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Pharmacokinetic/Pharmacodynamic Parameters of NNG-DEPO (Stimus) With Aranesp® (Amgen) in Treatment of Anemia in CKD Patients on Dialysis (CKD)

Primary Purpose

Chronic Kidney Disease

Status
Active
Phase
Phase 1
Locations
Vietnam
Study Type
Interventional
Intervention
Stimus
Sponsored by
Nanogen Pharmaceutical Biotechnology Joint Stock Company
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Kidney Disease focused on measuring darbepoetin alfa, Nanogen, CKD, dialysis, treatment of anemia

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria The patients signed the informe consent form and adhere to study visit schedule. Male or female patients aged from 18 to 65 years. Patients on hemodialysis or peritoneal dialysis for at least 3 months and have Hb baseline <10 g/dL during the screening period. Have transferrin saturation ≥ 20%, serum ferritin ≥ 200 ng/mL, vitamin B12 and folate within the normal range. Have expected survival of at least 6 months from time of enrollment (by investigator's assessment). Women childbearing age must agree to use medically acceptable methods of contraception during the study and for 6 months after the last study treatment. The patient does not have any serious medical conditions that may affect to study treatment compliance. Exclusion Criteria Uncontrolled hypertension over 2 weeks prior to and within the screening period (BP ≥ 160/90 mmHg). Patients treated with Darbepoetin alfa or r-HuEPO within 4 weeks prior to enrollment. Patients with Uncontrolled diabetes mellitus with HbA1C ≥ 10%. Congestive Heart Failure of grade 3 or 4 as New York Heart Association classification. History of unstable angina or myocardial infarction within 6 months. History of Grand mal seizures in last 2 years. Present with severe hyperparathyroidism (iPTH >1500 pg/mL for Dialysis). History of major surgery within 12 weeks prior to screening. Systemic hematologic disorders including sickle cell anemia, myelodysplastic syndromes, hematological malignancy, myeloma and hemolytic anemia. Systemic infections, active inflammatory diseases and malignancies. Active liver disease or hepatic with liver enzymes AST and ALT raised > 2-times of laboratory normal values, child B or child C cirrhosis. Are being treated with androgen therapy within the 8 weeks prior to the screening period. Pregnant or suspected pregnant women, breast-feeding women. Patients scheduled for any transplant procedure within 6 months of screening or with a previous history of kidney transplantation. Patients who are hypersensitive to any of substances of investigational product. Patients using drugs that can affect the concentration of Hb in the blood (except blood-forming drugs such as iron, folic acid). Patients with seropositivity to HIV, HBV or anti-HCV. Patients having acute tuberculosis or any acute bacterial infection within 1 month prior to the screening. Patient has occult blood in stool or any other known source of internal bleeding and confirmed gastrointestinal bleeding by endoscopy. Patients with blood transfusion due to acute bleeding within 12 weeks prior to screening period. Patients with a history of immunosuppressive therapy within 1 month. The patient is suffering from advanced cancer. Patients having participated in any other clinical trial within 1 month prior to the screening period. The patient had any medical condition that the investigator assessed as affecting the study.

Sites / Locations

  • NANOGEN Pharmaceutical Biotechnology JSC

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Stimus

Aranesp

Arm Description

Treatment: Nanogen's Darbepoetin alfa 10µg/0.4mL, 20µg/0.5mL, 40µg/0.4mL, 60µg/0.3mL, prefilled syringe

Control: Amgen's Aranesp® 10µg/0.4mL, 20µg/0.5mL, 40µg/0.4mL, 60µg/0.3mL, prefilled syringe

Outcomes

Primary Outcome Measures

PK parameters comparison between NNG-DEPO and Aranesp®: Cmax
Serum peak concentrations (Cmax)
PK parameters comparison between NNG-DEPO and Aranesp®: AUC(0, t)
Area under the curve from 0 to t (AUC 0-t)

Secondary Outcome Measures

PD parameters comparison between NNG-DEPO and Aranesp®: Cmax of reticulocytes
Serum peak concentrations (Cmax) of reticulocytes
PD parameters comparison between NNG-DEPO and Aranesp®: AUC(0, t) of reticulocytes
Area under the curve from 0 to t (AUC 0-t) of reticulocytes
PD parameters comparison between NNG-DEPO and Aranesp®: Tmax of reticulocytes
Time for the drug to reach peak concentration (Tmax) of reticulocytes
PK parameters comparison between NNG-DEPO and Aranesp®:Tmax
Time for the drug to reach peak concentration (Tmax)
PK parameters comparison between NNG-DEPO and Aranesp®: AUC(0,∞)
Area under the curve from 0 to ∞ (AUC0-∞)
PK parameters comparison between NNG-DEPO and Aranesp®:T1/2
Half-life (T1/2)
PK parameters comparison between NNG-DEPO and Aranesp®: CL/F
CL/F
PK parameters comparison between NNG-DEPO and Aranesp®:Vz/F
Vz/F
PK parameters comparison between NNG-DEPO and Aranesp®: λz.
λz.
Proportion of the adverse events (AE) including physical examinations, vital signs, and clinical laboratory investigations.
Rate of AE and SAE occurence

Full Information

First Posted
October 13, 2022
Last Updated
November 23, 2022
Sponsor
Nanogen Pharmaceutical Biotechnology Joint Stock Company
Collaborators
Vietstar Biomedical Research, Clinical Research Consultants, Inc., Clinical Research Viet Nam Skill Training And Consultant Company Limited
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1. Study Identification

Unique Protocol Identification Number
NCT05636891
Brief Title
Pharmacokinetic/Pharmacodynamic Parameters of NNG-DEPO (Stimus) With Aranesp® (Amgen) in Treatment of Anemia in CKD Patients on Dialysis
Acronym
CKD
Official Title
Randomized, Double-blind, Parallel, Active Controlled Study to Compare Pharmacokinetic/Pharmacodynamic Parameters of Nanogen's Darbepoetin Alfa With Aranesp® (Amgen) in Treatment of Anemia in Chronic Kidney Disease Patients on Dialysis
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
August 8, 2019 (Actual)
Primary Completion Date
November 30, 2022 (Anticipated)
Study Completion Date
December 31, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Nanogen Pharmaceutical Biotechnology Joint Stock Company
Collaborators
Vietstar Biomedical Research, Clinical Research Consultants, Inc., Clinical Research Viet Nam Skill Training And Consultant Company Limited

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This is a double-blind, randomized, active-control study with 2-study arms-darbepoetin alfa biosimilar and Aranesp, noninferiority trial design in dialysis patients. Dialysis patients will be randomized into 1:1 ratio to receive either Darbepoetin alfa or Aranesp 0.75 µg/kg by subcutaneous injection every other week for 24 weeks. Pharmacokinetic/pharmacodynamic parameters for evaluation are assessed as per study endpoints at defined time points on all patients. During the treatment, dose adjustments will be made as necessary to achieve a hemoglobin response, defined as maintaining Hb in target range 10 - 12 g/dL.
Detailed Description
PHASE OF TRIAL: I SAMPLE SIZE: 43 for pharmacokinetic/pharmacodynamic parameters TARGET POPULATION: Patients with chronic kidney disease undergoing dialysis STUDY GROUPS: Darbepoetin alfa (Nanogen) SC 0.75 µg/kg Q2W, for 24 weeks. Aranesp® (Amgen) SC 0.75 µg/kg Q2W, for 24 weeks. PK ASSESSMENT: Blood samples for PK assessments will be collected at: IV: time zero (predose) before injection of study drug and then after 0.25, 0.5, 4, 12, 24, 48, 96, 144, 240 and 336 hours post-dose. SC: time zero (predose) before injection of study drug and then after 4, 12, 24, 48, 96, 144, 240 and 336 hours post-dose. PD ASSESSMENT: Blood samples for PD assessments will be collected at time zero (predose) before injection of study drug and then after 24, 48, 96, 144, 240 and 336 hours post-dose. SAFETY AND TOLERABILITY ASSESSMENT: Safety and tolerability assessments will be performed at each visit. Following variables will be considered to define the safety and tolerability of investigational drugs: Clinical adverse events (AEs): frequency of AEs, overall and by intensity. Severe clinical adverse events (SAEs): frequency of AEs, overall and by intensity. Symptoms directed physical examination including body weight, and vital signs during treatment period: mean change from baseline and the frequency of clinically relevant changes from baseline. Laboratory tests: frequency of clinically relevant changes from baseline. The frequency of any concomitant medication administered to treat any adverse events. Presence of anti-bodies to darbepoetin alfa (immunogenicity).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Kidney Disease
Keywords
darbepoetin alfa, Nanogen, CKD, dialysis, treatment of anemia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
43 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Stimus
Arm Type
Experimental
Arm Description
Treatment: Nanogen's Darbepoetin alfa 10µg/0.4mL, 20µg/0.5mL, 40µg/0.4mL, 60µg/0.3mL, prefilled syringe
Arm Title
Aranesp
Arm Type
Active Comparator
Arm Description
Control: Amgen's Aranesp® 10µg/0.4mL, 20µg/0.5mL, 40µg/0.4mL, 60µg/0.3mL, prefilled syringe
Intervention Type
Biological
Intervention Name(s)
Stimus
Intervention Description
NNG-DEPO (Darbepoetin alfa 10 mcg/0.4 mL, 20 mcg/0.5 mL, 40 mcg/0.4 mL, 60 mcg/0.3 mL) is available as a prefilled syringe in a sterile, colorless, glass tube. Aranesp® (Darbepoetin alfa 10 mcg/ 0.4 mL, 20 mcg/ 0.5 mL, 40 mcg/ 0.4 mL, 60 mcg/ 0.3 mL) is manufactured by Amgen, as a pre-filled syringe in a sterile, glass tube, colourless. Storage: 2-8ºC, not frozen. The process of transporting and storing the drug must ensure the temperature in the range of 2-8ºC. NNG-DEPO/Aranesp is administered subcutaneously (or intravenously for patients with PK-PD in the previous IV group), at a dose of 0.75 g/kg initially, every 2 weeks at the second visit. IPs will be prepared according to standard procedure (SOP). Dosage adjustment guideline: Patients will have hemoglobin levels monitored every 2 weeks. The investigators will evaluate and adjust the dose of Darbepoetin alfa to maintain the Hb levels within the target range (10 - 12 g/dL)
Primary Outcome Measure Information:
Title
PK parameters comparison between NNG-DEPO and Aranesp®: Cmax
Description
Serum peak concentrations (Cmax)
Time Frame
IV:Assessed predose and at 0.25; 0.5; 4;12;24;48;96;144;240;336 hours postdose/ SC: Assessed predose and at 4;12;24;48;96;144;240;336 hours postdose
Title
PK parameters comparison between NNG-DEPO and Aranesp®: AUC(0, t)
Description
Area under the curve from 0 to t (AUC 0-t)
Time Frame
IV:Assessed predose and at 0.25; 0.5; 4;12;24;48;96;144;240;336 hours postdose/ SC: Assessed predose and at 4;12;24;48;96;144;240;336 hours postdose
Secondary Outcome Measure Information:
Title
PD parameters comparison between NNG-DEPO and Aranesp®: Cmax of reticulocytes
Description
Serum peak concentrations (Cmax) of reticulocytes
Time Frame
Assessed predose and at and at 24;48;96;144;240;336 hours postdose
Title
PD parameters comparison between NNG-DEPO and Aranesp®: AUC(0, t) of reticulocytes
Description
Area under the curve from 0 to t (AUC 0-t) of reticulocytes
Time Frame
Assessed predose and at and at 24;48;96;144;240;336 hours postdose
Title
PD parameters comparison between NNG-DEPO and Aranesp®: Tmax of reticulocytes
Description
Time for the drug to reach peak concentration (Tmax) of reticulocytes
Time Frame
Assessed predose and at and at 24;48;96;144;240;336 hours postdose
Title
PK parameters comparison between NNG-DEPO and Aranesp®:Tmax
Description
Time for the drug to reach peak concentration (Tmax)
Time Frame
IV:Assessed predose and at 0.25; 0.5; 4;12;24;48;96;144;240;336 hours postdose/ SC: Assessed predose and at 4;12;24;48;96;144;240;336 hours postdose
Title
PK parameters comparison between NNG-DEPO and Aranesp®: AUC(0,∞)
Description
Area under the curve from 0 to ∞ (AUC0-∞)
Time Frame
IV:Assessed predose and at 0.25; 0.5; 4;12;24;48;96;144;240;336 hours postdose/ SC: Assessed predose and at 4;12;24;48;96;144;240;336 hours postdose
Title
PK parameters comparison between NNG-DEPO and Aranesp®:T1/2
Description
Half-life (T1/2)
Time Frame
IV:Assessed predose and at 0.25; 0.5; 4;12;24;48;96;144;240;336 hours postdose/ SC: Assessed predose and at 4;12;24;48;96;144;240;336 hours postdose
Title
PK parameters comparison between NNG-DEPO and Aranesp®: CL/F
Description
CL/F
Time Frame
IV:Assessed predose and at 0.25; 0.5; 4;12;24;48;96;144;240;336 hours postdose/ SC: Assessed predose and at 4;12;24;48;96;144;240;336 hours postdose
Title
PK parameters comparison between NNG-DEPO and Aranesp®:Vz/F
Description
Vz/F
Time Frame
IV:Assessed predose and at 0.25; 0.5; 4;12;24;48;96;144;240;336 hours postdose/ SC: Assessed predose and at 4;12;24;48;96;144;240;336 hours postdose
Title
PK parameters comparison between NNG-DEPO and Aranesp®: λz.
Description
λz.
Time Frame
IV:Assessed predose and at 0.25; 0.5; 4;12;24;48;96;144;240;336 hours postdose/ SC: Assessed predose and at 4;12;24;48;96;144;240;336 hours postdose
Title
Proportion of the adverse events (AE) including physical examinations, vital signs, and clinical laboratory investigations.
Description
Rate of AE and SAE occurence
Time Frame
Week 0 (Assessed predose)- Week 24]

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria The patients signed the informe consent form and adhere to study visit schedule. Male or female patients aged from 18 to 65 years. Patients on hemodialysis or peritoneal dialysis for at least 3 months and have Hb baseline <10 g/dL during the screening period. Have transferrin saturation ≥ 20%, serum ferritin ≥ 200 ng/mL, vitamin B12 and folate within the normal range. Have expected survival of at least 6 months from time of enrollment (by investigator's assessment). Women childbearing age must agree to use medically acceptable methods of contraception during the study and for 6 months after the last study treatment. The patient does not have any serious medical conditions that may affect to study treatment compliance. Exclusion Criteria Uncontrolled hypertension over 2 weeks prior to and within the screening period (BP ≥ 160/90 mmHg). Patients treated with Darbepoetin alfa or r-HuEPO within 4 weeks prior to enrollment. Patients with Uncontrolled diabetes mellitus with HbA1C ≥ 10%. Congestive Heart Failure of grade 3 or 4 as New York Heart Association classification. History of unstable angina or myocardial infarction within 6 months. History of Grand mal seizures in last 2 years. Present with severe hyperparathyroidism (iPTH >1500 pg/mL for Dialysis). History of major surgery within 12 weeks prior to screening. Systemic hematologic disorders including sickle cell anemia, myelodysplastic syndromes, hematological malignancy, myeloma and hemolytic anemia. Systemic infections, active inflammatory diseases and malignancies. Active liver disease or hepatic with liver enzymes AST and ALT raised > 2-times of laboratory normal values, child B or child C cirrhosis. Are being treated with androgen therapy within the 8 weeks prior to the screening period. Pregnant or suspected pregnant women, breast-feeding women. Patients scheduled for any transplant procedure within 6 months of screening or with a previous history of kidney transplantation. Patients who are hypersensitive to any of substances of investigational product. Patients using drugs that can affect the concentration of Hb in the blood (except blood-forming drugs such as iron, folic acid). Patients with seropositivity to HIV, HBV or anti-HCV. Patients having acute tuberculosis or any acute bacterial infection within 1 month prior to the screening. Patient has occult blood in stool or any other known source of internal bleeding and confirmed gastrointestinal bleeding by endoscopy. Patients with blood transfusion due to acute bleeding within 12 weeks prior to screening period. Patients with a history of immunosuppressive therapy within 1 month. The patient is suffering from advanced cancer. Patients having participated in any other clinical trial within 1 month prior to the screening period. The patient had any medical condition that the investigator assessed as affecting the study.
Facility Information:
Facility Name
NANOGEN Pharmaceutical Biotechnology JSC
City
Ho Chi Minh City
Country
Vietnam

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

Pharmacokinetic/Pharmacodynamic Parameters of NNG-DEPO (Stimus) With Aranesp® (Amgen) in Treatment of Anemia in CKD Patients on Dialysis

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