Phase III Clinical Study of Recombinant Erythropoiesis Stimulating Protein Injection (rESP) in the Treatment of Anemia in Hemodialysis Patients With Chronic Renal Failure
Primary Purpose
Kidney Failure, Chronic, Hemodialysis
Status
Recruiting
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
Human Erythropoiesis Injection (CHO cell)
Recombinant Erythropoiesis Stimulating Protein Injection(CHO cell)
Sponsored by
About this trial
This is an interventional treatment trial for Kidney Failure, Chronic
Eligibility Criteria
Inclusion Criteria:
- Volunteer as a subject must understand the study procedure and sign the informed consent form;
- 18 years old ≤ age ≤ 75 years old when sign ICF, gender is not limited;
- Patients diagnosed with chronic renal failure anemia were receiving maintenance hemodialysis for at least 3 months and 2-3 times a week; The dialysis frequency was stable and there was no change in the dialysis plan throughout the study period;
- Before enrollment, patient being treated short-acting EPO stabilization therapy for at least 12 weeks, the average concentration of hemoglobin in the screening period is in the range of 100~120 g/L (including both ends), and the difference is less than 10g/L;
- Iron status and dialysis status were evaluated within 4 weeks before enrollment to meet the following requirements:
Transferrin saturation (TSAT) ≥20% and serum ferritin (SF) ≥200 μg/L; Dialysis parameters: urea clearance index spKt/V≥1.2;
- Subjects agree to use reliable contraceptives by themselves and their spouses from the screening period to within 3 months after the end of the study;
Exclusion Criteria:
- Allergic to the investigational drug or any ingredient in the investigational drug or has had a severe allergic reaction to the drug in the past;
- Except of renal anemia, there are other diseases that cause chronic anemia (such as sickle cell anemia, myelodysplastic syndrome, hematological malignancies, myeloma, hemolytic anemia, pure red blood cell aplastic anemia), blood systemic disease or coagulopathy;
- Patients who have received or plan to have a kidney transplant during the study period, or who plan to have other surgical procedures during the study period (mainly major surgeries, except those with low blood loss that do not affect Hb concentration);
- Patients with acute or chronic blood loss (such as upper gastrointestinal bleeding, etc.) within 3 months prior to enrollment were excluded from the scope of hemorrhage caused by minor surgeries such as temporary vascular access required by clinical medical procedures;
- Patiernts who was suffering from malignant hypertension or poor control of blood pressure (systolic blood pressure >180 mmHg or diastolic blood pressure >100 mmHg);
- The following conditions (including but not limited to) occurred in the laboratory examination during the screening period, and the investigator judged that the participants were not eligible for inclusion: a) Patients who were positive for HBsAg, anti-HIV, anti-HCV, and Treponema pallidum antibodies; b) The aspartate aminotransferase or alanine aminotransferase is greater than 3 times the upper limit of normal; c) Serum albumin < 35g/L;
- Patiernts who was suffering from severe secondary hyperparathyroidism (sustained blood iPTH/PTH >1000 ng/L);
- Patients with previous thromboembolic disease (excluding luminal infarction), history of severe hematopoietic system, and high clotting tendency;
- Patiernts with severe cardiovascular and cerebrovascular disease, severe or unstable coronary artery disease, heart failure (NYHA class III or IV), temporary vascular access, or myocardial infarction or stroke within 3 months before enrollment;
- A history of malignant neoplasms, except for: basal cell or squamous cell carcinoma of the skin determined to be cured or no recurrence within 5 years, with radical excision, or carcinoma in situ at any site;
- The researchers identified those with severe infectious disease or chronic, uncontrolled inflammation within the first four weeks of enrollment;
- All epilepsy or epilepsy history except of childhood febrile seizures, post-traumatic or abstinence single seizures;
- Those who have received androgen therapy or who have received blood transfusion therapy within the past 8 weeks before enrollment;
- Patients who had a pacemaker for more than 5 years; If no more than 5 years of cardiac pacemaker working status assessment and test unqualified;
- 3 months as a subject to participate in other new drug clinical trials or to the group when the withdrawal time is shorter than the five half-life of the test drug (whichever is the longest of the two);
- Subjects were in the middle of pregnancy or lactation at the time of enrollment;
- Alcohol, drug or drug addicts;
- Other conditions that may not be suitable for the study as determined by the investigator.
Sites / Locations
- Chinese PLA General HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Experimental
Arm Label
Group A
Group B
Arm Description
Intravenous administration, maintaining the same dose and frequency administrated in the sceening period, for 32 weeks
Intravenous administration,50μg, once every two weeks, for 32 weeks
Outcomes
Primary Outcome Measures
hemoglobin concentration
the amount of change in mean Hb concentration compared with baseline Hb concentration during the evaluation period
Secondary Outcome Measures
maintenance rate
the proportion of subjects whose average Hb concentration remained within the target range during the evaluation period
proportion of subjects
the proportion of subjects whose range of dose adjustments decreased or increased by 25% still did not reach 100-120 g/L (both ends)
proportion of times
the proportion of times the measured Hb concentration remains within the target range during the subject evaluation period
average weekly dose
the average weekly dose of the drug during the evaluation period
average hemoglobin concentration
the mean Hb concentration during the evaluation period
mean reticulocyte count
changes in mean values of reticulocyte compared to baseline values during the evaluation period
mean red blood cell count
changes in mean values of red blood cell count compared to baseline values during the evaluation period
adverse events
the type, proportion and severity of adverse events
number of dose adjustments
the number of dose adjustments used by the subject during the treatment and evaluation period
the ratio of subjects who are adjusted
the ratio of subjects who are adjusted during the treatment and evaluation period
incidence of Human Erythropoietin antibodies and anti-rESP antibodies
incidence of Human Erythropoietin antibodies and anti-rESP antibodies
Maximum Plasma Concentration (Cmax)
the Cmax of rESP in patients with long-term medication
Area Under the Curve (AUC)
the AUC of rESP in patients with long-term medication
Full Information
NCT ID
NCT05211167
First Posted
January 13, 2022
Last Updated
January 13, 2022
Sponsor
Shenyang Sunshine Pharmaceutical Co., LTD.
1. Study Identification
Unique Protocol Identification Number
NCT05211167
Brief Title
Phase III Clinical Study of Recombinant Erythropoiesis Stimulating Protein Injection (rESP) in the Treatment of Anemia in Hemodialysis Patients With Chronic Renal Failure
Official Title
A Multicenter, Randomized, Parallel-controlled Phase III Trial Comparing the Efficacy and Safety of Recombinant Erythropoiesis Stimulating Protein Injection (CHO Cell) With Ipbio in Maintenance Therapy in Hemodialysis Patients With Anemia in Chronic Renal Failure
Study Type
Interventional
2. Study Status
Record Verification Date
January 2022
Overall Recruitment Status
Recruiting
Study Start Date
July 1, 2021 (Actual)
Primary Completion Date
June 30, 2023 (Anticipated)
Study Completion Date
December 30, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Shenyang Sunshine Pharmaceutical Co., LTD.
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 verify the efficacy of recombinant erythropoiesis stimulating protein injection (CHO cell) in hemodialysis patients with chronic renal failure anemia maintenance treatment is not inferior to yibio.
Detailed Description
In this phase 3, open label, active comparator parallel controlled study, patients were randomly assigned to two study groups: one active comparator control group (Human Erythropoietin Injection , maintaining the same dose and frequency administrated in the sceening period ), and experimental groups (50μg, once every two weeks). All the patients were administered intravenously for 32 weeks and were evaluated the efficacy, safety and pharmacokinetic characteristics. During the whole study period, dosage adjustment was not allowed in the first 4 weeks, while in the remaining trial period dosage adjustment was allowed once every two weeks if necessary.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Kidney Failure, Chronic, Hemodialysis
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
300 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Group A
Arm Type
Active Comparator
Arm Description
Intravenous administration, maintaining the same dose and frequency administrated in the sceening period, for 32 weeks
Arm Title
Group B
Arm Type
Experimental
Arm Description
Intravenous administration,50μg, once every two weeks, for 32 weeks
Intervention Type
Drug
Intervention Name(s)
Human Erythropoiesis Injection (CHO cell)
Intervention Description
Human Erythropoiesis Injection (CHO cell) is a recombinant human erythropoietin with the same biological effects as natural erythropoietin
Intervention Type
Drug
Intervention Name(s)
Recombinant Erythropoiesis Stimulating Protein Injection(CHO cell)
Other Intervention Name(s)
rESP
Intervention Description
rESP is a high glucose medium and long-acting recombinant protein products, containing 165 amino acids by adding 3 glycosylation sites
Primary Outcome Measure Information:
Title
hemoglobin concentration
Description
the amount of change in mean Hb concentration compared with baseline Hb concentration during the evaluation period
Time Frame
25th-32nd week
Secondary Outcome Measure Information:
Title
maintenance rate
Description
the proportion of subjects whose average Hb concentration remained within the target range during the evaluation period
Time Frame
25th-32nd week
Title
proportion of subjects
Description
the proportion of subjects whose range of dose adjustments decreased or increased by 25% still did not reach 100-120 g/L (both ends)
Time Frame
for 32 weeks
Title
proportion of times
Description
the proportion of times the measured Hb concentration remains within the target range during the subject evaluation period
Time Frame
25th-32nd week
Title
average weekly dose
Description
the average weekly dose of the drug during the evaluation period
Time Frame
25th-32nd week
Title
average hemoglobin concentration
Description
the mean Hb concentration during the evaluation period
Time Frame
25th-32nd week
Title
mean reticulocyte count
Description
changes in mean values of reticulocyte compared to baseline values during the evaluation period
Time Frame
25th-32nd week
Title
mean red blood cell count
Description
changes in mean values of red blood cell count compared to baseline values during the evaluation period
Time Frame
25th-32nd week
Title
adverse events
Description
the type, proportion and severity of adverse events
Time Frame
for 32 weeks
Title
number of dose adjustments
Description
the number of dose adjustments used by the subject during the treatment and evaluation period
Time Frame
for 32 weeks
Title
the ratio of subjects who are adjusted
Description
the ratio of subjects who are adjusted during the treatment and evaluation period
Time Frame
for 32 weeks
Title
incidence of Human Erythropoietin antibodies and anti-rESP antibodies
Description
incidence of Human Erythropoietin antibodies and anti-rESP antibodies
Time Frame
for 32 weeks
Title
Maximum Plasma Concentration (Cmax)
Description
the Cmax of rESP in patients with long-term medication
Time Frame
for 32 weeks
Title
Area Under the Curve (AUC)
Description
the AUC of rESP in patients with long-term medication
Time Frame
for 32 weeks
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:
Volunteer as a subject must understand the study procedure and sign the informed consent form;
18 years old ≤ age ≤ 75 years old when sign ICF, gender is not limited;
Patients diagnosed with chronic renal failure anemia were receiving maintenance hemodialysis for at least 3 months and 2-3 times a week; The dialysis frequency was stable and there was no change in the dialysis plan throughout the study period;
Before enrollment, patient being treated short-acting EPO stabilization therapy for at least 12 weeks, the average concentration of hemoglobin in the screening period is in the range of 100~120 g/L (including both ends), and the difference is less than 10g/L;
Iron status and dialysis status were evaluated within 4 weeks before enrollment to meet the following requirements:
Transferrin saturation (TSAT) ≥20% and serum ferritin (SF) ≥200 μg/L; Dialysis parameters: urea clearance index spKt/V≥1.2;
Subjects agree to use reliable contraceptives by themselves and their spouses from the screening period to within 3 months after the end of the study;
Exclusion Criteria:
Allergic to the investigational drug or any ingredient in the investigational drug or has had a severe allergic reaction to the drug in the past;
Except of renal anemia, there are other diseases that cause chronic anemia (such as sickle cell anemia, myelodysplastic syndrome, hematological malignancies, myeloma, hemolytic anemia, pure red blood cell aplastic anemia), blood systemic disease or coagulopathy;
Patients who have received or plan to have a kidney transplant during the study period, or who plan to have other surgical procedures during the study period (mainly major surgeries, except those with low blood loss that do not affect Hb concentration);
Patients with acute or chronic blood loss (such as upper gastrointestinal bleeding, etc.) within 3 months prior to enrollment were excluded from the scope of hemorrhage caused by minor surgeries such as temporary vascular access required by clinical medical procedures;
Patiernts who was suffering from malignant hypertension or poor control of blood pressure (systolic blood pressure >180 mmHg or diastolic blood pressure >100 mmHg);
The following conditions (including but not limited to) occurred in the laboratory examination during the screening period, and the investigator judged that the participants were not eligible for inclusion: a) Patients who were positive for HBsAg, anti-HIV, anti-HCV, and Treponema pallidum antibodies; b) The aspartate aminotransferase or alanine aminotransferase is greater than 3 times the upper limit of normal; c) Serum albumin < 35g/L;
Patiernts who was suffering from severe secondary hyperparathyroidism (sustained blood iPTH/PTH >1000 ng/L);
Patients with previous thromboembolic disease (excluding luminal infarction), history of severe hematopoietic system, and high clotting tendency;
Patiernts with severe cardiovascular and cerebrovascular disease, severe or unstable coronary artery disease, heart failure (NYHA class III or IV), temporary vascular access, or myocardial infarction or stroke within 3 months before enrollment;
A history of malignant neoplasms, except for: basal cell or squamous cell carcinoma of the skin determined to be cured or no recurrence within 5 years, with radical excision, or carcinoma in situ at any site;
The researchers identified those with severe infectious disease or chronic, uncontrolled inflammation within the first four weeks of enrollment;
All epilepsy or epilepsy history except of childhood febrile seizures, post-traumatic or abstinence single seizures;
Those who have received androgen therapy or who have received blood transfusion therapy within the past 8 weeks before enrollment;
Patients who had a pacemaker for more than 5 years; If no more than 5 years of cardiac pacemaker working status assessment and test unqualified;
3 months as a subject to participate in other new drug clinical trials or to the group when the withdrawal time is shorter than the five half-life of the test drug (whichever is the longest of the two);
Subjects were in the middle of pregnancy or lactation at the time of enrollment;
Alcohol, drug or drug addicts;
Other conditions that may not be suitable for the study as determined by the investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Gang Tong, MD
Phone
021-60970099
Email
tonggang@3sbio.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
XiangMei Chen, MD
Organizational Affiliation
Chinese PLA General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Chinese PLA General Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
200443
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
XiangMei Chen, MD
Phone
13501261896
Email
Xmchen301@126.com
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Learn more about this trial
Phase III Clinical Study of Recombinant Erythropoiesis Stimulating Protein Injection (rESP) in the Treatment of Anemia in Hemodialysis Patients With Chronic Renal Failure
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