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An Observational Study of Mircera (Methoxy Polyethylene Glycol-Epoetin Beta) in Stage III-IV Chronic Kidney Disease Patients Not on Dialysis With Renal Anemia

Efficacy of Methoxy Poly-Ethylene Glycol Epoetin Beta (C.E.R.A.) for Correction of Anemia and Maintenance of the Hb Levels in CKD Patients in Stage III - IV, Not on Dialysis, Treated According to Routine Clinical Practice

Status
Completed
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT01695746
Enrollment
108
Registered
2012-09-28
Start date
2011-08-31
Completion date
2013-11-30
Last updated
2016-06-02

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

Conditions

Anemia

Brief summary

This observational study will evaluate the use in clinical practice and efficacy of Mircera (methoxy polyethylene glycol-epoetin beta) in stage III-IV chronic kidney disease patients not on dialysis receiving Mircera for the treatment of chronic renal anemia. Eligible patients will be followed for 24 weeks.

Interventions

Participants receiving 0.6 mcg/kg of C.E.R.A. once every two weeks for correction of anemia and conversion to C.E.R.A. dose 120, 200, or 360 mcg either once monthly; or 60, 100, or 180 mcg once every 2 weeks for maintenance of Hb according to local clinical practice or prescribing information will be observed.

Sponsors

Hoffmann-La Roche
Lead SponsorINDUSTRY

Study design

Observational model
COHORT
Time perspective
PROSPECTIVE

Eligibility

Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No

Inclusion criteria

* Adult patients, 18 to 65 years of age, inclusive * Patients with stage III-IV chronic kidney disease not on dialysis * Erythropoiesis stimulating agent (ESA) naïve with Hb \< 10 g/dL, or on treatment with ESAs other than Mircera and Hb within the target range of 10-12 g/dL * Adequate iron status as judged by the treating physician

Exclusion criteria

* Hypersensitivity to recombinant human erythropoietin, polyethylene glycol or to any constituent of the study medication * Clinically significant concomitant disease or disorder as defined by protocol * Clinical suspicion of pure red cell aplasia (PRCA) * Planned elective surgery during the study period , except for cataract surgery or vascular access surgery * Transfusion of red blood cells in the previous 2 months * Pregnant women * Contraindications for Mircera according to local prescribing information or as judged by the investigator

Design outcomes

Primary

MeasureTime frameDescription
Mean Height of Participants at Baseline (Week 0)At Baseline (Week 0)The mean body height of the participants was measured and summarized in centimeters (cm). Baseline is defined as Week 0.
Mean Weight of Participants at Baseline (Week 0)At Baseline (Week 0)The mean body weight of the participants was measured and summarized in kg. Baseline is defined as Week 0.
Number of Participants With Co-morbidities at Baseline (Week 0)At Baseline (Week 0)Co-morbidities were those medical disorders present in the medical history but unresolved at Baseline. The number of participants with different co-morbidities is presented. Baseline is defined as Week 0.
Mean Time to Achieve Target Hemoglobin Range (10-12 Gram/Deciliter)Up to Week 24Correction of anemia was evaluated in participants with Hb \< 10 gram/deciliter (g/dL). Hemoglobin levels were recorded for each participant at enrollment and at different time points during the study up to Week 24. The mean time required to achieve target Hb range (10-12 g/dL) was calculated using the following formula: Time to achieve target range = (Date of Hb evaluation when participant achieves target range at first time - visit date of first dosing) + 1.
Percentage of Participants Maintaining Hemoglobin Level Within 1 Gram/Deciliter of Baseline ValueUp to Week 24Maintenance of Hb levels was to be evaluated for participants on Erythropoiesis stimulating agent (ESA) with Hb levels 10-12 g/dL. None of the participants in the enrolled population had received treatment with other ESAs and had pre-therapy Hb level as 10 g/dL or above. Therefore, the percentage of participants who had received treatment with other ESAs and were maintaining Hb level within 1 g/dL of baseline value during the study could not be evaluated. Baseline is defined as Week 0.

Secondary

MeasureTime frameDescription
Percentage of Participants Achieving Hemoglobin Target Range (10-12 Gram/Deciliter) at Least Once During the StudyUp to Week 24Correction of anemia was evaluated in participants with Hb \< 10 g/dL at enrollment. Hemoglobin levels were recorded for each participant at enrollment and at different time points during the study up to Week 24. The percentage of participants achieving the target Hb range (10-12 g/dL) at least once during the study is presented.
Number of Participants With Adverse Events and Serious Adverse EventsUp to Week 24An adverse event (AE) is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. Pre-existing conditions which worsened during this study were reported as AEs. A serious adverse event (SAE) is any untoward medical occurrence that at any dose results in death, are life threatening, requires hospitalization or prolongation of hospitalization or results in disability/incapacity, and congenital anomaly/birth defect.
Mean Time Spent in the Hemoglobin Target Range (10 - 12 Gram/Deciliter)Up to Week 24The Hb concentration was recorded for all the participants at enrollment and different time points throughout the study up to Week 24. The mean time spent (in weeks) by the participants in the target range (10 - 12 g/dL) is presented.
Mean Dose of C.E.R.A. AdministeredUp to Week 24The mean dose of C.E.R.A. administered during the study is reported. This accounts for the study drug injected through subcutaneous route at a frequency of every 4 weeks or once a month and every 2 weeks or fortnightly.
Number of Doses of C.E.R.A. Administered by Different RoutesUp to Week 24The number of doses of C.E.R.A. administered by the intravenous or subcutaneous route is presented. The number of doses for total population is calculated by summation and presented in table below as per routes of administration.
Number of Participants Who Received Concomitant Treatment for AnemiaUp to Week 24Medications that were used during the study treatment period (from the date of first dose of study medication to the end of the study) were included as concomitant medications. The number of participants taking concomitant medications prescribed for the treatment of anemia (for example iron) is presented.

Countries

India

Participant flow

Recruitment details

A total of 108 participants were enrolled in this study conducted from 30 August 2011 to 13 November 2013 at 6 sites in India.

Participants by arm

ArmCount
C.E.R.A.
Participants with chronic renal anemia Stage III-IV, not on dialysis, were administered C.E.R.A. according to routine clinical practice and were followed for the treatment duration of 24 weeks (6 months). Dosing and titration of C.E.R.A. treatment was at the discretion of the investigator in accordance with local clinical practice or prescribing information. Dosing instructions as per the local label were - For correction of anemia: 0.6 mcg/kg of C.E.R.A. once every two weeks, and for Maintenance of Hb levels: Conversion to C.E.R.A. dose (120, 200, or 360 mcg either once monthly; or 60, 100, or 180 mcg once every 2 weeks) depending on the previous weekly epoetin or darbepoetin dose.
108
Total108

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event1
Overall StudyNon-compliance by the participant3
Overall StudyParticipant not willing to participate3
Overall StudyProtocol Violation5

Baseline characteristics

CharacteristicC.E.R.A.
Age, Continuous55.5 years
STANDARD_DEVIATION 7.178
Sex: Female, Male
Female
36 Participants
Sex: Female, Male
Male
72 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
2 / 108
serious
Total, serious adverse events
2 / 108

Outcome results

Primary

Mean Height of Participants at Baseline (Week 0)

The mean body height of the participants was measured and summarized in centimeters (cm). Baseline is defined as Week 0.

Time frame: At Baseline (Week 0)

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

ArmMeasureValue (MEAN)Dispersion
C.E.R.A.Mean Height of Participants at Baseline (Week 0)163.15 cmStandard Deviation 7.366
Primary

Mean Time to Achieve Target Hemoglobin Range (10-12 Gram/Deciliter)

Correction of anemia was evaluated in participants with Hb \< 10 gram/deciliter (g/dL). Hemoglobin levels were recorded for each participant at enrollment and at different time points during the study up to Week 24. The mean time required to achieve target Hb range (10-12 g/dL) was calculated using the following formula: Time to achieve target range = (Date of Hb evaluation when participant achieves target range at first time - visit date of first dosing) + 1.

Time frame: Up to Week 24

Population: The intent-to-treat (ITT) population included all participants who received at least 1 dose of C.E.R.A. (Week 0), for whom data for at least one follow-up variable was available, and who did not have a major protocol violation. The participants who achieved target Hb range (10-12 g/dL) were included in the analysis.

ArmMeasureValue (MEAN)Dispersion
C.E.R.A.Mean Time to Achieve Target Hemoglobin Range (10-12 Gram/Deciliter)9.61 WeeksStandard Deviation 6.13
Primary

Mean Weight of Participants at Baseline (Week 0)

The mean body weight of the participants was measured and summarized in kg. Baseline is defined as Week 0.

Time frame: At Baseline (Week 0)

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

ArmMeasureValue (MEAN)Dispersion
C.E.R.A.Mean Weight of Participants at Baseline (Week 0)60.23 kgStandard Deviation 9.618
Primary

Number of Participants With Co-morbidities at Baseline (Week 0)

Co-morbidities were those medical disorders present in the medical history but unresolved at Baseline. The number of participants with different co-morbidities is presented. Baseline is defined as Week 0.

Time frame: At Baseline (Week 0)

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

ArmMeasureGroupValue (NUMBER)
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Nephrolithiasis2 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Anaemia2 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Myocardial ischaemia4 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Congenital cystic kidney disease1 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Renal hypoplasia1 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Hypothyroidism4 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Liver disorder1 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Diabetes mellitus18 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Dyslipidaemia1 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Type 1 diabetes mellitus1 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Type 2 diabetes mellitus66 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Osteoarthritis2 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Osteoporosis1 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Rheumatoid arthritis1 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Systemic lupus erythematosus1 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Glomerulonephritis2 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Nephropathy1 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Renal failure chronic28 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Tubulointerstitial nephritis1 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Asthma1 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Chronic obstructive pulmonary disorders1 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Coronary angioplasty1 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Renal transplant1 Participants
C.E.R.A.Number of Participants With Co-morbidities at Baseline (Week 0)Hypertension90 Participants
Primary

Percentage of Participants Maintaining Hemoglobin Level Within 1 Gram/Deciliter of Baseline Value

Maintenance of Hb levels was to be evaluated for participants on Erythropoiesis stimulating agent (ESA) with Hb levels 10-12 g/dL. None of the participants in the enrolled population had received treatment with other ESAs and had pre-therapy Hb level as 10 g/dL or above. Therefore, the percentage of participants who had received treatment with other ESAs and were maintaining Hb level within 1 g/dL of baseline value during the study could not be evaluated. Baseline is defined as Week 0.

Time frame: Up to Week 24

Population: The ITT population was the anticipated population for analysis.

Secondary

Mean Dose of C.E.R.A. Administered

The mean dose of C.E.R.A. administered during the study is reported. This accounts for the study drug injected through subcutaneous route at a frequency of every 4 weeks or once a month and every 2 weeks or fortnightly.

Time frame: Up to Week 24

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

ArmMeasureValue (MEAN)Dispersion
C.E.R.A.Mean Dose of C.E.R.A. Administered75.5 mcg per monthStandard Deviation 26.79
Secondary

Mean Time Spent in the Hemoglobin Target Range (10 - 12 Gram/Deciliter)

The Hb concentration was recorded for all the participants at enrollment and different time points throughout the study up to Week 24. The mean time spent (in weeks) by the participants in the target range (10 - 12 g/dL) is presented.

Time frame: Up to Week 24

Population: The ITT population included all participants who received at least 1 dose of C.E.R.A. (Week 0), for whom data for at least one follow-up variable was available, and who did not have a major protocol violation. The participants who achieved target Hb range (10-12 g/dL) were included in the analysis.

ArmMeasureValue (MEAN)Dispersion
C.E.R.A.Mean Time Spent in the Hemoglobin Target Range (10 - 12 Gram/Deciliter)16.69 WeeksStandard Deviation 4.124
Secondary

Number of Doses of C.E.R.A. Administered by Different Routes

The number of doses of C.E.R.A. administered by the intravenous or subcutaneous route is presented. The number of doses for total population is calculated by summation and presented in table below as per routes of administration.

Time frame: Up to Week 24

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

ArmMeasureGroupValue (NUMBER)
C.E.R.A.Number of Doses of C.E.R.A. Administered by Different RoutesIntravenous route0 Doses
C.E.R.A.Number of Doses of C.E.R.A. Administered by Different RoutesSubcutaneous route572 Doses
Secondary

Number of Participants Who Received Concomitant Treatment for Anemia

Medications that were used during the study treatment period (from the date of first dose of study medication to the end of the study) were included as concomitant medications. The number of participants taking concomitant medications prescribed for the treatment of anemia (for example iron) is presented.

Time frame: Up to Week 24

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

ArmMeasureGroupValue (NUMBER)
C.E.R.A.Number of Participants Who Received Concomitant Treatment for AnemiaMultivitamin17 Participants
C.E.R.A.Number of Participants Who Received Concomitant Treatment for AnemiaIron supplement15 Participants
C.E.R.A.Number of Participants Who Received Concomitant Treatment for AnemiaVitamin B15 Participants
C.E.R.A.Number of Participants Who Received Concomitant Treatment for AnemiaIron + multivitamin2 Participants
Secondary

Number of Participants With Adverse Events and Serious Adverse Events

An adverse event (AE) is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. Pre-existing conditions which worsened during this study were reported as AEs. A serious adverse event (SAE) is any untoward medical occurrence that at any dose results in death, are life threatening, requires hospitalization or prolongation of hospitalization or results in disability/incapacity, and congenital anomaly/birth defect.

Time frame: Up to Week 24

Population: The safety population was defined as all participants entered into the study.

ArmMeasureGroupValue (NUMBER)
C.E.R.A.Number of Participants With Adverse Events and Serious Adverse EventsNumber of participants with any AE4 Participants
C.E.R.A.Number of Participants With Adverse Events and Serious Adverse EventsNumber of participants with any SAE2 Participants
Secondary

Percentage of Participants Achieving Hemoglobin Target Range (10-12 Gram/Deciliter) at Least Once During the Study

Correction of anemia was evaluated in participants with Hb \< 10 g/dL at enrollment. Hemoglobin levels were recorded for each participant at enrollment and at different time points during the study up to Week 24. The percentage of participants achieving the target Hb range (10-12 g/dL) at least once during the study is presented.

Time frame: Up to Week 24

Population: The ITT population included all participants who received at least 1 dose of C.E.R.A. (Week 0), for whom data for at least one follow-up variable was available, and who did not have a major protocol violation.

ArmMeasureValue (NUMBER)
C.E.R.A.Percentage of Participants Achieving Hemoglobin Target Range (10-12 Gram/Deciliter) at Least Once During the Study90.2 Percentage of participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026