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Study of HEMAX PFS Versus EPREX/ ERYPO® in Predialysis Chronic Kidney Disease

Primary Purpose

Anemia of Chronic Kidney Disease

Status
Unknown status
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Erythropoietin alfa
Sponsored by
Bio Sidus SA
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 epoetin, erythropoietin, Eprex, Hemax, Anemia, Chronic Kidney Disease, pre-dialysis

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients older than 18 years
  • Patients with pre-dialysis chronic renal failure (CRF) defined by a glomerular filtration rate (calculated with the Modification of Diet in Renal Disease Study formula) ≥15 ml/ min and <60 ml/ min, by 1.73 m2
  • Anemic patients that should be treated and levels of hemoglobin <10.5 g/dl and ≥ 7.5 g/dl.
  • Patients that have the will and capacity to sign a written inform consent.
  • Post-menopause women for at least 2 years, or sterile by surgery for at least 6 months. Women of childbearing age must have a negative pregnancy test at baseline and be willing to get an adequate method of contraception.

Exclusion Criteria:

  • Patients that are planned to be on dialysis or have a renal transplant in the following 6 months.
  • Transferrin iron Saturation < 20%.
  • Etiology of renal failure (as secondary to autoimmune diseases) that, to the judge to the physician, can affect the normal development of the protocol.
  • Active bleeding or history of hemorrhage that have led to a significative decrease of hematocrit in the last 30 days.
  • Non-controlled hypertension (≥160 mm Hg of systolic pressure and/or ≥100 mm Hg of diastolic pressure with anti-hypertensive treatment).
  • Anemia caused by any other cause than renal disease.
  • Having a transfusion in the last 3 months before basal visit or during screening.
  • Treatment with an erythropoiesis stimulant in the last 3 months before basal visit or screening.
  • Increase risk of thromboembolic disease: history of arterial thromboembolia (stroke, transient ischemic attack, Acute coronary syndrome, etc.) in the last 6 months or venous in the last 12 months before screening; surgery in the last month before screening; prolong immobilization or orthopedic surgery programmed in the following 6 months or any other condition that to the judge of the investigator can increase the risk of thromboembolism.
  • Hematological disease or myelodysplastic syndrome or history of hematological neoplasm or solid tumor in the last 5 years.
  • History of congestive heart failure
  • Pregnancy or breast feeding
  • Refuse to participate in the protocol or any medical condition, that in the investigator opinion, is significant to prevent the participant from being included in the trial.

Sites / Locations

  • CEMEDIC
  • CEREHA
  • CIMEL
  • CIPREC (Centro de Investigación y Prevención Cardiovascular)
  • GEMA Consultorio
  • Hospital Argerich
  • Hospital Británico de Buenos Aires
  • Hospital Durand
  • Hospital Fernandez
  • Hospital Ramos Mejía
  • IPHIC

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Eprex/Erypo

Hemax PFS

Arm Description

Receive EPREX/ ERYPO® subcutaneously with an initial dose of 29 IU/ kg twice a week (2000 IU twice a week for 70 kg of weight), to be titrated according to the scheme that is summarized below. There will be a follow - up of patients with visits to the site every two weeks during the first 12 weeks of dose titration that will be followed by 12 additional weeks of dose maintenance with visits every 4 weeks.

receive HEMAX® PFS subcutaneously with an initial dose of 29 IU/ kg twice a week (2000 IU twice a week for 70 kg of weight), to be titrated according to the scheme that is summarized below. There will be a follow - up of patients with visits to the site every two weeks during the first 12 weeks of dose titration that will be followed by 12 additional weeks of dose maintenance with visits every 4 weeks.

Outcomes

Primary Outcome Measures

Efficacy Evaluation through the increase of Hemoglobin levels
Evaluate the efficacy of treatment with erythropoietin alfa through increased levels of hemoglobin from baseline value to the mean value of the 8 to 12 weeks of treatment, comparing patients treated with HEMAX® PFS versus EPREX/ ERYPO®.
Adverse Events and Adverse Reactions (safety and tolerability) at week 12
Evaluate the safety through the incidence of adverse events and adverse reactions after 12 and 24 weeks of treatment, comparing patients treated with HEMAX® PFS versus those treated with EPREX/ ERYPO®.
Adverse Events and Adverse Reactions (safety and tolerability) at week 24
Evaluate the safety through the incidence of adverse events and adverse reactions after 12 and 24 weeks of treatment, comparing patients treated with HEMAX® PFS versus those treated with EPREX/ ERYPO®.

Secondary Outcome Measures

Percentage of responders patients
Evaluate the efficacy of treatment with erythropoietin alfa through the percentage of responder patients (increase of Hb ≥ 1g/ dl) after 12 weeks of treatment, comparing patients treated with HEMAX® PFS versus those treated with EPREX/ ERYPO®.
Percentage of patients that required any Transfusion
Evaluate the percentage of transfusional requirement after 12 weeks of treatment, comparing patients treated with HEMAX PFS versus those treated with EPREX/ ERYPO®.
Change of Hemoglobin level at week 12 of treatment
Evaluate the efficacy between arms (HEMAX® PFS and EPREX/ ERYPO®) of treatment with erythropoietin alfa through the change in the level of hemoglobin from baseline in every visit until the week 12 visit.
Evaluate the efficacy between arms 24 weeks: week doses in the titration
Evaluate the efficacy between arms (HEMAX® PFS and EPREX/ ERYPO®) of the change from the twice - a - week doses in the titration phase to a weekly dose in the maintenance phase through the changes in the hemoglobin levels from week 12 to weeks 16, 20 and 24 of treatment
Incidence of anti-drug antibodies (immunogenicity)
An anti-erythropoietin alfa antibody determination will be performed to evaluate treatment immunogenicity at week 12 and 24 visit
Concentration of Hepcidin
Hepcidin will be analyzed by ELISA at baseline, week 12 and 24 in order to evaluate the treatment response.

Full Information

First Posted
July 12, 2019
Last Updated
January 26, 2021
Sponsor
Bio Sidus SA
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1. Study Identification

Unique Protocol Identification Number
NCT04036253
Brief Title
Study of HEMAX PFS Versus EPREX/ ERYPO® in Predialysis Chronic Kidney Disease
Official Title
A Randomized, Comparative Study of HEMAX PFS® Versus EPREX/ ERYPO® in the Treatment of Anemia With Epoetin Alfa in Patients With Predialysis Chronic Kidney Disease
Study Type
Interventional

2. Study Status

Record Verification Date
January 2021
Overall Recruitment Status
Unknown status
Study Start Date
February 28, 2018 (Actual)
Primary Completion Date
July 30, 2021 (Anticipated)
Study Completion Date
January 30, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Bio Sidus SA

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Phase III, multicenter, randomized, open, controlled clinical trial. A study designed as phase III, in 120 patients with chronic renal failure in the pre-dialysis stage, evaluate efficacy and safety of Hemax PFS® (PFS: prefilled syringes) vs the innovator erythropoietin alfa product (Eprex®).

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
epoetin, erythropoietin, Eprex, Hemax, Anemia, Chronic Kidney Disease, pre-dialysis

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Eprex/Erypo
Arm Type
Active Comparator
Arm Description
Receive EPREX/ ERYPO® subcutaneously with an initial dose of 29 IU/ kg twice a week (2000 IU twice a week for 70 kg of weight), to be titrated according to the scheme that is summarized below. There will be a follow - up of patients with visits to the site every two weeks during the first 12 weeks of dose titration that will be followed by 12 additional weeks of dose maintenance with visits every 4 weeks.
Arm Title
Hemax PFS
Arm Type
Experimental
Arm Description
receive HEMAX® PFS subcutaneously with an initial dose of 29 IU/ kg twice a week (2000 IU twice a week for 70 kg of weight), to be titrated according to the scheme that is summarized below. There will be a follow - up of patients with visits to the site every two weeks during the first 12 weeks of dose titration that will be followed by 12 additional weeks of dose maintenance with visits every 4 weeks.
Intervention Type
Biological
Intervention Name(s)
Erythropoietin alfa
Intervention Description
Prefilled syringes of erythropoietin
Primary Outcome Measure Information:
Title
Efficacy Evaluation through the increase of Hemoglobin levels
Description
Evaluate the efficacy of treatment with erythropoietin alfa through increased levels of hemoglobin from baseline value to the mean value of the 8 to 12 weeks of treatment, comparing patients treated with HEMAX® PFS versus EPREX/ ERYPO®.
Time Frame
12 weeks of treatment
Title
Adverse Events and Adverse Reactions (safety and tolerability) at week 12
Description
Evaluate the safety through the incidence of adverse events and adverse reactions after 12 and 24 weeks of treatment, comparing patients treated with HEMAX® PFS versus those treated with EPREX/ ERYPO®.
Time Frame
12 weeks of treatment
Title
Adverse Events and Adverse Reactions (safety and tolerability) at week 24
Description
Evaluate the safety through the incidence of adverse events and adverse reactions after 12 and 24 weeks of treatment, comparing patients treated with HEMAX® PFS versus those treated with EPREX/ ERYPO®.
Time Frame
24 weeks of treatment
Secondary Outcome Measure Information:
Title
Percentage of responders patients
Description
Evaluate the efficacy of treatment with erythropoietin alfa through the percentage of responder patients (increase of Hb ≥ 1g/ dl) after 12 weeks of treatment, comparing patients treated with HEMAX® PFS versus those treated with EPREX/ ERYPO®.
Time Frame
12 weeks of treatment
Title
Percentage of patients that required any Transfusion
Description
Evaluate the percentage of transfusional requirement after 12 weeks of treatment, comparing patients treated with HEMAX PFS versus those treated with EPREX/ ERYPO®.
Time Frame
12 weeks of treatment
Title
Change of Hemoglobin level at week 12 of treatment
Description
Evaluate the efficacy between arms (HEMAX® PFS and EPREX/ ERYPO®) of treatment with erythropoietin alfa through the change in the level of hemoglobin from baseline in every visit until the week 12 visit.
Time Frame
Intragroup efficacy until week 12
Title
Evaluate the efficacy between arms 24 weeks: week doses in the titration
Description
Evaluate the efficacy between arms (HEMAX® PFS and EPREX/ ERYPO®) of the change from the twice - a - week doses in the titration phase to a weekly dose in the maintenance phase through the changes in the hemoglobin levels from week 12 to weeks 16, 20 and 24 of treatment
Time Frame
Intragroup efficacy until week 24
Title
Incidence of anti-drug antibodies (immunogenicity)
Description
An anti-erythropoietin alfa antibody determination will be performed to evaluate treatment immunogenicity at week 12 and 24 visit
Time Frame
12 and 24 weeks of treatment
Title
Concentration of Hepcidin
Description
Hepcidin will be analyzed by ELISA at baseline, week 12 and 24 in order to evaluate the treatment response.
Time Frame
24 weeks of treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients older than 18 years Patients with pre-dialysis chronic renal failure (CRF) defined by a glomerular filtration rate (calculated with the Modification of Diet in Renal Disease Study formula) ≥15 ml/ min and <60 ml/ min, by 1.73 m2 Anemic patients that should be treated and levels of hemoglobin <10.5 g/dl and ≥ 7.5 g/dl. Patients that have the will and capacity to sign a written inform consent. Post-menopause women for at least 2 years, or sterile by surgery for at least 6 months. Women of childbearing age must have a negative pregnancy test at baseline and be willing to get an adequate method of contraception. Exclusion Criteria: Patients that are planned to be on dialysis or have a renal transplant in the following 6 months. Transferrin iron Saturation < 20%. Etiology of renal failure (as secondary to autoimmune diseases) that, to the judge to the physician, can affect the normal development of the protocol. Active bleeding or history of hemorrhage that have led to a significative decrease of hematocrit in the last 30 days. Non-controlled hypertension (≥160 mm Hg of systolic pressure and/or ≥100 mm Hg of diastolic pressure with anti-hypertensive treatment). Anemia caused by any other cause than renal disease. Having a transfusion in the last 3 months before basal visit or during screening. Treatment with an erythropoiesis stimulant in the last 3 months before basal visit or screening. Increase risk of thromboembolic disease: history of arterial thromboembolia (stroke, transient ischemic attack, Acute coronary syndrome, etc.) in the last 6 months or venous in the last 12 months before screening; surgery in the last month before screening; prolong immobilization or orthopedic surgery programmed in the following 6 months or any other condition that to the judge of the investigator can increase the risk of thromboembolism. Hematological disease or myelodysplastic syndrome or history of hematological neoplasm or solid tumor in the last 5 years. History of congestive heart failure Pregnancy or breast feeding Refuse to participate in the protocol or any medical condition, that in the investigator opinion, is significant to prevent the participant from being included in the trial.
Facility Information:
Facility Name
CEMEDIC
City
Buenos Aires
Country
Argentina
Facility Name
CEREHA
City
Buenos Aires
Country
Argentina
Facility Name
CIMEL
City
Buenos Aires
Country
Argentina
Facility Name
CIPREC (Centro de Investigación y Prevención Cardiovascular)
City
Caba
Country
Argentina
Facility Name
GEMA Consultorio
City
Caba
Country
Argentina
Facility Name
Hospital Argerich
City
Caba
Country
Argentina
Facility Name
Hospital Británico de Buenos Aires
City
Caba
Country
Argentina
Facility Name
Hospital Durand
City
Caba
Country
Argentina
Facility Name
Hospital Fernandez
City
Caba
Country
Argentina
Facility Name
Hospital Ramos Mejía
City
Caba
Country
Argentina
Facility Name
IPHIC
City
Asunción
Country
Paraguay

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Study of HEMAX PFS Versus EPREX/ ERYPO® in Predialysis Chronic Kidney Disease

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