A Phase 3b Study of Erythropoietin Drugs Using a Specified Dosing Algorithm in Patients With Chronic Kidney Disease on Hemodialysis

NCT ID: NCT02504294

Last Updated: 2018-06-13

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

View full results

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

432 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-07-13

Study Completion Date

2016-07-16

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

A phase 3b study for subjects receiving Epogen to compare a dosing algorithm between Hospira Epoetin and Standard of Care Epogen.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Primary Objective: To evaluate switching from Epogen to Epoetin Hospira for maintenance of hemoglobin levels in anemic chronic kidney disease (CKD) subjects on hemodialysis using a specified algorithm for the dosing of erythropoietin stimulating agents (ESA).

Secondary Objective: To evaluate switching from Epogen to Epoetin Hospira on the dosing of ESA in anemic CKD subjects on hemodialysis using a specified algorithm for the dosing of ESA.

Exploratory Objectives: To generate hypotheses regarding maintenance of hemoglobin levels, dosing of ESA, intravenous (IV) iron dosing requirements, transferrin saturation (TSAT) levels and ferritin levels associated with the switch from Epogen to Epoetin Hospira in anemic CKD subjects on hemodialysis using specified algorithms for the dosing of ESA and for the dosing of IV iron, that are standard of care.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Chronic Kidney Disease (CKD)

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Epoetin Hospira

Epoetin Hospira Arm

Group Type OTHER

Epoetin Hospira Arm

Intervention Type BIOLOGICAL

Epoetin Hospira Arm: Epoetin Hospira will be administered intravenously (IV) per the analogous version of the Fresenius Medical Care North America (FMCNA) cMAB 1 (inclusive of version 1.0, 1.1,...)erythropoietin stimulating agents (ESA) dosing algorithm for Epoetin Hospira for 24 weeks. Subjects will have Epoetin Hospira initiated using the same ESA dose level and frequency of administration for Epogen prior to randomization into the trial. Subjects will also receive IV iron per the FMCNA protocol that is standard of care at FMCNA clinics.

IV Iron

Intervention Type DRUG

Subjects will also receive IV iron per the FMCNA protocol that is standard of care at FMCNA clinics.

Standard of Care

Standard of care arm

Group Type OTHER

Standard of Care Arm

Intervention Type OTHER

Standard of care arm: No interventions will be performed in this arm for the clinical study; and subjects will receive ongoing standard of care, which includes Epogen administered IV per the FMCNA cMAB 5 (inclusive of versions 5.0, 5.1,....) ESA dosing algorithm and IV iron per the FMCNA protocol that is standard of care, at FMCNA clinics during the contemporaneous 24 week period.

IV Iron

Intervention Type DRUG

Subjects will also receive IV iron per the FMCNA protocol that is standard of care at FMCNA clinics.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Epoetin Hospira Arm

Epoetin Hospira Arm: Epoetin Hospira will be administered intravenously (IV) per the analogous version of the Fresenius Medical Care North America (FMCNA) cMAB 1 (inclusive of version 1.0, 1.1,...)erythropoietin stimulating agents (ESA) dosing algorithm for Epoetin Hospira for 24 weeks. Subjects will have Epoetin Hospira initiated using the same ESA dose level and frequency of administration for Epogen prior to randomization into the trial. Subjects will also receive IV iron per the FMCNA protocol that is standard of care at FMCNA clinics.

Intervention Type BIOLOGICAL

Standard of Care Arm

Standard of care arm: No interventions will be performed in this arm for the clinical study; and subjects will receive ongoing standard of care, which includes Epogen administered IV per the FMCNA cMAB 5 (inclusive of versions 5.0, 5.1,....) ESA dosing algorithm and IV iron per the FMCNA protocol that is standard of care, at FMCNA clinics during the contemporaneous 24 week period.

Intervention Type OTHER

IV Iron

Subjects will also receive IV iron per the FMCNA protocol that is standard of care at FMCNA clinics.

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

Subjects eligible to be entered into the study will meet all of the following criteria:

1. Adult female or male subjects; age ≥ 18 years.
2. End stage renal disease subjects treated in-center with the modality of hemodialysis for ≥ 120 days.
3. Diagnosed with anemia.
4. Administered routine Epogen therapy for at least 16 weeks by an IV route for treatment of anemia using an Epogen version of an FMCNA dosing algorithm for ESA, and did not miss more than 3 prescribed doses of Epogen within 12 weeks prior to randomization.
5. Currently using the IV Epogen version of the ESA dosing algorithm cMAB 5 (inclusive of versions 5.0, 5.1, …) for anemia management.
6. Receiving hemodialysis at a clinic using the FMCNA dosing algorithm for IV iron that is the FMCNA standard of care treatment for iron replacement.

Exclusion Criteria

Subjects that meet any of the following criteria will be ineligible to be entered into the interventional cohort:

1. Subjects unable to provide a signed and dated informed consent for this clinical research study.
2. As determined by the Investigator, female subjects of child bearing potential who do not agree to use a highly effective method of contraception.
3. Any condition as determined by the investigator that would place a subject at an increased risk, or preclude subject's full compliance with the study procedures and visits.
4. Female subjects who are known to be or found to be, pregnant or lactating.
5. Subjects that are not a candidate for ESA therapies per the label warnings listed in the package insert for Epogen and/or contraindications to Epoetin Hospira listed in the Investigators' Brochure; or have had a known positive test for anti-rhEPO antibodies.
6. Treatment with any investigational drug within 30 days prior to randomization and throughout this clinical trial.
7. Diagnosed with any concurrent condition that could lead to greater-than-normal loss of blood, including but not limited to:

* Menorrhagia, peptic ulcer disease, gastrointestinal bleeding, blood dyscrasia, hemoglobinopathy
* Use of anticoagulation therapy, including warfarin with a target international normalized ratio (INR) of 2 or greater Anti-platelet therapy (e.g. aspirin or clopidogrel) is permitted, as is heparin given during hemodialysis. Low-dose warfarin is permitted and defined as the presence of at least two INR values less than or equal to 1.5 during the 120 days prior to enrollment and no values exceeding 1.5 at any time after 120 days prior to enrollment.

Subjects started on warfarin with a known INR goal of 2.0 or greater are to receive no further treatment with the study drugs, but follow up visits can continue.

Subjects on warfarin who meet criteria to enter the study are terminated if an INR \> 2.0 is discovered or if no INR is available for 60 days.
8. History of transfusion of any blood product in the past 3 months, or 2 or more transfusions in the past 1 year; or donated or lost \> 475 mL blood volume (including plasmapheresis) in the past 3 months.
9. Subjects currently receiving a long acting ESA, or who have received a long acting ESA in the 16 weeks prior to study randomization
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Hospira, now a wholly owned subsidiary of Pfizer

INDUSTRY

Sponsor Role collaborator

Pfizer

INDUSTRY

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Pfizer CT.gov Call Center

Role: STUDY_DIRECTOR

Pfizer

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

California Institute of Renal Research

Chula Vista, California, United States

Site Status

California Institute of Renal Research at Fresenius Medical Care

Poway, California, United States

Site Status

Fresenius Medical Care Rancho

Rancho Bernardo, California, United States

Site Status

California Institute of Renal Research at Fresenius Medical Care Kearny Mesa

San Diego, California, United States

Site Status

Fresenius Medical Care Paradise Valley

San Diego, California, United States

Site Status

Fresenius Medical Care

Tampa, Florida, United States

Site Status

Fresenius Medical Care

Tampa, Florida, United States

Site Status

Genesis Clinical Research, LLC

Tampa, Florida, United States

Site Status

Frenova Renal Research

Boise, Idaho, United States

Site Status

Fresenius Medical Care North America - Liberty Dialysis

Boise, Idaho, United States

Site Status

Frenova Renal Research

Caldwell, Idaho, United States

Site Status

Fresenius Medical Care North America - Liberty Dialysis

Caldwell, Idaho, United States

Site Status

Frenova Renal Research

Meridian, Idaho, United States

Site Status

Fresenius Medical Care North America - Liberty Dialysis

Meridian, Idaho, United States

Site Status

Frenova Renal Research

Nampa, Idaho, United States

Site Status

Fresenius Medical Care North America - Liberty Dialysis

Nampa, Idaho, United States

Site Status

Fresenius Medical Care-Kalamazoo East

Kalamazoo, Michigan, United States

Site Status

Paragon Health PC DBA Nephrology Center

Kalamazoo, Michigan, United States

Site Status

Fresenius Medical Care-Oshtemo

Kalamazoo, Michigan, United States

Site Status

Fresenius Medical Care, Biloxi Dialysis Unit

Biloxi, Mississippi, United States

Site Status

North Gulfport

Gulfport, Mississippi, United States

Site Status

South Mississippi Kidney Center

Gulfport, Mississippi, United States

Site Status

FMC Charlotte

Charlotte, North Carolina, United States

Site Status

Metrolina Nephrology Associates, PA

Charlotte, North Carolina, United States

Site Status

Briggs Avenue Dialysis Center

Durham, North Carolina, United States

Site Status

Durham Nephrology Associates

Durham, North Carolina, United States

Site Status

FMC Matthews

Matthews, North Carolina, United States

Site Status

Fresenius Medical Care- Lansdale Dialysis

Lansdale, Pennsylvania, United States

Site Status

Delaware Valley Nephrology and Hypertension Associates, PC

Philadelphia, Pennsylvania, United States

Site Status

Fresenius Medical Care

Warwick, Rhode Island, United States

Site Status

Fresenius Crossville Dialysis Unit

Crossville, Tennessee, United States

Site Status

Fresenius Medical Care-Franklin

Franklin, Tennessee, United States

Site Status

Knoxville Kidney Center, PLLC

Knoxville, Tennessee, United States

Site Status

Fresenius Dialysis West

Knoxville, Tennessee, United States

Site Status

Nephrology Associates, PC

Nashville, Tennessee, United States

Site Status

Fresenius Medical Care - Austin North 4478

Austin, Texas, United States

Site Status

Research Management Inc

Austin, Texas, United States

Site Status

Mission Bend Dialysis (FMC#3971)

Houston, Texas, United States

Site Status

Southwest Houston Research, Ltd.

Houston, Texas, United States

Site Status

Gamma Medical Research Inc

McAllen, Texas, United States

Site Status

Rosenberg Dialysis (FMC#1197)

Rosenberg, Texas, United States

Site Status

Fresenius Medical Care Weslaco

Weslaco, Texas, United States

Site Status

Fresenius Medical Care Carolina

Carolina, , Puerto Rico

Site Status

Fresenius Medical Care

Humacao, , Puerto Rico

Site Status

Fresenius Medical Care San Juan

San Juan, , Puerto Rico

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States Puerto Rico

References

Explore related publications, articles, or registry entries linked to this study.

Chung EY, Palmer SC, Saglimbene VM, Craig JC, Tonelli M, Strippoli GF. Erythropoiesis-stimulating agents for anaemia in adults with chronic kidney disease: a network meta-analysis. Cochrane Database Syst Rev. 2023 Feb 13;2(2):CD010590. doi: 10.1002/14651858.CD010590.pub3.

Reference Type DERIVED
PMID: 36791280 (View on PubMed)

Thadhani R, Guilatco R, Hymes J, Maddux FW, Ahuja A. Switching from Epoetin Alfa (Epogen(R)) to Epoetin Alfa-Epbx (RetacritTM) Using a Specified Dosing Algorithm: A Randomized, Non-Inferiority Study in Adults on Hemodialysis. Am J Nephrol. 2018;48(3):214-224. doi: 10.1159/000492621. Epub 2018 Sep 7.

Reference Type DERIVED
PMID: 30196301 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

C3461008

Identifier Type: OTHER

Identifier Source: secondary_id

ZIN-EPO-1503

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.