City
La Palma
State/Province
California
ZIP/Postal Code
90623
Country
United States
Facility Name
Academic Medical Research Institute, Inc
City
Los Angeles
State/Province
California
ZIP/Postal Code
90022
Country
United States
Facility Name
Apex Research of Riverside
City
Riverside
State/Province
California
ZIP/Postal Code
92505
Country
United States
Facility Name
Capital Nephrology Medical Group
City
Sacramento
State/Province
California
ZIP/Postal Code
95825
Country
United States
Facility Name
La Jolla Clinical Research, Inc
City
San Diego
State/Province
California
ZIP/Postal Code
92103
Country
United States
Facility Name
California Institute of Renal Research
City
San Diego
State/Province
California
ZIP/Postal Code
92123
Country
United States
Facility Name
Denver Nephrology
City
Denver
State/Province
Colorado
ZIP/Postal Code
80230
Country
United States
Facility Name
Creekside Medical Research
City
DeLand
State/Province
Florida
ZIP/Postal Code
32123
Country
United States
Facility Name
Riverside Clinical Research
City
Edgewater
State/Province
Florida
ZIP/Postal Code
32132
Country
United States
Facility Name
Pines Clinical Research, Inc
City
Pembroke Pines
State/Province
Florida
ZIP/Postal Code
33028
Country
United States
Facility Name
Kidney Care Associates, LLC
City
Augusta
State/Province
Georgia
ZIP/Postal Code
30909
Country
United States
Facility Name
Renal Physicians of Georgia, PC
City
Macon
State/Province
Georgia
ZIP/Postal Code
31217
Country
United States
Facility Name
Pacific Renal Research Institute
City
Meridian
State/Province
Idaho
ZIP/Postal Code
83642
Country
United States
Facility Name
Advanced Renal Care
City
Evergreen Park
State/Province
Illinois
ZIP/Postal Code
60805
Country
United States
Facility Name
Kansas Nephrology Research Institute
City
Wichita
State/Province
Kansas
ZIP/Postal Code
67214
Country
United States
Facility Name
Renal Associates of Baton Rouge
City
Baton Rouge
State/Province
Louisiana
ZIP/Postal Code
70808
Country
United States
Facility Name
Western New England Renal & Transplant Associates
City
Springfield
State/Province
Massachusetts
ZIP/Postal Code
01107
Country
United States
Facility Name
Renaissance Renal Research
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48236
Country
United States
Facility Name
Michigan Kidney Consultants, PC
City
Pontiac
State/Province
Michigan
ZIP/Postal Code
48341
Country
United States
Facility Name
Clinical Research Consultants
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64111
Country
United States
Facility Name
Lincoln Nephrology & Hypertension
City
Lincoln
State/Province
Nebraska
ZIP/Postal Code
68105
Country
United States
Facility Name
Sierra Nevada Nephrology Asoociates
City
Reno
State/Province
Nevada
ZIP/Postal Code
89519
Country
United States
Facility Name
Mountain Kidney & Hypertension Associates
City
Asheville
State/Province
North Carolina
ZIP/Postal Code
28801
Country
United States
Facility Name
Metrolina Nephrology
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28204
Country
United States
Facility Name
Research Management, Inc
City
Austin
State/Province
Texas
ZIP/Postal Code
78732
Country
United States
Facility Name
Research Management, Inc.
City
Austin
State/Province
Texas
ZIP/Postal Code
78758
Country
United States
Facility Name
TAD Clinical Research
City
Lufkin
State/Province
Texas
ZIP/Postal Code
75904
Country
United States
Facility Name
Kidney & Hypertension Specialists
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78207
Country
United States
Facility Name
Clinical Advancement Center
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78215
Country
United States
Facility Name
San Antonio Kidney Disease Center
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Mendez Center for Clinical Research
City
Alexandria
State/Province
Virginia
ZIP/Postal Code
22304
Country
United States
Facility Name
Nephrology Associates of Northern VA, Inc.
City
Fairfax
State/Province
Virginia
ZIP/Postal Code
22033
Country
United States
Facility Name
Peninsula Kidney Associates
City
Hampton
State/Province
Virginia
ZIP/Postal Code
23666
Country
United States

12. IPD Sharing Statement

Learn more about this trial

KRX-0502 (Ferric Citrate) for the Treatment of IDA in Adult Subjects With NDD-CKD

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