Trial Outcomes & Findings for Use Of Fragmin In Hemodialysis (NCT NCT01879618)

NCT ID: NCT01879618

Last Updated: 2017-03-10

Results Overview

A successful HD session is defined in terms of efficacy of the drug where the HD session had completed as planned: there was no premature termination due to Grade 3 or 4 clotting or saline flush to prevent the loss of the extracorporeal circuit due to clotting; it was not possible to return the participant's blood or assess the exact extent of clotting. HD sessions which terminated prematurely due to Grade 1 or 2 clotting, safety event, machine failure, or access site displacement were excluded from the analysis. The point estimate and 95% CI were computed based on generalized estimating equation (GEE) model for clustered binomial data.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

152 participants

Primary outcome timeframe

20 HD sessions (up to 4 hours)

Results posted on

2017-03-10

Participant Flow

The study was conducted in 12 sites in Canada, 10 of which enrolled participants. A total of 152 participants with chronic renal failure, who had at least 30 previous days of hemodialysis (HD) and had received ≤10,000 IU unfractionated heparin or low molectular weight heparin for anticoagulation during the past month were enrolled in the study.

The Screening Visit was performed within 9 days preceding first HD session where FRAGMIN was administered. The Final Study Visit took place 5 to 15 days after the final study HD session where the participant was treated with Fragmin (# 20 or the last HD session that was completed, if the partcipant prematurely terminated).

Participant milestones

Participant milestones
Measure
FRAGMIN
Participants were initially administered standard FRAGMIN dose of 5000 IU into the arterial side of the dialyzer and were permitted dose adjustments by increments/decrements of 500 or 1000 IU, for subsequent HD sessions depending upon the outcome of previous HD session and any intervening clinical events since previous HD session.
Overall Study
STARTED
152
Overall Study
COMPLETED
131
Overall Study
NOT COMPLETED
21

Reasons for withdrawal

Reasons for withdrawal
Measure
FRAGMIN
Participants were initially administered standard FRAGMIN dose of 5000 IU into the arterial side of the dialyzer and were permitted dose adjustments by increments/decrements of 500 or 1000 IU, for subsequent HD sessions depending upon the outcome of previous HD session and any intervening clinical events since previous HD session.
Overall Study
Does not meet entrance criteria
1
Overall Study
Withdrawal by Subject
1
Overall Study
Surgery;changed schedule; not available
8
Overall Study
Protocol Violation
6
Overall Study
Adverse Event
5

Baseline Characteristics

Use Of Fragmin In Hemodialysis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
FRAGMIN
n=152 Participants
Participants were initially administered standard FRAGMIN dose of 5000 IU into the arterial side of the dialyzer and were permitted dose adjustments by increments/decrements of 500 or 1000 IU, for subsequent HD sessions depending upon the outcome of previous HD session and any intervening clinical events since previous HD session.
Age, Continuous
57.1 Years
STANDARD_DEVIATION 14.7 • n=5 Participants
Sex: Female, Male
Female
46 Participants
n=5 Participants
Sex: Female, Male
Male
106 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 20 HD sessions (up to 4 hours)

Population: The Full Analysis Set (FAS) was used for all efficacy analyses which included all participants who received at least one dose of study medication. There were 2776 HD sessions from 151 participants included in the primary analysis.

A successful HD session is defined in terms of efficacy of the drug where the HD session had completed as planned: there was no premature termination due to Grade 3 or 4 clotting or saline flush to prevent the loss of the extracorporeal circuit due to clotting; it was not possible to return the participant's blood or assess the exact extent of clotting. HD sessions which terminated prematurely due to Grade 1 or 2 clotting, safety event, machine failure, or access site displacement were excluded from the analysis. The point estimate and 95% CI were computed based on generalized estimating equation (GEE) model for clustered binomial data.

Outcome measures

Outcome measures
Measure
FRAGMIN
n=151 Participants
Participants were initially administered standard FRAGMIN dose of 5000 IU into the arterial side of the dialyzer and were permitted dose adjustments by increments/decrements of 500 or 1000 IU, for subsequent HD sessions depending upon the outcome of previous HD session and any intervening clinical events since previous HD session.
Mean Percent of Successful HD Sessions
99.9 Percentage of HD Sessions
Interval 99.7 to 100.0

SECONDARY outcome

Timeframe: 20 HD sessions (up to 4 hours)

Population: FAS was used for all efficacy analyses which included all participants who received at least one dose of study medication. For this endpoint, there were 2630 evaluable HD sessions from 148 participants.

A HD session with an acceptable dose is defined in terms of efficacy of the drug: an HD session for which the dose at the next HD session did not need to be changed due to Grade 3 or 4 clotting, bleeding, access compression time \> 10 minutes, or other clinical event. The point estimate and 95% CI were computed based on GEE model for clustered binomial.

Outcome measures

Outcome measures
Measure
FRAGMIN
n=148 Participants
Participants were initially administered standard FRAGMIN dose of 5000 IU into the arterial side of the dialyzer and were permitted dose adjustments by increments/decrements of 500 or 1000 IU, for subsequent HD sessions depending upon the outcome of previous HD session and any intervening clinical events since previous HD session.
Mean Percent of HD Sessions With an Acceptable Dose
89.8 Percentage of HD sessions
Interval 87.4 to 91.9

Adverse Events

FRAGMIN

Serious events: 3 serious events
Other events: 27 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
FRAGMIN
n=152 participants at risk
Participants were initially administered standard FRAGMIN dose of 5000 IU into the arterial side of the dialyzer and were permitted dose adjustments by increments/decrements of 500 or 1000 IU, for subsequent HD sessions depending upon the outcome of previous HD session and any intervening clinical events since previous HD session.
Infections and infestations
Influenza
0.66%
1/152 • Number of events 1 • From screening (-9 days) up to 30 days after last dose of study drug.
Cardiac disorders
Atrial fibrillation
0.66%
1/152 • Number of events 1 • From screening (-9 days) up to 30 days after last dose of study drug.
Infections and infestations
Pneumonia
0.66%
1/152 • Number of events 1 • From screening (-9 days) up to 30 days after last dose of study drug.

Other adverse events

Other adverse events
Measure
FRAGMIN
n=152 participants at risk
Participants were initially administered standard FRAGMIN dose of 5000 IU into the arterial side of the dialyzer and were permitted dose adjustments by increments/decrements of 500 or 1000 IU, for subsequent HD sessions depending upon the outcome of previous HD session and any intervening clinical events since previous HD session.
Injury, poisoning and procedural complications
Arteriovenous fistula site haemorrhage
12.5%
19/152 • Number of events 19 • From screening (-9 days) up to 30 days after last dose of study drug.
Vascular disorders
Hypotension
5.3%
8/152 • Number of events 8 • From screening (-9 days) up to 30 days after last dose of study drug.

Additional Information

Pfizer ClinicalTrials.gov Call Center

Pfizer, Inc.

Phone: 1-800-718-1021

Results disclosure agreements

  • Principal investigator is a sponsor employee Pfizer has the right to review disclosures, requesting a delay of less than 60 days. Investigator will postpone single center publications until after disclosure of pooled data (all sites), less than 12 months from study completion/termination at all participating sites. Investigator may not disclose previously undisclosed confidential information other than study results.
  • Publication restrictions are in place

Restriction type: OTHER