A Study of Roxadustat to Treat Anemia in Children and Teenagers With Chronic Kidney Disease

NCT ID: NCT05970172

Last Updated: 2026-01-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-01-16

Study Completion Date

2027-10-30

Brief Summary

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Roxadustat is a licensed medicine to treat anemia in adults with chronic kidney disease (CKD). Anemia is a low level of red blood cells. Current treatment for anemia is to have injections of medicines called erythropoietin stimulating agents (also known as ESAs) to help the bone marrow make more red blood cells. These are often given together with iron. This treatment is also available to children and teenagers with CKD. However, there are some safety concerns with ESAs. Also, as roxadustat is taken orally, this may be another option for treating anemia in children and teenagers with CKD. In this study, children and teenagers with CKD and anemia will take roxadustat for up to 52 weeks to treat their anemia.

The main aim of the study is to learn how roxadustat affects anemia in children and teenagers with CKD.

This is an open-label study which means the children and teenagers in the study and the clinic staff know they will be taking roxadustat. In this study, the children and teenagers with CKD who need treatment for anemia can take part. Those currently being treated with an ESA will be switched to roxadustat. Those who have not been treated with an ESA can start on roxadustat straight away. All children and teenagers in the study will take roxadustat 3 times a week for up to 52 weeks (1 year). They will start on a fixed dose of roxadustat for 4 weeks. Blood samples will be taken regularly to check hemoglobin levels. The roxadustat dose may be changed if the blood levels of hemoglobin are too high, too low, or change too quickly. After 4 weeks the dose may be changed, if needed, to keep blood levels of hemoglobin in the blood to just below the normal range.

Firstly, teenagers will take roxadustat. 10 teenagers will take their fixed dose of roxadustat for 4 weeks. They will give blood samples to help the researchers work out the most suitable dose for the rest of the teenagers in the study. When the rest of the teenagers start taking roxadustat at the most suitable dose for teenagers, 10 children will take roxadustat for 4 weeks. These 10 children will give blood samples to help the researchers work out the most suitable dose for the rest of the children in the study. Then, the rest of the children will take roxadustat at the most suitable dose for children.

There will be many clinic visits during the study. Overnight hospital stays are not expected. There will be 1 visit every 2 weeks for the first 4 weeks of taking roxadustat, then every 4 weeks until the end of treatment. Finally there is 1 visit 4 weeks after treatment has finished.

During most visits, the children and teenagers will have their vital signs checked (blood pressure, body temperature and heart rate). Fluid status (how much water is in the body) will also be checked for those who need dialysis. The children and teenagers will also have blood tests and the study doctors will check for any medical problems. The children and teenagers will have a medical examination before their first dose of roxadustat and again at about 24-week (6-month) and 52-week (13-month) visits. They will have an electrocardiogram (ECG) before their first dose of roxadustat and again at the 12-week, 24-week, 36-week, and 52-week visit. They will also have urine tests at the 4-week, 24-week and 52-week visits. At the 52-week visit, the children and teenagers will also have blood tests for hemoglobin and iron levels. The study doctors will also check for any medical problems.

Detailed Description

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Conditions

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Chronic Kidney Disease Renal Anemia

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Roxadustat

Participants will receive roxadustat orally (or via gastric tube as an aqueous dispersion, if necessary) 3 times per week. The 24-week treatment period is defined as 4 weeks of fixed dose treatment followed by 20 weeks of dose titration(s). Dose titrations will be based on hemoglobin (Hb) monitoring. Participants in the study may receive roxadustat treatment for up to 52 weeks.

Group Type EXPERIMENTAL

Roxadustat

Intervention Type DRUG

Oral

Interventions

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Roxadustat

Oral

Intervention Type DRUG

Other Intervention Names

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ASP1517 FG-4592 Evrenzo

Eligibility Criteria

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Inclusion Criteria

* Participant has a diagnosis of anemia in CKD Kidney Disease Outcomes Quality Initiative stages 3 or 4 or 5. This can include participants not on dialysis or dialysis dependent (DD) participants (including hemodialysis, peritoneal dialysis and hemodiafiltration participants).
* Participants not on dialysis must have an estimated glomerular filtration rate (Schwartz formula) of \< 60 mL/min per 1.73 m\^2.
* ESA-treated participants should have a screening Hb level, assessed via HemoCue, between 10.0 and 12.0 g/dL; ESA-naïve participants can have a Hb level ≤ 11 g/dL.
* Participant has a ferritin level \> 100 ng/mL or a transferrin saturation (TSAT) value \> 20%.
* Participant has an alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2 x upper limit of normal (ULN) and total bilirubin (TBL) ≤ 1.5 x ULN at enrollment visit.
* Participant is treated with an ESA or is ESA-naïve, where ESA status is defined as:

* ESA-treated: Participant is taking a stable dose of an ESA for at least 4 weeks prior to screening.
* ESA-naïve: Participant has no prior ESA exposure OR participant's total prior ESA exposure ≤ 3 weeks within the preceding 4 weeks from screening OR participant was previously treated with and discontinued an ESA ≥ 8 weeks prior to screening.
* Female participant is not pregnant and at least 1 of the following conditions apply:

* Not a woman of childbearing potential (WOCBP)
* WOCBP who agrees to follow the contraceptive guidance from the time of informed consent through at least 4 weeks after final study intervention administration.
* Female participant must agree not to breastfeed starting at screening and throughout the study and for 4 weeks post-last roxadustat dose.
* Female participant must not donate ova starting at first administration of roxadustat and throughout the study period and for 4 weeks post-last roxadustat dose.
* Male participants with female partner(s) of childbearing potential (including breastfeeding partner) must agree to use contraception throughout the treatment period and for 4 weeks post-last roxadustat dose.
* Male participants must not donate sperm during the treatment period and for 4 weeks post-last roxadustat dose.
* Male participants with pregnant partner(s) must agree to remain abstinent or use a condom for the duration of the pregnancy throughout the study period and for 4 weeks post-last roxadustat dose.
* Participant and/or participant's parent or legal guardian agrees for the participant not to participate in another interventional study while participating in the present study.

Exclusion Criteria

* Participant has received any investigational therapy within 28 days or 5 half-lives, whichever is longer, prior to screening.
* Participant has any medical condition, including active, systemic or clinically significant infection which may pose a safety risk to a participant in this study, which may confound the safety or activity assessment or may interfere with study participation making the participant unsuitable for study.
* Participant has a known or suspected hypersensitivity to roxadustat, related hypoxia-inducible factor-prolyl hydroxylase inhibitors (HIF-PHI), or any components of the formulation used.
* Participant has uncontrolled hypertension (defined as ≥ 95th percentile + 12 mm Hg or ≥ 140/90 mm Hg \[whichever is lower\] for participants \< 13 years of age and ≥ 140/90 mm Hg for participants ≥ 13 years of age measured 3 times at the same visit) in the 2 weeks prior to screening.
* Participant has a known hematologic disease other than anemia secondary to renal disease,(e.g., history of sickle cell disease, sickle cell anemia, hemoglobin sickle cell disease, or hemoglobin sickle cell beta thalassemia).
* Participant has untreated hypothyroidism.
* Participant has severe hyperparathyroidism defined as serum parathyroid hormone (PTH) levels above 1000 pg/mL intact PTH within 4 weeks of screening.
* Participant has a functioning kidney allograft.
* Participant has a folate or B12 or carnitine deficiency. Acceptable if treated to normal values within 4 weeks of screening.
* Participant has a known active malignancy or malignancy within 18 months before the screening visit. Radiation or chemotherapy must be completed at least 12 months before the screening visit.
* Participant has a scheduled living donor organ transplantation date within 12 weeks of screening. If participant becomes eligible for a kidney transplant during study conduct, the participant should be discontinued.
* Participant has a whole blood or packed red blood cells (pRBC) transfusion during the 8 weeks prior to screening.
* Participant has any current condition leading to active significant blood loss in the past 4 weeks.
* Participant has a diagnosis of hemolytic uremic syndrome within 12 weeks prior to screening.

* Participant who has a previous diagnosis of atypical hemolytic syndrome must be relapse-free (stable hemoglobin (Hb), normal platelet count, normal serum lactate dehydrogenase, and normal haptoglobin level) for more than 12 weeks prior to screening.
* Participant has a history of chronic liver disease, including comorbidity with autosomal recessive polycystic kidney disease, cystinosis, and primary hyperoxaluria.
* Participant had an episode of peritonitis within 30 days of screening.
* Participant has active inflammation such as glomerulonephritis flare (i.e., lupus nephritis, immunoglobulin A (IgA) nephritis, rapidly progressive glomerulonephritis, membranoproliferative glomerulonephritis, antineutrophil cytoplasmic antibodies vasculitis) requiring pulse corticosteroid treatment or induction treatment with an immunosuppressive agent (i.e., cyclophosphamide, rituximab, or another monoclonal antibody) within 6 weeks of screening visit. Receipt of monoclonal antibody or biologic for maintenance treatment of underlying condition is acceptable.
* Participant has a known history of human immunodeficiency virus infection.
* Participant has rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption or is allergic to peanut or soya.
Minimum Eligible Age

2 Years

Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Astellas Pharma Global Development, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Medical Monitor

Role: STUDY_DIRECTOR

Astellas Pharma Global Development, Inc.

Locations

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Site BE32002

Brussels, , Belgium

Site Status RECRUITING

Site BE32001

Edegem, , Belgium

Site Status RECRUITING

Site BE32004

Ghent, , Belgium

Site Status RECRUITING

Site BE32003

Leuven, , Belgium

Site Status RECRUITING

Site BG35901

Sofia, , Bulgaria

Site Status RECRUITING

Site HR38501

Zagreb, , Croatia

Site Status RECRUITING

Site HR38503

Zagreb, , Croatia

Site Status RECRUITING

Site CZ42002

Brno, , Czechia

Site Status RECRUITING

Site CZ42001

Prague, , Czechia

Site Status RECRUITING

Site DK45001

Aarhus, , Denmark

Site Status RECRUITING

Site DE49001

Tübingen, , Germany

Site Status RECRUITING

Site GR30002

Athens, , Greece

Site Status RECRUITING

Site GR30001

Thessaloniki, , Greece

Site Status RECRUITING

Site IE35301

Dublin, , Ireland

Site Status RECRUITING

Site IT39003

Milan, , Italy

Site Status RECRUITING

Site IT39004

Padua, , Italy

Site Status RECRUITING

Site LB96101

El Achrafiyé, , Lebanon

Site Status RECRUITING

Site LT37001

Vilnius, , Lithuania

Site Status RECRUITING

Site NL31002

Rotterdam, , Netherlands

Site Status RECRUITING

Site NO47002

Oslo, , Norway

Site Status RECRUITING

Site PL48003

Krakow, , Poland

Site Status RECRUITING

Site PL48002

Warsaw, , Poland

Site Status RECRUITING

Site RO40002

Clug Napoca, , Romania

Site Status RECRUITING

Site RO40001

Timișoara, , Romania

Site Status RECRUITING

Site SA96602

Dammam, , Saudi Arabia

Site Status RECRUITING

Site SA96601

Riyadh, , Saudi Arabia

Site Status RECRUITING

Site SK42101

Bratislava, , Slovakia

Site Status RECRUITING

Site ES34003

Esplugues de Llobregat, , Spain

Site Status RECRUITING

Site SP34001

Madrid, , Spain

Site Status RECRUITING

Site SE46002

Mölnlycke, , Sweden

Site Status RECRUITING

Site SE46003

Mölnlycke, , Sweden

Site Status RECRUITING

Site TR90001

Ankara, , Turkey (Türkiye)

Site Status RECRUITING

Site TR90007

Ankara, , Turkey (Türkiye)

Site Status RECRUITING

Site TR90010

Ankara, , Turkey (Türkiye)

Site Status RECRUITING

Site TR90003

Istanbul, , Turkey (Türkiye)

Site Status RECRUITING

Site TR90008

Istanbul, , Turkey (Türkiye)

Site Status RECRUITING

Site TR90005

İzmit, , Turkey (Türkiye)

Site Status RECRUITING

Site TR90006

Kayseri, , Turkey (Türkiye)

Site Status RECRUITING

Site TR90002

Manisa, , Turkey (Türkiye)

Site Status RECRUITING

Site GB44005

Cardiff, , United Kingdom

Site Status RECRUITING

Site GB44006

Glasgow, , United Kingdom

Site Status RECRUITING

Site GB44008

Liverpool, , United Kingdom

Site Status RECRUITING

Site GB44007

London, , United Kingdom

Site Status RECRUITING

Site GB44003

Newcastle upon Tyne, , United Kingdom

Site Status RECRUITING

Site GB44001

Nottingham, , United Kingdom

Site Status RECRUITING

Site GB44004

Southampton, , United Kingdom

Site Status RECRUITING

Countries

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Belgium Bulgaria Croatia Czechia Denmark Germany Greece Ireland Italy Lebanon Lithuania Netherlands Norway Poland Romania Saudi Arabia Slovakia Spain Sweden Turkey (Türkiye) United Kingdom

Central Contacts

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Astellas Pharma Global Development, Inc.

Role: CONTACT

800-888-7704

Other Identifiers

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2022-501980-42-00

Identifier Type: REGISTRY

Identifier Source: secondary_id

1517-CL-1003

Identifier Type: -

Identifier Source: org_study_id

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