Hemodialysis Chronic Kidney Disease Patients With Anemia
Conditions
Keywords
ASP1517, Renal anemia, Hemodialysis, Roxadustat
Brief summary
The objective of this study is to evaluate the safety and efficacy of ASP1517 compared to darbepoetin alfa in hemodialysis chronic kidney disease patients with anemia.
Interventions
Oral
Intravenous
Sponsors
Study design
Eligibility
Inclusion criteria
* Subjects with renal anemia who have been receiving recombinant human erythropoietin (rHuEPO, two times weekly or three times weekly) or darbepoetin alfa (intravenous treatment) within the doses approved in Japan for more than 8 weeks before the screening assessment * Mean of the subject's two most recent Hb values before dialysis after the longest dialysis interval during the Screening Period must be ≥10.0 g/dL and ≤12.0 g/dL * Either transferrin saturation (TSAT) ≥ 20% or serum ferritin ≥ 100 ng/mL during the screening period * Female subject must either: Be of non-childbearing potential: * post-menopausal (defined as at least 1 year without any menses) prior to Screening, or * documented surgically sterile Or, if of childbearing potential, * Agree not to try to become pregnant during the study and for 28 days after the final study drug administration * And have a negative pregnancy test at Screening * And, if heterosexually active, agree to consistently use two forms of highly effective form of birth control (at least one of which must be a barrier method) starting at Screening and throughout the study period and continued for 28 days after the final study drug administration. * Female subject must agree not to breastfeed starting at Screening and throughout the study period, and continued for 28 days after the final study drug administration. * Female subject must not donate ova starting at Screening and throughout the study period, and continued for 28 days after the final study drug administration. * Male subject and their female spouse/partners who are of childbearing potential must be using two forms of highly effective form of birth control (at least one of which must be a barrier method) starting at Screening and continue throughout the study period, and for 12 weeks after the final study drug administration * Male subject must not donate sperm starting at Screening and throughout the study period and, for 12 weeks after the final study drug administration
Exclusion criteria
* Concurrent retinal neovascular lesion untreated and macular edema untreated * Concurrent autoimmune disease with inflammation that could impact erythropoiesis * History of gastric/intestinal resection considered influential on the absorption of drugs in the gastrointestinal tract (excluding resection of gastric or colon polyps) or concurrent gastroparesis * Uncontrolled hypertension * Concurrent congestive heart failure (NYHA Class III or higher) * History of hospitalization for treatment of stroke, myocardial infarction, or pulmonary embolism within 12 weeks before the screening assessment * Positive for hepatitis B surface antigen (HBsAg) or anti-hepatitis C virus (HCV) antibody at the screening assessment, or positive for human immunodeficiency virus (HIV) in a past test * Concurrent other form of anemia than renal anemia * History of pure red cell aplasia * Having received treatment with protein anabolic hormone, testosterone enanthate, or mepitiostane within 6 weeks before the screening assessment * Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), or total bilirubin that is greater than the criteria, or previous or concurrent another serious liver disease at screening assessment * Previous or current malignant tumor (no recurrence for at least 5 years is eligible.) * Having undergone blood transfusion and/or a surgical procedure considered to promote anemia (excluding shunt reconstruction surgery for access to the blood) and/or ophthalmological surgery within 4 weeks before the screening assessment * Having undergone a kidney transplantation * Having a previous history of treatment with ASP1517 * History of serious drug allergy including anaphylactic shock * Participation in another clinical study or post-marketing clinical study (including that of a medical device) within 12 weeks before informed consent acquisition
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change from baseline in the average hemoglobin (Hb) | Baseline and Weeks 18 to 24 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of participants with the target Hb level from Week 18 to Week 24 | Week 18 to 24 | — |
| Proportion of participants with the target Hb level at each week | Up to Week 24 | — |
| Change from week 0 in Hb levels to each week | Up to Week 24 | — |
| Proportion of measurement points with the target Hb level from Week 18 to Week 24 | Week 18 to 24 | — |
| Rate of rise in Hb levels (g/dL/week) from week 0 to at the earliest date of week 4, time of discontinuation, or time of dose adjustment | Up to Week 4 | — |
| Average hematocrit level | Up to Week 24 | — |
| Average reticulocyte level | Up to Week 24 | — |
| Average iron (Fe) level | Up to Week 24 | — |
| Average ferritin level | Up to Week 24 | — |
| Average transferrin level | Up to Week 24 | — |
| Average total iron binding capacity level | Up to Week 24 | — |
| Average soluble transferrin receptor level | Up to Week 24 | — |
| Average transferrin saturation level | Up to Week 24 | — |
| Average Hb from Week 18 to Week 24 | Week 18 to 24 | — |
| Quality of life assessed by SF-36 | Up to Week 24 | SF-36: Medical Outcomes Study 36-Item Short-Form Health Survey |
| Quality of life assessed by EQ-5D-5L | Up to Week 24 | EQ-5D-5L: EuroQol 5 Dimension 5-Levels |
| Quality of life assessed by FACT-An | Up to Week 24 | FACT-An: Functional Assessment of Cancer Therapy-Anemia |
| Number of hospitalizations | Up to Week 24 | — |
| Duration of hospitalizations | Up to Week 24 | — |
| Plasma concentration of unchanged ASP1517 | Up to Week 24 | — |
| Safety assessed by incidence of adverse events | Up to Week 24 | — |
| Number of participants with abnormal Laboratory values and/or adverse events related to treatment | Up to Week 24 | — |
| Number of participants with abnormal Vital signs and/or adverse events related to treatment | Up to Week 24 | — |
| Number of participants with abnormal 12-lead electrocardiogram (ECG) values | Up to Week 24 | Any clinically significant adverse changes on the ECG will be reported as adverse events. |
| Safety assessed by ophthalmological examination: fundoscopy | Up to Week 24 | — |
| Safety assessed by ophthalmological examination: Optical coherence tomography | Up to Week 24 | — |
| Safety assessed by ophthalmological examination: visual acuity | Up to Week 24 | — |
| Average reticulocyte hemoglobin content level | Up to Week 24 | — |
Countries
Japan