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TARGTEPO Treatment for Anemia in Chronic Kidney Disease (CKD) Patients and End-Stage Renal Disease (ESRD)

Primary Purpose

Chronic Kidney Disease, End Stage Renal Disease

Status
Completed
Phase
Phase 1
Locations
Israel
Study Type
Interventional
Intervention
MDGN201 TARGTEPO
Sponsored by
Aevi Genomic Medicine, LLC, a Cerecor company
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Kidney Disease

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. For ESRD patients: Subject diagnosed with Anemia due to Chronic Renal Failure CKD stage 5 on hemodialysis treatment for at least 6 months. Average Hb during last month between 9 to 12g/dL.
  2. Kt/V >1
  3. INR not higher than 1.2
  4. Serum albumin >3.5
  5. Subjects with adequate iron stores (transferrin saturation > 20.0% and/or ferritin >100 ng/ml).

Exclusion Criteria:

  1. Uncontrolled hypertension (defined as diastolic blood pressure > 110 mmHg or systolic blood pressure > 180 mmHg during screening).
  2. Subjects who receive oral anti-coagulation treatment (e.g. warfarin)
  3. Subjects who receive Acetyl Salicylic Acid (ASA) above 325 mg/day or patients who receive ASA treatment between 100mg/d and 325 mg/d who cannot discontinue it for 1 week prior to each EPODURE procedure
  4. Patients currently receiving injections of long-acting Erythropoiesis Stimulating Agents (ESA) (e.g. Aranesp, Mircera), a patient on long acting ESA can be switched to a short acting preparation (e.g Eprex) and enroll in the study after meeting the inclusion criteria and not meeting any other exclusion criteria.
  5. Congestive heart failure (New York Heart Association functional class III or IV).
  6. Grand mal seizures within 2 years of the screening visit.
  7. Clinical evidence of severe hyperparathyroidism as defined by PTH levels of > 10 times the upper normal limits.
  8. Major surgery within 12 weeks of the screening visit.
  9. Systemic hematologic diseases (e.g., sickle cell anemia, thalassemia, myelodysplastic syndromes, hematologic malignancy, myeloma, hemolytic anemia).
  10. Current systemic infection, active inflammatory disease, or malignancy under active treatment.
  11. Subjects known to have tested positive at any time in the past for antibodies to erythropoietic proteins.
  12. Subject has history of malignancy within the past 2 years prior to the screening visit, with the exception of basal cell carcinoma.
  13. Subjects with other concurrent severe and/or uncontrolled medical condition which could compromise participation in the study (i.e. active infection, uncontrolled diabetes, uncontrolled hypertension, congestive heart failure, unstable angina, ventricular arrhythmias, active ischemic heart disease, myocardial infarction within six months, uncompensated cirrhosis, active upper GI tract ulceration).
  14. Subject is currently enrolled in, or has not yet completed a period of at least 30 days or five half-lives of the investigational drug whichever is longer, since ending other investigational device or drug trial(s) prior to Screening phase.
  15. Psychiatric, addictive, or any other disorder that compromises ability to provide informed consent for participation in this study.
  16. Female subjects of child-bearing potential and males that do not agree to use acceptable methods of contraception during the study.
  17. Pregnant and lactating female subjects.
  18. Chronic alcoholic or drug abuse subjects.
  19. Steroid or other immunosuppressive treatment (other than topical or inhaled steroids).
  20. Subjects unwilling or unable to comply with the study procedures.
  21. EPO Naïve subjects.
  22. Known sensitivity to Gentamycin and Amphotericin
  23. History of chronic or active Hepatitis B and/or C infection or positive serology at screening and known positive HIV or positive serology at screening.
  24. Subject had blood transfusion within 84 days prior to Screening visit.
  25. Subject has a date for renal transplantation.
  26. Subject has a temporary or permanent hemodialysis catheter, unless: Subject has a permanent hemodialysis catheter over 6 months without signs/events of line sepsis.
  27. Refer to the USPI - Depo-Medrol - Methylprednisolone Acetate - Injectable (Appendix A) for any concomitant drug taken by the patient which its interaction with Depo-Medrol will warrant exclusion from this protocol.

Sites / Locations

  • Barzili Medical Center
  • Meir Medical Center
  • Medical Center of the Galilee
  • Tel Aviv Sourasky Medical Center
  • Assaf Harofeh Medical Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Group A

Group B

Group C

Arm Description

MDGN201 TARGTEPO secreting EPO (18-25 IU/Kg/day)

MDGN201 TARGTEPO secreting EPO (35-45 IU/Kg/day)

MDGN201 TARGTEPO secreting EPO (55-65 IU/Kg/day)

Outcomes

Primary Outcome Measures

Total EPO Secretion
Percent (%) of Hb Measurements After Implantation Within 9-11 g/dL
Percent (%) of Hb Measurements After Implantation Within 9-12 g/dL
Due to the small sample size and the dispersion of total EPO secretion, the efficacy analyses were performed on all of the patients as a single cohort of intended dose between 25 and 45 U/Kg/d.

Secondary Outcome Measures

Full Information

First Posted
April 16, 2014
Last Updated
February 15, 2018
Sponsor
Aevi Genomic Medicine, LLC, a Cerecor company
Collaborators
Medgenics Medical Israel Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT02117427
Brief Title
TARGTEPO Treatment for Anemia in Chronic Kidney Disease (CKD) Patients and End-Stage Renal Disease (ESRD)
Official Title
Safety and Efficacy of Sustained Erythropoietin Therapy of Anemia in Chronic Kidney Disease (CKD) Patients and End-Stage Renal Disease (ESRD) Dialysis Patients Using MDGN201 TARGTEPO
Study Type
Interventional

2. Study Status

Record Verification Date
February 2018
Overall Recruitment Status
Completed
Study Start Date
May 27, 2014 (Actual)
Primary Completion Date
June 30, 2016 (Actual)
Study Completion Date
March 20, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Aevi Genomic Medicine, LLC, a Cerecor company
Collaborators
Medgenics Medical Israel Ltd.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The objectives of this study are to assess safety and to evaluate the biologic activity of TARGTEPO treatment.
Detailed Description
This is a Phase I-II, open-label study. Each patient will receive targeted dose of EPO delivered via TARGTEPO. The targeted doses will be determined according to 3 cohorts as follows: Group A (18-25 IU/Kg/day), Group B (35-45 IU/Kg/day), Group C (55-65 IU/Kg/day). The objective is to evaluate safety and biologic activity of TARGTEPO treatment when maintaining Hb levels within the target range of 9-12 g/dl. Biological activity assessments will include duration of TARGTEPO secretion as measured by serum EPO levels above baseline

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Kidney Disease, End Stage Renal Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
11 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group A
Arm Type
Experimental
Arm Description
MDGN201 TARGTEPO secreting EPO (18-25 IU/Kg/day)
Arm Title
Group B
Arm Type
Experimental
Arm Description
MDGN201 TARGTEPO secreting EPO (35-45 IU/Kg/day)
Arm Title
Group C
Arm Type
Experimental
Arm Description
MDGN201 TARGTEPO secreting EPO (55-65 IU/Kg/day)
Intervention Type
Biological
Intervention Name(s)
MDGN201 TARGTEPO
Intervention Description
Erythropoietin secreted by TARGTEPO transduced with MDGN201
Primary Outcome Measure Information:
Title
Total EPO Secretion
Time Frame
up to 52 weeks
Title
Percent (%) of Hb Measurements After Implantation Within 9-11 g/dL
Time Frame
52 weeks
Title
Percent (%) of Hb Measurements After Implantation Within 9-12 g/dL
Description
Due to the small sample size and the dispersion of total EPO secretion, the efficacy analyses were performed on all of the patients as a single cohort of intended dose between 25 and 45 U/Kg/d.
Time Frame
52 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: For ESRD patients: Subject diagnosed with Anemia due to Chronic Renal Failure CKD stage 5 on hemodialysis treatment for at least 6 months. Average Hb during last month between 9 to 12g/dL. Kt/V >1 INR not higher than 1.2 Serum albumin >3.5 Subjects with adequate iron stores (transferrin saturation > 20.0% and/or ferritin >100 ng/ml). Exclusion Criteria: Uncontrolled hypertension (defined as diastolic blood pressure > 110 mmHg or systolic blood pressure > 180 mmHg during screening). Subjects who receive oral anti-coagulation treatment (e.g. warfarin) Subjects who receive Acetyl Salicylic Acid (ASA) above 325 mg/day or patients who receive ASA treatment between 100mg/d and 325 mg/d who cannot discontinue it for 1 week prior to each EPODURE procedure Patients currently receiving injections of long-acting Erythropoiesis Stimulating Agents (ESA) (e.g. Aranesp, Mircera), a patient on long acting ESA can be switched to a short acting preparation (e.g Eprex) and enroll in the study after meeting the inclusion criteria and not meeting any other exclusion criteria. Congestive heart failure (New York Heart Association functional class III or IV). Grand mal seizures within 2 years of the screening visit. Clinical evidence of severe hyperparathyroidism as defined by PTH levels of > 10 times the upper normal limits. Major surgery within 12 weeks of the screening visit. Systemic hematologic diseases (e.g., sickle cell anemia, thalassemia, myelodysplastic syndromes, hematologic malignancy, myeloma, hemolytic anemia). Current systemic infection, active inflammatory disease, or malignancy under active treatment. Subjects known to have tested positive at any time in the past for antibodies to erythropoietic proteins. Subject has history of malignancy within the past 2 years prior to the screening visit, with the exception of basal cell carcinoma. Subjects with other concurrent severe and/or uncontrolled medical condition which could compromise participation in the study (i.e. active infection, uncontrolled diabetes, uncontrolled hypertension, congestive heart failure, unstable angina, ventricular arrhythmias, active ischemic heart disease, myocardial infarction within six months, uncompensated cirrhosis, active upper GI tract ulceration). Subject is currently enrolled in, or has not yet completed a period of at least 30 days or five half-lives of the investigational drug whichever is longer, since ending other investigational device or drug trial(s) prior to Screening phase. Psychiatric, addictive, or any other disorder that compromises ability to provide informed consent for participation in this study. Female subjects of child-bearing potential and males that do not agree to use acceptable methods of contraception during the study. Pregnant and lactating female subjects. Chronic alcoholic or drug abuse subjects. Steroid or other immunosuppressive treatment (other than topical or inhaled steroids). Subjects unwilling or unable to comply with the study procedures. EPO Naïve subjects. Known sensitivity to Gentamycin and Amphotericin History of chronic or active Hepatitis B and/or C infection or positive serology at screening and known positive HIV or positive serology at screening. Subject had blood transfusion within 84 days prior to Screening visit. Subject has a date for renal transplantation. Subject has a temporary or permanent hemodialysis catheter, unless: Subject has a permanent hemodialysis catheter over 6 months without signs/events of line sepsis. Refer to the USPI - Depo-Medrol - Methylprednisolone Acetate - Injectable (Appendix A) for any concomitant drug taken by the patient which its interaction with Depo-Medrol will warrant exclusion from this protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shany Blum, MD PhD
Organizational Affiliation
Aevi Genomic Medicine, LLC, a Cerecor company
Official's Role
Study Director
Facility Information:
Facility Name
Barzili Medical Center
City
Ashkelon
Country
Israel
Facility Name
Meir Medical Center
City
Kfar Saba
Country
Israel
Facility Name
Medical Center of the Galilee
City
Nahariya
Country
Israel
Facility Name
Tel Aviv Sourasky Medical Center
City
Tel Aviv
Country
Israel
Facility Name
Assaf Harofeh Medical Center
City
Zrifin
Country
Israel

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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TARGTEPO Treatment for Anemia in Chronic Kidney Disease (CKD) Patients and End-Stage Renal Disease (ESRD)

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