Evaluation of the Effectiveness of Paricalcitol Versus Cinacalcet With Low-Dose Vitamin D (IMPACT SHPT)
Chronic Kidney Disease, Secondary Hyperparathyroidism, Hemodialysis
About this trial
This is an interventional treatment trial for Chronic Kidney Disease focused on measuring Zemplar, paricalcitol, IMPACT SHPT, Hemodialysis, Chronic Kidney Disease Stage 5
Eligibility Criteria
Inclusion Criteria
- Male or female patients >= 18 years old.
- Patient was diagnosed with Stage 5 chronic kidney disease (CKD) and had been receiving intravenous (IV) or oral vitamin D receptor activators (VDRAs) or cinacalcet during the 8 weeks prior to the screening period or naïve patients who had not received VDRA or cinacalcet within 8 weeks of screening.
- Patient was on maintenance HD (hemodialysis) 3 times weekly (TIW) for at least 3 months prior to screening and was expected to remain on HD for the duration of the study.
For entry into the Pre-Treatment Washout Period (for patients who were not naïve to VDRAs and cinacalcet), the patient had to have screening laboratory values of:
- iPTH level 130 to 700 pg/mL
- Serum Total Alkaline Phosphatase level >= 40 U/L
- Calcium level <= 10.0 mg/dL (2.49 mmol/L)
- Calcium-phosphorus product (CaxP) <= 75 mg2/dL2 (US) and <= 70 mg2/dL2 (non-US)
Exclusion Criteria
- Patient had a history of parathyroidectomy.
- Patient had a current malignancy (with the exception of basal or squamous cell carcinoma of the skin), or clinically significant liver disease, in the opinion of the investigator.
- Use of known inhibitors (i.e., ketoconazole) or inducers (i.e., carbamazepine) of cytochrome P450 (including grapefruit and/or grapefruit juice) 3A (CYP3A) or drugs metabolized by cytochrome P450 2D6 (CYP2D6) (e.g., flecainide, vinblastine, thioridazine, and most tricyclic antidepressants) within 2 weeks prior to study drug administration. Commonly used beta blockers such as metoprolol and carvedilol are allowed but are metabolized by CYP2D6; thus, an adjustment to a lower dose may have been required.
- Patient was known to be human immunodeficiency (HIV) positive.
Sites / Locations
- Site Reference ID/Investigator# 22781
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- Site Reference ID/Investigator# 38343
- Site Reference ID/Investigator# 21362
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- Site Reference ID/Investigator# 38462
- Site Reference ID/Investigator# 21365
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- Site Reference ID/Investigator# 23782
- Site Reference ID/Investigator# 22364
- Site Reference ID/Investigator# 23912
- Site Reference ID/Investigator# 21747
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- Site Reference ID/Investigator# 23103
- Site Reference ID/Investigator# 41982
- Site Reference ID/Investigator# 40222
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Active Comparator
Active Comparator
Active Comparator
Active Comparator
IV Paricalcitol
Cinacalcet (at sites with IV paricalcitol)
Oral paricalcitol
Cinacalcet (at sites with oral paricalcitol)
Participants in the IV stratum received intravenous (IV) paricalcitol and, if hypercalcemia (calcium >= 10.5 mg/dL), received 30 mg of oral cinacalcet. Paricalcitol was dosed at 0.07 mcg/kg with titration every 2 weeks.
Participants in the IV stratum received 30 mg of oral cinacalcet daily with a low-dose vitamin D receptor activator (VDRA) (doxercalciferol IV 1 mcg 3 times weekly (TIW) at sites in the US and alfacalcidol capsules 0.25 mcg daily at sites in Russia).
Participants in the oral stratum received oral paricalcitol and, if hypercalcemia (calcium >= 10.5 mg/dL), received 30 mg of oral cinacalcet. Paricalcitol was dosed at mcg = IPTH/60 3 times weekly (TIW) with titration every 2 weeks.
Participants in the oral stratum received 30 mg of oral cinacalcet daily with a low-dose vitamin D receptor activator (VDRA) (alfacalcidol capsules 0.25 mcg daily).