Pediatric Chronic Kidney Disease Safety and Efficacy

NCT ID: NCT01277510

Last Updated: 2020-06-29

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

43 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-06-28

Brief Summary

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The purpose of this study is to assess the safety and efficacy of adding cinacalcet to the current treatment of secondary hyperparathyroidism in children currently receiving dialysis compared to a treatment regimen that does not include cinacalcet.

Detailed Description

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Secondary hyperparathyroidism (SHPT) is a condition that can develop early in patients with chronic kidney disease (CKD), usually gets worse over time, and is known to cause problems for patients on dialysis. Children on dialysis can have a wide range of bone and growth issues, and common treatments have a chance of making these things worse by increasing serum calcium and serum phosphorus. Cinacalcet has been shown to be effective in controlling parathyroid hormone (PTH), calcium and phosphorus in adults. The purpose of this study is to show that including cinacalcet in the treatment of SHPT will lower the levels of intact parathyroid hormone (iPTH) in a larger number of pediatric patients with CKD who are receiving dialysis, compared to a treatment regimen that does not include cinacalcet.

Conditions

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Chronic Kidney Disease Hyperparathyroidism Hyperparathyroidism, Secondary Kidney Disease Secondary Hyperparathyroidism

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Placebo

Participants received standard of care and placebo once daily for 30 weeks during the double-blind phase. During the open-label phase, participants received cinacalcet with standard of care for an additional 30 weeks. The starting dose of cinacalcet was ≤ 0.20 mg/kg based on dry weight, and could be titrated up according to plasma iPTH and serum calcium levels every 4 weeks up to Week 54 to a maximum dose of 4.2 mg/kg.

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type DRUG

Placebo tablets and capsules for sprinkling identical to active treatment.

Standard of Care

Intervention Type DRUG

All participants, regardless of treatment assignment, will receive standard of care with vitamin D sterols (calcitriol and its analogs), as prescribed by the treating physician.

Cinacalcet

Participants received standard of care and cinacalcet once daily for 30 weeks during the double-blind phase. The starting dose of cinacalcet was ≤ 0.20 mg/kg based on dry weight, and could be titrated up according to plasma iPTH and serum calcium levels every 4 weeks until Week 24 to a maximum dose of 4.2 mg/kg. During the open-label phase participants continued to receive cinacalcet with standard of care for an additional 30 weeks.

Group Type EXPERIMENTAL

cinacalcet capsule

Intervention Type DRUG

Cinacalcet was prepared for oral administration as both capsules for sprinkling and film coated tablets for swallowing.

Standard of Care

Intervention Type DRUG

All participants, regardless of treatment assignment, will receive standard of care with vitamin D sterols (calcitriol and its analogs), as prescribed by the treating physician.

Interventions

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cinacalcet capsule

Cinacalcet was prepared for oral administration as both capsules for sprinkling and film coated tablets for swallowing.

Intervention Type DRUG

placebo

Placebo tablets and capsules for sprinkling identical to active treatment.

Intervention Type DRUG

Standard of Care

All participants, regardless of treatment assignment, will receive standard of care with vitamin D sterols (calcitriol and its analogs), as prescribed by the treating physician.

Intervention Type DRUG

Other Intervention Names

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Sensipar, Mimpara

Eligibility Criteria

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Inclusion Criteria

* Age 6 to less than 18 years at screening
* Diagnosed with CKD and SHPT receiving hemodialysis or peritoneal dialysis for ≥ 2 months before randomization
* Dry weight ≥ 12.5 kg at screening
* iPTH obtained from the central laboratory must be \> 300 pg/mL (31.8 pmol/L)
* Serum calcium (corrected) obtained from the central laboratory must be ≥ 8.8 mg/dL (2.2 mmol/L)
* Serum phosphorus obtained from the central laboratory ≥ 4.0 mg/dL (1.3 mmol/L) for children 6 to less than 12 years old, or ≥ 3.5 mg/dL (1.1 mmol/L) for children 12 to less than 18 years old
* Subjects already receiving vitamin D sterols (either calcitriol or a synthetic analog), a stable dose within the last 2 months prior to randomization
* Subjects taking growth hormone, a stable dose defined as no change \> than 20% in the last 2 months prior to randomization
* Subjects on anti-convulsant medication must be on a stable dose for 3 months, and have a therapeutic blood level of the anti-convulsant at the time of randomization
* Subjects must be on a dialysate calcium concentration of ≥ 2.5 mEq/L (1.25 mmol/L) for at least 2 months prior to randomization

Exclusion Criteria

* Underwent parathyroidectomy in the last 6 months
* Anticipated parathyroidectomy within 6 months after randomization
* Received therapy with cinacalcet (sensipar/mimpara) within the last month
* A new onset of seizure or worsening of a pre-existing seizure disorder within the last 3 months
* Scheduled date for kidney transplant from a known living donor that makes completion of the study unlikely
Minimum Eligible Age

6 Years

Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Amgen

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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MD

Role: STUDY_DIRECTOR

Amgen

Locations

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Research Site

Westmead, New South Wales, Australia

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Herston, Queensland, Australia

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Parkville, Victoria, Australia

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Brussels, , Belgium

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Edegem, , Belgium

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Ghent, , Belgium

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Leuven, , Belgium

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Heidelberg, , Germany

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Marburg, , Germany

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Budapest, , Hungary

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Debrecen, , Hungary

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Pécs, , Hungary

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Szeged, , Hungary

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Mexico City, Mexico City, Mexico

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Aguascalientes, , Mexico

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Gdansk, , Poland

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Gorzów Wielkopolski, , Poland

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Lodz, , Poland

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Warsaw, , Poland

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Warsaw, , Poland

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Moscow, , Russia

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Saint Petersburg, , Russia

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Samara, , Russia

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Banská Bystrica, , Slovakia

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Bratislava, , Slovakia

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Košice, , Slovakia

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Barakaldo, Basque Country, Spain

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Barcelona, Catalonia, Spain

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Barcelona, Cataluña, Spain

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Barakaldo, PaÃ-s Vasco, Spain

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Valencia, Valencia, Spain

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Madrid, , Spain

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Birmingham, Alabama, United States

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Los Angeles, California, United States

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San Francisco, California, United States

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Gainesville, Florida, United States

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Baltimore, Maryland, United States

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Boston, Massachusetts, United States

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Kansas City, Missouri, United States

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St Louis, Missouri, United States

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St Louis, Missouri, United States

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Livingston, New Jersey, United States

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The Bronx, New York, United States

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Greenville, North Carolina, United States

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Cincinnati, Ohio, United States

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Portland, Oregon, United States

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Philadelphia, Pennsylvania, United States

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Houston, Texas, United States

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San Antonio, Texas, United States

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Charlottesville, Virginia, United States

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Randwick, New South Wales, Australia

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Countries

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United States Australia Belgium Germany Hungary Mexico Poland Russia Slovakia Spain

References

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Warady BA, Iles JN, Ariceta G, Dehmel B, Hidalgo G, Jiang X, Laskin B, Shahinfar S, Vande Walle J, Schaefer F. A randomized, double-blind, placebo-controlled study to assess the efficacy and safety of cinacalcet in pediatric patients with chronic kidney disease and secondary hyperparathyroidism receiving dialysis. Pediatr Nephrol. 2019 Mar;34(3):475-486. doi: 10.1007/s00467-018-4116-y. Epub 2018 Nov 30.

Reference Type BACKGROUND
PMID: 30506144 (View on PubMed)

Warady BA, Ng E, Bloss L, Mo M, Schaefer F, Bacchetta J. Cinacalcet studies in pediatric subjects with secondary hyperparathyroidism receiving dialysis. Pediatr Nephrol. 2020 Sep;35(9):1679-1697. doi: 10.1007/s00467-020-04516-4. Epub 2020 May 4.

Reference Type BACKGROUND
PMID: 32367309 (View on PubMed)

Related Links

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http://www.amgentrials.com

AmgenTrials clinical trials website

Other Identifiers

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20070208

Identifier Type: -

Identifier Source: org_study_id

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