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A Single-dose Study in Paediatric Patients Aged 2 to Less Than 18 Years With Secondary Hyperparathyroidism (sHPT) Receiving Haemodialysis

An Open-label, Single-dose Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Etelcalcetide (AMG 416) in Paediatric Subjects Aged 2 to Less Than 18 Years With Secondary Hyperparathyroidism (sHPT) Receiving Maintenance Haemodialysis

Status
Completed
Phases
Phase 1
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02833857
Enrollment
11
Registered
2016-07-14
Start date
2017-03-14
Completion date
2018-10-31
Last updated
2019-07-10

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

Conditions

Chronic Kidney Disease, Secondary Hyperparathyroidism

Keywords

Secondary Hyperparathyroidism, chronic kidney disease, hemodialysis

Brief summary

This is a study to evaluate the safety and pharmacokinetics in pediatric patients with secondary hyperparathyroidism receiving a single dose of etelcalcetide at the end of hemodialysis.

Interventions

A single IV-bolus dose of 0.035 mg/kg etelcalcetide into the venous line of the dialysis circuit at the end of a hemodialysis session.

Sponsors

Amgen
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
2 Years to 17 Years
Healthy volunteers
No

Inclusion criteria

* Subject's parent has provided informed consent and subject has provided assent * Children Age 2 to less than 18 years * Diagnosed with chronic kidney disease * Diagnosed with secondary hyperparathyroidism receiving hemodialysis, * Weighing at least 7 kg * Laboratory results within specified range.

Exclusion criteria

* Currently receiving treatment in another investigation device or drug study * Subject has received cinacalcet therapy within 30 days * History of prolongation QT interval * Subject is taking any medications that are on the QT prolongation medication list * Electrocardiograph (ECG) measurements within specified range.

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in Corrected (Fridericia) QT Interval at End of StudyBaseline and day 30 (end of study)
Change From Baseline in Serum Potassium Concentration at End of StudyBaseline and day 30 (end of study)
Change From Baseline in Intact Parathyroid Hormone (iPTH) Levels Over TimeBaseline and day 1, 4 hours postdose, day 3, day 8, day 10, and day 30 (end of study)
Change From Baseline in Heart Rate at End of StudyBaseline and day 30 (end of study)
Change From Baseline in Temperature at End of StudyBaseline and day 30 (end of study)
Change From Baseline in Blood Pressure at End of StudyBaseline and day 30 (end of study)
Change From Baseline in PR Interval at End of StudyBaseline and day 30 (end of study)
Change From Baseline in QRS Interval at End of StudyBaseline and day 30 (end of study)
Change From Baseline in QT Interval at End of StudyBaseline and day 30 (end of study)
Change From Baseline in Corrected (Bazett) QT Interval at End of StudyBaseline and day 30 (end of study)
Common Treatment-emergent Adverse Events30 daysA treatment-emergent adverse event is any adverse event (AE) that begins or worsens after the initial dose of study drug (etelcalcetide) and up to 30 days after the last dose. Common adverse events were defined as adverse events occurring in at least 2 participants. The Medical Dictionary for Regulatory Activities (MedDRA) version 21.0 was used for coding all adverse events.
Change From Baseline in Serum Corrected Calcium Concentration Over TimeBaseline and Day 1, 4 hours postdose, day 3, day 8, day 10, and day 30 (end of study)When albumin was less than 4.0 mg/dL, the calcium concentration was corrected according to the formula: cCa (mmol/L) = measured total serum calcium (mmol/L) + 0.02 (40 - serum albumin \[g/L\]).
Change From Baseline in Serum Phosphorus Concentration at End of StudyBaseline and day 30 (end of study)

Secondary

MeasureTime frameDescription
Change From Baseline in Serum Ionized Calcium ConcentrationBaseline and Day 1, 4 hours postdose, day 3, day 8, day 10, and day 30 (end of study)
Maximum Observed Plasma Concentration (Cmax) of Etelcalcetide10 minutes, 4 hours, and 3, 5, 8, 10, and 30 days postdosePlasma etelcalcetide concentrations were measured using a validated high performance liquid chromatography assay. The lower limit of quantitation was 0.200 ng/mL.
Time to Maximum Concentration (Tmax) of Etelcalcetide10 minutes, 4 hours, and 3, 5, 8, 10, and 30 days postdosePlasma etelcalcetide concentrations were measured using a validated high performance liquid chromatography assay. The lower limit of quantitation was 0.200 ng/mL.
Area Under the Plasma Etelcalcetide Concentration-Time Curve From Time Zero to Time of Last Quantifiable Concentration (AUClast)10 minutes, 4 hours, and 3, 5, 8, 10, and 30 days postdosePlasma etelcalcetide concentrations were measured using a validated high performance liquid chromatography assay. The lower limit of quantitation was 0.200 ng/mL. Area under the curve for plasma etelcalcetide from time zero to the last quantifiable concentration (AUClast) was estimated using the linear trapezoidal method.
Area Under the Plasma Etelcalcetide Concentration-Time Curve From Time Zero Infinity (AUCinf)10 minutes, 4 hours, and 3, 5, 8, 10, and 30 days postdosePlasma etelcalcetide concentrations were measured using a validated high performance liquid chromatography assay. The lower limit of quantitation was 0.200 ng/mL. Area under the concentration-time curve from time zero to infinite time (AUCinf) was estimated using the linear trapezoidal method.
Terminal Half-life (T1/2,z) of Etelcalcetide10 minutes, 4 hours, and 3, 5, 8, 10, and 30 days postdosePlasma etelcalcetide concentrations were measured using a validated high performance liquid chromatography assay. The lower limit of quantitation was 0.200 ng/mL. Terminal half life of plasma etelcalcetide (t1/2,z) was calculated as t1/2,z = ln(2)/λz, where λz is the first-order terminal rate constant estimated by linear regression of the terminal log-linear phase.
Number of Participants Who Developed Anti-etelcalcetide Binding AntibodiesBaseline and day 30Samples were collected predose and at end of study (day 30) and tested for anti etelcalcetide binding antibodies using a validated immunoassay. Developing antibody binding was defined as participants who were binding antibody positive postbaseline with a negative result at baseline.
Number of Participants With Treatment-emergent Adverse Events30 daysA treatment-emergent adverse event is any adverse event that begins or worsens after the initial dose of study drug (etelcalcetide) and up to 30 days after the last dose. The severity of each adverse event was graded using the National Cancer Institute-Common Terminology Criteria for Adverse Events (CTCAE) version 4.0, where Grade 1 = Mild (asymptomatic or mild symptoms), Grade 2 = Moderate (minimal, local or noninvasive intervention indicated), Grade 3 = Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated, Grade 4 = Life-threatening consequences; urgent intervention indicated, and Grade 5 = Death related to AE.
Change From Baseline in Serum Total Calcium ConcentrationBaseline and Day 1, 4 hours postdose, day 3, day 8, day 10, and day 30 (end of study)

Countries

Belgium, Germany, Lithuania, Poland, United Kingdom, United States

Participant flow

Recruitment details

This study was conducted at 6 centers in the United States, United Kingdom, and the European Union. Participants were enrolled from 14 March 2017 to 01 October 2018.

Participants by arm

ArmCount
Etelcalcetide
Participants received a single, intravenous (IV) bolus administration of 0.035 mg/kg etelcalcetide at the end of hemodialysis on study day 1.
11
Total11

Baseline characteristics

CharacteristicEtelcalcetide
Age, Continuous10.3 years
STANDARD_DEVIATION 4.3
Age, Customized
Adolescents (12 to 17 years)
6 Participants
Age, Customized
Children (2 to 11 years)
5 Participants
Blood Pressure
Diastolic blood pressure
66.7 mmHg
STANDARD_DEVIATION 15.1
Blood Pressure
Systolic blood pressure
119.4 mmHg
STANDARD_DEVIATION 15.9
Corrected (Bazett) QT Interval (QTcB)424.2 ms
STANDARD_DEVIATION 29.1
Corrected (Fridericia) QT Interval (QTcF)402.7 ms
STANDARD_DEVIATION 26.1
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
9 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
Heart Rate87.4 beats/minute
STANDARD_DEVIATION 9.9
PR Interval133.8 ms
STANDARD_DEVIATION 8.7
QRS Interval82.0 ms
STANDARD_DEVIATION 10.9
QT Interval363.5 ms
STANDARD_DEVIATION 26.2
Race/Ethnicity, Customized
Black (or African American)
2 Participants
Race/Ethnicity, Customized
White
9 Participants
Serum Calcium Concentration2.41 mmol/L
STANDARD_DEVIATION 0.08
Serum Corrected Calcium Concentration2.42 mmol/L
STANDARD_DEVIATION 0.08
Serum Intact Parathyroid Hormone Concentration66.10 pmol/L
STANDARD_DEVIATION 57.57
Serum Ionized Calcium Concentration1.16 mmol/L
STANDARD_DEVIATION 0.07
Serum Phosphorus Concentration1.79 mmol/L
STANDARD_DEVIATION 0.45
Serum Potassium Concentration4.77 mmol/L
STANDARD_DEVIATION 0.55
Sex: Female, Male
Female
6 Participants
Sex: Female, Male
Male
5 Participants
Temperature36.6 degrees celsius
STANDARD_DEVIATION 0.3

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
0 / 11
other
Total, other adverse events
6 / 11
serious
Total, serious adverse events
0 / 11

Outcome results

Primary

Change From Baseline in Blood Pressure at End of Study

Time frame: Baseline and day 30 (end of study)

Population: Treated participants

ArmMeasureGroupValue (MEAN)Dispersion
EtelcalcetideChange From Baseline in Blood Pressure at End of StudySystolic blood pressure0.2 mmHgStandard Deviation 17.5
EtelcalcetideChange From Baseline in Blood Pressure at End of StudyDiastolic blood pressure3.8 mmHgStandard Deviation 8.5
Primary

Change From Baseline in Corrected (Bazett) QT Interval at End of Study

Time frame: Baseline and day 30 (end of study)

Population: Treated participants

ArmMeasureValue (MEAN)Dispersion
EtelcalcetideChange From Baseline in Corrected (Bazett) QT Interval at End of Study-2.1 msStandard Deviation 32.2
Primary

Change From Baseline in Corrected (Fridericia) QT Interval at End of Study

Time frame: Baseline and day 30 (end of study)

Population: Treated participants

ArmMeasureValue (MEAN)Dispersion
EtelcalcetideChange From Baseline in Corrected (Fridericia) QT Interval at End of Study-0.5 msStandard Deviation 23.3
Primary

Change From Baseline in Heart Rate at End of Study

Time frame: Baseline and day 30 (end of study)

Population: Treated participants

ArmMeasureValue (MEAN)Dispersion
EtelcalcetideChange From Baseline in Heart Rate at End of Study-4.5 beats/minuteStandard Deviation 9.3
Primary

Change From Baseline in Intact Parathyroid Hormone (iPTH) Levels Over Time

Time frame: Baseline and day 1, 4 hours postdose, day 3, day 8, day 10, and day 30 (end of study)

Population: Treated participants with available data at each time point.

ArmMeasureGroupValue (MEAN)Dispersion
EtelcalcetideChange From Baseline in Intact Parathyroid Hormone (iPTH) Levels Over TimeDay 1, 4 hours-29.44 pmol/LStandard Deviation 37.16
EtelcalcetideChange From Baseline in Intact Parathyroid Hormone (iPTH) Levels Over TimeDay 3-14.81 pmol/LStandard Deviation 37.81
EtelcalcetideChange From Baseline in Intact Parathyroid Hormone (iPTH) Levels Over TimeDay 8-10.20 pmol/LStandard Deviation 38.16
EtelcalcetideChange From Baseline in Intact Parathyroid Hormone (iPTH) Levels Over TimeDay 10-4.68 pmol/LStandard Deviation 37.92
EtelcalcetideChange From Baseline in Intact Parathyroid Hormone (iPTH) Levels Over TimeDay 30-19.81 pmol/LStandard Deviation 51.29
Primary

Change From Baseline in PR Interval at End of Study

Time frame: Baseline and day 30 (end of study)

Population: Treated participants

ArmMeasureValue (MEAN)Dispersion
EtelcalcetideChange From Baseline in PR Interval at End of Study-3.6 msStandard Deviation 13.9
Primary

Change From Baseline in QRS Interval at End of Study

Time frame: Baseline and day 30 (end of study)

Population: Treated participants

ArmMeasureValue (MEAN)Dispersion
EtelcalcetideChange From Baseline in QRS Interval at End of Study-2.6 msStandard Deviation 6.8
Primary

Change From Baseline in QT Interval at End of Study

Time frame: Baseline and day 30 (end of study)

Population: Treated participants

ArmMeasureValue (MEAN)Dispersion
EtelcalcetideChange From Baseline in QT Interval at End of Study2.8 msStandard Deviation 21.6
Primary

Change From Baseline in Serum Corrected Calcium Concentration Over Time

When albumin was less than 4.0 mg/dL, the calcium concentration was corrected according to the formula: cCa (mmol/L) = measured total serum calcium (mmol/L) + 0.02 (40 - serum albumin \[g/L\]).

Time frame: Baseline and Day 1, 4 hours postdose, day 3, day 8, day 10, and day 30 (end of study)

Population: Treated participants with available data at each time point.

ArmMeasureGroupValue (MEAN)Dispersion
EtelcalcetideChange From Baseline in Serum Corrected Calcium Concentration Over TimeDay 1, 4 hours-0.03 mmol/LStandard Deviation 0.12
EtelcalcetideChange From Baseline in Serum Corrected Calcium Concentration Over TimeDay 3-0.03 mmol/LStandard Deviation 0.08
EtelcalcetideChange From Baseline in Serum Corrected Calcium Concentration Over TimeDay 80.03 mmol/LStandard Deviation 0.09
EtelcalcetideChange From Baseline in Serum Corrected Calcium Concentration Over TimeDay 100.03 mmol/LStandard Deviation 0.07
EtelcalcetideChange From Baseline in Serum Corrected Calcium Concentration Over TimeDay 30-0.01 mmol/LStandard Deviation 0.16
Primary

Change From Baseline in Serum Phosphorus Concentration at End of Study

Time frame: Baseline and day 30 (end of study)

Population: Treated participants

ArmMeasureValue (MEAN)Dispersion
EtelcalcetideChange From Baseline in Serum Phosphorus Concentration at End of Study0.08 mmol/LStandard Deviation 0.31
Primary

Change From Baseline in Serum Potassium Concentration at End of Study

Time frame: Baseline and day 30 (end of study)

Population: Treated participants

ArmMeasureValue (MEAN)Dispersion
EtelcalcetideChange From Baseline in Serum Potassium Concentration at End of Study0.45 mmol/LStandard Deviation 1.21
Primary

Change From Baseline in Temperature at End of Study

Time frame: Baseline and day 30 (end of study)

Population: Treated participants

ArmMeasureValue (MEAN)Dispersion
EtelcalcetideChange From Baseline in Temperature at End of Study0.1 degrees celsiusStandard Deviation 0.4
Primary

Common Treatment-emergent Adverse Events

A treatment-emergent adverse event is any adverse event (AE) that begins or worsens after the initial dose of study drug (etelcalcetide) and up to 30 days after the last dose. Common adverse events were defined as adverse events occurring in at least 2 participants. The Medical Dictionary for Regulatory Activities (MedDRA) version 21.0 was used for coding all adverse events.

Time frame: 30 days

Population: Participants who received at least 1 dose of etelcalcetide (safety analysis set)

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
EtelcalcetideCommon Treatment-emergent Adverse EventsHeadache2 Participants
EtelcalcetideCommon Treatment-emergent Adverse EventsCalcium ionised decreased2 Participants
EtelcalcetideCommon Treatment-emergent Adverse EventsHypotension2 Participants
Secondary

Area Under the Plasma Etelcalcetide Concentration-Time Curve From Time Zero Infinity (AUCinf)

Plasma etelcalcetide concentrations were measured using a validated high performance liquid chromatography assay. The lower limit of quantitation was 0.200 ng/mL. Area under the concentration-time curve from time zero to infinite time (AUCinf) was estimated using the linear trapezoidal method.

Time frame: 10 minutes, 4 hours, and 3, 5, 8, 10, and 30 days postdose

Population: Pharmacokinetic analysis set with available AUCinf data

ArmMeasureValue (MEAN)Dispersion
EtelcalcetideArea Under the Plasma Etelcalcetide Concentration-Time Curve From Time Zero Infinity (AUCinf)1700 hr*ng/mLStandard Deviation 1420
Secondary

Area Under the Plasma Etelcalcetide Concentration-Time Curve From Time Zero to Time of Last Quantifiable Concentration (AUClast)

Plasma etelcalcetide concentrations were measured using a validated high performance liquid chromatography assay. The lower limit of quantitation was 0.200 ng/mL. Area under the curve for plasma etelcalcetide from time zero to the last quantifiable concentration (AUClast) was estimated using the linear trapezoidal method.

Time frame: 10 minutes, 4 hours, and 3, 5, 8, 10, and 30 days postdose

Population: Pharmacokinetic analysis set

ArmMeasureValue (MEAN)Dispersion
EtelcalcetideArea Under the Plasma Etelcalcetide Concentration-Time Curve From Time Zero to Time of Last Quantifiable Concentration (AUClast)1360 hr*ng/mLStandard Deviation 1110
Secondary

Change From Baseline in Serum Ionized Calcium Concentration

Time frame: Baseline and Day 1, 4 hours postdose, day 3, day 8, day 10, and day 30 (end of study)

Population: Treated participants with available data at each time point.

ArmMeasureGroupValue (MEAN)Dispersion
EtelcalcetideChange From Baseline in Serum Ionized Calcium ConcentrationDay 1, 4 hours-0.05 mmol/LStandard Deviation 0.13
EtelcalcetideChange From Baseline in Serum Ionized Calcium ConcentrationDay 3-0.01 mmol/LStandard Deviation 0.08
EtelcalcetideChange From Baseline in Serum Ionized Calcium ConcentrationDay 80.02 mmol/LStandard Deviation 0.07
EtelcalcetideChange From Baseline in Serum Ionized Calcium ConcentrationDay 100.01 mmol/LStandard Deviation 0.06
EtelcalcetideChange From Baseline in Serum Ionized Calcium ConcentrationDay 300.03 mmol/LStandard Deviation 0.06
Secondary

Change From Baseline in Serum Total Calcium Concentration

Time frame: Baseline and Day 1, 4 hours postdose, day 3, day 8, day 10, and day 30 (end of study)

Population: Treated participants with available data at each time point.

ArmMeasureGroupValue (MEAN)Dispersion
EtelcalcetideChange From Baseline in Serum Total Calcium ConcentrationDay 1, 4 hours-0.02 mmol/LStandard Deviation 0.12
EtelcalcetideChange From Baseline in Serum Total Calcium ConcentrationDay 3-0.02 mmol/LStandard Deviation 0.08
EtelcalcetideChange From Baseline in Serum Total Calcium ConcentrationDay 80.03 mmol/LStandard Deviation 0.08
EtelcalcetideChange From Baseline in Serum Total Calcium ConcentrationDay 100.02 mmol/LStandard Deviation 0.08
EtelcalcetideChange From Baseline in Serum Total Calcium ConcentrationDay 30-0.01 mmol/LStandard Deviation 0.16
Secondary

Maximum Observed Plasma Concentration (Cmax) of Etelcalcetide

Plasma etelcalcetide concentrations were measured using a validated high performance liquid chromatography assay. The lower limit of quantitation was 0.200 ng/mL.

Time frame: 10 minutes, 4 hours, and 3, 5, 8, 10, and 30 days postdose

Population: The pharmacokinetic analysis set

ArmMeasureValue (MEAN)Dispersion
EtelcalcetideMaximum Observed Plasma Concentration (Cmax) of Etelcalcetide50.8 ng/mLStandard Deviation 29.3
Secondary

Number of Participants Who Developed Anti-etelcalcetide Binding Antibodies

Samples were collected predose and at end of study (day 30) and tested for anti etelcalcetide binding antibodies using a validated immunoassay. Developing antibody binding was defined as participants who were binding antibody positive postbaseline with a negative result at baseline.

Time frame: Baseline and day 30

Population: Treated participants

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
EtelcalcetideNumber of Participants Who Developed Anti-etelcalcetide Binding Antibodies2 Participants
Secondary

Number of Participants With Treatment-emergent Adverse Events

A treatment-emergent adverse event is any adverse event that begins or worsens after the initial dose of study drug (etelcalcetide) and up to 30 days after the last dose. The severity of each adverse event was graded using the National Cancer Institute-Common Terminology Criteria for Adverse Events (CTCAE) version 4.0, where Grade 1 = Mild (asymptomatic or mild symptoms), Grade 2 = Moderate (minimal, local or noninvasive intervention indicated), Grade 3 = Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated, Grade 4 = Life-threatening consequences; urgent intervention indicated, and Grade 5 = Death related to AE.

Time frame: 30 days

Population: All Treated participants

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
EtelcalcetideNumber of Participants With Treatment-emergent Adverse EventsAny adverse event6 Participants
EtelcalcetideNumber of Participants With Treatment-emergent Adverse EventsAdverse events ≥ grade 32 Participants
EtelcalcetideNumber of Participants With Treatment-emergent Adverse EventsAdverse events ≥ grade 40 Participants
EtelcalcetideNumber of Participants With Treatment-emergent Adverse EventsSerious adverse events0 Participants
EtelcalcetideNumber of Participants With Treatment-emergent Adverse EventsAEs leading to discontinuation of etelcalcetide0 Participants
EtelcalcetideNumber of Participants With Treatment-emergent Adverse EventsFatal adverse events0 Participants
EtelcalcetideNumber of Participants With Treatment-emergent Adverse EventsTreatment-related adverse events0 Participants
EtelcalcetideNumber of Participants With Treatment-emergent Adverse EventsTreatment-related AEs ≥ grade 30 Participants
Secondary

Terminal Half-life (T1/2,z) of Etelcalcetide

Plasma etelcalcetide concentrations were measured using a validated high performance liquid chromatography assay. The lower limit of quantitation was 0.200 ng/mL. Terminal half life of plasma etelcalcetide (t1/2,z) was calculated as t1/2,z = ln(2)/λz, where λz is the first-order terminal rate constant estimated by linear regression of the terminal log-linear phase.

Time frame: 10 minutes, 4 hours, and 3, 5, 8, 10, and 30 days postdose

Population: Pharmacokinetic analysis set with available T1/2,z data

ArmMeasureValue (MEAN)Dispersion
EtelcalcetideTerminal Half-life (T1/2,z) of Etelcalcetide5.77 daysStandard Deviation 2.66
Secondary

Time to Maximum Concentration (Tmax) of Etelcalcetide

Plasma etelcalcetide concentrations were measured using a validated high performance liquid chromatography assay. The lower limit of quantitation was 0.200 ng/mL.

Time frame: 10 minutes, 4 hours, and 3, 5, 8, 10, and 30 days postdose

Population: The pharmacokinetic concentration analysis set was composed of all participants who received etelcalcetide and had at least 1 pharmacokinetic sample collected.

ArmMeasureValue (MEDIAN)
EtelcalcetideTime to Maximum Concentration (Tmax) of Etelcalcetide0.17 hours

Source: ClinicalTrials.gov · Data processed: Feb 26, 2026