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PBF-1681 (Ferric Citrate) for the Treatment of IDA in Patients With NDD-CKD

Primary Purpose

Anemia of Chronic Kidney Disease

Status
Completed
Phase
Phase 3
Locations
Taiwan
Study Type
Interventional
Intervention
Ferric citrate
Placebo
Sponsored by
Panion & BF Biotech Inc.
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 Ferric Citrate, Anemia, Chronic Kidney Disease

Eligibility Criteria

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

Inclusion Criteria:

  1. Men or women ≥18 years of age at screening.
  2. CKD with eGFR <60 mL/min at screening using the 4-variable Modification of Diet in Renal Disease equation, where up to 20% of subjects with eGFR <15 mL/min are allowed.
  3. Hgb ≥9.0 g/dL and ≤11.5 g/dL at screening.
  4. Serum ferritin <300 ng/mL and TSAT <30% at screening.
  5. Serum iPTH ≤600 pg/mL at screening.
  6. Must consume minimally 2 meals per day.
  7. Willing to give written informed consent.
  8. Women may be enrolled if they are:

    1. Documented to be surgically sterile or postmenopausal (amenorrhea >1 year and follicle-stimulating hormone ≥30 mU/mL), or
    2. Practicing true abstinence for at least 28 days prior to study drug administration until 30 days after study drug administration and having a negative serum pregnancy test at screening, or
    3. Using 2 forms of highly effective contraception, out of which 1 should be a physical barrier (condom or diaphragm), and another method such as adequate hormonal method (eg, contraceptive implants, injectables, oral contraceptives) or non-hormonal methods (eg, intrauterine device, spermicidals) from screening or at least 2 weeks prior to study drug administration (whichever is earlier) until 30 days after the study drug administration and having a negative serum pregnancy test at screening.

Exclusion Criteria:

  1. Cause of anemia other than iron deficiency.
  2. Serum phosphate <3.5 mg/dL at screening.
  3. IV iron administered within 4 weeks of the start of screening.
  4. ESA administered within 4 weeks of the start of screening.
  5. Blood transfusion within 4 weeks of the start of screening.
  6. Liver enzymes (alanine aminotransferase [ALT]/aspartate aminotransferase [AST]) >3 times upper limit of normal (ULN) at screening.
  7. Symptomatic GI bleeding or symptomatic inflammatory bowel disease within 12 weeks of the start of screening.
  8. Concurrent GI diseases assessed by Investigators to be inappropriate for the study, eg, acute peptic ulcer, chronic ulcerative colitis, and regional enteritis.
  9. Active infection requiring systemic antimicrobial treatment such as antibiotics, antiviral, or antifungals at screening.
  10. Concomitant or prior malignancy, except non-melanoma skin cancer or disease-free for ≥2 years after curative therapy.
  11. Subjects with known allergic reaction to previous oral iron therapy.
  12. Subjects who were intolerant to oral iron therapy.
  13. History of hemochromatosis.
  14. Scheduled kidney transplant or initiation of dialysis planned within 24 weeks of the start of screening.
  15. Planned surgery or hospitalization (anticipated to last >72 hours) during the Randomized Period of the study other than dialysis access-related surgery.
  16. Any other medical condition that, in the Investigators' opinion, may disturb subject's completion or optimal participation of the study, act as a significant confounding variable, or carry significant risks to a subject.

Sites / Locations

  • Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Chung-Ho Memorial Hospital
  • Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang-Gung Memorial Hospital
  • Division of Nephrology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital
  • Division of Nephrology, Department of Internal Medicine, Far East Memorial Hospital
  • Division of Nephrology, Department of Internal Medicine, China Medical University Hospital
  • Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital
  • Department of Integrated Diagnostics and Therapeutics, National Taiwan University Hospital
  • Division of Nephrology, Department of Internal Medicine, Taipei Veterans General Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

PBF-1681 (ferric citrate)

Placebo

Arm Description

PBF-1681 (ferric citrate) will be dosed two times a day with the 2 largest meals (preferred) or three times a day with meals.

Matching placebo will be dosed two times a day with the 2 largest meals (preferred) or three times a day with meals.

Outcomes

Primary Outcome Measures

The proportion of subjects achieving an increase in Hgb of ≥1.0 g/dL at any time point between baseline and the end of the 16-week Randomized Period.
Efficacy analyses were performed for the population consisted of all subjects who were randomized, had a baseline laboratory value, took at least 1 dose of study drug or placebo, and had at least 1 post-baseline laboratory assessment during the randomized period.

Secondary Outcome Measures

Hemoglobin (Hgb)
The mean change from baseline to the end of the Randomized Period in Hgb.
Transferring saturation (TSAT)
The mean change from baseline to the end of the Randomized Period in TSAT.
Ferritin
The mean change from baseline to the end of the Randomized Period in ferritin.
Serum Phosphate
The mean change from baseline to the end of the Randomized Period in serum phosphate.
Sustained increase in Hgb of ≥0.75 g/dL
The proportion of subjects achieving a sustained increase in Hgb of ≥0.75 g/dL from baseline over any 4-week interval during the Randomization Period.

Full Information

First Posted
September 2, 2020
Last Updated
March 7, 2023
Sponsor
Panion & BF Biotech Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04543812
Brief Title
PBF-1681 (Ferric Citrate) for the Treatment of IDA in Patients With NDD-CKD
Official Title
A Phase 3 Study of PBF-1681 Comprising a 16-week, Placebo-controlled, Double-blind Randomized Period and an 8-week, Open-label Extension Period for the Treatment of Iron Deficiency Anemia in Patients With Non-Dialysis Dependent CKD
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Completed
Study Start Date
October 14, 2020 (Actual)
Primary Completion Date
October 28, 2022 (Actual)
Study Completion Date
December 16, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Panion & BF Biotech Inc.

4. Oversight

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

5. Study Description

Brief Summary
To assess the safety and effectiveness of PBF-1681 for the treatment of Iron Deficiency Anemia in patients with Non-Dialysis Dependent Chronic Kidney Disease.
Detailed Description
This is a Phase 3, 24-week, multicenter study in Taiwan, comprising a 16-week, randomized, double-blind, placebo-controlled period ("Randomized Period"), followed by an 8-week open-label extension period, where all subjects receive PBF-1681 (ferric citrate) ("Extension Period"). The study will consist of 10 visits over a period of 24 weeks. There will be a screening period of up to 14 days. Approximately 200 subjects will be randomized into the Randomized Period in a 1:1 ratio to receive either PBF-1681 or matching placebo, at baseline.

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
Ferric Citrate, Anemia, Chronic Kidney Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
141 (Actual)

8. Arms, Groups, and Interventions

Arm Title
PBF-1681 (ferric citrate)
Arm Type
Experimental
Arm Description
PBF-1681 (ferric citrate) will be dosed two times a day with the 2 largest meals (preferred) or three times a day with meals.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Matching placebo will be dosed two times a day with the 2 largest meals (preferred) or three times a day with meals.
Intervention Type
Drug
Intervention Name(s)
Ferric citrate
Intervention Description
Ferric citrate will be provided as a 1g tablet. All intervention doses will be based on hemoglobin levels.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Matching placebo will be provided as a 1g tablet. All intervention doses will be based on hemoglobin levels.
Primary Outcome Measure Information:
Title
The proportion of subjects achieving an increase in Hgb of ≥1.0 g/dL at any time point between baseline and the end of the 16-week Randomized Period.
Description
Efficacy analyses were performed for the population consisted of all subjects who were randomized, had a baseline laboratory value, took at least 1 dose of study drug or placebo, and had at least 1 post-baseline laboratory assessment during the randomized period.
Time Frame
16 weeks
Secondary Outcome Measure Information:
Title
Hemoglobin (Hgb)
Description
The mean change from baseline to the end of the Randomized Period in Hgb.
Time Frame
16 weeks
Title
Transferring saturation (TSAT)
Description
The mean change from baseline to the end of the Randomized Period in TSAT.
Time Frame
16 weeks
Title
Ferritin
Description
The mean change from baseline to the end of the Randomized Period in ferritin.
Time Frame
16 weeks
Title
Serum Phosphate
Description
The mean change from baseline to the end of the Randomized Period in serum phosphate.
Time Frame
16 weeks
Title
Sustained increase in Hgb of ≥0.75 g/dL
Description
The proportion of subjects achieving a sustained increase in Hgb of ≥0.75 g/dL from baseline over any 4-week interval during the Randomization Period.
Time Frame
16 weeks
Other Pre-specified Outcome Measures:
Title
Serum calcium
Description
The mean change from baseline to the end of the Randomized Period in serum calcium.
Time Frame
16 weeks
Title
Serum bicarbonate
Description
The mean change from baseline to the end of the Randomized Period in serum bicarbonate.
Time Frame
16 weeks
Title
Serum iron
Description
The mean change from baseline to the end of the Randomized Period in serum iron.
Time Frame
16 weeks
Title
Unsaturated iron binding capacity (UIBC)
Description
The mean change from baseline to the end of the Randomized Period in UIBC.
Time Frame
16 weeks
Title
Total iron binding capacity (TIBC)
Description
The mean change from baseline to the end of the Randomized Period in TIBC.
Time Frame
16 weeks
Title
Hematocrit
Description
The mean change from baseline to the end of the Randomized Period in hematocrit.
Time Frame
16 weeks
Title
Intact parathyroid hormone (iPTH)
Description
The mean change from baseline to the end of the Randomized Period in iPTH.
Time Frame
16 weeks
Title
Fibroblast growth factor 23 (intact and C-terminal)
Description
The mean change from baseline to the end of the Randomized Period in FGF23 (intact and C-terminal).
Time Frame
16 weeks
Title
Serum aluminum
Description
The mean change from baseline to the end of the Randomized Period in serum aluminum.
Time Frame
16 weeks
Title
Sustained increase in Hgb
Description
The proportion of subjects achieving a sustained increase in Hgb of ≥0.75 g/dL from baseline over any 4-week interval during the Randomized Period, provided that an increase in Hgb of ≥1.0 g/dL had occurred during that 4-week interval
Time Frame
16 weeks
Title
Increase in Hgb of ≥1.0 g/dL
Description
Time (in days) to first increase in Hgb of ≥1.0 g/dL from baseline.
Time Frame
16 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Men or women ≥18 years of age at screening. CKD with eGFR <60 mL/min at screening using the 4-variable Modification of Diet in Renal Disease equation, where up to 20% of subjects with eGFR <15 mL/min are allowed. Hgb ≥9.0 g/dL and ≤11.5 g/dL at screening. Serum ferritin <300 ng/mL and TSAT <30% at screening. Serum iPTH ≤600 pg/mL at screening. Must consume minimally 2 meals per day. Willing to give written informed consent. Women may be enrolled if they are: Documented to be surgically sterile or postmenopausal (amenorrhea >1 year and follicle-stimulating hormone ≥30 mU/mL), or Practicing true abstinence for at least 28 days prior to study drug administration until 30 days after study drug administration and having a negative serum pregnancy test at screening, or Using 2 forms of highly effective contraception, out of which 1 should be a physical barrier (condom or diaphragm), and another method such as adequate hormonal method (eg, contraceptive implants, injectables, oral contraceptives) or non-hormonal methods (eg, intrauterine device, spermicidals) from screening or at least 2 weeks prior to study drug administration (whichever is earlier) until 30 days after the study drug administration and having a negative serum pregnancy test at screening. Exclusion Criteria: Cause of anemia other than iron deficiency. Serum phosphate <3.5 mg/dL at screening. IV iron administered within 4 weeks of the start of screening. ESA administered within 4 weeks of the start of screening. Blood transfusion within 4 weeks of the start of screening. Liver enzymes (alanine aminotransferase [ALT]/aspartate aminotransferase [AST]) >3 times upper limit of normal (ULN) at screening. Symptomatic GI bleeding or symptomatic inflammatory bowel disease within 12 weeks of the start of screening. Concurrent GI diseases assessed by Investigators to be inappropriate for the study, eg, acute peptic ulcer, chronic ulcerative colitis, and regional enteritis. Active infection requiring systemic antimicrobial treatment such as antibiotics, antiviral, or antifungals at screening. Concomitant or prior malignancy, except non-melanoma skin cancer or disease-free for ≥2 years after curative therapy. Subjects with known allergic reaction to previous oral iron therapy. Subjects who were intolerant to oral iron therapy. History of hemochromatosis. Scheduled kidney transplant or initiation of dialysis planned within 24 weeks of the start of screening. Planned surgery or hospitalization (anticipated to last >72 hours) during the Randomized Period of the study other than dialysis access-related surgery. Any other medical condition that, in the Investigators' opinion, may disturb subject's completion or optimal participation of the study, act as a significant confounding variable, or carry significant risks to a subject.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mei-I Wu, MD, PhD
Organizational Affiliation
Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital
Official's Role
Study Chair
Facility Information:
Facility Name
Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Chung-Ho Memorial Hospital
City
Kaohsiung
ZIP/Postal Code
80756
Country
Taiwan
Facility Name
Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang-Gung Memorial Hospital
City
Kaohsiung
ZIP/Postal Code
83301
Country
Taiwan
Facility Name
Division of Nephrology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital
City
Keelung
ZIP/Postal Code
20401
Country
Taiwan
Facility Name
Division of Nephrology, Department of Internal Medicine, Far East Memorial Hospital
City
New Taipei City
ZIP/Postal Code
22060
Country
Taiwan
Facility Name
Division of Nephrology, Department of Internal Medicine, China Medical University Hospital
City
Taichung
ZIP/Postal Code
40433
Country
Taiwan
Facility Name
Division of Nephrology, Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital
City
Taipei county
ZIP/Postal Code
23561
Country
Taiwan
Facility Name
Department of Integrated Diagnostics and Therapeutics, National Taiwan University Hospital
City
Taipei
ZIP/Postal Code
10002
Country
Taiwan
Facility Name
Division of Nephrology, Department of Internal Medicine, Taipei Veterans General Hospital
City
Taipei
ZIP/Postal Code
11217
Country
Taiwan

12. IPD Sharing Statement

Plan to Share IPD
No

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PBF-1681 (Ferric Citrate) for the Treatment of IDA in Patients With NDD-CKD

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