Continuous Soluble Ferric Pyrophosphate (SFP) Iron Delivery Via Dialysate in Hemodialysis Patients

NCT ID: NCT01320202

Last Updated: 2017-04-26

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE3
• Total Enrollment: 305 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2011-03-31
• Study Completion Date: 2013-11-30

Brief Summary

The purpose of this study is to confirm the safety and efficacy of Soluble Ferric Pyrophosphate (SFP) dialysate solution in maintaining iron delivery for erythropoiesis in anemic adult patients with chronic kidney disease (CKD) receiving hemodialysis. Efficacy will be measured primarily by the change from baseline in hemoglobin (Hgb).

Detailed Description

Screening: 2-3 weeks prior to enrollment in Stage 1.

Stage 1 (Run-In): 1-4 weeks depending on qualification for Stage 2.

Stage 2 (Randomized Blinded Treatment): 12 months unless withdrawn prematurely.

Stage 3 (Open-Label Treatment): The duration of Stage 2 plus Stage 3 is intended to be 18 months regardless of treatment assignment in Stage 2.

Conditions

Renal Failure Chronic Requiring Hemodialysis

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Soluble Ferric Pyrophosphate (SFP) in dialysate

11 micrograms (µg) of iron / deciliter (dL) of dialysate.

Group Type: ACTIVE_COMPARATOR

Soluble Ferric Pyrophosphate (SFP)

Intervention Type: DRUG

Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 18 months.

Standard Dialysate

0 micrograms (µg) of iron / deciliter (dL) of dialysate.

Group Type: PLACEBO_COMPARATOR

Standard dialysate

Intervention Type: DEVICE

Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week.

Interventions

Soluble Ferric Pyrophosphate (SFP)

Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 18 months.

Intervention Type: DRUG

Standard dialysate

Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week.

Intervention Type: DEVICE

Eligibility Criteria

Inclusion Criteria

• Adult subject ≥ 18 years of age undergoing chronic hemodialysis three or four times per week for chronic kidney disease (CKD) for at least 4 months, and expected to remain on hemodialysis three to four times weekly and be able to complete the duration of the study.
• Received IV iron therapy between 6 months and 2 weeks prior to enrollment in order to replace iron losses resulting from hemodialysis procedure.
• Mean Screening Hgb ≥ 9.5 to ≤ 11.5 grams per deciliter (g/dL).
• Mean Screening Transferrin Saturation (TSAT) ≥ 15% to ≤ 40%.
• Mean Screening serum ferritin ≥ 200 to ≤ 800 micrograms per liter (µg/L).
• If being administered epoetin, darbepoetin, or CERA, epoetin dose ≤ 45,000 Units (U)/week, darbepoetin dose ≤ 200 micrograms (µg)/week, or CERA dose ≤ 400 micrograms (µg)/month during the four weeks prior to enrollment.

• Patient currently enrolled in the Stage 1 run-in period of study.
• Undergoing chronic hemodialysis three or four times per week for chronic kidney disease (CKD), and expected to remain on hemodialysis three to four times weekly and be able to complete duration of the study.
• Mean Hgb ≥ 9.5 to ≤ 11.5 g/dL over the three most recent consecutive every-week measurements prior to randomization.
• Stable Hgb defined as ≤ 1.0 g/dL difference between the maximum and minimum Hgb values over the 3 weeks immediately prior to randomization.
• Mean TSAT ≥ 15% to ≤ 40% over the two most recent consecutive every-other-week measurements prior to randomization.
• Mean serum ferritin ≥ 200 to ≤ 800 µg/L over the two most recent consecutive every-other-week measurements prior to randomization.
• If being administered epoetin, darbepoetin, or CERA, epoetin dose ≤ 45,000 U/week, darbepoetin dose ≤ 200 µg/week, or CERA dose ≤ 400 µg/month during the four weeks prior to randomization.

• Patient randomized in Stage 2 who has completed the full duration of Stage 2 and less than 4 weeks have elapsed since completion of Stage 2, OR
• Patient in Stage 2 who has been prematurely withdrawn from Stage 2 for protocol-defined Protocol-Mandated Change in Anemia Management and less than 4 weeks have elapsed since withdrawal from Stage 2, OR
• Patient in Stage 2 who has been prematurely withdrawn from Stage 2 for Hgb >11.5 g/dL over ≥ 1 week confirmed by ≥ 2 consecutive measurements AND an associated increase in Hgb by ≥ 1 g/dL over 4 weeks.

Exclusion Criteria

• Patient has living kidney donor identified or living-donor kidney transplant scheduled. (Note: Patients awaiting deceased-donor transplant need not be excluded.)
• Vascular access for dialysis with femoral catheter or non-tunneled catheter.
• Received a total of > 800 milligrams (mg) IV iron during the 8 weeks prior to enrollment
• If being administered an ESA, route of administration change or ESA dose change > 35% (i.e., [max - min dose]/max dose > 0.35) over the 2 weeks prior to screening.
• Serum albumin < 3.0 grams per deciliter (g/dL) any time over the 8 weeks prior to enrollment.
• Red Blood Cell (RBC) or whole blood transfusion within 12 weeks prior to enrollment.

Stage 2:

• Patient has living kidney donor identified or living-donor kidney transplant scheduled. (Note: Patients awaiting deceased-donor transplant need not be excluded.)
• Vascular access for dialysis with femoral catheter or non-tunneled catheter.
• Received any amount of IV iron during the 4 weeks prior to randomization.
• If being administered an (Erythropoietin Stimulating Agent) ESA, change in dose over the 6 weeks immediately prior to randomization.
• Serum albumin < 3.0 g/dL any time over the 8 weeks prior to randomization.
• RBC or whole blood transfusion during Stage 1.

Stage 3:

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Rockwell Medical Technologies, Inc.

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Ray Pratt, MD

Role: STUDY_DIRECTOR

Rockwell Medical

Locations

Bakersfield, California, United States

Investigative Site

Chula Vista, California, United States

Cudahy, California, United States

Downey, California, United States

Encino, California, United States

Los Angeles, California, United States

Los Angeles, California, United States

Los Angeles, California, United States

Los Angeles, California, United States

National City, California, United States

Northridge, California, United States

Ontario, California, United States

Panorama City, California, United States

Riverside, California, United States

San Dimas, California, United States

Simi Valley, California, United States

West Covina, California, United States

Yuba City, California, United States

Investigative Site

Waterbury, Connecticut, United States

Waterbury, Connecticut, United States

Coral Springs, Florida, United States

Miami, Florida, United States

Investigative Site

Augusta, Georgia, United States

Chicago, Illinois, United States

Michigan City, Indiana, United States

Detroit, Michigan, United States

Las Vegas, Nevada, United States

Investigative Site

Mineola, New York, United States

Investigative Site

Ridgewood, New York, United States

Rosedale, New York, United States

Yonkers, New York, United States

Asheville, North Carolina, United States

Durham, North Carolina, United States

Winston-Salem, North Carolina, United States

Cincinnati, Ohio, United States

Toledo, Ohio, United States

Sumter, South Carolina, United States

Chattanooga, Tennessee, United States

Arlington, Texas, United States

Fort Worth, Texas, United States

Investigative Site

Houston, Texas, United States

Houston, Texas, United States

San Antonio, Texas, United States

Fairfax, Virginia, United States

Shorewood, Wisconsin, United States

Caguas, , Puerto Rico

Carolina, , Puerto Rico

Countries

United States; Puerto Rico

References

Fishbane SN, Singh AK, Cournoyer SH, Jindal KK, Fanti P, Guss CD, Lin VH, Pratt RD, Gupta A. Ferric pyrophosphate citrate (Triferic) administration via the dialysate maintains hemoglobin and iron balance in chronic hemodialysis patients. Nephrol Dial Transplant. 2015 Dec;30(12):2019-26. doi: 10.1093/ndt/gfv277. Epub 2015 Jul 13.

Reference Type: DERIVED

PMID: 26175145 (View on PubMed)

Other Identifiers

RMTI-SFP-4

Identifier Type: -

Identifier Source: org_study_id