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Dose Ranging Study of Dialysate Containing Soluble Iron to Treat Subjects With End Stage Renal Disease (ESRD) Receiving Chronic Hemodialysis

Primary Purpose

End-Stage Renal Disease (ESRD)

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Standard Bicarbonate Solution
Soluble Ferric Pyrophosphate
Soluble Ferric Pyrophosphate
Soluble Ferric Pyrophosphate
Soluble Ferric Pyrophosphate
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 (ESRD) focused on measuring Subjects with ESRD receiving chronic Hemodialysis

Eligibility Criteria

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

Selected Inclusion Criteria:

  1. Adult subject ≥ 18 years of age undergoing chronic hemodialysis for end-stage renal disease (ESRD) three times a week
  2. Hemoglobin (Hgb) values on two successive screening/baseline measures immediately prior to the start of the study averaging 10.1 to 11.5 grams/ deciliter (g/dL), inclusive
  3. Transferrin Saturation (TSAT) values that average 20% or more, but not exceeding 35%, prior to dialysis measured during the screening period
  4. Ferritin values that average 200 to 800 micrograms/ liter (µg/L), inclusive, measured during the screening period. An average ferritin above 800 µg/L but no greater than 1200 µg/L is allowed if the average TSAT is 20% to no greater than 25%.
  5. Except for vascular access surgery, subject has no hospitalization in previous three months for a significant illness that, in the opinion of the Investigator, confers a significant risk of hospitalization during the course of the study. No blood transfusions within the last 4 weeks are allowed.
  6. Subject has an adequate dialyzer blood flow rate that is acceptable to the Principal Investigator

Exclusion Criteria:

  1. Hemoglobin (Hgb) values on two successive baseline/screening measurements that average ≥ 11.6g/dL
  2. Subject with a current malignancy involving a site other than skin
  3. Subject with a history of drug or alcohol abuse within the last six months
  4. Subject believed to be unable to complete the entire study (e.g., due to a concurrent disease, life expectancy of less than a year)
  5. Subject who the Principal Investigator considers will be placed at increased risk by the study procedures
  6. Subject requiring hemodialysis more than 3 times per week on a regular basis.
  7. Subject who is unable to discontinue oral iron or intravenous iron supplements for the duration of the study
  8. Subject who is pregnant
  9. Subject considered incompetent to give an informed consent
  10. Subject with a positive test for Hepatitis B Surface Antigen within the past 30 days or during screening
  11. Subject with known HIV infection (if this is not known, no HIV testing will be performed)
  12. Subject with cirrhosis of the liver based on histological criteria or clinical criteria (presence of ascites, esophageal varices, spider nevi, or history of hepatic encephalopathy). Subject with hepatitis C, in the absence of cirrhosis, is not excluded from participation in the study if ALT and AST levels are below 2 times the upper limit of normal consistently during the 2 months preceding enrollment
  13. Subject with active tuberculosis, fungal, viral, or parasitic infection
  14. Subject with active bacterial infection requiring antibiotic therapy
  15. Subject with pre-dialysis Corrected Q-wave to T-wave (QTc) interval ≥ 470 milliseconds (ms)
  16. Subject with a history of hypokalemia, decompensated heart failure, or family history of Long QT Syndrome that in the Investigator's judgment poses a risk for Torsades de Pointe during the study
  17. Subject using concomitant medications known to prolong QT/QTc interval (See Appendix I, TABLE A)
  18. Subject receiving more than 60,000 units or 120 micrograms of erythropoietin (Epogen®, Procrit®, or Aranesp®) per week
  19. Subject has participated in another clinical trial within 30 days of signing Informed Consent

Sites / Locations

  • Investigator
  • Investigator
  • Investigator
  • Investigator
  • Investigative Site
  • Investigator
  • Investigator
  • Investigative Site
  • Investigator
  • Investigator
  • Investigative Site
  • Investigator
  • Investigator
  • Investigator
  • Investigator
  • Investigator
  • Investigator
  • Investigator
  • Investigative Site
  • Investigator
  • Investigative Site
  • Investigator
  • Investigator
  • Investigator
  • Investigator
  • Investigator
  • Investigator
  • Investigative Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Placebo Comparator

Experimental

Experimental

Experimental

Experimental

Arm Label

0 µg iron/dL of dialysate

5 µg iron/dL of dialysate

10 µg iron/dL of dialysate

12 µg iron/dL of dialysate

15 µg iron/dL of dialysate

Arm Description

Placebo 0 micrograms (µg) of iron/ deciliter (dL) of dialysate

5 micrograms (µg) of iron/ deciliter (dL) of dialysate

10 micrograms (µg) of iron/ deciliter (dL) of dialysate

12 micrograms (µg) of iron/ deciliter (dL) of dialysate

15 micrograms (µg) of iron/ deciliter (dL) of dialysate

Outcomes

Primary Outcome Measures

Percent of Subjects Whose Hemoglobin (Hgb) Decreases by a Total of 1.0 Grams/ Deciliter (g/dL) (or More) From Baseline on Each of Two Successive Measurements.
Efficacy of a Soluble Ferric Pyrophosphate (SFP)-containing dialysate solution in maintaining physiological iron levels during chronic HD, as measured by the percent of subjects whose hgb decreases by a total of 1.0 g/dL (or more) from baseline on each of two successive measurements. Hemoglobin was obtained weekly at the mid-week dialysis treatments and compared to baseline value (average of two hgb measurements obtained at the two consecutive baseline visits prior to randomization).

Secondary Outcome Measures

Change From Baseline in Hemoglobin (Hgb)
Time in Days for Hgb to Decrease by a Total of > = 1.0 g/dL From Baseline on Each of Two Successive Measurements in Each Treatment Group.
Kaplan-Meier Estimate of Time to First Hgb Decrease by >= 1.0 g/dL
Reticulocyte Hemoglobin (CHr) Values Every Four Weeks, and at the End of the Subject's Treatment.
Efficacy of SFP administration in dialysate solution as measured by Chr values every four weeks, and at the end of the Subject's Treatment (up to 26 weeks).
Number of Subjects With Infection Episodes Requiring Antibiotic or Anti-fungal Therapy in Each Treatment Group.
Number of Subjects With a Rise in Hemoglobin (Hgb) to 12.6 g/dL or More on Two Separate Occasions Measured One Week Apart.

Full Information

First Posted
October 19, 2007
Last Updated
November 17, 2020
Sponsor
Rockwell Medical Technologies, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00548249
Brief Title
Dose Ranging Study of Dialysate Containing Soluble Iron to Treat Subjects With End Stage Renal Disease (ESRD) Receiving Chronic Hemodialysis
Official Title
A Dose Ranging Study of Dialysate Containing Soluble Ferric Pyrophosphate (SFP) Versus Control in Subjects With ESRD Receiving Chronic Hemodialysis.
Study Type
Interventional

2. Study Status

Record Verification Date
November 2020
Overall Recruitment Status
Completed
Study Start Date
August 2007 (undefined)
Primary Completion Date
October 2009 (Actual)
Study Completion Date
January 2010 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine whether Dialysate containing soluble iron (Soluble Ferric Pyrophosphate) is safe and effective in maintaining physiological iron levels during chronic hemodialysis.
Detailed Description
The study was designed to evaluate the efficacy of SFP-containing dialysate solution in maintaining physiological iron levels during chronic hemodialysis, as measured by the primary endpoint of the percent of patients whose Hemoglobin (Hgb) decreased by at least 1.0 gram/ deciliter (g/dL) from baseline. The efficacy and safety findings are to be used to determine the optimal concentration of SFP needed to safely maintain iron levels, compensating for iron losses during chronic hemodialysis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
End-Stage Renal Disease (ESRD)
Keywords
Subjects with ESRD receiving chronic Hemodialysis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
131 (Actual)

8. Arms, Groups, and Interventions

Arm Title
0 µg iron/dL of dialysate
Arm Type
Placebo Comparator
Arm Description
Placebo 0 micrograms (µg) of iron/ deciliter (dL) of dialysate
Arm Title
5 µg iron/dL of dialysate
Arm Type
Experimental
Arm Description
5 micrograms (µg) of iron/ deciliter (dL) of dialysate
Arm Title
10 µg iron/dL of dialysate
Arm Type
Experimental
Arm Description
10 micrograms (µg) of iron/ deciliter (dL) of dialysate
Arm Title
12 µg iron/dL of dialysate
Arm Type
Experimental
Arm Description
12 micrograms (µg) of iron/ deciliter (dL) of dialysate
Arm Title
15 µg iron/dL of dialysate
Arm Type
Experimental
Arm Description
15 micrograms (µg) of iron/ deciliter (dL) of dialysate
Intervention Type
Device
Intervention Name(s)
Standard Bicarbonate Solution
Other Intervention Name(s)
Placebo
Intervention Description
Patients received 0 micrograms (µg) of iron/ decilited (dL) of dialysate during dialysis 3 times/week for up to 26 weeks.
Intervention Type
Drug
Intervention Name(s)
Soluble Ferric Pyrophosphate
Other Intervention Name(s)
SFP
Intervention Description
Patients received 5 micrograms (µg) of iron/ decilited (dL) of dialysate during dialysis 3 times/week for up to 26 weeks.
Intervention Type
Drug
Intervention Name(s)
Soluble Ferric Pyrophosphate
Other Intervention Name(s)
SFP
Intervention Description
Patients received 10 micrograms (µg) of iron/ decilited (dL) of dialysate during dialysis 3 times/week for up to 26 weeks.
Intervention Type
Drug
Intervention Name(s)
Soluble Ferric Pyrophosphate
Other Intervention Name(s)
SFP
Intervention Description
Patients received 12 micrograms (µg) of iron/ decilited (dL) of dialysate during dialysis 3 times/week for up to 26 weeks.
Intervention Type
Drug
Intervention Name(s)
Soluble Ferric Pyrophosphate
Other Intervention Name(s)
SFP
Intervention Description
Patients received 15 micrograms (µg) of iron/ decilited (dL) of dialysate during dialysis 3 times/week for up to 26 weeks.
Primary Outcome Measure Information:
Title
Percent of Subjects Whose Hemoglobin (Hgb) Decreases by a Total of 1.0 Grams/ Deciliter (g/dL) (or More) From Baseline on Each of Two Successive Measurements.
Description
Efficacy of a Soluble Ferric Pyrophosphate (SFP)-containing dialysate solution in maintaining physiological iron levels during chronic HD, as measured by the percent of subjects whose hgb decreases by a total of 1.0 g/dL (or more) from baseline on each of two successive measurements. Hemoglobin was obtained weekly at the mid-week dialysis treatments and compared to baseline value (average of two hgb measurements obtained at the two consecutive baseline visits prior to randomization).
Time Frame
up to 26 weeks
Secondary Outcome Measure Information:
Title
Change From Baseline in Hemoglobin (Hgb)
Time Frame
two time points: baseline and final evaluation (last post baseline assessment, up to 26 weeks)
Title
Time in Days for Hgb to Decrease by a Total of > = 1.0 g/dL From Baseline on Each of Two Successive Measurements in Each Treatment Group.
Description
Kaplan-Meier Estimate of Time to First Hgb Decrease by >= 1.0 g/dL
Time Frame
Up to 26 weeks
Title
Reticulocyte Hemoglobin (CHr) Values Every Four Weeks, and at the End of the Subject's Treatment.
Description
Efficacy of SFP administration in dialysate solution as measured by Chr values every four weeks, and at the end of the Subject's Treatment (up to 26 weeks).
Time Frame
Every 4 weeks
Title
Number of Subjects With Infection Episodes Requiring Antibiotic or Anti-fungal Therapy in Each Treatment Group.
Time Frame
At each dialysis session for up to 26 weeks
Title
Number of Subjects With a Rise in Hemoglobin (Hgb) to 12.6 g/dL or More on Two Separate Occasions Measured One Week Apart.
Time Frame
two separate sessions measured one week apart.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Selected Inclusion Criteria: Adult subject ≥ 18 years of age undergoing chronic hemodialysis for end-stage renal disease (ESRD) three times a week Hemoglobin (Hgb) values on two successive screening/baseline measures immediately prior to the start of the study averaging 10.1 to 11.5 grams/ deciliter (g/dL), inclusive Transferrin Saturation (TSAT) values that average 20% or more, but not exceeding 35%, prior to dialysis measured during the screening period Ferritin values that average 200 to 800 micrograms/ liter (µg/L), inclusive, measured during the screening period. An average ferritin above 800 µg/L but no greater than 1200 µg/L is allowed if the average TSAT is 20% to no greater than 25%. Except for vascular access surgery, subject has no hospitalization in previous three months for a significant illness that, in the opinion of the Investigator, confers a significant risk of hospitalization during the course of the study. No blood transfusions within the last 4 weeks are allowed. Subject has an adequate dialyzer blood flow rate that is acceptable to the Principal Investigator Exclusion Criteria: Hemoglobin (Hgb) values on two successive baseline/screening measurements that average ≥ 11.6g/dL Subject with a current malignancy involving a site other than skin Subject with a history of drug or alcohol abuse within the last six months Subject believed to be unable to complete the entire study (e.g., due to a concurrent disease, life expectancy of less than a year) Subject who the Principal Investigator considers will be placed at increased risk by the study procedures Subject requiring hemodialysis more than 3 times per week on a regular basis. Subject who is unable to discontinue oral iron or intravenous iron supplements for the duration of the study Subject who is pregnant Subject considered incompetent to give an informed consent Subject with a positive test for Hepatitis B Surface Antigen within the past 30 days or during screening Subject with known HIV infection (if this is not known, no HIV testing will be performed) Subject with cirrhosis of the liver based on histological criteria or clinical criteria (presence of ascites, esophageal varices, spider nevi, or history of hepatic encephalopathy). Subject with hepatitis C, in the absence of cirrhosis, is not excluded from participation in the study if ALT and AST levels are below 2 times the upper limit of normal consistently during the 2 months preceding enrollment Subject with active tuberculosis, fungal, viral, or parasitic infection Subject with active bacterial infection requiring antibiotic therapy Subject with pre-dialysis Corrected Q-wave to T-wave (QTc) interval ≥ 470 milliseconds (ms) Subject with a history of hypokalemia, decompensated heart failure, or family history of Long QT Syndrome that in the Investigator's judgment poses a risk for Torsades de Pointe during the study Subject using concomitant medications known to prolong QT/QTc interval (See Appendix I, TABLE A) Subject receiving more than 60,000 units or 120 micrograms of erythropoietin (Epogen®, Procrit®, or Aranesp®) per week Subject has participated in another clinical trial within 30 days of signing Informed Consent
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Richard Yocum, MD
Organizational Affiliation
Rockwell Medical Technologies
Official's Role
Study Director
Facility Information:
Facility Name
Investigator
City
Tempe
State/Province
Arizona
ZIP/Postal Code
85284
Country
United States
Facility Name
Investigator
City
Hacienda Heights
State/Province
California
ZIP/Postal Code
91745
Country
United States
Facility Name
Investigator
City
Los Angeles
State/Province
California
ZIP/Postal Code
90059
Country
United States
Facility Name
Investigator
City
Whittier
State/Province
California
ZIP/Postal Code
90603
Country
United States
Facility Name
Investigative Site
City
Augusta
State/Province
Georgia
ZIP/Postal Code
30901
Country
United States
Facility Name
Investigator
City
Meridian
State/Province
Idaho
ZIP/Postal Code
83642
Country
United States
Facility Name
Investigator
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60617
Country
United States
Facility Name
Investigative Site
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202-1718
Country
United States
Facility Name
Investigator
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70115
Country
United States
Facility Name
Investigator
City
Springfield
State/Province
Massachusetts
ZIP/Postal Code
01107
Country
United States
Facility Name
Investigative Site
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48202
Country
United States
Facility Name
Investigator
City
Hackensack
State/Province
New Jersey
ZIP/Postal Code
07601
Country
United States
Facility Name
Investigator
City
Brooklyn
State/Province
New York
ZIP/Postal Code
11212
Country
United States
Facility Name
Investigator
City
Great Neck
State/Province
New York
ZIP/Postal Code
11021
Country
United States
Facility Name
Investigator
City
Mineola
State/Province
New York
ZIP/Postal Code
11501
Country
United States
Facility Name
Investigator
City
New York
State/Province
New York
ZIP/Postal Code
10013
Country
United States
Facility Name
Investigator
City
Ridgewood
State/Province
New York
ZIP/Postal Code
11385
Country
United States
Facility Name
Investigator
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27103
Country
United States
Facility Name
Investigative Site
City
Canton
State/Province
Ohio
ZIP/Postal Code
44718
Country
United States
Facility Name
Investigator
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45229
Country
United States
Facility Name
Investigative Site
City
Hershey
State/Province
Pennsylvania
ZIP/Postal Code
17033
Country
United States
Facility Name
Investigator
City
Arlington
State/Province
Texas
ZIP/Postal Code
76011
Country
United States
Facility Name
Investigator
City
Fort Worth
State/Province
Texas
ZIP/Postal Code
76105
Country
United States
Facility Name
Investigator
City
McAllen
State/Province
Texas
ZIP/Postal Code
78503
Country
United States
Facility Name
Investigator
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78207
Country
United States
Facility Name
Investigator
City
Arlington
State/Province
Virginia
ZIP/Postal Code
22206
Country
United States
Facility Name
Investigator
City
Seattle
State/Province
Washington
ZIP/Postal Code
92133
Country
United States
Facility Name
Investigative Site
City
Edmonton
State/Province
Alberta
ZIP/Postal Code
T6G2B7
Country
Canada

12. IPD Sharing Statement

Learn more about this trial

Dose Ranging Study of Dialysate Containing Soluble Iron to Treat Subjects With End Stage Renal Disease (ESRD) Receiving Chronic Hemodialysis

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