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Hemoglobin Maintenance in Pediatric ESRD (End-stage Renal Disease) Patients by Ferric Pyrophosphate Citrate (FPC)

Primary Purpose

End Stage Renal Disease

Status
Recruiting
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Triferic
Sponsored by
Rockwell Medical Technologies, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for End Stage Renal Disease focused on measuring dialysis, pediatric, chronic kidney disease, anemia

Eligibility Criteria

6 Months - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

A patient will be eligible for inclusion in the study only if all of the following criteria are met:

  1. Parents/legal guardians of the patient have the ability to understand the requirements of the study and have demonstrated a willingness to have their child comply with all study procedures by signing an institutional review board-approved informed consent form. Where applicable, assent of the patient has also been obtained for all study procedures prior to any study-related activities.
  2. Patient is between 6 months and <18 years of age at screening.
  3. Patient has chronic kidney disease receiving in-center hemodialysis at least twice weekly for at least 3 months prior to screening.
  4. Patient is receiving adequate hemodialysis as assessed by the investigator and based on a single pool Kt/V measurement >1.2.
  5. Patient has a vascular access (tunneled catheter, AV fistula or AV graft) suitable to support blood flows for hemodialysis treatment.
  6. Patient has a body mass of ≥11 lbs (5 kg).
  7. Patient is iron-replete as measured by a TSAT ≥ 20% and a ferritin >100 µg/L at screening.
  8. Patient has a whole blood Hgb concentration of ≥ 9.5 g/dL at screening.
  9. If the patient is female, she must be pre-pubertal, have had documented surgical sterilization prior to Baseline admission, or be practicing adequate birth control. All female patients who have reached menarche must have a negative serum pregnancy test during screening. It is the investigator's responsibility to determine whether the patient has adequate birth control for study participation.
  10. Patients who have experienced a previous adverse event with IV iron products are eligible to participate in this study if the agent that caused the event is not administered during the Baseline period.

Exclusion Criteria:

A patient will not be eligible for inclusion in the study if any of the following criteria apply:

  1. Patient is positive for human immunodeficiency virus (HIV) or hepatitis B by history.
  2. Patient is receiving intravenous or oral antibiotics or antifungals for any infectious process. (Prophylactic antibiotics administered on a regular basis are allowed. Patients may enter the study once the infection has cleared.)
  3. Patient has evidence of an ongoing active inflammatory process (e.g., systemic lupus erythematosus, acute or chronic active hepatitis, etc.) requiring treatment.
  4. Patient has been dosed in an investigational drug study within the 30 days prior to Baseline.
  5. Administration of iron containing phosphate binder ferric citrate (Auryxia) or sucroferric oxyhydroxide (Velphoro) within 2 weeks prior to Baseline. (Patient is only eligible if iron based binders are stopped at least 2 weeks prior to Baseline).

Sites / Locations

  • Loma Linda University HospitalRecruiting
  • Childrens Hospital National Medical CenterRecruiting
  • Riley Hospital for Children at Indiana UniversityRecruiting
  • Children's Mercy HospitalRecruiting
  • Carolina's Medical CenterRecruiting
  • Cincinnati Children's HospitalRecruiting
  • University of Texas Health Science Center At San AntonioRecruiting
  • Childrens Hospital and Medical Center- SeattleRecruiting
  • University of Puerto Rico School of MedicineRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Triferic via IV and Hemodialysate

Historic Control Observational Arm

Arm Description

Upon completion of the Baseline observational periods, all enrolled patients will transition to the interventional period where they will then receive Triferic. The Triferic will be administered via the liquid bicarbonate concentrate at a dialysate concentration of 2 uM or via IV at a dose of 0.1 mg Fe/kg, if the patient does not receive dialysis using liquid bicarbonate, for up to an additional 36 weeks (depending on duration of observational Baseline period). Hgb and CHr will continue to be measured bi-weekly and iron profiles will be obtained at 4 week intervals. In the Triferic phase of the study,changes in ESA dose will be allowed according to the study site existing protocol. IV iron will only be administered if ferritin meets the criteria for iron deficiency. Patients will remain in the interventional period for either 36 or 28 weeks (depending on randomization assignment), at which time a final study visit will take place

Up to 75 patients will be enrolled in the Observational Arm. Patients who participate in the historical control observational arm will not receive any study medication, but will have Hgb, CHr and serum iron profiles collected at 4 week intervals for up to a total of 44 weeks.

Outcomes

Primary Outcome Measures

Assess the incidence of adverse events of Triferic administration via dialysate and IV in pediatric CKD-5HD patients
Incidence and severity of adverse events compared to Baseline.

Secondary Outcome Measures

Assess the ability of Triferic to maintain hemoglobin in pediatric CKD-5HD patients
Change from Baseline in hemoglobin concentration
Assess the proportion of patients maintaining hemoglobin between 10.5-12.0 g/dL compared to baseline
Proportion of patients maintaining hemoglobin between 10.5 - 12.0 g/dL compared toBaseline
Assess the change in reticulocyte hemoglobin content (CHr).
Change from Baseline in reticulocyte hemoglobin content (CHr).

Full Information

First Posted
January 20, 2020
Last Updated
April 19, 2021
Sponsor
Rockwell Medical Technologies, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04239391
Brief Title
Hemoglobin Maintenance in Pediatric ESRD (End-stage Renal Disease) Patients by Ferric Pyrophosphate Citrate (FPC)
Official Title
Hemoglobin Maintenance in Pediatric ESRD Patients by Ferric Pyrophosphate Citrate (FPC)
Study Type
Interventional

2. Study Status

Record Verification Date
February 2021
Overall Recruitment Status
Recruiting
Study Start Date
September 1, 2020 (Actual)
Primary Completion Date
August 31, 2023 (Anticipated)
Study Completion Date
November 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Rockwell Medical Technologies, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The main purpose is to determine the safety of Triferic iron administered via dialysate and intravenously in pediatric patients with chronic kidney disease on chronic hemodialysis (CKD-5HD). It is a global, multi- center, open-label study.
Detailed Description
This is a global, multi- center, multi dose, open-label study assessing the safety of Triferic iron administered via dialysate and intravenously to pediatric patients (< 18 years of age) receiving chronic hemodialysis (CKD-5HD). Total participation in the study is approximately 44 weeks and is comprised of a screening visit, baseline, open label treatment, and a follow-up visit. Upon completion of the respective Baseline observational periods, all patients will transition to the interventional period where they will receive Triferic. The Triferic will be administered via the liquid bicarbonate or via IV. Once patients enter the interventional period, IV iron will only be administered if ferritin <100 µg/L and Hgb decreases by ≥0.5g/dL from the last value obtained in the observational Baseline period. Patients will remain in the interventional period for either 36 or 28 weeks (depending on randomization assignment), at which time a final study visit will take place.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
End Stage Renal Disease
Keywords
dialysis, pediatric, chronic kidney disease, anemia

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Triferic via IV and Hemodialysate
Arm Type
Experimental
Arm Description
Upon completion of the Baseline observational periods, all enrolled patients will transition to the interventional period where they will then receive Triferic. The Triferic will be administered via the liquid bicarbonate concentrate at a dialysate concentration of 2 uM or via IV at a dose of 0.1 mg Fe/kg, if the patient does not receive dialysis using liquid bicarbonate, for up to an additional 36 weeks (depending on duration of observational Baseline period). Hgb and CHr will continue to be measured bi-weekly and iron profiles will be obtained at 4 week intervals. In the Triferic phase of the study,changes in ESA dose will be allowed according to the study site existing protocol. IV iron will only be administered if ferritin meets the criteria for iron deficiency. Patients will remain in the interventional period for either 36 or 28 weeks (depending on randomization assignment), at which time a final study visit will take place
Arm Title
Historic Control Observational Arm
Arm Type
No Intervention
Arm Description
Up to 75 patients will be enrolled in the Observational Arm. Patients who participate in the historical control observational arm will not receive any study medication, but will have Hgb, CHr and serum iron profiles collected at 4 week intervals for up to a total of 44 weeks.
Intervention Type
Drug
Intervention Name(s)
Triferic
Other Intervention Name(s)
FPC
Intervention Description
Ferric Pyrophosphate Citrate
Primary Outcome Measure Information:
Title
Assess the incidence of adverse events of Triferic administration via dialysate and IV in pediatric CKD-5HD patients
Description
Incidence and severity of adverse events compared to Baseline.
Time Frame
44 weeks
Secondary Outcome Measure Information:
Title
Assess the ability of Triferic to maintain hemoglobin in pediatric CKD-5HD patients
Description
Change from Baseline in hemoglobin concentration
Time Frame
44 weeks
Title
Assess the proportion of patients maintaining hemoglobin between 10.5-12.0 g/dL compared to baseline
Description
Proportion of patients maintaining hemoglobin between 10.5 - 12.0 g/dL compared toBaseline
Time Frame
44 weeks
Title
Assess the change in reticulocyte hemoglobin content (CHr).
Description
Change from Baseline in reticulocyte hemoglobin content (CHr).
Time Frame
44 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Months
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: A patient will be eligible for inclusion in the study only if all of the following criteria are met: Parents/legal guardians of the patient have the ability to understand the requirements of the study and have demonstrated a willingness to have their child comply with all study procedures by signing an institutional review board-approved informed consent form. Where applicable, assent of the patient has also been obtained for all study procedures prior to any study-related activities. Patient is between 6 months and <18 years of age at screening. Patient has chronic kidney disease receiving in-center hemodialysis at least twice weekly for at least 3 months prior to screening. Patient is receiving adequate hemodialysis as assessed by the investigator and based on a single pool Kt/V measurement >1.2. Patient has a vascular access (tunneled catheter, AV fistula or AV graft) suitable to support blood flows for hemodialysis treatment. Patient has a body mass of ≥11 lbs (5 kg). Patient is iron-replete as measured by a TSAT ≥ 20% and a ferritin >100 µg/L at screening. Patient has a whole blood Hgb concentration of ≥ 9.5 g/dL at screening. If the patient is female, she must be pre-pubertal, have had documented surgical sterilization prior to Baseline admission, or be practicing adequate birth control. All female patients who have reached menarche must have a negative serum pregnancy test during screening. It is the investigator's responsibility to determine whether the patient has adequate birth control for study participation. Patients who have experienced a previous adverse event with IV iron products are eligible to participate in this study if the agent that caused the event is not administered during the Baseline period. Exclusion Criteria: A patient will not be eligible for inclusion in the study if any of the following criteria apply: Patient is positive for human immunodeficiency virus (HIV) or hepatitis B by history. Patient is receiving intravenous or oral antibiotics or antifungals for any infectious process. (Prophylactic antibiotics administered on a regular basis are allowed. Patients may enter the study once the infection has cleared.) Patient has evidence of an ongoing active inflammatory process (e.g., systemic lupus erythematosus, acute or chronic active hepatitis, etc.) requiring treatment. Patient has been dosed in an investigational drug study within the 30 days prior to Baseline. Administration of iron containing phosphate binder ferric citrate (Auryxia) or sucroferric oxyhydroxide (Velphoro) within 2 weeks prior to Baseline. (Patient is only eligible if iron based binders are stopped at least 2 weeks prior to Baseline).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Emily Akin
Phone
913-485-9082
Email
eakin@georgeclinical.com
First Name & Middle Initial & Last Name or Official Title & Degree
Terrilyn Sharpe, MSHS
Phone
248-819-3088
Email
tsharpe@rockwellmed.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Raymond D Pratt, MD FACP
Organizational Affiliation
Rockwell Medical, Inc
Official's Role
Study Director
Facility Information:
Facility Name
Loma Linda University Hospital
City
Loma Linda
State/Province
California
ZIP/Postal Code
92354
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jacqueline Lopez
Email
JANLopez@llu.edu
First Name & Middle Initial & Last Name & Degree
Rita Sheth, MD
Facility Name
Childrens Hospital National Medical Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20010
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nadia Itani
Email
njitani@childrensnational.org
First Name & Middle Initial & Last Name & Degree
Marva Moxey Mims, MD
Facility Name
Riley Hospital for Children at Indiana University
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sherry Wilson
Email
slw2@iu.edu
First Name & Middle Initial & Last Name & Degree
Neha Pottanat, MD
Facility Name
Children's Mercy Hospital
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64108
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Stephen Morrison
Email
ssmorison@cmh.edu
First Name & Middle Initial & Last Name & Degree
Bradley Warady, MD
Facility Name
Carolina's Medical Center
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28203
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jennifer Lamothe
Phone
704-446-3705
Email
jennifer.lamothe@atriumhealth.org
First Name & Middle Initial & Last Name & Degree
Donald Weaver, MD
Facility Name
Cincinnati Children's Hospital
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Bliss Magella
Phone
513-636-7832
Email
Bliss.Magella@cchmc.org
First Name & Middle Initial & Last Name & Degree
Francisco Flores, MD
Facility Name
University of Texas Health Science Center At San Antonio
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sonia Januario
Email
januario@uthscsa.edu
First Name & Middle Initial & Last Name & Degree
Mazen Arar, MD
Facility Name
Childrens Hospital and Medical Center- Seattle
City
Seattle
State/Province
Washington
ZIP/Postal Code
98105
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Megan Kelton
Phone
206-987-5539
Email
Megan.Kelton@seattlechildrens.org
First Name & Middle Initial & Last Name & Degree
Jodi Smith, MD
Facility Name
University of Puerto Rico School of Medicine
City
San Juan
ZIP/Postal Code
00963-5067
Country
Puerto Rico
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marta Suarez, MD
Phone
787-759-9595
Email
marta.suarez@upr.edu

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Hemoglobin Maintenance in Pediatric ESRD (End-stage Renal Disease) Patients by Ferric Pyrophosphate Citrate (FPC)

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