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Ferric Citrate for the Treatment of Hyperphosphatemia in Patients With Chronic Kidney Disease Undergoing Hemodialysis

Primary Purpose

Hyperphosphatemia, End Stage Renal Disease, ESRD

Status
Unknown status
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
Ferric citrate tablet
Sevelamer carbonate tablet
Sponsored by
Sinomune Pharmaceutical Co., Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hyperphosphatemia

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Between the age of 18 and 75 years (including the boundary value) and no gender limitation;
  2. Patients who maintain the hemodialysis schedule (including hemofiltration (HF) hemodialysis (HDF) hemoperfusion (HP)) as not less than 3 times a week in the 3 months before random enrollment.
  3. Patients with a serum phosphorus level between 1.97 to 3.23 mmol/L (excluding the boundary value) after washout.
  4. Kt/Vurea ≥1.2 or URR ≥65%.
  5. Before the screening period, CKD-MBD related drug treatment is stable for more than one month, including the use of vitamin D (active vitamin D, vitamin D analogues, etc.) or calcimimetics (cinacalcet, etc.) and the dose remains unchanged.
  6. The expected survival is greater than 6 months.
  7. Willing to give written informed consent.

Exclusion Criteria:

  1. Patients with a serum ferritin level ≥800 ng/mL or TSAT ≥50%.
  2. Patients with hemochromatosis or patients receiving treatment for iron overload, or patients with paroxysmal sleep hemoglobinuria.
  3. Patients who received blood transfusions within 3 months prior to Screening, or patients with hemoglobin ≤60 g/L.
  4. Patients with intact-PTH >1000 pg/mL
  5. Patients complicated with any of the following gastrointestinal diseases: acute peptic ulcer, chronic ulcerative colitis, localized enteritis, intestinal obstruction, habitual constipation (number of stools once per week), and chronic diarrhea (number of stools four times per day), or patients with a history of gastrectomy or enterectomy or patients who had undergone gastrointestinal surgery within 3 months prior to Screening, or patients with dysphagia.
  6. Patients with impaired liver function (hepatic dysfunction or serum total bilirubin, aspartate aminotransferase or alanine aminotransferase ≥ 2 times the upper limit of normal) or patients with cirrhosis.
  7. Patients with a history of parathyroidectomy (PTx) or percutaneous anhydrous ethanol injection (PEIT) within 6 months.
  8. Patients with uncontrolled diabetes or uncontrolled high blood pressure or current active infectious diseases such as active viral hepatitis.
  9. Patients with a history of severe allergies may be allergic to research drugs.
  10. Patients with cerebrovascular disease (cerebral infarction, cerebral hemorrhage, etc.) or cardiovascular disease (congestive heart failure of Class III or severer in NYHA classification) requiring hospitalization within 6 months prior to Screening, or patients who use antiarrhythmic drugs to control arrhythmias or who use antiepileptic drugs to control seizures.
  11. Patients who plan to receive a kidney transplant during the study period.
  12. Patients with a history of drug and alcohol abuse
  13. Patients with active or advanced malignancy.
  14. Women who are pregnant or lactating
  15. Patients complicated with active bleeding or requiring anticoagulation therapy with citrate in hemodialysis
  16. Patients who had participated in other clinical studies within 1 month prior to Screening.
  17. Patients who are not suitable for participating in the trial according to the investigator's judgment

Sites / Locations

  • The first affiliated hospital of Baotou medical collegeRecruiting
  • Beijing Tongren HospitalRecruiting
  • Peking Union Medical College HospitalRecruiting
  • The Second Xiangya Hospital of Central South UniversityRecruiting
  • Xiangya Hospital Central South UniversityRecruiting
  • The second hospital of Dalian medical universityRecruiting
  • The affiliated hospital of Inner Mongolia Medical UniversityRecruiting
  • The second people's hospital of HuaianRecruiting
  • Jinan central hospitalRecruiting
  • Shandong province Qianfoshan hospitalRecruiting
  • Zhongnan Hospital Southeast UniversityRecruiting
  • The people's hospital of Guangxi Zhuang Autonomous RegionRecruiting
  • Shenzhen people's hospitalRecruiting
  • The third hospital of Hebei medical universityRecruiting
  • General Hospital of Tianjin Medical UniversityRecruiting
  • First Affiliated Hospital of Zhengzhou UniversityRecruiting
  • Henan provincal people's hospitalRecruiting
  • Zhengzhou People's HospitalRecruiting
  • Zhuzhou Central HospitalRecruiting
  • The First Affiliated Hospital of Xinjiang Medical UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Ferric citrate tablet

Sevelamer carbonate tablet

Arm Description

Ferric citrate arm will receive ferric citrate tablets three times a day with each meal.

Sevelamer carbonate arm will receive sevelamer carbonate tablets three times a day with each meal.

Outcomes

Primary Outcome Measures

The change in serum phosphorus levels
The change in serum phosphorus levels at the end of treatment as compared to baseline (before the first dose).

Secondary Outcome Measures

Changes in serum phosphorus levels
Changes in serum phosphorus levels from baseline
Area under the curve of serum phosphorus level
Area under the curve of serum phosphorus level to visit time (AUC 0-12 weeks)
The proportion of subjects whose serum phosphorus levels reached the target
The proportion of subjects whose serum phosphorus levels reached the target range at week 4, 6, 8 and 12 of treatment (the standard was defined as blood phosphorus ≤1.78mmol /L, and ≥1.13mmol /L).
The change in serum calcium (corrected) levels.
The change in serum calcium (corrected) levels at week 4, 8 and 12 of treatment as compared to baseline.
The change in the level of intact-PTH levels.
The change in the level of intact-PTH levels at week 4, 8 and 12 of treatment as compared to baseline.

Full Information

First Posted
June 30, 2020
Last Updated
June 30, 2020
Sponsor
Sinomune Pharmaceutical Co., Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT04456803
Brief Title
Ferric Citrate for the Treatment of Hyperphosphatemia in Patients With Chronic Kidney Disease Undergoing Hemodialysis
Official Title
A Study to Evaluate the Efficacy and Safety of Ferric Citrate Tablet for the Treatment of Hyperphosphatemia in Patients With Chronic Kidney Disease Undergoing Hemodialysis
Study Type
Interventional

2. Study Status

Record Verification Date
June 2020
Overall Recruitment Status
Unknown status
Study Start Date
May 24, 2019 (Actual)
Primary Completion Date
March 2021 (Anticipated)
Study Completion Date
July 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sinomune Pharmaceutical Co., Ltd

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
To evaluate the efficacy and safety of ferric citrate tablet in the control of serum phosphorus levels in patients with chronic kidney disease undergoing hemodialysis.
Detailed Description
This is a multicenter, randomized, open-label, parallel, phase III study. This study is consisting of a Screening/Washout period (14 days) and a Treatment/Observation period (12 weeks). The subjects with regular hemodialysis should stop using the phosphorus binder before the Washout period. During the Treatment period, the subjects will be randomly assigned to the ferric citrate tablets group (study group) or sevelamer carbonate tablet group (control group) in the ratio of 1:1.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hyperphosphatemia, End Stage Renal Disease, ESRD

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Ferric citrate tablet
Arm Type
Experimental
Arm Description
Ferric citrate arm will receive ferric citrate tablets three times a day with each meal.
Arm Title
Sevelamer carbonate tablet
Arm Type
Active Comparator
Arm Description
Sevelamer carbonate arm will receive sevelamer carbonate tablets three times a day with each meal.
Intervention Type
Drug
Intervention Name(s)
Ferric citrate tablet
Intervention Description
250mg/tablet, manufactured by Sinomune Pharmaceutical
Intervention Type
Drug
Intervention Name(s)
Sevelamer carbonate tablet
Other Intervention Name(s)
Renvela
Intervention Description
800 mg/tablet, manufactured by Genzyme Ireland Limited
Primary Outcome Measure Information:
Title
The change in serum phosphorus levels
Description
The change in serum phosphorus levels at the end of treatment as compared to baseline (before the first dose).
Time Frame
12 Weeks
Secondary Outcome Measure Information:
Title
Changes in serum phosphorus levels
Description
Changes in serum phosphorus levels from baseline
Time Frame
week 2, 4, 6, 8
Title
Area under the curve of serum phosphorus level
Description
Area under the curve of serum phosphorus level to visit time (AUC 0-12 weeks)
Time Frame
week 0, 2, 4, 6, 8, 12
Title
The proportion of subjects whose serum phosphorus levels reached the target
Description
The proportion of subjects whose serum phosphorus levels reached the target range at week 4, 6, 8 and 12 of treatment (the standard was defined as blood phosphorus ≤1.78mmol /L, and ≥1.13mmol /L).
Time Frame
week 4, 6, 8 and 12
Title
The change in serum calcium (corrected) levels.
Description
The change in serum calcium (corrected) levels at week 4, 8 and 12 of treatment as compared to baseline.
Time Frame
week 4, 8 and 12
Title
The change in the level of intact-PTH levels.
Description
The change in the level of intact-PTH levels at week 4, 8 and 12 of treatment as compared to baseline.
Time Frame
week 4, 8 and 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Between the age of 18 and 75 years (including the boundary value) and no gender limitation; Patients who maintain the hemodialysis schedule (including hemofiltration (HF) hemodialysis (HDF) hemoperfusion (HP)) as not less than 3 times a week in the 3 months before random enrollment. Patients with a serum phosphorus level between 1.97 to 3.23 mmol/L (excluding the boundary value) after washout. Kt/Vurea ≥1.2 or URR ≥65%. Before the screening period, CKD-MBD related drug treatment is stable for more than one month, including the use of vitamin D (active vitamin D, vitamin D analogues, etc.) or calcimimetics (cinacalcet, etc.) and the dose remains unchanged. The expected survival is greater than 6 months. Willing to give written informed consent. Exclusion Criteria: Patients with a serum ferritin level ≥800 ng/mL or TSAT ≥50%. Patients with hemochromatosis or patients receiving treatment for iron overload, or patients with paroxysmal sleep hemoglobinuria. Patients who received blood transfusions within 3 months prior to Screening, or patients with hemoglobin ≤60 g/L. Patients with intact-PTH >1000 pg/mL Patients complicated with any of the following gastrointestinal diseases: acute peptic ulcer, chronic ulcerative colitis, localized enteritis, intestinal obstruction, habitual constipation (number of stools once per week), and chronic diarrhea (number of stools four times per day), or patients with a history of gastrectomy or enterectomy or patients who had undergone gastrointestinal surgery within 3 months prior to Screening, or patients with dysphagia. Patients with impaired liver function (hepatic dysfunction or serum total bilirubin, aspartate aminotransferase or alanine aminotransferase ≥ 2 times the upper limit of normal) or patients with cirrhosis. Patients with a history of parathyroidectomy (PTx) or percutaneous anhydrous ethanol injection (PEIT) within 6 months. Patients with uncontrolled diabetes or uncontrolled high blood pressure or current active infectious diseases such as active viral hepatitis. Patients with a history of severe allergies may be allergic to research drugs. Patients with cerebrovascular disease (cerebral infarction, cerebral hemorrhage, etc.) or cardiovascular disease (congestive heart failure of Class III or severer in NYHA classification) requiring hospitalization within 6 months prior to Screening, or patients who use antiarrhythmic drugs to control arrhythmias or who use antiepileptic drugs to control seizures. Patients who plan to receive a kidney transplant during the study period. Patients with a history of drug and alcohol abuse Patients with active or advanced malignancy. Women who are pregnant or lactating Patients complicated with active bleeding or requiring anticoagulation therapy with citrate in hemodialysis Patients who had participated in other clinical studies within 1 month prior to Screening. Patients who are not suitable for participating in the trial according to the investigator's judgment
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Sinomune Pharma
Phone
+86 18101967192
Email
zxh@sinomune.com
First Name & Middle Initial & Last Name or Official Title & Degree
Sinomune Pharma
Phone
+86 15951141363
Email
huanglu@sinomune.com
Facility Information:
Facility Name
The first affiliated hospital of Baotou medical college
City
Baotou
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Caili Wang
Facility Name
Beijing Tongren Hospital
City
Beijing
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Guojuan Zhang
Facility Name
Peking Union Medical College Hospital
City
Beijing
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xuemei Li
Facility Name
The Second Xiangya Hospital of Central South University
City
Changsha
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hong Liu
Facility Name
Xiangya Hospital Central South University
City
Changsha
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xiangcheng Xiao
Facility Name
The second hospital of Dalian medical university
City
Dalian
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Feng Zheng
Facility Name
The affiliated hospital of Inner Mongolia Medical University
City
Hohhot
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jianrong Zhao
Facility Name
The second people's hospital of Huaian
City
Huai'an
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Donghui Zheng
Facility Name
Jinan central hospital
City
Jinan
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xiaoping Wang
Facility Name
Shandong province Qianfoshan hospital
City
Jinan
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zunsong Wang
Facility Name
Zhongnan Hospital Southeast University
City
Nanjing
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Bicheng Liu
Facility Name
The people's hospital of Guangxi Zhuang Autonomous Region
City
Nanning
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kun Ye
Facility Name
Shenzhen people's hospital
City
Shenzhen
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xinzhou Zhang
Facility Name
The third hospital of Hebei medical university
City
Shijiazhuang
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ying Li
Facility Name
General Hospital of Tianjin Medical University
City
Tianjin
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tiekun Yan
Facility Name
First Affiliated Hospital of Zhengzhou University
City
Zhengzhou
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Pei Wang
Facility Name
Henan provincal people's hospital
City
Zhengzhou
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Qing Zhu
Facility Name
Zhengzhou People's Hospital
City
Zhengzhou
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Li Xing
Facility Name
Zhuzhou Central Hospital
City
Zhuzhou
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xiumei Hu
Facility Name
The First Affiliated Hospital of Xinjiang Medical University
City
Ürümqi
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Suhua Li

12. IPD Sharing Statement

Learn more about this trial

Ferric Citrate for the Treatment of Hyperphosphatemia in Patients With Chronic Kidney Disease Undergoing Hemodialysis

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