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LATINO Study: A Study of Mircera for the Maintenance Treatment of Dialysis Patients With Chronic Renal Anemia.

A Single-Arm Open-Label Study to Assess the Efficacy, Safety, and Tolerability of Once-Monthly Administration of Intravenous and/or Subcutaneous C.E.R.A for the Maintenance of Hemoglobin Levels in Dialysis Patients With Chronic Renal Anemia

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00517413
Enrollment
163
Registered
2007-08-17
Start date
2007-10-31
Completion date
2010-05-31
Last updated
2016-04-29

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Anemia

Brief summary

This single arm study will assess the efficacy and safety of Mircera when administered once monthly, subcutaneously or intravenously, for the maintenance of hemoglobin levels in dialysis patients with chronic renal anemia. Patients currently receiving maintenance treatment with epoetin alfa will receive monthly injections of Mircera with a starting dose (120, 200 or 360 micrograms) derived from the dose of epoetin alfa they were receiving in the week preceding study start. The anticipated time on study treatment is 3-12 months, and the target sample size is 100-500 individuals.

Interventions

DRUGmethoxy polyethylene glycol-epoetin beta [Mircera]

120, 200 or 360 micrograms sc or iv monthly, starting dose

Sponsors

Hoffmann-La Roche
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* adult patients, \>=18 years of age; * chronic renal anemia; * hemodialysis or peritoneal dialysis, with same mode of dialysis for \>=3 months before and throughout screening period; * stable maintenance epoetin alfa therapy for past 2 months.

Exclusion criteria

* transfusion of red blood cells during previous 2 months; * poorly controlled hypertension requiring interruption of epoetin alfa in past 6 months; * acute or chronic bleeding during previous 2 months.

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants Maintaining Their Mean Hb Concentration Within ±1.0 Gram/Deciliter of Their Reference Hb and Between 10.5 and 12.5 Gram/DeciliterEEP (Week 16 to 24)The haemoglobin (Hb) levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The reference Hb value was defined on the basis of individual participant's all assessments at Weeks -4, -3, -2, -1 and 0. The Hb value on the first day of first dose (Week 0) was included in the calculation, as this assessment was performed before the first dose was given. The percentage of participants maintaining their mean Hb concentration within +/-1.0 gram/deciliter (g/dL) of their reference Hb and between 10.5 and 12.5 g/dL are reported for efficacy evaluation period (EEP). Efficacy evaluation period was from Week 16 to Week 24 after completion of 16-week dose titration period (DTP).

Secondary

MeasureTime frameDescription
Percentage of Participants Maintaining Hb Concentration Within The Target Range 10.5 and 12.5 g/dL Throughout the EEPEEP (Week 16 to 24)The Hb levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The percentage of participants maintaining their mean Hb concentration within the target range 10.5 and 12.5 g/dL throughout the EEP are reported.
Mean Time Spent by the Participants in the Hb Target Range 10.5-12.5 g/dL During EEPEEP (Week 16 to 24)The Hb levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The mean time (days) spent by the participants in the Hb target range 10.5 to 12.5 is reported.
Mean C.E.R.A Dose To Maintain Hb Level Within the Range 10.5-12.5 g/dL Throughout the EEPEEP (Week 16 to 24)The Hb levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The mean C.E.R.A dose required to maintain the Hb level within the range 10.5-12.5 g/dL throughout the EEP is presented.
Percentage of Participants Requiring Dose Adjustments of C.E.R.A During the DTP and EEPBaseline (Week 0) to Week 24Dose adjustments were necessary when Hb increased or decreased by a clinically significant amount. The dose of C.E.R.A. was adjusted to maintain the individual participant's Hb within a range of +/-1.0 g/dL of the reference Hb concentration and between 10.5 and 12.5 g/dL throughout the DTP (Week 0 to Week 16) and the EEP (Weeks 16 to 24). The reference Hb value was taken as the mean of all Hb assessments during the stability verification period (Weeks -4, -3, -2, -1). The percentage of participants requiring C.E.R.A dose adjustments during the DTP and EEP are presented.
Mean Monthly Dose of C.E.R.A During the DTP and EEPBaseline (Week 0) to Week 24The initial dose of C.E.R.A. was 120, 200, or 360 mcg IV or SC every 4 weeks for 48 weeks, which was based on the last dose of the previous ESA. Dose adjustments were necessary when Hb increased or decreased by a clinically significant amount. The dose of C.E.R.A. was adjusted to maintain the individual participant's Hb within a range of +/-1.0 g/dL of the reference Hb concentration and between 10.5 and 12.5 g/dL throughout the DTP and the EEP. The reference Hb value was taken as the mean of all Hb assessments during the stability verification period. The mean monthly doses of C.E.R.A during the DTP and EEP are presented.
Incidence of Red Blood Cell Transfusions During the C.E.R.A. Treatment PhaseBaseline (Week 0) to Week 44Red blood cell (RBC) transfusions were permitted during the treatment period in case of medical need. The pre-transfusion Hb level was measured before any transfusion was administered.
Number of Participants With Adverse Events and Serious Adverse EventsUp to Week 52Adverse event (AE) and Serious adverse event (SAE) data was reported for the safety population which included all participants who entered into the study.
Mean Haemoglobin Levels Over TimeBaseline (Week 0), Week 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, and 48The Hb levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The standard reference range for Hb are as follows: Female: min-max for lower limit=11 to 13 g/dL and min-max for upper limit=14 to 18.1 g/dL; Male: min-max for lower limit=12 to 14.2 g/dL and min-max for upper limit=16 to 18.1 g/dL.
Mean Change in the Hb Concentration Between the Stability Verification Period and the EEPSVP (Week -4 to -1), EEP (Week 16 to 24)The Hb levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The mean change in the Hb concentration between the Stability Verification Period (SVP) and the EEP is reported.
Mean White Blood Cells and Thrombocyte Levels Over TimeBaseline (Week 0), Week 8, 16, 24, 32, 40, and 48The white blood cells (WBC) and thrombocyte levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The standard reference ranges for WBC are as follows: Female/Male: min-max for lower limit= 3.5 - 5\*10\^9 cells/L and min-max of upper limit= 9 -13.5\*10\^9 cells/L. The standard reference ranges for thrombocyte are as follows: Female/Male: min-max for lower limit= 130 - 150\*10\^9 cells/L and min-max of upper limit= 300 - 450\*10\^9 cells/L.
Mean Phosphate and Potassium Levels Over TimeBaseline (Week 0), Week 8, 16, 24, 32, 40, and 48The phosphate and potassium levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The standard reference ranges for phosphate are as follows: Female/Male: min-max for lower limit= 0.48435 - 0.9687 mmol/L and min-max for upper limit=1.45305 - 2.2603 mmol/L. The standard reference ranges for potassium are as follows: Female/Male: min-max for lower limit=3.1 - 3.7 mmol/L and min-max for upper limit=5 - 5.5 mmol/L.
Mean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeBaseline (Week 0), Week 8, 16, 24, 32, 40, and 48The creatinine, iron, and total iron binding capacity (TIBC) levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The standard reference ranges for creatinine are as follows: Female: min-max for lower limit=0 - 70.72 mmol/L and min-max for upper limit=79.56 - 123.76 mmol/L; Male: min-max for lower limit=0 - 70.72 mmol/L and min-max for upper limit=97.24 - 123.76 mmol/L. The standard reference ranges for iron are as follows: Female: min-max for lower limit=6.265 - 10.74 mmol/L and min-max for upper limit=25.06 - 32.22 mmol/L and Male: min-max for lower limit=6.265 - 11.635 mmol/L and min-max for upper limit=25.06 - 32.22 mmol/L. The standard reference ranges for TIBC are as follows: Female: min-max for lower limit=19.69 - 49.046 mmol/L and min-max for upper limit=62.65 - 88.963 mmol/L and Male: min-max for lower limit=19.69 - 52.089 mmol/L and min-max for upper limit=62.65 - 80.55 mmol/L.
Mean Transferrin Saturation Levels Over TimeBaseline (Week 0), Week 8, 16, 24, 32, 40, and 48Transferrin saturation (TSAT) is the ratio of serum iron and total iron-binding capacity. Transferrin is a blood protein that picks up iron absorbed by the intestines and transports it from one location to another. When iron absorption is abnormally high, transferrin proteins become more saturated with iron. An elevated TS value therefore reflects an increase in iron absorption. The TSAT levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. TSAT was calculated automatically in the electronic case report form (eCRF) according to the following formulae: TSAT= (Serum Iron\*100)/(Transferrin\*1.41) or TSAT=(Serum Iron\*100)/TIBC. Calculated data was not provided by laboratory; therefore no reference range is available.
Mean Albumin and Transferrin Levels Over TimeBaseline (Week 0), Week 8, 16, 24, 32, 40, and 48The albumin and transferrin levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The standard reference ranges for albumin are as follows: Female/Male: min-max for lower limit=30 - 35 g/L and min-max for upper limit=48 - 55 g/L. The standard reference ranges for transferrin are as follows: Female/Male: min-max for lower limit=1.5 - 2.3 g/L and min-max for upper limit=2.87 - 4.3 g/L.
Mean C-Reactive Protein Levels Over TimeBaseline (Week 0), 8, 16, 24, 32, 40, and 48C-reactive protein (CRP) is produced by the liver. The level of CRP rises when there is inflammation throughout the body. The CRP test is a general test to check for inflammation in the body.The CRP levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The standard reference ranges for CRP are as follows: Female/Male: min-max for lower limit=0 - 10 mg/L and min-max for upper limit=0.5 - 30 mg/L.
Mean Ferritin Levels Over TimeBaseline (Week 0), Week 8, 16, 24, 32, 40, and 48Ferritin is a protein found inside cells that stores iron so that the body can use it later. A ferritin test indirectly measures the amount of iron in your blood. The Ferritin levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The standard reference ranges for ferritin are as follows: Female: min-max for lower limit=6 - 50 mcg/L and min-max for upper limit=120 - 400 mcg/L; Male: min-max for lower limit=10 - 50 mcg/L and min-max for upper limit=200 - 400 mcg/L.
Mean Hematocrit Levels Over TimeBaseline (Week 0), Week 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, and 48The haematocrit (HCT) levels in fraction were recorded for each participant at enrollment and at different time points during the study up to Week 48. The standard reference range for hematocrit are as follows: Female: min-max for lower limit=0.12 - 0.38 and min-max of upper limit=0.43 - 0.537; Male: min-max for lower limit=0.35 - 0.45 and min-max of upper limit=0.45 - 0.54.

Countries

Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, Peru, Uruguay, Venezuela

Participant flow

Recruitment details

A total of 261 participants were screened and 163 participants were enrolled from 26 centers in 9 countries (Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, Peru, Uruguay, Venezuela) from 08 October 2007 to 15 May 2010.

Participants by arm

ArmCount
C.E.R.A
Participants with chronic renal anaemia who were on dialysis and were previously treated with IV or SC epoetin alfa, epoetin beta or darbepoetin alfa, received monthly treatment with C.E.R.A. The initial dose of C.E.R.A. was based on the last dose of the previous ESA; 120, 200, or 360 mcg C.E.R.A., IV or SC, every 4 weeks for 48 weeks.
161
Total161

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event7
Overall StudyDeath13
Overall StudyFailure to return1
Overall StudyOther-Reasons23
Overall StudyProtocol Violation15
Overall StudyWithdrawal by Subject2

Baseline characteristics

CharacteristicC.E.R.A
Age, Continuous53.7 Years
STANDARD_DEVIATION 14.95
Sex: Female, Male
Female
67 Participants
Sex: Female, Male
Male
94 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
40 / 162
serious
Total, serious adverse events
53 / 162

Outcome results

Primary

Percentage of Participants Maintaining Their Mean Hb Concentration Within ±1.0 Gram/Deciliter of Their Reference Hb and Between 10.5 and 12.5 Gram/Deciliter

The haemoglobin (Hb) levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The reference Hb value was defined on the basis of individual participant's all assessments at Weeks -4, -3, -2, -1 and 0. The Hb value on the first day of first dose (Week 0) was included in the calculation, as this assessment was performed before the first dose was given. The percentage of participants maintaining their mean Hb concentration within +/-1.0 gram/deciliter (g/dL) of their reference Hb and between 10.5 and 12.5 g/dL are reported for efficacy evaluation period (EEP). Efficacy evaluation period was from Week 16 to Week 24 after completion of 16-week dose titration period (DTP).

Time frame: EEP (Week 16 to 24)

Population: The Per-Protocol Population (PP) included all participants in the safety population except those who had \<3 recorded Hb values; withdrawn; inadequate iron defined as mean serum ferritin =\<100 nanogram/milliliter (ng/mL) or mean TSAT=\<20% or mean hypochromic RBCs\>=10%; or had missing administration of C.E.R.A. all during EEP (Week 16-24).

ArmMeasureValue (NUMBER)
C.E.R.APercentage of Participants Maintaining Their Mean Hb Concentration Within ±1.0 Gram/Deciliter of Their Reference Hb and Between 10.5 and 12.5 Gram/Deciliter43.7 Percentage of participants
Secondary

Incidence of Red Blood Cell Transfusions During the C.E.R.A. Treatment Phase

Red blood cell (RBC) transfusions were permitted during the treatment period in case of medical need. The pre-transfusion Hb level was measured before any transfusion was administered.

Time frame: Baseline (Week 0) to Week 44

Population: The safety population included all participants who entered into the study.

ArmMeasureValue (NUMBER)
C.E.R.AIncidence of Red Blood Cell Transfusions During the C.E.R.A. Treatment Phase13 participants
Secondary

Mean Albumin and Transferrin Levels Over Time

The albumin and transferrin levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The standard reference ranges for albumin are as follows: Female/Male: min-max for lower limit=30 - 35 g/L and min-max for upper limit=48 - 55 g/L. The standard reference ranges for transferrin are as follows: Female/Male: min-max for lower limit=1.5 - 2.3 g/L and min-max for upper limit=2.87 - 4.3 g/L.

Time frame: Baseline (Week 0), Week 8, 16, 24, 32, 40, and 48

Population: The safety population included all participants who entered into the study.

ArmMeasureGroupValue (MEAN)Dispersion
C.E.R.AMean Albumin and Transferrin Levels Over TimeAlbumin at Week 0 (n=157)39.5 g/LStandard Deviation 4.61
C.E.R.AMean Albumin and Transferrin Levels Over TimeAlbumin at Week 8 (n=134)39.3 g/LStandard Deviation 5.1
C.E.R.AMean Albumin and Transferrin Levels Over TimeAlbumin at Week 16 (n=134)39.3 g/LStandard Deviation 5.96
C.E.R.AMean Albumin and Transferrin Levels Over TimeAlbumin at Week 24 (n=124)39.3 g/LStandard Deviation 5.4
C.E.R.AMean Albumin and Transferrin Levels Over TimeAlbumin at Week 32 (n=111)39.4 g/LStandard Deviation 6.24
C.E.R.AMean Albumin and Transferrin Levels Over TimeAlbumin at Week 40 (n=99)39.9 g/LStandard Deviation 5.25
C.E.R.AMean Albumin and Transferrin Levels Over TimeAlbumin at Week 48 (n=98)39.6 g/LStandard Deviation 4.96
C.E.R.AMean Albumin and Transferrin Levels Over TimeTransferrin at Week 0 (n=75)1.82 g/LStandard Deviation 0.47
C.E.R.AMean Albumin and Transferrin Levels Over TimeTransferrin at Week 8 (n=57)1.84 g/LStandard Deviation 0.54
C.E.R.AMean Albumin and Transferrin Levels Over TimeTransferrin at Week 16 (n=63)1.81 g/LStandard Deviation 0.54
C.E.R.AMean Albumin and Transferrin Levels Over TimeTransferrin at Week 24 (n=54)1.90 g/LStandard Deviation 0.49
C.E.R.AMean Albumin and Transferrin Levels Over TimeTransferrin at Week 32 (n==44)1.91 g/LStandard Deviation 0.6
C.E.R.AMean Albumin and Transferrin Levels Over TimeTransferrin at Week 40 (n=47)1.96 g/LStandard Deviation 0.59
C.E.R.AMean Albumin and Transferrin Levels Over TimeTransferrin at Week 48 (n=46)2.96 g/LStandard Deviation 7.48
Secondary

Mean C.E.R.A Dose To Maintain Hb Level Within the Range 10.5-12.5 g/dL Throughout the EEP

The Hb levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The mean C.E.R.A dose required to maintain the Hb level within the range 10.5-12.5 g/dL throughout the EEP is presented.

Time frame: EEP (Week 16 to 24)

Population: The Intention To Treat (ITT) population included participants who received at least 1 dose of C.E.R.A. (Week 0) and for whom data for at least one follow-up variable were available.

ArmMeasureValue (MEAN)Dispersion
C.E.R.AMean C.E.R.A Dose To Maintain Hb Level Within the Range 10.5-12.5 g/dL Throughout the EEP139.6 mcgStandard Deviation 86.58
Secondary

Mean Change in the Hb Concentration Between the Stability Verification Period and the EEP

The Hb levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The mean change in the Hb concentration between the Stability Verification Period (SVP) and the EEP is reported.

Time frame: SVP (Week -4 to -1), EEP (Week 16 to 24)

Population: The Intention To Treat (ITT) population included participants who received at least 1 dose of C.E.R.A. (Week 0) and for whom data for at least one follow-up variable were available.

ArmMeasureValue (MEAN)Dispersion
C.E.R.AMean Change in the Hb Concentration Between the Stability Verification Period and the EEP0.08 g/dLStandard Deviation 1.48
Secondary

Mean C-Reactive Protein Levels Over Time

C-reactive protein (CRP) is produced by the liver. The level of CRP rises when there is inflammation throughout the body. The CRP test is a general test to check for inflammation in the body.The CRP levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The standard reference ranges for CRP are as follows: Female/Male: min-max for lower limit=0 - 10 mg/L and min-max for upper limit=0.5 - 30 mg/L.

Time frame: Baseline (Week 0), 8, 16, 24, 32, 40, and 48

Population: The safety population included all participants who entered into the study. n = the number of participants analyzed at a given time point.

ArmMeasureGroupValue (MEAN)Dispersion
C.E.R.AMean C-Reactive Protein Levels Over TimeCRP at Week 48 (n=88)61.7 mg/LStandard Deviation 169.6
C.E.R.AMean C-Reactive Protein Levels Over TimeCRP at Week 0 (n=113)54.1 mg/LStandard Deviation 147.89
C.E.R.AMean C-Reactive Protein Levels Over TimeCRP at Week 8 (n=102)87.5 mg/LStandard Deviation 218.41
C.E.R.AMean C-Reactive Protein Levels Over TimeCRP at Week 16 (n=107)186.8 mg/LStandard Deviation 1414.66
C.E.R.AMean C-Reactive Protein Levels Over TimeCRP at Week 24 (n=104)64.0 mg/LStandard Deviation 163.67
C.E.R.AMean C-Reactive Protein Levels Over TimeCRP at Week 32 (n=94)53.4 mg/LStandard Deviation 118.21
C.E.R.AMean C-Reactive Protein Levels Over TimeCRP at Week 40 (n=84)250.6 mg/LStandard Deviation 1890.84
Secondary

Mean Creatinine, Iron, and Total Iron Binding Capacity Levels Over Time

The creatinine, iron, and total iron binding capacity (TIBC) levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The standard reference ranges for creatinine are as follows: Female: min-max for lower limit=0 - 70.72 mmol/L and min-max for upper limit=79.56 - 123.76 mmol/L; Male: min-max for lower limit=0 - 70.72 mmol/L and min-max for upper limit=97.24 - 123.76 mmol/L. The standard reference ranges for iron are as follows: Female: min-max for lower limit=6.265 - 10.74 mmol/L and min-max for upper limit=25.06 - 32.22 mmol/L and Male: min-max for lower limit=6.265 - 11.635 mmol/L and min-max for upper limit=25.06 - 32.22 mmol/L. The standard reference ranges for TIBC are as follows: Female: min-max for lower limit=19.69 - 49.046 mmol/L and min-max for upper limit=62.65 - 88.963 mmol/L and Male: min-max for lower limit=19.69 - 52.089 mmol/L and min-max for upper limit=62.65 - 80.55 mmol/L.

Time frame: Baseline (Week 0), Week 8, 16, 24, 32, 40, and 48

Population: The safety population included all participants who entered into the study. n = the number of participants analyzed at a given time point.

ArmMeasureGroupValue (MEAN)Dispersion
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeCreatinine at Week 0 (n=153)847.1 μmol/LStandard Deviation 269.15
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeCreatinine at Week 8 (n=120)823.4 μmol/LStandard Deviation 274.17
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeCreatinine at Week 16 (n=122)814.0 μmol/LStandard Deviation 268.76
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeCreatinine at Week 24 (n=118)822.9 μmol/LStandard Deviation 265.76
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeCreatinine at Week 32 (n=112)804.5 μmol/LStandard Deviation 284.33
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeCreatinine at Week 40 (n=95)809.7 μmol/LStandard Deviation 292.23
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeCreatinine at Week 48 (n=93)816.6 μmol/LStandard Deviation 315.21
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeIron at Week 0 (n=159)13.9 μmol/LStandard Deviation 6.28
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeIron at Week 8 (n=136)16.0 μmol/LStandard Deviation 6.79
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeIron at Week 16 (n=133)17.6 μmol/LStandard Deviation 9.79
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeIron at Week 24 (n=121)16.5 μmol/LStandard Deviation 8.12
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeIron at Week 32 (n=110)16.0 μmol/LStandard Deviation 8.28
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeIron at Week 40 (n=99)16.3 μmol/LStandard Deviation 7.75
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeIron at Week 48 (n=97)14.4 μmol/LStandard Deviation 6.55
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeTIBC at Week 0 (n=97)38.5 μmol/LStandard Deviation 10.38
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeTIBC at Week 8 (n=75)39.7 μmol/LStandard Deviation 11.23
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeTIBC at Week 16 (n=74)41.5 μmol/LStandard Deviation 11.99
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeTIBC at Week 24 (n=76)42.0 μmol/LStandard Deviation 19.8
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeTIBC at Week 32 (n=68)41.4 μmol/LStandard Deviation 11.97
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeTIBC at Week 40 (n=66)39.6 μmol/LStandard Deviation 9.31
C.E.R.AMean Creatinine, Iron, and Total Iron Binding Capacity Levels Over TimeTIBC at Week 48 (n=58)44.0 μmol/LStandard Deviation 23.57
Secondary

Mean Ferritin Levels Over Time

Ferritin is a protein found inside cells that stores iron so that the body can use it later. A ferritin test indirectly measures the amount of iron in your blood. The Ferritin levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The standard reference ranges for ferritin are as follows: Female: min-max for lower limit=6 - 50 mcg/L and min-max for upper limit=120 - 400 mcg/L; Male: min-max for lower limit=10 - 50 mcg/L and min-max for upper limit=200 - 400 mcg/L.

Time frame: Baseline (Week 0), Week 8, 16, 24, 32, 40, and 48

Population: The safety population included all participants who entered into the study. n = the number of participants analyzed at a given time point.

ArmMeasureGroupValue (MEAN)Dispersion
C.E.R.AMean Ferritin Levels Over TimeFerritin at Week 0 (n=157)591.8 mcg/LStandard Deviation 420.67
C.E.R.AMean Ferritin Levels Over TimeFerritin at Week 8 (n=134)617.0 mcg/LStandard Deviation 428.36
C.E.R.AMean Ferritin Levels Over TimeFerritin at Week 16 (n=131)598.8 mcg/LStandard Deviation 408.2
C.E.R.AMean Ferritin Levels Over TimeFerritin at Week 24 (n=123)578.5 mcg/LStandard Deviation 403.87
C.E.R.AMean Ferritin Levels Over TimeFerritin at Week 32 (n=110)583.0 mcg/LStandard Deviation 478.92
C.E.R.AMean Ferritin Levels Over TimeFerritin at Week 40 (n=98)591.2 mcg/LStandard Deviation 457.24
C.E.R.AMean Ferritin Levels Over TimeFerritin at Week 48 (n=97)590.3 mcg/LStandard Deviation 433.97
Secondary

Mean Haemoglobin Levels Over Time

The Hb levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The standard reference range for Hb are as follows: Female: min-max for lower limit=11 to 13 g/dL and min-max for upper limit=14 to 18.1 g/dL; Male: min-max for lower limit=12 to 14.2 g/dL and min-max for upper limit=16 to 18.1 g/dL.

Time frame: Baseline (Week 0), Week 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, and 48

Population: The safety population included all participants who entered into the study. n = the number of participants analyzed at a given time point.

ArmMeasureGroupValue (MEAN)Dispersion
C.E.R.AMean Haemoglobin Levels Over TimeHb at Week 0 (n=162)11.4 g/dLStandard Deviation 0.58
C.E.R.AMean Haemoglobin Levels Over TimeHb at Week 8 (n=151)11.7 g/dLStandard Deviation 1.44
C.E.R.AMean Haemoglobin Levels Over TimeHb at Week 12 (n=144)11.7 g/dLStandard Deviation 1.67
C.E.R.AMean Haemoglobin Levels Over TimeHb at Week 16 (n=141)11.6 g/dLStandard Deviation 1.56
C.E.R.AMean Haemoglobin Levels Over TimeHb at Week 20 (n=137)11.5 g/dLStandard Deviation 1.65
C.E.R.AMean Haemoglobin Levels Over TimeHb at Week 24 (n=132)11.6 g/dLStandard Deviation 1.36
C.E.R.AMean Haemoglobin Levels Over TimeHb at Week 28 (n=121)11.8 g/dLStandard Deviation 1.38
C.E.R.AMean Haemoglobin Levels Over TimeHb at Week 32 (n=120)11.6 g/dLStandard Deviation 1.62
C.E.R.AMean Haemoglobin Levels Over TimeHb at Week 36 (n= 114)11.7 g/dLStandard Deviation 1.58
C.E.R.AMean Haemoglobin Levels Over TimeHb at Week 40 (n=110)11.7 g/dLStandard Deviation 1.31
C.E.R.AMean Haemoglobin Levels Over TimeHb at Week 44 (n=105)11.5 g/dLStandard Deviation 1.39
C.E.R.AMean Haemoglobin Levels Over TimeHb at Week 48 (n=103)11.4 g/dLStandard Deviation 1.27
Secondary

Mean Hematocrit Levels Over Time

The haematocrit (HCT) levels in fraction were recorded for each participant at enrollment and at different time points during the study up to Week 48. The standard reference range for hematocrit are as follows: Female: min-max for lower limit=0.12 - 0.38 and min-max of upper limit=0.43 - 0.537; Male: min-max for lower limit=0.35 - 0.45 and min-max of upper limit=0.45 - 0.54.

Time frame: Baseline (Week 0), Week 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, and 48

Population: The safety population included all participants who entered into the study. n = the number of participants analyzed at a given time point.

ArmMeasureGroupValue (MEAN)Dispersion
C.E.R.AMean Hematocrit Levels Over TimeHCT at Week 44 (n=101)0.35 Proportion of red blood cells in bloodStandard Deviation 0.04
C.E.R.AMean Hematocrit Levels Over TimeHCT at Week 48 (n=103)0.35 Proportion of red blood cells in bloodStandard Deviation 0.04
C.E.R.AMean Hematocrit Levels Over TimeHCT at Week 0 (n=162)0.35 Proportion of red blood cells in bloodStandard Deviation 0.02
C.E.R.AMean Hematocrit Levels Over TimeHCT at Week 8 (n=151)0.35 Proportion of red blood cells in bloodStandard Deviation 0.05
C.E.R.AMean Hematocrit Levels Over TimeHCT at Week 12 (n=139)0.36 Proportion of red blood cells in bloodStandard Deviation 0.05
C.E.R.AMean Hematocrit Levels Over TimeHCT at Week 16 (n=141)0.35 Proportion of red blood cells in bloodStandard Deviation 0.05
C.E.R.AMean Hematocrit Levels Over TimeHCT at Week 20 (n=132)0.35 Proportion of red blood cells in bloodStandard Deviation 0.05
C.E.R.AMean Hematocrit Levels Over TimeHCT at Week 24 (n=132)0.35 Proportion of red blood cells in bloodStandard Deviation 0.04
C.E.R.AMean Hematocrit Levels Over TimeHCT at Week 28 (n=117)0.36 Proportion of red blood cells in bloodStandard Deviation 0.04
C.E.R.AMean Hematocrit Levels Over TimeHCT at Week 32 (n=119)0.36 Proportion of red blood cells in bloodStandard Deviation 0.05
C.E.R.AMean Hematocrit Levels Over TimeHCT at Week 36 (n=110)0.36 Proportion of red blood cells in bloodStandard Deviation 0.05
C.E.R.AMean Hematocrit Levels Over TimeHCT at Week 40 (n=110)0.36 Proportion of red blood cells in bloodStandard Deviation 0.04
Secondary

Mean Monthly Dose of C.E.R.A During the DTP and EEP

The initial dose of C.E.R.A. was 120, 200, or 360 mcg IV or SC every 4 weeks for 48 weeks, which was based on the last dose of the previous ESA. Dose adjustments were necessary when Hb increased or decreased by a clinically significant amount. The dose of C.E.R.A. was adjusted to maintain the individual participant's Hb within a range of +/-1.0 g/dL of the reference Hb concentration and between 10.5 and 12.5 g/dL throughout the DTP and the EEP. The reference Hb value was taken as the mean of all Hb assessments during the stability verification period. The mean monthly doses of C.E.R.A during the DTP and EEP are presented.

Time frame: Baseline (Week 0) to Week 24

Population: The Intention To Treat (ITT) population included participants who received at least 1 dose of C.E.R.A. (Week 0) and for whom data for at least one follow-up variable were available.

ArmMeasureGroupValue (MEAN)Dispersion
C.E.R.AMean Monthly Dose of C.E.R.A During the DTP and EEPMean monthly dose during DTP142.5 mcgStandard Deviation 50.32
C.E.R.AMean Monthly Dose of C.E.R.A During the DTP and EEPMean monthly dose during EEP139.6 mcgStandard Deviation 86.58
Secondary

Mean Phosphate and Potassium Levels Over Time

The phosphate and potassium levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The standard reference ranges for phosphate are as follows: Female/Male: min-max for lower limit= 0.48435 - 0.9687 mmol/L and min-max for upper limit=1.45305 - 2.2603 mmol/L. The standard reference ranges for potassium are as follows: Female/Male: min-max for lower limit=3.1 - 3.7 mmol/L and min-max for upper limit=5 - 5.5 mmol/L.

Time frame: Baseline (Week 0), Week 8, 16, 24, 32, 40, and 48

Population: The safety population included all participants who entered into the study. n = the number of participants analyzed at a given time point.

ArmMeasureGroupValue (MEAN)Dispersion
C.E.R.AMean Phosphate and Potassium Levels Over TimePhosphate at Week 0 (n=154)1.61 mmol/LStandard Deviation 0.55
C.E.R.AMean Phosphate and Potassium Levels Over TimePhosphate at Week 8 (n=135)1.69 mmol/LStandard Deviation 0.59
C.E.R.AMean Phosphate and Potassium Levels Over TimePhosphate at Week 16 (n=131)1.70 mmol/LStandard Deviation 0.57
C.E.R.AMean Phosphate and Potassium Levels Over TimePhosphate at Week 24 (n=125)1.68 mmol/LStandard Deviation 0.57
C.E.R.AMean Phosphate and Potassium Levels Over TimePhosphate at Week 32 (n=110)1.60 mmol/LStandard Deviation 0.61
C.E.R.AMean Phosphate and Potassium Levels Over TimePhosphate at Week 40 (n=105)1.59 mmol/LStandard Deviation 0.6
C.E.R.AMean Phosphate and Potassium Levels Over TimePhosphate at Week 48 (n=97)1.61 mmol/LStandard Deviation 0.65
C.E.R.AMean Phosphate and Potassium Levels Over TimePotassium at Week 0 (n=159)4.90 mmol/LStandard Deviation 0.87
C.E.R.AMean Phosphate and Potassium Levels Over TimePotassium at Week 8 (n=133)4.80 mmol/LStandard Deviation 0.86
C.E.R.AMean Phosphate and Potassium Levels Over TimePotassium at Week 16 (n=133)4.90 mmol/LStandard Deviation 0.87
C.E.R.AMean Phosphate and Potassium Levels Over TimePotassium at Week 24 (n=124)4.90 mmol/LStandard Deviation 0.89
C.E.R.AMean Phosphate and Potassium Levels Over TimePotassium at Week 32 (n=110)4.80 mmol/LStandard Deviation 0.83
C.E.R.AMean Phosphate and Potassium Levels Over TimePotassium at Week 40 (n=104)4.80 mmol/LStandard Deviation 0.88
C.E.R.AMean Phosphate and Potassium Levels Over TimePotassium at Week 48 (n=99)5.00 mmol/LStandard Deviation 0.9
Secondary

Mean Time Spent by the Participants in the Hb Target Range 10.5-12.5 g/dL During EEP

The Hb levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The mean time (days) spent by the participants in the Hb target range 10.5 to 12.5 is reported.

Time frame: EEP (Week 16 to 24)

Population: The Intention To Treat (ITT) population included participants who received at least 1 dose of C.E.R.A. (Week 0) and for whom data for at least one follow-up variable were available.

ArmMeasureValue (MEAN)Dispersion
C.E.R.AMean Time Spent by the Participants in the Hb Target Range 10.5-12.5 g/dL During EEP30 daysStandard Deviation 19.98
Secondary

Mean Transferrin Saturation Levels Over Time

Transferrin saturation (TSAT) is the ratio of serum iron and total iron-binding capacity. Transferrin is a blood protein that picks up iron absorbed by the intestines and transports it from one location to another. When iron absorption is abnormally high, transferrin proteins become more saturated with iron. An elevated TS value therefore reflects an increase in iron absorption. The TSAT levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. TSAT was calculated automatically in the electronic case report form (eCRF) according to the following formulae: TSAT= (Serum Iron\*100)/(Transferrin\*1.41) or TSAT=(Serum Iron\*100)/TIBC. Calculated data was not provided by laboratory; therefore no reference range is available.

Time frame: Baseline (Week 0), Week 8, 16, 24, 32, 40, and 48

Population: The safety population included all participants who entered into the study. n = the number of participants analyzed at a given time point.

ArmMeasureGroupValue (MEAN)Dispersion
C.E.R.AMean Transferrin Saturation Levels Over TimeTSAT at Week 0 (n=135)34.7 Percentage of Transferrin SaturationStandard Deviation 19.16
C.E.R.AMean Transferrin Saturation Levels Over TimeTSAT at Week 8 (n=113)39.8 Percentage of Transferrin SaturationStandard Deviation 19.52
C.E.R.AMean Transferrin Saturation Levels Over TimeTSAT at Week 16 (n=113)46.3 Percentage of Transferrin SaturationStandard Deviation 28.26
C.E.R.AMean Transferrin Saturation Levels Over TimeTSAT at Week 24 (n=108)42.1 Percentage of Transferrin SaturationStandard Deviation 22.2
C.E.R.AMean Transferrin Saturation Levels Over TimeTSAT at Week 32 (n=96)39.3 Percentage of Transferrin SaturationStandard Deviation 24.83
C.E.R.AMean Transferrin Saturation Levels Over TimeTSAT at Week 40 (n=91)40.2 Percentage of Transferrin SaturationStandard Deviation 21.85
C.E.R.AMean Transferrin Saturation Levels Over TimeTSAT at Week 48 (n=84)36.8 Percentage of Transferrin SaturationStandard Deviation 21.56
Secondary

Mean White Blood Cells and Thrombocyte Levels Over Time

The white blood cells (WBC) and thrombocyte levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The standard reference ranges for WBC are as follows: Female/Male: min-max for lower limit= 3.5 - 5\*10\^9 cells/L and min-max of upper limit= 9 -13.5\*10\^9 cells/L. The standard reference ranges for thrombocyte are as follows: Female/Male: min-max for lower limit= 130 - 150\*10\^9 cells/L and min-max of upper limit= 300 - 450\*10\^9 cells/L.

Time frame: Baseline (Week 0), Week 8, 16, 24, 32, 40, and 48

Population: The safety population included all participants who entered into the study. n = the number of participants analyzed at a given time point.

ArmMeasureGroupValue (MEAN)Dispersion
C.E.R.AMean White Blood Cells and Thrombocyte Levels Over TimeThrombocyte at Week 16 (n=135)207.4 10^9 cells/LStandard Deviation 57.76
C.E.R.AMean White Blood Cells and Thrombocyte Levels Over TimeWBC at Week 0 (n=160)6.8 10^9 cells/LStandard Deviation 1.9
C.E.R.AMean White Blood Cells and Thrombocyte Levels Over TimeWBC at Week 8 (n=147)6.5 10^9 cells/LStandard Deviation 2.1
C.E.R.AMean White Blood Cells and Thrombocyte Levels Over TimeWBC at Week 16 (n=137)6.7 10^9 cells/LStandard Deviation 2.01
C.E.R.AMean White Blood Cells and Thrombocyte Levels Over TimeWBC at Week 24 (n=130)6.6 10^9 cells/LStandard Deviation 2.09
C.E.R.AMean White Blood Cells and Thrombocyte Levels Over TimeWBC at Week 32 (n=116)6.6 10^9 cells/LStandard Deviation 1.78
C.E.R.AMean White Blood Cells and Thrombocyte Levels Over TimeWBC at Week 40 (n=106)6.6 10^9 cells/LStandard Deviation 2.19
C.E.R.AMean White Blood Cells and Thrombocyte Levels Over TimeWBC at Week 48 (n=101)6.6 10^9 cells/LStandard Deviation 1.98
C.E.R.AMean White Blood Cells and Thrombocyte Levels Over TimeThrombocyte at Week 0 (n=159)219.7 10^9 cells/LStandard Deviation 59.73
C.E.R.AMean White Blood Cells and Thrombocyte Levels Over TimeThrombocyte at Week 8 (n=144)204.4 10^9 cells/LStandard Deviation 56.21
C.E.R.AMean White Blood Cells and Thrombocyte Levels Over TimeThrombocyte at Week 24 (n=129)205.2 10^9 cells/LStandard Deviation 52.28
C.E.R.AMean White Blood Cells and Thrombocyte Levels Over TimeThrombocyte at Week 32 (n=117)207.9 10^9 cells/LStandard Deviation 69.97
C.E.R.AMean White Blood Cells and Thrombocyte Levels Over TimeThrombocyte at Week 40 (n=105)209.3 10^9 cells/LStandard Deviation 55.95
C.E.R.AMean White Blood Cells and Thrombocyte Levels Over TimeThrombocyte at Week 48 (n=101)209.0 10^9 cells/LStandard Deviation 58.38
Secondary

Number of Participants With Adverse Events and Serious Adverse Events

Adverse event (AE) and Serious adverse event (SAE) data was reported for the safety population which included all participants who entered into the study.

Time frame: Up to Week 52

Population: The safety population included all participants who entered into the study.

ArmMeasureGroupValue (NUMBER)
C.E.R.ANumber of Participants With Adverse Events and Serious Adverse EventsParticipants with AE120 participants
C.E.R.ANumber of Participants With Adverse Events and Serious Adverse EventsParticipants with SAE53 participants
Secondary

Percentage of Participants Maintaining Hb Concentration Within The Target Range 10.5 and 12.5 g/dL Throughout the EEP

The Hb levels were recorded for each participant at enrollment and at different time points during the study up to Week 48. The percentage of participants maintaining their mean Hb concentration within the target range 10.5 and 12.5 g/dL throughout the EEP are reported.

Time frame: EEP (Week 16 to 24)

Population: The Intention To Treat (ITT) population included participants who received at least 1 dose of C.E.R.A. (Week 0) and for whom data for at least one follow-up variable were available.

ArmMeasureValue (NUMBER)
C.E.R.APercentage of Participants Maintaining Hb Concentration Within The Target Range 10.5 and 12.5 g/dL Throughout the EEP47.8 Percentage of participants
Secondary

Percentage of Participants Requiring Dose Adjustments of C.E.R.A During the DTP and EEP

Dose adjustments were necessary when Hb increased or decreased by a clinically significant amount. The dose of C.E.R.A. was adjusted to maintain the individual participant's Hb within a range of +/-1.0 g/dL of the reference Hb concentration and between 10.5 and 12.5 g/dL throughout the DTP (Week 0 to Week 16) and the EEP (Weeks 16 to 24). The reference Hb value was taken as the mean of all Hb assessments during the stability verification period (Weeks -4, -3, -2, -1). The percentage of participants requiring C.E.R.A dose adjustments during the DTP and EEP are presented.

Time frame: Baseline (Week 0) to Week 24

Population: The Intention To Treat (ITT) population included participants who received at least 1 dose of C.E.R.A. (Week 0) and for whom data for at least one follow-up variable were available.

ArmMeasureGroupValue (NUMBER)
C.E.R.APercentage of Participants Requiring Dose Adjustments of C.E.R.A During the DTP and EEPDose adjustment during DTP65.8 Percentage of participants
C.E.R.APercentage of Participants Requiring Dose Adjustments of C.E.R.A During the DTP and EEPDose adjustment during EEP51.1 Percentage of participants

Source: ClinicalTrials.gov · Data processed: Mar 13, 2026