Trial Outcomes & Findings for A Study of Subcutaneous Mircera in Participants With Chronic Kidney Disease Not Treated With ESA or on Dialysis (NCT NCT00559637)

NCT ID: NCT00559637

Last Updated: 2016-04-06

Results Overview

Participants with both hemoglobin values of the evaluation phase (Months 8 and 9, i.e., Study Days 200-260, values were at least 21 days apart) in the range of 11-12 g/dL were classified as responder. Participants who received transfusion of erythrocytes between Study Day 139 and 260, or with at least one value missing or outside the range were classified as non-responder for the hemoglobin-range concerned.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

184 participants

Primary outcome timeframe

Evaluation phase (Months 8 and 9)

Results posted on

2016-04-06

Participant Flow

Participant milestones

Participant milestones
Measure
Methoxy Polyethylene Glycol-epoetin Beta
Methoxy polyethylene glycol-epoetin beta was administered subcutaneously once a month. The starting dose was 1.2 micrograms per kilogram (mcg/kg) of body weight. Further dose adjustments were performed during the study depending on the hemoglobin value. Total duration of treatment was 9 months for all participants in the study and up to 11 months if participants were shifted to dialysis.
Overall Study
STARTED
184
Overall Study
COMPLETED
130
Overall Study
NOT COMPLETED
54

Reasons for withdrawal

Reasons for withdrawal
Measure
Methoxy Polyethylene Glycol-epoetin Beta
Methoxy polyethylene glycol-epoetin beta was administered subcutaneously once a month. The starting dose was 1.2 micrograms per kilogram (mcg/kg) of body weight. Further dose adjustments were performed during the study depending on the hemoglobin value. Total duration of treatment was 9 months for all participants in the study and up to 11 months if participants were shifted to dialysis.
Overall Study
Adverse Event
22
Overall Study
Withdrawal by Subject
4
Overall Study
Protocol Violation
6
Overall Study
Withdrawal criteria fulfilled
4
Overall Study
Failure to return
6
Overall Study
Insufficient response
3
Overall Study
Started requiring dialysis after month 7
2
Overall Study
Suspected lung cancer
1
Overall Study
Participation in another study
1
Overall Study
Delayed administration of C.E.R.A
1
Overall Study
Change of center
1
Overall Study
Change of home
1
Overall Study
Inclusion or exclusion criteria violated
2

Baseline Characteristics

A Study of Subcutaneous Mircera in Participants With Chronic Kidney Disease Not Treated With ESA or on Dialysis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Methoxy Polyethylene Glycol-epoetin Beta
n=184 Participants
Methoxy polyethylene glycol-epoetin beta was administered subcutaneously once a month. The starting dose was 1.2 mcg/kg of body weight. Further dose adjustments were performed during the study depending on the hemoglobin value. Total duration of treatment was 9 months for all participants in the study and up to 11 months if participants were shifted to dialysis.
Age, Continuous
66.4 years
STANDARD_DEVIATION 15.77 • n=5 Participants
Sex: Female, Male
Female
91 Participants
n=5 Participants
Sex: Female, Male
Male
93 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Evaluation phase (Months 8 and 9)

Population: Intent to treat (ITT) population included all participants who received at least one dose of study medication with at least one hemoglobin value measured during treatment period.

Participants with both hemoglobin values of the evaluation phase (Months 8 and 9, i.e., Study Days 200-260, values were at least 21 days apart) in the range of 11-12 g/dL were classified as responder. Participants who received transfusion of erythrocytes between Study Day 139 and 260, or with at least one value missing or outside the range were classified as non-responder for the hemoglobin-range concerned.

Outcome measures

Outcome measures
Measure
Methoxy Polyethylene Glycol-epoetin Beta
n=178 Participants
Methoxy polyethylene glycol-epoetin beta was administered subcutaneously once a month. The starting dose was 1.2 mcg/kg of body weight. Further dose adjustments were performed during the study depending on the hemoglobin value. Total duration of treatment was 9 months for all participants in the study and up to 11 months if participants were shifted to dialysis.
Percentage of Participants With Both Hemoglobin Values of the Evaluation Phase in the Range of 11-12 Grams Per Deciliter (g/dL)
10.67 percentage of participants
Interval 6.55 to 16.17

PRIMARY outcome

Timeframe: Evaluation phase (Months 8 and 9)

Population: ITT population

Participants with both hemoglobin values of the evaluation phase (Months 8 and 9, i.e., Study Days 200-260, values were at least 21 days apart) in the range of 11-13 g/dL were classified as responder. Participants who received transfusion of erythrocytes between Study Day 139 and 260, or with at least one value missing or outside the range were classified as non-responder for the hemoglobin-range concerned.

Outcome measures

Outcome measures
Measure
Methoxy Polyethylene Glycol-epoetin Beta
n=178 Participants
Methoxy polyethylene glycol-epoetin beta was administered subcutaneously once a month. The starting dose was 1.2 mcg/kg of body weight. Further dose adjustments were performed during the study depending on the hemoglobin value. Total duration of treatment was 9 months for all participants in the study and up to 11 months if participants were shifted to dialysis.
Percentage of Participants With Both Hemoglobin Values of the Evaluation Phase in the Range of 11-13 g/dL
29.21 percentage of participants
Interval 22.65 to 36.48

PRIMARY outcome

Timeframe: Baseline, evaluation phase (Months 8 and 9)

Population: ITT population. Here, number of participants analyzed = participants who were evaluable for this outcome.

The change from the baseline hemoglobin value to the mean hemoglobin value of the evaluation phase was only calculated if both the baseline value and the mean of the evaluation phase (mean of Months 8 and 9) were available. In case of only one available hemoglobin value within the evaluation phase, that single value replaced the mean.

Outcome measures

Outcome measures
Measure
Methoxy Polyethylene Glycol-epoetin Beta
n=131 Participants
Methoxy polyethylene glycol-epoetin beta was administered subcutaneously once a month. The starting dose was 1.2 mcg/kg of body weight. Further dose adjustments were performed during the study depending on the hemoglobin value. Total duration of treatment was 9 months for all participants in the study and up to 11 months if participants were shifted to dialysis.
Change From Baseline in Hemoglobin Value to the Evaluation Phase
1.6 g/dL
Standard Deviation 1.10

SECONDARY outcome

Timeframe: Baseline to Month 9

Population: ITT population

The duration of hemoglobin values staying within the range of 11-12 g/dL was defined as the number of (not necessarily consecutive) months with all corresponding hemoglobin values in the respective range. All months with missing hemoglobin values were counted as months where the hemoglobin value did not stay within the respective range.

Outcome measures

Outcome measures
Measure
Methoxy Polyethylene Glycol-epoetin Beta
n=178 Participants
Methoxy polyethylene glycol-epoetin beta was administered subcutaneously once a month. The starting dose was 1.2 mcg/kg of body weight. Further dose adjustments were performed during the study depending on the hemoglobin value. Total duration of treatment was 9 months for all participants in the study and up to 11 months if participants were shifted to dialysis.
Duration of Hemoglobin Values in the Range of 11-12 g/dL
2.40 months
Standard Deviation 1.796

SECONDARY outcome

Timeframe: Baseline to Month 9

Population: ITT population

The duration of hemoglobin values staying within the range of 11-13 g/dL was defined as the number of (not necessarily consecutive) months with all corresponding hemoglobin values in the respective range. All months with missing hemoglobin values were counted as months where the hemoglobin value did not stay within the respective range.

Outcome measures

Outcome measures
Measure
Methoxy Polyethylene Glycol-epoetin Beta
n=178 Participants
Methoxy polyethylene glycol-epoetin beta was administered subcutaneously once a month. The starting dose was 1.2 mcg/kg of body weight. Further dose adjustments were performed during the study depending on the hemoglobin value. Total duration of treatment was 9 months for all participants in the study and up to 11 months if participants were shifted to dialysis.
Duration of Hemoglobin Values in the Range of 11-13 g/dL
3.62 months
Standard Deviation 2.450

SECONDARY outcome

Timeframe: Baseline to Month 9

Population: ITT population. Here, number of participants analyzed = participants who were evaluable for this outcome.

The duration (number of months) until the hemoglobin value exceeded 11 g/dL for the first time was summarized for participants for whom at least one measured hemoglobin value exceeded 11 g/dL.

Outcome measures

Outcome measures
Measure
Methoxy Polyethylene Glycol-epoetin Beta
n=152 Participants
Methoxy polyethylene glycol-epoetin beta was administered subcutaneously once a month. The starting dose was 1.2 mcg/kg of body weight. Further dose adjustments were performed during the study depending on the hemoglobin value. Total duration of treatment was 9 months for all participants in the study and up to 11 months if participants were shifted to dialysis.
Time to Increase of Hemoglobin Value to Over 11 g/dL
2.28 months
Standard Deviation 1.649

SECONDARY outcome

Timeframe: Baseline until Month 8

Population: ITT population

A dose adjustment was defined as a change versus the preceding dose. It included dose increase, dose reduction and dose interruption. An interruption (no dose given) was always counted as a dose adjustment, regardless of whether or not at the previous time point a dose had been administered. After an interruption a change in the dose relative to the dose given before the interruption was counted as a dose adjustment.

Outcome measures

Outcome measures
Measure
Methoxy Polyethylene Glycol-epoetin Beta
n=178 Participants
Methoxy polyethylene glycol-epoetin beta was administered subcutaneously once a month. The starting dose was 1.2 mcg/kg of body weight. Further dose adjustments were performed during the study depending on the hemoglobin value. Total duration of treatment was 9 months for all participants in the study and up to 11 months if participants were shifted to dialysis.
Total Number of Dose Adjustments
Total number of dose adjustments
595 dose adjustments
Total Number of Dose Adjustments
Total number of dose increases
249 dose adjustments
Total Number of Dose Adjustments
Total number of dose reductions
210 dose adjustments
Total Number of Dose Adjustments
Total number of dose interruptions
136 dose adjustments

SECONDARY outcome

Timeframe: Baseline to Month 9

Population: ITT population

RBC transfusions could be given during the study, if medically necessary, i.e., in participants with severe anemia with distinct symptoms or signs of anemia (such as in participants with acute blood loss, with severe angina, or whose hemoglobin decreased to critical levels).

Outcome measures

Outcome measures
Measure
Methoxy Polyethylene Glycol-epoetin Beta
n=178 Participants
Methoxy polyethylene glycol-epoetin beta was administered subcutaneously once a month. The starting dose was 1.2 mcg/kg of body weight. Further dose adjustments were performed during the study depending on the hemoglobin value. Total duration of treatment was 9 months for all participants in the study and up to 11 months if participants were shifted to dialysis.
Total Number of Red Blood Cell (RBC) Transfusions
39 number of transfusions

Adverse Events

Methoxy Polyethylene Glycol-epoetin Beta

Serious events: 88 serious events
Other events: 109 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Methoxy Polyethylene Glycol-epoetin Beta
n=184 participants at risk
Methoxy polyethylene glycol-epoetin beta was administered subcutaneously once a month. The starting dose was 1.2 mcg/kg of body weight. Further dose adjustments were performed during the study depending on the hemoglobin value. Total duration of treatment was 9 months for all participants in the study and up to 11 months if participants were shifted to dialysis.
Renal and urinary disorders
Renal failure
14.7%
27/184 • Baseline to Month 11
Safety population
Renal and urinary disorders
Renal failure chronic
4.3%
8/184 • Baseline to Month 11
Safety population
Renal and urinary disorders
Renal impairment
2.7%
5/184 • Baseline to Month 11
Safety population
Renal and urinary disorders
Renal failure acute
1.1%
2/184 • Baseline to Month 11
Safety population
Renal and urinary disorders
Renal cyst haemorrhage
0.54%
1/184 • Baseline to Month 11
Safety population
Blood and lymphatic system disorders
Nephrogenic anaemia
6.5%
12/184 • Baseline to Month 11
Safety population
Blood and lymphatic system disorders
Haemorrhagic anaemia
3.3%
6/184 • Baseline to Month 11
Safety population
Blood and lymphatic system disorders
Anaemia
1.6%
3/184 • Baseline to Month 11
Safety population
Blood and lymphatic system disorders
Heparin-induced thrombocytopenia
0.54%
1/184 • Baseline to Month 11
Safety population
Injury, poisoning and procedural complications
Shunt occlusion
2.7%
5/184 • Baseline to Month 11
Safety population
Injury, poisoning and procedural complications
Anaemia postoperative
1.1%
2/184 • Baseline to Month 11
Safety population
Injury, poisoning and procedural complications
Drug toxicity
0.54%
1/184 • Baseline to Month 11
Safety population
Injury, poisoning and procedural complications
Fall
0.54%
1/184 • Baseline to Month 11
Safety population
Injury, poisoning and procedural complications
Femoral neck fracture
0.54%
1/184 • Baseline to Month 11
Safety population
Injury, poisoning and procedural complications
Lumbar vertebral fracture
0.54%
1/184 • Baseline to Month 11
Safety population
Injury, poisoning and procedural complications
Meniscus lesion
0.54%
1/184 • Baseline to Month 11
Safety population
Injury, poisoning and procedural complications
Post procedural haematoma
0.54%
1/184 • Baseline to Month 11
Safety population
Injury, poisoning and procedural complications
Post procedural haemorrhage
0.54%
1/184 • Baseline to Month 11
Safety population
Injury, poisoning and procedural complications
Traumatic haematoma
0.54%
1/184 • Baseline to Month 11
Safety population
Cardiac disorders
Cardiac failure
2.2%
4/184 • Baseline to Month 11
Safety population
Cardiac disorders
Angina unstable
1.1%
2/184 • Baseline to Month 11
Safety population
Cardiac disorders
Atrial fibrillation
1.1%
2/184 • Baseline to Month 11
Safety population
Cardiac disorders
Tachyarrhythmia
1.1%
2/184 • Baseline to Month 11
Safety population
Cardiac disorders
Bradycardia
0.54%
1/184 • Baseline to Month 11
Safety population
Cardiac disorders
Cardiogenic shock
0.54%
1/184 • Baseline to Month 11
Safety population
Cardiac disorders
Myocardial infarction
0.54%
1/184 • Baseline to Month 11
Safety population
Cardiac disorders
Pericardial effusion
0.54%
1/184 • Baseline to Month 11
Safety population
Infections and infestations
Sepsis
1.6%
3/184 • Baseline to Month 11
Safety population
Infections and infestations
Bronchitis
0.54%
1/184 • Baseline to Month 11
Safety population
Infections and infestations
Bronchopneumonia
0.54%
1/184 • Baseline to Month 11
Safety population
Infections and infestations
Cystitis
0.54%
1/184 • Baseline to Month 11
Safety population
Infections and infestations
Gastroenteritis
0.54%
1/184 • Baseline to Month 11
Safety population
Infections and infestations
Herpes zoster ophthalmic
0.54%
1/184 • Baseline to Month 11
Safety population
Infections and infestations
Meningitis enterococcal
0.54%
1/184 • Baseline to Month 11
Safety population
Infections and infestations
Pneumonia
0.54%
1/184 • Baseline to Month 11
Safety population
Infections and infestations
Postoperative wound infection
0.54%
1/184 • Baseline to Month 11
Safety population
Infections and infestations
Tracheobronchitis
0.54%
1/184 • Baseline to Month 11
Safety population
Infections and infestations
Urinary tract infection
0.54%
1/184 • Baseline to Month 11
Safety population
Gastrointestinal disorders
Gastric ulcer haemorrhage
1.1%
2/184 • Baseline to Month 11
Safety population
Gastrointestinal disorders
Abdominal hernia
0.54%
1/184 • Baseline to Month 11
Safety population
Gastrointestinal disorders
Abdominal pain
0.54%
1/184 • Baseline to Month 11
Safety population
Gastrointestinal disorders
Abdominal pain upper
0.54%
1/184 • Baseline to Month 11
Safety population
Gastrointestinal disorders
Aphthous stomatitis
0.54%
1/184 • Baseline to Month 11
Safety population
Gastrointestinal disorders
Diverticulitis intestinal haemorrhagic
0.54%
1/184 • Baseline to Month 11
Safety population
Gastrointestinal disorders
Gastric haemorrhage
0.54%
1/184 • Baseline to Month 11
Safety population
Gastrointestinal disorders
Haemorrhoidal haemorrhage
0.54%
1/184 • Baseline to Month 11
Safety population
General disorders
Drug ineffective
1.1%
2/184 • Baseline to Month 11
Safety population
General disorders
Medical device complication
1.1%
2/184 • Baseline to Month 11
Safety population
General disorders
Device dislocation
0.54%
1/184 • Baseline to Month 11
Safety population
General disorders
Device malfunction
0.54%
1/184 • Baseline to Month 11
Safety population
General disorders
Oedema
0.54%
1/184 • Baseline to Month 11
Safety population
General disorders
Pyrexia
0.54%
1/184 • Baseline to Month 11
Safety population
Metabolism and nutrition disorders
Hypoglycaemia
1.1%
2/184 • Baseline to Month 11
Safety population
Metabolism and nutrition disorders
Cachexia
0.54%
1/184 • Baseline to Month 11
Safety population
Metabolism and nutrition disorders
Dehydration
0.54%
1/184 • Baseline to Month 11
Safety population
Metabolism and nutrition disorders
Diabetes mellitus
0.54%
1/184 • Baseline to Month 11
Safety population
Metabolism and nutrition disorders
Diabetic foot
0.54%
1/184 • Baseline to Month 11
Safety population
Metabolism and nutrition disorders
Diabetic ketoacidosis
0.54%
1/184 • Baseline to Month 11
Safety population
Metabolism and nutrition disorders
Hyperglycaemia
0.54%
1/184 • Baseline to Month 11
Safety population
Metabolism and nutrition disorders
Hyperkalaemia
0.54%
1/184 • Baseline to Month 11
Safety population
Respiratory, thoracic and mediastinal disorders
Pleural effusion
1.1%
2/184 • Baseline to Month 11
Safety population
Respiratory, thoracic and mediastinal disorders
Pulmonary embolism
1.1%
2/184 • Baseline to Month 11
Safety population
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease
0.54%
1/184 • Baseline to Month 11
Safety population
Respiratory, thoracic and mediastinal disorders
Dyspnoea
0.54%
1/184 • Baseline to Month 11
Safety population
Respiratory, thoracic and mediastinal disorders
Sleep apnoea syndrome
0.54%
1/184 • Baseline to Month 11
Safety population
Vascular disorders
Deep vein thrombosis
0.54%
1/184 • Baseline to Month 11
Safety population
Vascular disorders
Haematoma
0.54%
1/184 • Baseline to Month 11
Safety population
Vascular disorders
Peripheral arterial occlusive disease
0.54%
1/184 • Baseline to Month 11
Safety population
Vascular disorders
Poor peripheral circulation
0.54%
1/184 • Baseline to Month 11
Safety population
Vascular disorders
Venous thrombosis limb
0.54%
1/184 • Baseline to Month 11
Safety population
Investigations
Haemoglobin decreased
1.1%
2/184 • Baseline to Month 11
Safety population
Investigations
Blood pressure increased
0.54%
1/184 • Baseline to Month 11
Safety population
Investigations
Blood sodium decreased
0.54%
1/184 • Baseline to Month 11
Safety population
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Gallbladder cancer
0.54%
1/184 • Baseline to Month 11
Safety population
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Gastric cancer
0.54%
1/184 • Baseline to Month 11
Safety population
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Lung squamous cell carcinoma stage unspecified
0.54%
1/184 • Baseline to Month 11
Safety population
Nervous system disorders
Cerebrovascular accident
0.54%
1/184 • Baseline to Month 11
Safety population
Nervous system disorders
Hypertensive encephalopathy
0.54%
1/184 • Baseline to Month 11
Safety population
Nervous system disorders
Ischaemic stroke
0.54%
1/184 • Baseline to Month 11
Safety population
Skin and subcutaneous tissue disorders
Skin ulcer
1.1%
2/184 • Baseline to Month 11
Safety population
Skin and subcutaneous tissue disorders
Rash
0.54%
1/184 • Baseline to Month 11
Safety population
Immune system disorders
Anti-neutrophil cytoplasmic antibody positive vasculitis
0.54%
1/184 • Baseline to Month 11
Safety population
Immune system disorders
Kidney transplant rejection
0.54%
1/184 • Baseline to Month 11
Safety population
Congenital, familial and genetic disorders
Congenital cystic kidney disease
0.54%
1/184 • Baseline to Month 11
Safety population
Ear and labyrinth disorders
Vertigo
0.54%
1/184 • Baseline to Month 11
Safety population
Eye disorders
Retinal artery occlusion
0.54%
1/184 • Baseline to Month 11
Safety population

Other adverse events

Other adverse events
Measure
Methoxy Polyethylene Glycol-epoetin Beta
n=184 participants at risk
Methoxy polyethylene glycol-epoetin beta was administered subcutaneously once a month. The starting dose was 1.2 mcg/kg of body weight. Further dose adjustments were performed during the study depending on the hemoglobin value. Total duration of treatment was 9 months for all participants in the study and up to 11 months if participants were shifted to dialysis.
Ear and labyrinth disorders
Vertigo
7.1%
13/184 • Baseline to Month 11
Safety population
Endocrine disorders
Hyperparathyroidism secondary
9.2%
17/184 • Baseline to Month 11
Safety population
Gastrointestinal disorders
Nausea
7.1%
13/184 • Baseline to Month 11
Safety population
Gastrointestinal disorders
Diarrhoea
6.5%
12/184 • Baseline to Month 11
Safety population
General disorders
Oedema
15.2%
28/184 • Baseline to Month 11
Safety population
General disorders
Oedema peripheral
10.9%
20/184 • Baseline to Month 11
Safety population
General disorders
Fatigue
5.4%
10/184 • Baseline to Month 11
Safety population
Infections and infestations
Bronchitis
6.0%
11/184 • Baseline to Month 11
Safety population
Infections and infestations
Urinary tract infection
5.4%
10/184 • Baseline to Month 11
Safety population
Metabolism and nutrition disorders
Iron deficiency
7.1%
13/184 • Baseline to Month 11
Safety population
Metabolism and nutrition disorders
Hyperphosphataemia
6.0%
11/184 • Baseline to Month 11
Safety population
Metabolism and nutrition disorders
Acidosis
5.4%
10/184 • Baseline to Month 11
Safety population
Musculoskeletal and connective tissue disorders
Muscle spasms
7.1%
13/184 • Baseline to Month 11
Safety population
Vascular disorders
Hypertension
30.4%
56/184 • Baseline to Month 11
Safety population

Additional Information

Medical Communications

Hoffmann-La Roche

Phone: 800-821-8590

Results disclosure agreements

  • Principal investigator is a sponsor employee The Study being conducted under this Agreement is part of the Overall Study. Investigator is free to publish in reputable journals or to present at professional conferences the results of the Study, but only after the first publication or presentation that involves the Overall Study. The Sponsor may request that Confidential Information be deleted and/or the publication be postponed in order to protect the Sponsor's intellectual property rights.
  • Publication restrictions are in place

Restriction type: OTHER