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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04155125
Registration number
NCT04155125
Ethics application status
Date submitted
29/10/2019
Date registered
7/11/2019
Date last updated
22/12/2023
Titles & IDs
Public title
A Study of Efepoetin Alfa in Treating Anaemia Associated With Chronic Kidney Diseases Patient
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Scientific title
Open-Label Randomised Controlled Trial of Efepoetin Alfa for Treatment of Anaemia Associated With Chronic Kidney Disease Patients Not on Dialysis (ND-CKD). A Non- Inferiority Trial Compared to Methoxy Polyethylene Glycol-Epoetin Beta (MIRCERA)
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Secondary ID [1]
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GXE4KGBio-001
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Anaemia Associated With Chronic Kidney Disease
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Condition category
Condition code
Renal and Urogenital
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Kidney disease
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Renal and Urogenital
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Other renal and urogenital disorders
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Blood
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Anaemia
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - efepoetin alfa
Treatment: Drugs - Mircera
Experimental: efepoetin alfa - Route of administration: Subcutaneous Injection.
The administration interval and initial dosage for subjects who are randomly assigned to subcutaneous efepoetin alfa will be starting from 4 µg/kg BW once per 2 weeks, then titrated based on Hb level during study period.
Placebo comparator: Mircera - Route of administration: Subcutaneous Injection.
The starting dosage of Mircera arm will be 0.6 µg/kg BW per 2 weeks based on prior data in similar study populations with subsequent titration to achieve targeted Hb range. During the correction treatment period, the dosage of study drug will be adjusted to achieve a Hb level range within 10 - 12 g/dL and an increase =1.0 g/dL versus the individual patient's baseline Hb level. During the extension period, Hb levels should be maintained between 10 and 12 g/dL.
Treatment: Drugs: efepoetin alfa
The administration interval and initial dosage for subjects who are randomly assigned to subcutaneous efepoetin alfa will be starting from 4 µg/kg BW once per 2 weeks, then titrated based on Hb level during study period.
Treatment: Drugs: Mircera
The starting dosage of Mircera arm will be 0.6 µg/kg BW per 2 weeks based on prior data in similar study populations with subsequent titration to achieve targeted Hb range. During the correction treatment period, the dosage of study drug will be adjusted to achieve a Hb level range within 10 - 12 g/dL and an increase =1.0 g/dL versus the individual patient's baseline Hb level. During the extension period, Hb levels should be maintained between 10 and 12 g/dL.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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To assess the efficacy of efepoetin alfa in the treatment of anaemia associated with CKD as measured by haemoglobin (Hb) response rate at the end of correction treatment evaluation period
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Assessment method [1]
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Measurement is done by an increase in Hb more than or equal to 1 g/dL compared with baseline and a Hb concentration within range of 10 - 12 g/dL inclusive without transfusion during evaluation period
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Timepoint [1]
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Measurement from the date of Randomization till the End of the Corrective Treatment period, assessed up to 20 weeks.
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Secondary outcome [1]
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Characterise safety and tolerability of subcutaneous efepoetin alfa is being measured by based on the frequency of adverse events and on the number of out of range laboratory values.
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Assessment method [1]
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Safety endpoints parameters including Serious Adverse Events (SAE) specified below
1. Composite outcome of cardiovascular death or a nonfatal myocardial infarction or stroke
2. All-cause mortality
3. Cardiovascular mortality
4. Acute myocardial infarction
5. Heart failure
6. Acute kidney injury defined according to Acute Kidney Injury Network (AKIN) criteria
7. Abnormal clinical laboratory tests (haematology, biochemistry including serum ferritin and TSAT)
8. Anti-efepoetin alfa or anti-Mircera antibody titres
9. Clinically meaningful abnormal findings of vital signs
10. Development of clinically meaningful electrocardiogram abnormalities
11. Hospitalisations (excluding those for logistic reasons)
It is a composite outcome. Any abnormal test findings during the study will be helpful in reviewing the outcome.
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Timepoint [1]
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Measurement from the time the subject provides informed consent through and including 28 calendar days after the last study drug administration.
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Eligibility
Key inclusion criteria
1. Age should be greater than or equal to the minimum age of consent in the applicable country
2. Stage 3 or 4 CKD (eGFR = 15 and < 60 mL/min/1.73 m2)
3. ESA-naive (no prior ESA use) subjects whose Hb at baseline is = 8 g/dL and < 10 g/dL, or ESA prior users whose Hb at baseline is = 8 g/dL and < 10 g/dL and who have stopped using ESA at least 12 weeks till the screening
4. Ferritin = 100 ng/mL and transferrin saturation (TSAT) = 20%
5. Subject must be willing to complete all study-related activities and follow-up visits
6. Evidence of a signed and dated informed consent document indicating that the subject has been informed of all pertinent aspects of the study.
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Minimum age
18
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Need for dialysis therapy expected in the next 12 months or rapid progression of CKD (e.g., eGFR decrease of >20% within 12 weeks)
2. Received a blood transfusion (including RBC transfusion) within the 12 weeks prior to screening, or blood transfusion is anticipated during the study period
3. Have a history of overt gastrointestinal bleeding or any other bleeding episode associated with a fall in Hb of = 1 g/dL, within the last 8 weeks prior to screening
4. Have an unstable Hb for any reason, in the investigator's opinion
5. Have non-renal anaemia (any anaemia where the investigator considers the anaemia is predominantly due to a non-renal cause. Non-renal causes include, but are not limited to vitamin B12 or folic acid deficiency, homozygous sickle-cell disease, thalassemia of all types, other non-renal cause of anaemia such as myelodysplasia or haematological malignancies)
6. Platelet count of = 50 x109/L
7. Vitamin B12 deficiency defined as total serum levels of < 181 pmol/L (246 pg/ml) 10
8. Folic acid deficiency defined as total serum levels < 7.63 nmol/L (3.37 ng/mL) 10
9. Pure red cell aplasia, or a history of pure red cell aplasia
10. Poorly controlled hypertension defined as a sitting SBP =170 mmHg and/or DBP =100 mm Hg
11. Chronic congestive heart failure (New York Heart Association class IV) or are otherwise at high risk for early withdrawal or interruption of the study (due to myocardial infarction, severe or unstable coronary artery disease, stroke, or severe liver disease) within the 12 weeks before screening or during screening
12. Active or not active malignancy (except non-melanoma skin cancer) within five years before screening
13. Planned live kidney transplantation scheduled within 52 weeks after the screening visit
14. Uncontrolled hyperparathyroidism, in the investigator's opinion
15. Uncontrolled hypothyroidism determined by the investigator that they cannot participate in the study
16. Active acute or chronic infection, or uncontrolled or symptomatic inflammatory disease (e.g., rheumatoid arthritis, systemic lupus erythematosus), or a C-reactive protein level > 15 mg/L. (Routinely screening for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infection is not required in this protocol. By history or current clinical evidence, patients with active acute HBV or HCV infection should be excluded. Chronic HBV/HCV infection with LFTs > 3 times of normal are excluded. Known HIV positive patients are excluded)
17. Immunosuppressive therapy (other than corticosteroids for a chronic condition, or tacrolimus/cyclosporine) within 12 weeks prior to baseline
18. Life expectancy of less than 52 weeks
19. Planned surgery during the study period (excluding minor skin excisions)
20. Have received investigational drug(s) other than those of this study within 4 weeks prior to screening, or will receive investigational drug(s) other than those of this study during the study period
21. History or clinical evidence of cardiovascular, haematologic or hepatic (ALT, AST, bilirubin values above three times the upper limit of normal [ULN] at screening) or any physical conditions that, in the opinion of the investigator, would compromise participation in the study
22. With a cognitive or psychiatric condition rendering the subject unable to be cooperative with and complete study requirements
23. Hypersensitivity to any one of the investigational drugs
24. Subjects are, in the judgement of the investigator, otherwise inappropriate for entry into the study
25. Subjects who are investigational site staff members directly involved in the conduct of the trial and their family members, site staff members otherwise supervised by the Investigator, or subjects who are KGBio or CRO employees directly involved in the conduct of the trial
26. Participation in other studies involving same investigational drug(s) (Phases 1-4) of this study within 12 weeks before screening
27. Females of childbearing potential or males who are unable/unwilling to take adequate contraceptive precautions defined by the protocol for the duration of the study and for at least 28 days after last dose of investigational product. Females have a positive pregnancy test result within 24 hours prior to study entry, is otherwise known to be pregnant, plans to become pregnant in the next 12 months or is currently breastfeeding.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
2/07/2020
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
30/06/2023
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Sample size
Target
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Accrual to date
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Final
391
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Recruitment in Australia
Recruitment state(s)
NSW,SA,TAS
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Recruitment hospital [1]
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Renal Research Gosford - Gosford
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Royal Adelaide Hospital - Adelaide
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Launceston General Hospital - Launceston
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2250 - Gosford
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5000 - Adelaide
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7250 - Launceston
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Recruitment outside Australia
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Indonesia
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Jakarta Pusat
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Daejeon
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Incheon
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Sejong
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Sibu
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Ubon Ratchathani
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
PT Kalbe Genexine Biologics
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Address
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Other collaborator category [1]
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Commercial sector/industry
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Name [1]
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Novotech (Australia) Pty Limited
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Ethics approval
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Summary
Brief summary
This is an open-label, randomised, multicenter, Mircera-controlled, parallel-group, Phase III study to determine whether subcutaneous administered efepoetin alfa is as effective and well tolerated as subcutaneous Mircera for anaemia correction and maintenance in erythropoiesis stimulating agent (ESA)-naïve subjects who have CKD and are not on dialysis. ESA prior users who have stopped using ESA at least 12 weeks till screening will also be eligible for this study provided they fulfil all the subject entry criteria.
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Trial website
https://clinicaltrials.gov/study/NCT04155125
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Contacts
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04155125
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