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A Study of Intermittent Oral Dosing of ASP1517 in Peritoneal Dialysis Chronic Kidney Disease Patients With Anemia

Primary Purpose

Peritoneal Dialysis Chronic Kidney Disease Patients With Anemia

Status
Completed
Phase
Phase 3
Locations
Japan
Study Type
Interventional
Intervention
roxadustat
Sponsored by
Astellas Pharma Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peritoneal Dialysis Chronic Kidney Disease Patients With Anemia focused on measuring Peritoneal dialysis, Roxadustat, Renal anemia, ASP1517

Eligibility Criteria

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

Inclusion Criteria:

  • Female subject must either:

Be of non-childbearing potential:

  • post-menopausal (defined as at least 1 year without any menses) prior to Screening, or
  • documented surgically sterile Or, if of childbearing potential,
  • Agree not to try to become pregnant during the study and for 28 days after the final study drug administration
  • And have a negative pregnancy test at Screening
  • And, if heterosexually active, agree to consistently use two forms of highly effective form of birth control (at least one of which must be a barrier method) starting at Screening and throughout the study period and continued for 28 days after the final study drug administration.

    • Female subject must agree not to breastfeed starting at Screening and throughout the study period, and continued for 28 days after the final study drug administration.
    • Female subject must not donate ova starting at Screening and throughout the study period, and continued for 28 days after the final study drug administration.
    • Male subject and their female spouse/partners who are of childbearing potential must be using two forms of highly effective form of birth control (at least one of which must be a barrier method) starting at Screening and continue throughout the study period, and for 12 weeks after the final study drug administration
    • Male subject must not donate sperm starting at Screening and throughout the study period and, for 12 weeks after the final study drug administration
    • Subjects who have not received Erythropoieses Stimulating Agents (ESAs):
  • Subjects who have been receiving peritoneal dialysis for more than 4 weeks before the screening assessment
  • Subjects who have never received ESAs after starting peritoneal dialysis, or subjects who have not received ESAs within 6 weeks before the screening assessment.
  • Mean of the subject's two most recent Hb values before randomization during the Screening Period must be <10.5 g/dL with an absolute difference ≤1.3 g/dL between the two values
  • Either transferrin saturation (TSAT) ≥ 5% or serum ferritin ≥ 30 ng/mL during the screening period

    • Subjects who have been receiving ESAs:
  • Subjects with renal anemia who have been receiving ESA within the doses approved in Japan for more than 8 weeks after starting peritoneal dialysis, before the screening assessment
  • Mean of the subject's two most recent Hb values before randomization during the Screening Period must be ≥10.0 g/dL and ≤12.0 g/dL
  • TSAT ≥ 20% or serum ferritin ≥ 100 ng/mL during the screening period

Exclusion Criteria:

  • Subjects who had trouble with continuing peritoneal dialysis due to peritonitis, development of catheter trouble (e.g. tunnel infection) within 4 weeks before the screening assessment
  • Concurrent retinal neovascular lesion requiring treatment and macular edema requiring treatment
  • Concurrent autoimmune disease with inflammation that could impact erythropoiesis
  • History of gastric/intestinal resection considered influential on the absorption of drugs in the gastrointestinal tract (excluding resection of gastric or colon polyps) or concurrent gastro-paresis
  • Uncontrolled hypertension
  • Concurrent congestive heart failure (NYHA Class III or higher)
  • History of hospitalization for treatment of stroke, myocardial infarction, or pulmonary embolism within 12 weeks before the screening assessment
  • Positive for hepatitis B surface antigen (HBsAg) or anti-hepatitis C virus (HCV) antibody at the screening assessment, or positive for human immunodeficiency virus (HIV) in a past test
  • Concurrent other form of anemia than renal anemia
  • Having received treatment with protein anabolic hormone, testosterone enanthate, or mepitiostane within 6 weeks before the screening assessment
  • Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), total bilirubin, or Alkaline Phosphatase (ALP) that is greater than the criteria below, or previous or concurrent another serious liver disease at screening assessment
  • Previous or current malignant tumor (no recurrence for at least 5 years is eligible.)
  • Having undergone blood transfusion and/or a surgical procedure considered to promote anemia (excluding shunt reconstruction surgery for access to the blood) within 4 weeks before the screening assessment
  • Having undergone a kidney transplantation
  • Having a previous history of treatment with ASP1517
  • History of serious drug allergy including anaphylactic shock
  • Participation in another clinical study or post-marketing clinical study (including that of a medical device) within 12 weeks before informed consent acquisition

Sites / Locations

  • Site JP00002
  • Site JP00004
  • Site JP00010
  • Site JP00013
  • Site JP00001
  • Site JP00005
  • Site JP00012
  • Site JP00014
  • Site JP00006
  • Site JP00008
  • Site JP00003
  • SIte JP00015
  • Site JP00009
  • Site JP00007
  • Site JP00011

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

ASP1517 Low Dose Group (ESA Untreated)

ASP1517 High Dose Group (ESA Untreated)

ASP1517 ESAs Treated Group

Arm Description

This group includes subjects who have not received Erythropoieses Stimulating Agents (ESAs). Study drug will be dosed three times weekly and dose adjustments will be made during the study.

This group includes subjects who have not received ESAs. Study drug will be dosed three times weekly and dose adjustments will be made during the study.

This group includes subjects who have received ESAs. The treatment was converted from ESAs to study drug. Study drug will be dosed three times weekly and dose adjustments will be made during the study.

Outcomes

Primary Outcome Measures

Hemoglobin (Hb) Response Rate from Week 18 to Week 24
Hb response defined as average Hb within the target range in this outcome

Secondary Outcome Measures

Hb Response rate
Hb response is defined as reaching target values for Hb and change of Hb from baseline in this outcome.
Average Hb levels from week 18 to week 24
Change from baseline in the average Hb levels of week 18 to week 24
Rate of rise in Hb levels (g/dL/week)
Proportion of time points with target Hb levels
Proportion of participants who achieve the target Hb level at each week
Proportion of participants who achieve the lower limit of the target Hb level
Time to achieve the lower limit of the target Hb level
Change from baseline in Hb level at each week
Efficacy assessed by hematocrit
Hematocrit will be summarized by ASP1517 low dose Erythropoieses Stimulating Agent (ESA) untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.
Efficacy assessed by reticulocytes/ erythrocytes
Reticulocytes/Erythrocytes will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.
Efficacy assessed by Iron (Fe)
Fe will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.
Efficacy assessed by ferritin
Ferritin will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.
Efficacy assessed by transferrin
Transferrin will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.
Efficacy assessed by total iron binding capacity
Total iron binding capacity will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.
Efficacy assessed by soluble transferrin receptor
Soluble transferrin receptor will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.
Efficacy assessed by transferrin saturation
Transferrin saturation will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.
Efficacy assessed by reticulocyte hemoglobin content
Reticulocyte hemoglobin content will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.
Quality of life assessed by SF-36
SF-36: Medical Outcomes Study 36-Item Short-Form Health Survey
Quality of life assessed by EQ-5D
EQ-5D: EuroQol 5 Dimension
Quality of life assessed by FACT-An
FACT-An: Functional Assessment of Cancer Therapy-Anemia
Occurrence of hospitalizations
Safety assessed by incidence of adverse events
Number of participants with abnormal Vital signs and/or adverse events related to treatment
Safety assessed by standard 12-lead electrocardiogram
Number of participants with abnormal Laboratory values and/or adverse events related to treatment
Plasma concentration of unchanged ASP1517

Full Information

First Posted
May 20, 2016
Last Updated
December 19, 2019
Sponsor
Astellas Pharma Inc
Collaborators
FibroGen
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1. Study Identification

Unique Protocol Identification Number
NCT02780726
Brief Title
A Study of Intermittent Oral Dosing of ASP1517 in Peritoneal Dialysis Chronic Kidney Disease Patients With Anemia
Official Title
A Phase 3, Multi-center, Open-label Study of Intermittent Oral Dosing of ASP1517 in Peritoneal Dialysis Chronic Kidney Disease Patients With Anemia
Study Type
Interventional

2. Study Status

Record Verification Date
December 2019
Overall Recruitment Status
Completed
Study Start Date
June 22, 2016 (Actual)
Primary Completion Date
August 2, 2017 (Actual)
Study Completion Date
August 2, 2017 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The objective of this study is to evaluate the safety and efficacy of ASP1517 in peritoneal dialysis chronic kidney disease patients with anemia.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peritoneal Dialysis Chronic Kidney Disease Patients With Anemia
Keywords
Peritoneal dialysis, Roxadustat, Renal anemia, ASP1517

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
ASP1517 Low Dose Group (ESA Untreated)
Arm Type
Experimental
Arm Description
This group includes subjects who have not received Erythropoieses Stimulating Agents (ESAs). Study drug will be dosed three times weekly and dose adjustments will be made during the study.
Arm Title
ASP1517 High Dose Group (ESA Untreated)
Arm Type
Experimental
Arm Description
This group includes subjects who have not received ESAs. Study drug will be dosed three times weekly and dose adjustments will be made during the study.
Arm Title
ASP1517 ESAs Treated Group
Arm Type
Experimental
Arm Description
This group includes subjects who have received ESAs. The treatment was converted from ESAs to study drug. Study drug will be dosed three times weekly and dose adjustments will be made during the study.
Intervention Type
Drug
Intervention Name(s)
roxadustat
Other Intervention Name(s)
ASP1517
Intervention Description
Oral
Primary Outcome Measure Information:
Title
Hemoglobin (Hb) Response Rate from Week 18 to Week 24
Description
Hb response defined as average Hb within the target range in this outcome
Time Frame
Up to Week 24
Secondary Outcome Measure Information:
Title
Hb Response rate
Description
Hb response is defined as reaching target values for Hb and change of Hb from baseline in this outcome.
Time Frame
Up to Week 24
Title
Average Hb levels from week 18 to week 24
Time Frame
Up to week 24
Title
Change from baseline in the average Hb levels of week 18 to week 24
Time Frame
Baseline and up to Week 24
Title
Rate of rise in Hb levels (g/dL/week)
Time Frame
Up to Week 4
Title
Proportion of time points with target Hb levels
Time Frame
Up to Week 24
Title
Proportion of participants who achieve the target Hb level at each week
Time Frame
Up to Week 24
Title
Proportion of participants who achieve the lower limit of the target Hb level
Time Frame
Up to Week 24
Title
Time to achieve the lower limit of the target Hb level
Time Frame
Up to Week 24
Title
Change from baseline in Hb level at each week
Time Frame
Baseline and Up to Week 24
Title
Efficacy assessed by hematocrit
Description
Hematocrit will be summarized by ASP1517 low dose Erythropoieses Stimulating Agent (ESA) untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.
Time Frame
Up to Week 24
Title
Efficacy assessed by reticulocytes/ erythrocytes
Description
Reticulocytes/Erythrocytes will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.
Time Frame
Up to Week 24
Title
Efficacy assessed by Iron (Fe)
Description
Fe will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.
Time Frame
Up to Week 24
Title
Efficacy assessed by ferritin
Description
Ferritin will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.
Time Frame
Up to Week 24
Title
Efficacy assessed by transferrin
Description
Transferrin will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.
Time Frame
Up to Week 24
Title
Efficacy assessed by total iron binding capacity
Description
Total iron binding capacity will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.
Time Frame
Up to Week 24
Title
Efficacy assessed by soluble transferrin receptor
Description
Soluble transferrin receptor will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.
Time Frame
Up to Week 24
Title
Efficacy assessed by transferrin saturation
Description
Transferrin saturation will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.
Time Frame
Up to Week 24
Title
Efficacy assessed by reticulocyte hemoglobin content
Description
Reticulocyte hemoglobin content will be summarized by ASP1517 low dose ESA untreated group, ASP1517 high dose ESA untreated group and ASP1517 ESAs treated Group.
Time Frame
Up to Week 24
Title
Quality of life assessed by SF-36
Description
SF-36: Medical Outcomes Study 36-Item Short-Form Health Survey
Time Frame
Up to Week 24
Title
Quality of life assessed by EQ-5D
Description
EQ-5D: EuroQol 5 Dimension
Time Frame
Up to Week 24
Title
Quality of life assessed by FACT-An
Description
FACT-An: Functional Assessment of Cancer Therapy-Anemia
Time Frame
Up to Week 24
Title
Occurrence of hospitalizations
Time Frame
Up to Week 24
Title
Safety assessed by incidence of adverse events
Time Frame
Up to Week 24
Title
Number of participants with abnormal Vital signs and/or adverse events related to treatment
Time Frame
Up to Week 24
Title
Safety assessed by standard 12-lead electrocardiogram
Time Frame
Up to Week 24
Title
Number of participants with abnormal Laboratory values and/or adverse events related to treatment
Time Frame
Up to Week 24
Title
Plasma concentration of unchanged ASP1517
Time Frame
Up to Week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Female subject must either: Be of non-childbearing potential: post-menopausal (defined as at least 1 year without any menses) prior to Screening, or documented surgically sterile Or, if of childbearing potential, Agree not to try to become pregnant during the study and for 28 days after the final study drug administration And have a negative pregnancy test at Screening And, if heterosexually active, agree to consistently use two forms of highly effective form of birth control (at least one of which must be a barrier method) starting at Screening and throughout the study period and continued for 28 days after the final study drug administration. Female subject must agree not to breastfeed starting at Screening and throughout the study period, and continued for 28 days after the final study drug administration. Female subject must not donate ova starting at Screening and throughout the study period, and continued for 28 days after the final study drug administration. Male subject and their female spouse/partners who are of childbearing potential must be using two forms of highly effective form of birth control (at least one of which must be a barrier method) starting at Screening and continue throughout the study period, and for 12 weeks after the final study drug administration Male subject must not donate sperm starting at Screening and throughout the study period and, for 12 weeks after the final study drug administration Subjects who have not received Erythropoieses Stimulating Agents (ESAs): Subjects who have been receiving peritoneal dialysis for more than 4 weeks before the screening assessment Subjects who have never received ESAs after starting peritoneal dialysis, or subjects who have not received ESAs within 6 weeks before the screening assessment. Mean of the subject's two most recent Hb values before randomization during the Screening Period must be <10.5 g/dL with an absolute difference ≤1.3 g/dL between the two values Either transferrin saturation (TSAT) ≥ 5% or serum ferritin ≥ 30 ng/mL during the screening period Subjects who have been receiving ESAs: Subjects with renal anemia who have been receiving ESA within the doses approved in Japan for more than 8 weeks after starting peritoneal dialysis, before the screening assessment Mean of the subject's two most recent Hb values before randomization during the Screening Period must be ≥10.0 g/dL and ≤12.0 g/dL TSAT ≥ 20% or serum ferritin ≥ 100 ng/mL during the screening period Exclusion Criteria: Subjects who had trouble with continuing peritoneal dialysis due to peritonitis, development of catheter trouble (e.g. tunnel infection) within 4 weeks before the screening assessment Concurrent retinal neovascular lesion requiring treatment and macular edema requiring treatment Concurrent autoimmune disease with inflammation that could impact erythropoiesis History of gastric/intestinal resection considered influential on the absorption of drugs in the gastrointestinal tract (excluding resection of gastric or colon polyps) or concurrent gastro-paresis Uncontrolled hypertension Concurrent congestive heart failure (NYHA Class III or higher) History of hospitalization for treatment of stroke, myocardial infarction, or pulmonary embolism within 12 weeks before the screening assessment Positive for hepatitis B surface antigen (HBsAg) or anti-hepatitis C virus (HCV) antibody at the screening assessment, or positive for human immunodeficiency virus (HIV) in a past test Concurrent other form of anemia than renal anemia Having received treatment with protein anabolic hormone, testosterone enanthate, or mepitiostane within 6 weeks before the screening assessment Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), total bilirubin, or Alkaline Phosphatase (ALP) that is greater than the criteria below, or previous or concurrent another serious liver disease at screening assessment Previous or current malignant tumor (no recurrence for at least 5 years is eligible.) Having undergone blood transfusion and/or a surgical procedure considered to promote anemia (excluding shunt reconstruction surgery for access to the blood) within 4 weeks before the screening assessment Having undergone a kidney transplantation Having a previous history of treatment with ASP1517 History of serious drug allergy including anaphylactic shock Participation in another clinical study or post-marketing clinical study (including that of a medical device) within 12 weeks before informed consent acquisition
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 JP00002
City
Aichi
Country
Japan
Facility Name
Site JP00004
City
Aichi
Country
Japan
Facility Name
Site JP00010
City
Aichi
Country
Japan
Facility Name
Site JP00013
City
Aichi
Country
Japan
Facility Name
Site JP00001
City
Fukuoka
Country
Japan
Facility Name
Site JP00005
City
Fukuoka
Country
Japan
Facility Name
Site JP00012
City
Hokkaido
Country
Japan
Facility Name
Site JP00014
City
Hokkaido
Country
Japan
Facility Name
Site JP00006
City
Ishikawa
Country
Japan
Facility Name
Site JP00008
City
Kanagawa
Country
Japan
Facility Name
Site JP00003
City
Nagano
Country
Japan
Facility Name
SIte JP00015
City
Okayama
Country
Japan
Facility Name
Site JP00009
City
Osaka
Country
Japan
Facility Name
Site JP00007
City
Tokushima
Country
Japan
Facility Name
Site JP00011
City
Toyama
Country
Japan

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Access to anonymized individual participant level data collected during the study, in addition to study-related supporting documentation, is planned for studies conducted with approved product indications and formulations, as well as compounds terminated during development. Studies conducted with product indications or formulations that remain active in development are assessed after study completion to determine if Individual Participant Data can be shared. Conditions and exceptions are described under the Sponsor Specific Details for Astellas on www.clinicalstudydatarequest.com.
IPD Sharing Time Frame
Access to participant level data is offered to researchers after publication of the primary manuscript (if applicable) and is available as long as Astellas has legal authority to provide the data.
IPD Sharing Access Criteria
Researchers must submit a proposal to conduct a scientifically relevant analysis of the study data. The research proposal is reviewed by an Independent Research Panel. If the proposal is approved, access to the study data is provided in a secure data sharing environment after receipt of a signed Data Sharing Agreement.
IPD Sharing URL
https://www.clinicalstudydatarequest.com/
Citations:
PubMed Identifier
36005278
Citation
Natale P, Palmer SC, Jaure A, Hodson EM, Ruospo M, Cooper TE, Hahn D, Saglimbene VM, Craig JC, Strippoli GF. Hypoxia-inducible factor stabilisers for the anaemia of chronic kidney disease. Cochrane Database Syst Rev. 2022 Aug 25;8(8):CD013751. doi: 10.1002/14651858.CD013751.pub2.
Results Reference
derived
Links:
URL
https://astellasclinicalstudyresults.com/study.aspx?ID=354
Description
Link to results on Astellas Clinical Study Results website

Learn more about this trial

A Study of Intermittent Oral Dosing of ASP1517 in Peritoneal Dialysis Chronic Kidney Disease Patients With Anemia

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