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Maintenance Treatment of Anemia Associated With Chronic Kidney Disease (CKD) in Hemodialysis Subjects on Epoetin Alfa / Beta Treatment Versus BAY85-3934 (DIALOGUE4)

Primary Purpose

Anemia, Renal Insufficiency, Chronic

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Molidustat (BAY 85-3934)
Epoetin alfa/beta
Sponsored by
Bayer
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Anemia focused on measuring Anemia of CKD on dialysis

Eligibility Criteria

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

Inclusion Criteria:

  • - Eligible subjects will have a diagnosis of anemia associated with CKD(chronic kidney disease).
  • Women without childbearing potential
  • Male or female subject ≥ 18 years of age with anemia of CKD at screening
  • On dialysis, defined as regular long-term hemodialysis, with the same modality of dialysis for ≥ 3 months before randomization
  • Dialysis vascular access via native arteriovenous fistula, synthetic graft, long-term catheters, or long-term tunneled catheters
  • Treated with epoetin alfa (US or Japan) or epoetin beta (Japan) via intravenous (IV) or subcutaneous (SC) route, on stable dosing defined as a < 50% change from the maximum prescribed weekly dose with no change in the prescribed frequency during the last 8 weeks prior to randomization
  • At least one kidney
  • Mean screening Hb concentration 9.0 to 11.5 g/dL inclusive (mean of all local laboratory Hb measurements [at least 2 measurements must be taken ≥ 2 days apart] during the 4 week screening period, AND none of the measurements can be < 9.0 g/dL or > 12.0 g /dL
  • Serum ferritin levels ≥ 100 μg/L OR transferrin saturation ≥ 20% at screening. Iron substitution is allowed
  • Folate and vitamin B12 levels above the lower limit of normal. Supplementation is allowed
  • Exclusion Criteria:
  • Subjects with significant acute or chronic bleeding, such as overt gastrointestinal bleeding
  • Hereditary hemoglobinopathies (including, but not limited to, sickle cell disease, beta thalassemia, and thalassemia major) which may be the primary cause of anemia
  • Chronic lymphoproliferative diseases
  • Any allograft (including renal allograft) in place and on immunosuppressive therapy, or a scheduled kidney transplant within the next 16 weeks (being on a waiting list does not exclude the subject)
  • Chronic inflammatory disease that could impact erythropoiesis (e.g., systemic lupus erythematosis, rheumatoid arthritis, celiac disease)
  • Subjects treated with immuno- or myelosuppressive therapy within 8 weeks prior to randomization: e.g., everolimus, sirolimus, rituximab, azathioprine, mycophenolate mofetil, mycophenolic acid, cyclosporine,methotrexate, and tacrolimus, chemotherapeutic agents and other anticancer agents, and systemic steroids (except inhaled steroids) for 7 days
  • RBC-containing transfusion within 8 weeks before randomization
  • History of cardio- (cerebro-) vascular events (e.g., unstable angina, myocardial infarction, stroke, transient ischemic attack, deep vein thrombosis, pulmonary embolism) within the last 6 months from the initial screening visit
  • Sustained, poorly controlled arterial hypertension or hypotension at screening, defined as a mean BP ≥ 180/110 mmHg or systolic BP < 95 mmHg, respectively
  • Severe rhythm or conduction disorder (e.g., HR < 50 or > 110 bpm, atrial flutter, prolonged QT >500 msec, second or third degree atrioventricular [AV]block if not treated with a pacemaker)
  • New York Heart Association Class III or IV congestive heart failure
  • Severe hepatic insufficiency (defined as alanine aminotransferase [ALT], aspartate aminotransferase [AST], or gamma-glutamyl transferase > 3 times the upper limit of normal [ULN], total bilirubin > 2 mg/dL, or Child-Pugh B or C) or active hepatitis in the investigator's opinion
  • A scheduled surgery that may be expected to lead to significant blood loss

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Active Comparator

Arm Label

Molidustat (BAY 85-3934)(25mg)

Molidustat (BAY 85-3934)(50mg)

Molidustat (BAY 85-3934) (75mg)

Molidustat (BAY 85-3934) (150mg)

Epoetin alfa/beta

Arm Description

Starting dose of 25 mg of BAY85-3934 as once-daily oral tablets. Regular titrations at dose control visits. Titration occuring every 4-weeks will be based on the subject's Hb response and tolerability of the prior dose. Total treatment time is 16 weeks. Planned doses include 15, 25, 50, 75, 100,150 and 200 mg once daily.

Starting dose of 50 mg of BAY85-3934 as once-daily oral tablets. Regular titrations at dose control visits Titration occuring every 4-weeks will be based on the subject's Hb response and tolerability of the prior dose. Total treatment time is 16 weeks. Planned doses include 15, 25, 50, 75, 100,150 and 200 mg once daily.

Starting dose of 75 mg of BAY85-3934 as once-daily oral tablets. Regular titrations at dose control visits Titration occuring every 4-weeks will be based on the subject's Hb response and tolerability of the prior dose. Total treatment time is 16 weeks. Planned doses include 15, 25, 50, 75, 100,150 and 200 mg once daily.,

Starting dose of 150 mg of BAY85-3934 as once-daily oral tablets. Regular titrations at dose control visits Titration occuring every 4-weeks will be based on the subject's Hb response and tolerability of the prior dose. Total treatment time is 16 weeks. Planned doses include 15, 25, 50, 75, 100, 150 and 200 mg once daily

Starting dose at the subject's current weekly dose. Administered IV or SC 3 times per week. Doses will be titrated at the scheduled dose control visits according to the local label. Titration will be based on the subject's Hb response and tolerability of the prior dose. Epoetin alfa may be administered in either the United States (US) or Japan; epoetin beta will only be administered in Japan.

Outcomes

Primary Outcome Measures

Change in local laboratory hemoglobin level from baseline to the average during the last 4 weeks treatment period

Secondary Outcome Measures

Mean of the hemoglobin (Hb) levels in the target range (10.0 to 11.0 g/dL)
Mean of the hemoglobin levels in the target range (9.5 to 11.5 g/dL)
Change from baseline in Hb during active treatment
Number of patients with hemoglobin levels outside the target range
Dose level in the evaluation period
Duration of exposure on each dose level
Number of subjects requiring titration of dose
Number of participants with serious adverse events as a measure of safety and tolerability

Full Information

First Posted
October 18, 2013
Last Updated
September 17, 2019
Sponsor
Bayer
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1. Study Identification

Unique Protocol Identification Number
NCT01975818
Brief Title
Maintenance Treatment of Anemia Associated With Chronic Kidney Disease (CKD) in Hemodialysis Subjects on Epoetin Alfa / Beta Treatment Versus BAY85-3934
Acronym
DIALOGUE4
Official Title
A Randomized, Parallel Group, Open-label, Multicenter Study to Investigate the Efficacy and Safety of Oral BAY85-3934 and Active Comparator (Epoetin Alfa / Beta) in the Maintenance Treatment of Subjects With Anemia Associated With Chronic Kidney Disease Who Are on Dialysis and on Treatment With an Erythropoiesis-stimulating Agent in the United States and Japan
Study Type
Interventional

2. Study Status

Record Verification Date
September 2019
Overall Recruitment Status
Completed
Study Start Date
October 28, 2013 (Actual)
Primary Completion Date
October 23, 2015 (Actual)
Study Completion Date
December 15, 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Bayer

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Evaluate efficacy and safety of 16 weeks of titrated dose treatment with BAY85-3934 versus epoetin alfa/beta as measured by hemoglobin (Hb) levels. Fixed starting doses of 25, 50,75 and 150 mg of BAY85-3934 titrated at the scheduled dose control visits. Titration will be based on the subject's Hb response and tolerability of the prior dose. Planned doses include 15, 25, 50, 75, 100,150 and 200 mg/day

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Anemia, Renal Insufficiency, Chronic
Keywords
Anemia of CKD on dialysis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
201 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Molidustat (BAY 85-3934)(25mg)
Arm Type
Experimental
Arm Description
Starting dose of 25 mg of BAY85-3934 as once-daily oral tablets. Regular titrations at dose control visits. Titration occuring every 4-weeks will be based on the subject's Hb response and tolerability of the prior dose. Total treatment time is 16 weeks. Planned doses include 15, 25, 50, 75, 100,150 and 200 mg once daily.
Arm Title
Molidustat (BAY 85-3934)(50mg)
Arm Type
Experimental
Arm Description
Starting dose of 50 mg of BAY85-3934 as once-daily oral tablets. Regular titrations at dose control visits Titration occuring every 4-weeks will be based on the subject's Hb response and tolerability of the prior dose. Total treatment time is 16 weeks. Planned doses include 15, 25, 50, 75, 100,150 and 200 mg once daily.
Arm Title
Molidustat (BAY 85-3934) (75mg)
Arm Type
Experimental
Arm Description
Starting dose of 75 mg of BAY85-3934 as once-daily oral tablets. Regular titrations at dose control visits Titration occuring every 4-weeks will be based on the subject's Hb response and tolerability of the prior dose. Total treatment time is 16 weeks. Planned doses include 15, 25, 50, 75, 100,150 and 200 mg once daily.,
Arm Title
Molidustat (BAY 85-3934) (150mg)
Arm Type
Experimental
Arm Description
Starting dose of 150 mg of BAY85-3934 as once-daily oral tablets. Regular titrations at dose control visits Titration occuring every 4-weeks will be based on the subject's Hb response and tolerability of the prior dose. Total treatment time is 16 weeks. Planned doses include 15, 25, 50, 75, 100, 150 and 200 mg once daily
Arm Title
Epoetin alfa/beta
Arm Type
Active Comparator
Arm Description
Starting dose at the subject's current weekly dose. Administered IV or SC 3 times per week. Doses will be titrated at the scheduled dose control visits according to the local label. Titration will be based on the subject's Hb response and tolerability of the prior dose. Epoetin alfa may be administered in either the United States (US) or Japan; epoetin beta will only be administered in Japan.
Intervention Type
Drug
Intervention Name(s)
Molidustat (BAY 85-3934)
Intervention Description
Oral doses of BAY85-3934 will be available in multiples of 25,50,75 and 150 mg tablets
Intervention Type
Biological
Intervention Name(s)
Epoetin alfa/beta
Primary Outcome Measure Information:
Title
Change in local laboratory hemoglobin level from baseline to the average during the last 4 weeks treatment period
Time Frame
Baseline and weeks 14 to 17
Secondary Outcome Measure Information:
Title
Mean of the hemoglobin (Hb) levels in the target range (10.0 to 11.0 g/dL)
Time Frame
From week 14 to 17
Title
Mean of the hemoglobin levels in the target range (9.5 to 11.5 g/dL)
Time Frame
From week 14 to 17
Title
Change from baseline in Hb during active treatment
Time Frame
Baseline and weeks 14 to 17
Title
Number of patients with hemoglobin levels outside the target range
Time Frame
From week 14 to 17
Title
Dose level in the evaluation period
Time Frame
Up to 16 weeks
Title
Duration of exposure on each dose level
Time Frame
Up to 16 weeks
Title
Number of subjects requiring titration of dose
Time Frame
Up to 16 weeks
Title
Number of participants with serious adverse events as a measure of safety and tolerability
Time Frame
Up to 16 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: - Eligible subjects will have a diagnosis of anemia associated with CKD(chronic kidney disease). Women without childbearing potential Male or female subject ≥ 18 years of age with anemia of CKD at screening On dialysis, defined as regular long-term hemodialysis, with the same modality of dialysis for ≥ 3 months before randomization Dialysis vascular access via native arteriovenous fistula, synthetic graft, long-term catheters, or long-term tunneled catheters Treated with epoetin alfa (US or Japan) or epoetin beta (Japan) via intravenous (IV) or subcutaneous (SC) route, on stable dosing defined as a < 50% change from the maximum prescribed weekly dose with no change in the prescribed frequency during the last 8 weeks prior to randomization At least one kidney Mean screening Hb concentration 9.0 to 11.5 g/dL inclusive (mean of all local laboratory Hb measurements [at least 2 measurements must be taken ≥ 2 days apart] during the 4 week screening period, AND none of the measurements can be < 9.0 g/dL or > 12.0 g /dL Serum ferritin levels ≥ 100 μg/L OR transferrin saturation ≥ 20% at screening. Iron substitution is allowed Folate and vitamin B12 levels above the lower limit of normal. Supplementation is allowed Exclusion Criteria: Subjects with significant acute or chronic bleeding, such as overt gastrointestinal bleeding Hereditary hemoglobinopathies (including, but not limited to, sickle cell disease, beta thalassemia, and thalassemia major) which may be the primary cause of anemia Chronic lymphoproliferative diseases Any allograft (including renal allograft) in place and on immunosuppressive therapy, or a scheduled kidney transplant within the next 16 weeks (being on a waiting list does not exclude the subject) Chronic inflammatory disease that could impact erythropoiesis (e.g., systemic lupus erythematosis, rheumatoid arthritis, celiac disease) Subjects treated with immuno- or myelosuppressive therapy within 8 weeks prior to randomization: e.g., everolimus, sirolimus, rituximab, azathioprine, mycophenolate mofetil, mycophenolic acid, cyclosporine,methotrexate, and tacrolimus, chemotherapeutic agents and other anticancer agents, and systemic steroids (except inhaled steroids) for 7 days RBC-containing transfusion within 8 weeks before randomization History of cardio- (cerebro-) vascular events (e.g., unstable angina, myocardial infarction, stroke, transient ischemic attack, deep vein thrombosis, pulmonary embolism) within the last 6 months from the initial screening visit Sustained, poorly controlled arterial hypertension or hypotension at screening, defined as a mean BP ≥ 180/110 mmHg or systolic BP < 95 mmHg, respectively Severe rhythm or conduction disorder (e.g., HR < 50 or > 110 bpm, atrial flutter, prolonged QT >500 msec, second or third degree atrioventricular [AV]block if not treated with a pacemaker) New York Heart Association Class III or IV congestive heart failure Severe hepatic insufficiency (defined as alanine aminotransferase [ALT], aspartate aminotransferase [AST], or gamma-glutamyl transferase > 3 times the upper limit of normal [ULN], total bilirubin > 2 mg/dL, or Child-Pugh B or C) or active hepatitis in the investigator's opinion A scheduled surgery that may be expected to lead to significant blood loss
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bayer Study Director
Organizational Affiliation
Bayer
Official's Role
Study Director
Facility Information:
City
Azusa
State/Province
California
ZIP/Postal Code
91702
Country
United States
City
Long Beach
State/Province
California
ZIP/Postal Code
90813
Country
United States
City
Los Angeles
State/Province
California
ZIP/Postal Code
90025
Country
United States
City
Lynwood
State/Province
California
ZIP/Postal Code
90262
Country
United States
City
Northridge
State/Province
California
ZIP/Postal Code
91324
Country
United States
City
San Dimas
State/Province
California
ZIP/Postal Code
91773
Country
United States
City
Whittier
State/Province
California
ZIP/Postal Code
90602
Country
United States
City
Whittier
State/Province
California
ZIP/Postal Code
90606
Country
United States
City
New Port Richey
State/Province
Florida
ZIP/Postal Code
34652
Country
United States
City
Pembroke Pines
State/Province
Florida
ZIP/Postal Code
33028
Country
United States
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48202
Country
United States
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48236
Country
United States
City
Creve Coeur
State/Province
Missouri
ZIP/Postal Code
63141
Country
United States
City
Eatontown
State/Province
New Jersey
ZIP/Postal Code
07724
Country
United States
City
Brooklyn
State/Province
New York
ZIP/Postal Code
11212
Country
United States
City
Buffalo
State/Province
New York
ZIP/Postal Code
14215
Country
United States
City
Fresh Meadows
State/Province
New York
ZIP/Postal Code
11365
Country
United States
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45206
Country
United States
City
Toledo
State/Province
Ohio
ZIP/Postal Code
43615
Country
United States
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73116
Country
United States
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37212-8150
Country
United States
City
Fort Worth
State/Province
Texas
ZIP/Postal Code
76104
Country
United States
City
Fort Worth
State/Province
Texas
ZIP/Postal Code
76105
Country
United States
City
Fort Worth
State/Province
Texas
ZIP/Postal Code
76164
Country
United States
City
Grand Prairie
State/Province
Texas
ZIP/Postal Code
75050
Country
United States
City
Houston
State/Province
Texas
ZIP/Postal Code
77004
Country
United States
City
Houston
State/Province
Texas
ZIP/Postal Code
77091
Country
United States
City
Mansfield
State/Province
Texas
ZIP/Postal Code
76063
Country
United States
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78215
Country
United States
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
City
Muroran
State/Province
Hokkaido
ZIP/Postal Code
050-0083
Country
Japan
City
Himeji
State/Province
Hyogo
ZIP/Postal Code
670-0947
Country
Japan
City
Kuwana
State/Province
Mie
ZIP/Postal Code
511-0061
Country
Japan
City
Kyoto
ZIP/Postal Code
607-8116
Country
Japan
City
Nagano
ZIP/Postal Code
388-8004
Country
Japan

12. IPD Sharing Statement

Citations:
PubMed Identifier
36005278
Citation
Natale P, Palmer SC, Jaure A, Hodson EM, Ruospo M, Cooper TE, Hahn D, Saglimbene VM, Craig JC, Strippoli GF. Hypoxia-inducible factor stabilisers for the anaemia of chronic kidney disease. Cochrane Database Syst Rev. 2022 Aug 25;8(8):CD013751. doi: 10.1002/14651858.CD013751.pub2.
Results Reference
derived
Links:
URL
http://clinicaltrials.bayer.com/
Description
Click here to find results for studies related to Bayer products

Learn more about this trial

Maintenance Treatment of Anemia Associated With Chronic Kidney Disease (CKD) in Hemodialysis Subjects on Epoetin Alfa / Beta Treatment Versus BAY85-3934

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