A Study of Efepoetin Alfa in Treating Anaemia Associated With Chronic Kidney Diseases Patient
Anaemia Associated With Chronic Kidney Disease
About this trial
This is an interventional treatment trial for Anaemia Associated With Chronic Kidney Disease
Eligibility Criteria
Inclusion Criteria:
- Age should be greater than or equal to the minimum age of consent in the applicable country
- Stage 3 or 4 CKD (eGFR ≥ 15 and < 60 mL/min/1.73 m2)
- ESA-naive (no prior ESA use) subjects whose Hb at baseline is ≥ 8 g/dL and < 10 g/dL, or ESA prior users whose Hb at baseline is ≥ 8 g/dL and < 10 g/dL and who have stopped using ESA at least 12 weeks till the screening
- Ferritin ≥ 100 ng/mL and transferrin saturation (TSAT) ≥ 20%
- Subject must be willing to complete all study-related activities and follow-up visits
- Evidence of a signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the study.
Exclusion Criteria:
- Need for dialysis therapy expected in the next 12 months or rapid progression of CKD (e.g., eGFR decrease of >20% within 12 weeks)
- Received a blood transfusion (including RBC transfusion) within the 12 weeks prior to screening, or blood transfusion is anticipated during the study period
- Have a history of overt gastrointestinal bleeding or any other bleeding episode associated with a fall in Hb of ≥ 1 g/dL, within the last 8 weeks prior to screening
- Have an unstable Hb for any reason, in the investigator's opinion
- Have non-renal anaemia (any anaemia where the investigator considers the anaemia is predominantly due to a non-renal cause. Non-renal causes include, but are not limited to vitamin B12 or folic acid deficiency, homozygous sickle-cell disease, thalassemia of all types, other non-renal cause of anaemia such as myelodysplasia or haematological malignancies)
- Platelet count of ≤ 50 x109/L
- Vitamin B12 deficiency defined as total serum levels of < 181 pmol/L (246 pg/ml) 10
- Folic acid deficiency defined as total serum levels < 7.63 nmol/L (3.37 ng/mL) 10
- Pure red cell aplasia, or a history of pure red cell aplasia
- Poorly controlled hypertension defined as a sitting SBP ≥170 mmHg and/or DBP ≥100 mm Hg
- Chronic congestive heart failure (New York Heart Association class IV) or are otherwise at high risk for early withdrawal or interruption of the study (due to myocardial infarction, severe or unstable coronary artery disease, stroke, or severe liver disease) within the 12 weeks before screening or during screening
- Active or not active malignancy (except non-melanoma skin cancer) within five years before screening
- Planned live kidney transplantation scheduled within 52 weeks after the screening visit
- Uncontrolled hyperparathyroidism, in the investigator's opinion
- Uncontrolled hypothyroidism determined by the investigator that they cannot participate in the study
- Active acute or chronic infection, or uncontrolled or symptomatic inflammatory disease (e.g., rheumatoid arthritis, systemic lupus erythematosus), or a C-reactive protein level > 15 mg/L. (Routinely screening for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infection is not required in this protocol. By history or current clinical evidence, patients with active acute HBV or HCV infection should be excluded. Chronic HBV/HCV infection with LFTs > 3 times of normal are excluded. Known HIV positive patients are excluded)
- Immunosuppressive therapy (other than corticosteroids for a chronic condition, or tacrolimus/cyclosporine) within 12 weeks prior to baseline
- Life expectancy of less than 52 weeks
- Planned surgery during the study period (excluding minor skin excisions)
- Have received investigational drug(s) other than those of this study within 4 weeks prior to screening, or will receive investigational drug(s) other than those of this study during the study period
- History or clinical evidence of cardiovascular, haematologic or hepatic (ALT, AST, bilirubin values above three times the upper limit of normal [ULN] at screening) or any physical conditions that, in the opinion of the investigator, would compromise participation in the study
- With a cognitive or psychiatric condition rendering the subject unable to be cooperative with and complete study requirements
- Hypersensitivity to any one of the investigational drugs
- Subjects are, in the judgement of the investigator, otherwise inappropriate for entry into the study
- Subjects who are investigational site staff members directly involved in the conduct of the trial and their family members, site staff members otherwise supervised by the Investigator, or subjects who are KGBio or CRO employees directly involved in the conduct of the trial
- Participation in other studies involving same investigational drug(s) (Phases 1-4) of this study within 12 weeks before screening
- Females of childbearing potential or males who are unable/unwilling to take adequate contraceptive precautions defined by the protocol for the duration of the study and for at least 28 days after last dose of investigational product. Females have a positive pregnancy test result within 24 hours prior to study entry, is otherwise known to be pregnant, plans to become pregnant in the next 12 months or is currently breastfeeding.
Sites / Locations
- Renal Research Gosford
- Royal Adelaide Hospital
- Launceston General Hospital
- Rspad Gatot Soebroto
- Rumah Sakit Islam Jakarta Cempaka Putih
- Rumah Sakit Islam Jakarta Pondok Kopi
- Rumah Sakit Pgi Cikini
- Rumah Sakit Umum Pusat Fatmawati
- Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo
- Chungnam National University Hospital
- Korea University Ansan Hospital
- Seoul National University Bundang Hospital
- The Catholic University of Korea Incheon St. Mary'S Hospital
- Chungnam National University Sejong Hospital
- Kyung Hee University Hospital At Gangdong
- The Catholic University of Korea Eunpyeong St. Mary'S Hospital
- The Catholic University of Korea Seoul St. Mary'S Hospital
- The Catholic University of Korea, Yeouido St. Mary'S Hospital
- Seri Manjung Hospital
- University of Malaya Medical Centre
- Hospital Raja Permaisuri Bainun
- Hospital Kajang
- Hospital Raja Perempuan Zainab II
- Hospital Kuala Lumpur
- Hospital Tengku Ampuan Afzan
- Hospital Serdang
- Hospital Sibu
- M3 Dialysis Center
- Baguio General Hospital Medical Center
- Norzel Medical and Diagnostic Clinic
- De La Salle Medical and Health Sciences Institute
- Davao Doctors Hospital
- West Visayas State University Hospital
- National Kidney and Transplant Institute
- Changhua Christian Hospital
- Hualien Tzu Chi Hospital
- Kaohsiung Medical University Chung-Ho Memorial Hospital
- Kaohsiung Veterans General Hospital
- Kaohsiung Chang Gung Hospital
- Keelung Chang Gung Memorial Hospital
- Taiching Veterans General Hospital
- Kuang Tien General Hospital
- Chi Mei Medical Center
- National Cheng Kung University Hospital
- National Taiwan University Hospital
- Tri-Service General Hospital
- Far Eastern Memorial Hospital
- Taipei Medical University - Shuang Ho Hospital
- Linkou Chang Gung Memorial Hospital
- Vajira Hospital
- Siriraj Hospital
- Maharaj Nakorn Chiang Mai Hospital
- Thammasat University Hospital
- Songklanagarind Hospital
- Sunpasitthiprasong Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
efepoetin alfa
Mircera
Route of administration: Subcutaneous Injection. The administration interval and initial dosage for subjects who are randomly assigned to subcutaneous efepoetin alfa will be starting from 4 μg/kg BW once per 2 weeks, then titrated based on Hb level during study period.
Route of administration: Subcutaneous Injection. The starting dosage of Mircera arm will be 0.6 μg/kg BW per 2 weeks based on prior data in similar study populations with subsequent titration to achieve targeted Hb range. During the correction treatment period, the dosage of study drug will be adjusted to achieve a Hb level range within 10 - 12 g/dL and an increase ≥1.0 g/dL versus the individual patient's baseline Hb level. During the extension period, Hb levels should be maintained between 10 and 12 g/dL.