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Single and Multiple Dosing Study in Hemodialysis Patients With Hyperphosphatemia in Japan

Primary Purpose

Chronic Kidney Disease, Hyperphosphatemia Undergoing Hemodialysis

Status
Completed
Phase
Phase 1
Locations
Japan
Study Type
Interventional
Intervention
ASP3325
Sponsored by
Astellas Pharma Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Kidney Disease focused on measuring Hyperphosphatemia, ASP3325, Chronic Kidney Disease, pharmacodynamics, pharmacokinetics

Eligibility Criteria

20 Years - 74 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Subject who has received maintenance hemodialysis 3 times a week for at least 12 weeks (84 days) prior to the scheduled first day of the washout period.
  • Subject who can receive morning dialysis from the start of the washout period to the end of follow-up period. (Part 2)
  • Subject with pre-dialysis serum Pi level between ≥6.0 and <10.0 mg/dL and be confirmed increase in serum Pi of ≥1.5 mg/dL after the maximum dialysis interval at the washout period week 1 or 2. (Part 2)
  • Subject who did not change the type or dose of any phosphate binder(s), any nutritional supplements or any other drugs with phosphorus reducing action for at least 4 weeks (28 days) prior to the scheduled first day of the washout period.
  • Subject who did not receive calcimimetics (e.g., cinacalcet HCl) for at least 12 weeks (84 days) prior to the scheduled first day of the washout period.
  • Subject taking native or active vitamin D (including vitamin D analogues), calcitonin agents or PTH agents must be on stable dose for at least 4 weeks (28 days) prior to the scheduled first day of the washout period.

Exclusion Criteria:

  • Subject who has a history of severe gastrointestinal disorder, major gastrointestinal surgery, malabsorption considered influential on the absorption of the drug and nutrition in the gastrointestinal tract.
  • Subject who has a history of parathyroid intervention (e.g., parathyroidectomy [PTx], percutaneous ethanol injection therapy [PEIT]).
  • Subject whose dry weight loss >5% within 12 weeks (84 days) prior to the scheduled start day of the washout period.
  • Confirmed serum intact PTH >1000 pg/mL at the start of the washout period (only applicable for Part 2).
  • Subject whose last 3 measurement values at the separate day of pre-dialysis systolic/diastolic blood pressure before the scheduled start day of the washout period or during the washout period are all 180 mmHg or higher and 120 mmHg or higher.
  • Subject who has severe congestive heart failure (i.e., NYHA cardiac function classification Class III or severer).
  • Subject who experienced a myocardial infarction or major surgery excluding vascular access surgery within 12 weeks (84 days) prior to the informed consent signing.
  • Subject who has any of liver function tests (ALT, AST, T-Bil) out of range as indicated below at the screening (Part 1) or during the washout period, or patients with a complication of serious hepatic disease (e.g., acute and active chronic hepatitis, liver cirrhosis). AST: >2×ULN, ALT: >2×ULN, T-Bil: >1.25×ULN
  • Subject with history or complication of malignant tumor (considered eligible if recurrence has not been observed for at least 5 years).
  • Subject with history of serious drug hypersensitivity, such as anaphylactic shock.

Sites / Locations

  • Site: 4
  • Site: 5
  • Site: 1
  • Site: 2
  • Site: 3

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Part1, ASP3325 Tablet A

Part2, ASP3325 Tablet B group 1

Part2, ASP3325 Tablet B group 2

Arm Description

ASP3325 tablets A will be orally administered with 150 mL of water in fasting condition on non-dialysis day in Day 1

ASP3325 tablets B will be orally administered t.i.d. 30 minutes before each meal for 2 weeks

ASP3325 tablets B will be orally administered t.i.d. 30 minutes just after each meal for 2 weeks

Outcomes

Primary Outcome Measures

Safety assessed by adverse events: Part 1
Safety assessed by adverse events: Part 2
Safety assessed by vital signs: Part 1
Vital signs include body temperature, blood pressure and pulse rate)
Safety assessed by vital signs: Part 2
Vital signs include body temperature, blood pressure and pulse rate)
Safety assessed by clinical laboratory test: Part 1
Clinical laboratory tests include hematology and biochemistry
Safety assessed by clinical laboratory test: Part 2
Clinical laboratory tests include hematology and biochemistry
Safety assessed by 12-Lead ECG: Part 1
ECG: electrocardiogram
Safety assessed by 12-Lead ECG: Part 2
ECG: electrocardiogram

Secondary Outcome Measures

Cmax of unchanged ASP3325
Cmax:maximum plasma concentration
tmax of unchanged ASP3325
tmax = time to reach maximum plasma concentration
AUClast of ASP3325
AUClast: Area under the Curve of plasma concentration during observation period in each observational day
AUCinf of ASP3325
AUCinf: Area under the Curve of plasma concentration
t1/2 of ASP3325
t1/2 = apparent terminal elimination half-life
Vz/F of ASP3325
Vz/F = apparent volume of distribution
CL/F of ASP3325
CL/F = oral clearance
Ctrough of ASP3325
Ctrough = observed trough concentration
Serum Pi of ASP3325
Serum Pi: serum phosphate concentration before dialysis
Serum Calcium (adjusted for albumin)
Corrected value of Calcium (Ca) (mg/dL) = Observed value of Ca (mg/dL) + [4-albumin (g/dL)
Serum concentration of intact PTH before dialysis
PTH = parathyroid hormone
Serum concentration of FGF23
FGF23 = fibroblast growth factor 23

Full Information

First Posted
July 8, 2015
Last Updated
October 22, 2018
Sponsor
Astellas Pharma Inc
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1. Study Identification

Unique Protocol Identification Number
NCT02510274
Brief Title
Single and Multiple Dosing Study in Hemodialysis Patients With Hyperphosphatemia in Japan
Official Title
A Phase 1, Single and Multiple Dosing Study to Evaluate Pharmacokinetics and Pharmacodynamics of ASP3325 in Patients With Chronic Kidney Disease and Hyperphosphatemia Undergoing Hemodialysis
Study Type
Interventional

2. Study Status

Record Verification Date
October 2018
Overall Recruitment Status
Completed
Study Start Date
May 12, 2014 (Actual)
Primary Completion Date
November 4, 2014 (Actual)
Study Completion Date
November 4, 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Astellas Pharma Inc

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The objective of this study is to assess PK, safety and tolerability of a single oral dose of ASP3325 and to assess PD, PK and safety of repeated oral doses of ASP3325 administered t.i.d. before or just after each meal
Detailed Description
[Part 1] This part is an open-label, uncontrolled study to evaluate PK and safety with single dosing of ASP3325 in hemodialysis patients. After washout period of therapeutic medication for hyperphosphatemia, six subjects will receive single oral administration of ASP3325 (Tablet A) on a non-dialysis day (Day 1). [Part 2] This part is a 2-arm, open-label, uncontrolled study to evaluate PD, PK and safety with dosing ASP3325 Tablet B t.i.d. before or just after each meal. Eligible subjects at screening will be entered into the washout period for stopping their phosphate-binding treatment. 20 subjects with serum inorganic phosphorus (Pi) level between ≥6.0 and <10.0 mg/dL during the washout period (washout period week 1 or washout period week 2) will be randomized to each treatment group and ASP3325 will be administered for 2 weeks until Day 14.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Kidney Disease, Hyperphosphatemia Undergoing Hemodialysis
Keywords
Hyperphosphatemia, ASP3325, Chronic Kidney Disease, pharmacodynamics, pharmacokinetics

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Part1, ASP3325 Tablet A
Arm Type
Experimental
Arm Description
ASP3325 tablets A will be orally administered with 150 mL of water in fasting condition on non-dialysis day in Day 1
Arm Title
Part2, ASP3325 Tablet B group 1
Arm Type
Experimental
Arm Description
ASP3325 tablets B will be orally administered t.i.d. 30 minutes before each meal for 2 weeks
Arm Title
Part2, ASP3325 Tablet B group 2
Arm Type
Experimental
Arm Description
ASP3325 tablets B will be orally administered t.i.d. 30 minutes just after each meal for 2 weeks
Intervention Type
Drug
Intervention Name(s)
ASP3325
Intervention Description
oral
Primary Outcome Measure Information:
Title
Safety assessed by adverse events: Part 1
Time Frame
Up to Day 7
Title
Safety assessed by adverse events: Part 2
Time Frame
Up to Day 22
Title
Safety assessed by vital signs: Part 1
Description
Vital signs include body temperature, blood pressure and pulse rate)
Time Frame
Up to Day 7
Title
Safety assessed by vital signs: Part 2
Description
Vital signs include body temperature, blood pressure and pulse rate)
Time Frame
Up to Day 22
Title
Safety assessed by clinical laboratory test: Part 1
Description
Clinical laboratory tests include hematology and biochemistry
Time Frame
Up to Day 7
Title
Safety assessed by clinical laboratory test: Part 2
Description
Clinical laboratory tests include hematology and biochemistry
Time Frame
Up to Day 22
Title
Safety assessed by 12-Lead ECG: Part 1
Description
ECG: electrocardiogram
Time Frame
Up to Day 7
Title
Safety assessed by 12-Lead ECG: Part 2
Description
ECG: electrocardiogram
Time Frame
Up to Day 22
Secondary Outcome Measure Information:
Title
Cmax of unchanged ASP3325
Description
Cmax:maximum plasma concentration
Time Frame
Part 1 Before administration, Day 1, 2, 4, 5 and 7
Title
tmax of unchanged ASP3325
Description
tmax = time to reach maximum plasma concentration
Time Frame
Part 1 Before administration, Day 1, 2, 4, 5 and 7
Title
AUClast of ASP3325
Description
AUClast: Area under the Curve of plasma concentration during observation period in each observational day
Time Frame
Part 1 Before administration, Day 1, 2, 4, 5 and 7
Title
AUCinf of ASP3325
Description
AUCinf: Area under the Curve of plasma concentration
Time Frame
Part 1 Before administration, Day 1, 2, 4, 5 and 7
Title
t1/2 of ASP3325
Description
t1/2 = apparent terminal elimination half-life
Time Frame
Part 1 Before administration, Day 1, 2, 4, 5 and 7
Title
Vz/F of ASP3325
Description
Vz/F = apparent volume of distribution
Time Frame
Part 1 Before administration, Day 1, 2, 4, 5 and 7
Title
CL/F of ASP3325
Description
CL/F = oral clearance
Time Frame
Part 1 Before administration, Day 1, 2, 4, 5 and 7
Title
Ctrough of ASP3325
Description
Ctrough = observed trough concentration
Time Frame
Part 2 Before administration, Day 3, 5, 8, 10, 12, 15 and 22
Title
Serum Pi of ASP3325
Description
Serum Pi: serum phosphate concentration before dialysis
Time Frame
Part 2 Day -21, -14, and -7 in washout period, Day 1, 8, 15 and 22
Title
Serum Calcium (adjusted for albumin)
Description
Corrected value of Calcium (Ca) (mg/dL) = Observed value of Ca (mg/dL) + [4-albumin (g/dL)
Time Frame
Part 2 Day -21, -14, and -7 in washout period, Day 1, 8, 15 and 22
Title
Serum concentration of intact PTH before dialysis
Description
PTH = parathyroid hormone
Time Frame
Part 2 Day -21 in washout period, Day 1, 8, 15 and 22
Title
Serum concentration of FGF23
Description
FGF23 = fibroblast growth factor 23
Time Frame
Part 2 Day -21 in washout period, Day 1, 8, 15 and 22

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
74 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject who has received maintenance hemodialysis 3 times a week for at least 12 weeks (84 days) prior to the scheduled first day of the washout period. Subject who can receive morning dialysis from the start of the washout period to the end of follow-up period. (Part 2) Subject with pre-dialysis serum Pi level between ≥6.0 and <10.0 mg/dL and be confirmed increase in serum Pi of ≥1.5 mg/dL after the maximum dialysis interval at the washout period week 1 or 2. (Part 2) Subject who did not change the type or dose of any phosphate binder(s), any nutritional supplements or any other drugs with phosphorus reducing action for at least 4 weeks (28 days) prior to the scheduled first day of the washout period. Subject who did not receive calcimimetics (e.g., cinacalcet HCl) for at least 12 weeks (84 days) prior to the scheduled first day of the washout period. Subject taking native or active vitamin D (including vitamin D analogues), calcitonin agents or PTH agents must be on stable dose for at least 4 weeks (28 days) prior to the scheduled first day of the washout period. Exclusion Criteria: Subject who has a history of severe gastrointestinal disorder, major gastrointestinal surgery, malabsorption considered influential on the absorption of the drug and nutrition in the gastrointestinal tract. Subject who has a history of parathyroid intervention (e.g., parathyroidectomy [PTx], percutaneous ethanol injection therapy [PEIT]). Subject whose dry weight loss >5% within 12 weeks (84 days) prior to the scheduled start day of the washout period. Confirmed serum intact PTH >1000 pg/mL at the start of the washout period (only applicable for Part 2). Subject whose last 3 measurement values at the separate day of pre-dialysis systolic/diastolic blood pressure before the scheduled start day of the washout period or during the washout period are all 180 mmHg or higher and 120 mmHg or higher. Subject who has severe congestive heart failure (i.e., NYHA cardiac function classification Class III or severer). Subject who experienced a myocardial infarction or major surgery excluding vascular access surgery within 12 weeks (84 days) prior to the informed consent signing. Subject who has any of liver function tests (ALT, AST, T-Bil) out of range as indicated below at the screening (Part 1) or during the washout period, or patients with a complication of serious hepatic disease (e.g., acute and active chronic hepatitis, liver cirrhosis). AST: >2×ULN, ALT: >2×ULN, T-Bil: >1.25×ULN Subject with history or complication of malignant tumor (considered eligible if recurrence has not been observed for at least 5 years). Subject with history of serious drug hypersensitivity, such as anaphylactic shock.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Director
Organizational Affiliation
Astellas Pharma Inc
Official's Role
Study Director
Facility Information:
Facility Name
Site: 4
City
Aichi
Country
Japan
Facility Name
Site: 5
City
Aichi
Country
Japan
Facility Name
Site: 1
City
Ibaraki
Country
Japan
Facility Name
Site: 2
City
Ibaraki
Country
Japan
Facility Name
Site: 3
City
Shizuoka
Country
Japan

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Access to anonymized individual participant level data will not be provided for this trial as it meets one or more of the exceptions described on www.clinicalstudydatarequest.com under "Sponsor Specific Details for Astellas."
Links:
URL
https://astellasclinicalstudyresults.com/study.aspx?ID=273
Description
Link to results on the Astellas Clinical Study Results website

Learn more about this trial

Single and Multiple Dosing Study in Hemodialysis Patients With Hyperphosphatemia in Japan

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