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A Phase 1 Study of Roxadustat in Subjects With Different Degrees of Renal Function

A Phase 1 Study to Evaluate the Pharmacokinetics of Roxadustat in Subjects With Different Degrees of Renal Function

Status
Completed
Phases
Phase 1
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02965040
Enrollment
34
Registered
2016-11-16
Start date
2016-12-12
Completion date
2017-12-11
Last updated
2020-02-12

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

Conditions

Impaired Renal Function, Normal Renal Function

Keywords

ASP1517, Normal renal function, Dialysis, Roxadustat, Metabolites, Pharmacokinetics, Impaired renal function

Brief summary

For subjects with normal renal function or severely impaired renal function, this study will evaluate the pharmacokinetics of roxadustat and its main metabolites in plasma and urine. For subjects with end stage renal disease (ESRD) on continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis (APD), this study will evaluate the pharmacokinetics of roxadustat and its main metabolites in plasma, urine and dialysate. For subjects with ESRD on hemodialysis (HD) or hemodiafiltration (HDF), this study will evaluate the pharmacokinetics of roxadustat and its main metabolites in plasma, urine and dialysate and also the effect of dialysis on the pharmacokinetics of roxadustat and its main metabolites.

Detailed description

This is a phase 1, open-label study in two sites. There will be four different renal function groups. For all subjects: Subjects will be allocated to the normal and severely impaired renal function groups based on estimated glomerular filtration rate (eGFR), calculated with the abbreviated modification of diet in renal disease (MDRD) equation. The eGFR will be based on the serum creatinine concentration and is assessed at screening and at day -2. The eGFR obtained at screening will determine the allocation. Subjects will be allocated to the ESRD groups based on their dialysis requirements. Subjects with normal and severely impaired renal function, and subjects with ESRD on CAPD or APD: Screening will take place from day -30 to day -3 and the subjects will be admitted to the clinical unit on day -2. The treatment period lasts 8 days, during which the subjects will receive a single oral dose of roxadustat in the morning of day 1 Subjects will complete the treatment period on day 6, provided that all required assessments have been performed and there are no medical reasons for a prolonged follow-up. The study will be completed with an end-of-study visit (ESV), which will take place between 5 and 9 days after the last treatment period-defined assessment (or after early withdrawal). Subjects with ESRD on HD or HDF: Screening will take place from day -30 to day -3 and subjects will complete 2 treatment periods of 8 days (period 1) and 7 days (period 2) in order to evaluate the pharmacokinetics of roxadustat with a single oral dose of roxadustat on day 1 of both periods after and before dialysis. Subjects will complete the treatment period 1 on day 6 followed by a wash-out period which is minimally 1 week and maximally 3 weeks. Subjects will complete period 2 on day 6, provided that all required assessments have been performed and there are no medical reasons for a prolonged follow-up. The study will be completed with an end-of-study visit (ESV), which will take place between 5 and 9 days after the last treatment period-defined assessment (or after early withdrawal). All subjects: Safety assessments will be performed throughout the study. An optional biobanking sample may be taken for potential exploratory, retrospective, gene polymorphism analysis. Roxadustat plasma, urine, and dialysate samples will be stored for potential exploratory metabolic profiling or exploratory biomarker analysis after the study.

Interventions

DRUGRoxadustat

Oral

Sponsors

Kyntra Bio
CollaboratorINDUSTRY
Astellas Pharma Europe B.V.
Lead SponsorINDUSTRY

Study design

Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
Yes

Inclusion criteria

Inclusion criteria for all subjects: * Subject has a body weight of 45 to 160 kg, inclusive. * For subjects with ESRD on CAPD or APD body weight should be recorded as the measured body weight minus abdominal dialysis fluid based on the last filling. For subjects with ESRD on HD or HDF the post-dialysis body weight will be recorded. Specific inclusion criteria for subjects with normal renal function: * Subject is a healthy male or female subject aged 40 to 75 years, inclusive. * Subject must have a pre-dose eGFR value based on the abbreviated MDRD method of greater than or equal to 90 mL/min/1.73 m\^2. Specific inclusion criteria for subjects with severely impaired renal function: * Subject is a male or female subject aged 18 to 75 years, inclusive. * Subject must have a pre-dose eGFR value based on the abbreviated MDRD method \[screening\] of \<30 mL/min/1.73 m\^2 and not be on dialysis. Specific inclusion criteria for subjects with ESRD on CAPD or APD: * Subject is a male or female subject aged 18 to 75 years, inclusive. * Subject is on CAPD or APD treatment with the same mode of dialysis for at least 4 months prior to admission to the clinical unit. Specific inclusion criteria for subjects with ESRD on HD or HDF: * Subject is a male or female subject aged 18 to 75 years, inclusive. * Subject is on HD or HDF treatment with the same mode of dialysis for at least 4 months prior to admission to the clinical unit and should have dialysis sessions three times weekly. Specific inclusion criteria for subjects with impaired renal function including severly impaired renal function and ESRD: * If a subject is being treated with short-acting ESAs, the subject agrees to discontinue treatment for at least 14 days prior to admission.

Design outcomes

Primary

MeasureTime frameDescription
Pharmacokinetics of sulfate of hydroxy-Roxadustat in plasma: TERUp to day 6
Pharmacokinetics of O-glucuronide-Roxadustat in plasma: AUClastUp to day 6
Pharmacokinetics of Roxadustat and its main metabolites in dialysate fluid: CLDUp to day 2CLD: dialysis clearance. For ESRD subjects on CAPD or APD and for ESRD subjects on HD or HDF (treatment period 2 only)
Pharmacokinetics of Roxadustat in dialysate fluid: fDUp to day 2fD: fraction of dose cleared by dialysis. For ESRD subjects on CAPD or APD and for ESRD subjects on HD or HDF (treatment period 2 only)
Pharmacokinetics of O-glucuronide-Roxadustat in urine: Aeinf%Up to day 4
Pharmacokinetics of O-glucoside-Roxadustat in urine: Aeinf%Up to day 4
Pharmacokinetics of sulfate of hydroxy-Roxadustat in urine: Aeinf%Up to day 4
Pharmacokinetics of Roxadustat in plasma: Effective t½ 48 hoursUp to day 6Effective t½ 48 hours: Effective half-life based on a dosing interval of 48 hours
Pharmacokinetics of Roxadustat in plasma: Effective t½ 56 hoursUp to day 6Effective t½ 56 hours: Effective half-life based on a dosing interval of 56 hours
Pharmacokinetics of O-glucuronide-Roxadustat in plasma: TERUp to day 6TER: Total exposure ratio
Pharmacokinetics of O-glucoside-Roxadustat in plasma: TERUp to day 6
Pharmacokinetics of O-glucuronide-Roxadustat in plasma: AUCinfUp to day 6
Pharmacokinetics of O-glucuronide-Roxadustat in plasma: CmaxUp to day 6
Pharmacokinetics of Roxadustat in plasma: CmaxUp to day 6Cmax: Maximum concentration
Pharmacokinetics of Roxadustat in plasma: Cmax,uUp to day 6Cmax,u: Maximum concentration of unbound compound
Pharmacokinetics of Roxadustat in plasma: AUCinfUp to day 6AUCinf: Area under the concentration-time curve from the time of dosing extrapolated to time infinity
Pharmacokinetics of Roxadustat in plasma: AUCinf,uUp to day 6AUCinf,u: Area under the concentration-time curve from the time of dosing extrapolated to time infinity for unbound concentration
Pharmacokinetics of Roxadustat in plasma: AUClastUp to day 6AUClast: Area under the concentration-time curve from the time of dosing to the last measurable concentration (Clast)
Pharmacokinetics of Roxadustat in plasma: AUClast,uUp to day 6AUClast,u: Area under the concentration-time curve from the time of dosing to the last measurable concentration (Clast) for unbound concentration
Pharmacokinetics of Roxadustat in plasma: CL/FUp to day 6CL/F: Apparent total systemic clearance after single or multiple extravascular dosing
Pharmacokinetics of Roxadustat in plasma: CLu/FUp to day 6CLu/F: Apparent total systemic clearance of unbound compound after extravascular dosing
Pharmacokinetics of Roxadustat in plasma: fuUp to day 6fu: Fraction of parent or metabolite available systemically unbound (= free fraction)
Pharmacokinetics of Roxadustat in plasma: tmaxUp to day 6tmax: Time of the maximum concentration
Pharmacokinetics of Roxadustat in plasma t1/2Up to day 6t1/2: Terminal elimination half-life
Pharmacokinetics of Roxadustat in plasma: Vz/FUp to day 6Vz/F: Apparent volume of distribution during the terminal elimination phase after single extravascular dosing
Pharmacokinetics of Roxadustat in plasma: Vz,u/FUp to day 6Vz,u/F: Apparent volume of distribution during the terminal elimination phase of unbound compound after extravascular dosing
Pharmacokinetics of O-glucuronide-Roxadustat in plasma: tlagUp to day 6tlag: Time prior to the time corresponding to the first measurable (non-zero) concentration
Pharmacokinetics of O-glucuronide-Roxadustat in plasma: tmaxUp to day 6
Pharmacokinetics of O-glucuronide-Roxadustat in plasma: t1/2Up to day 6
Pharmacokinetics of O-glucuronide-Roxadustat in plasma: MPRUp to day 6MPR: Metabolite to parent ratio of AUC using AUC (corrected) for the metabolite (corrected by molecular weight ratio of parent to metabolite)
Pharmacokinetics of O-glucoside -Roxadustat in plasma: CmaxUp to day 6
Pharmacokinetics of O-glucoside-Roxadustat in plasma: AUCinfUp to day 6
Pharmacokinetics of O-glucoside-Roxadustat in plasma: AUClastUp to day 6
Pharmacokinetics of O-glucoside-Roxadustat in plasma: tlagUp to day 6tlag: Time prior to the time corresponding to the first measurable (non-zero) concentration
Pharmacokinetics of O-glucoside-Roxadustat in plasma: tmaxUp to day 6
Pharmacokinetics of O-glucoside-Roxadustat in plasma: t1/2Up to day 6
Pharmacokinetics of O-glucoside-Roxadustat in plasma: MPRUp to day 6MPR: Metabolite to parent ratio of AUC using AUC(corrected) for the metabolite (corrected by molecular weight ratio of parent to metabolite)
Pharmacokinetics of sulfate of hydroxy-Roxadustat in plasma: CmaxUp to day 6
Pharmacokinetics of sulfate of hydroxy-Roxadustat in plasma: AUCinfUp to day 6
Pharmacokinetics of sulfate of hydroxy-Roxadustat in plasma: AUClastUp to day 6
Pharmacokinetics of sulfate of hydroxy-Roxadustat in plasma: tlagUp to day 6tlag: Time prior to the time corresponding to the first measurable (non-zero) concentration
Pharmacokinetics of sulfate of hydroxy-Roxadustat in plasma: tmaxUp to day 6
Pharmacokinetics of sulfate of hydroxy-Roxadustat in plasma: t1/2Up to day 6
Pharmacokinetics of sulfate of hydroxy-Roxadustat in plasma: MPRUp to day 6
Pharmacokinetics of Roxadustat in urine: CLRUp to day 4CLR: Renal clearance
Pharmacokinetics of Roxadustat in urine: CLR,uUp to day 4CLR,u: Renal clearance of unbound drug
Pharmacokinetics of Roxadustat in urine: AeinfUp to day 4Aeinf: Cumulative amount of compound excreted into urine from time of dosing extrapolated to time infinity
Pharmacokinetics of Roxadustat in urine: Aeinf%Up to day 4Aeinf%: Percent of drug dose excreted into urine (Aeinf) from time of dosing extrapolated to time infinity
Pharmacokinetics of Roxadustat in urine: AelastUp to day 4Aelast: Cumulative amount of drug excreted into urine from time of dosing up to the collection time of the last measurable concentration
Pharmacokinetics of Roxadustat in urine: Aelast%Up to day 4Aelast%: Percent of drug dose excreted into urine (Aelast) from time of dosing up to the collection time of the last measurable concentration
Pharmacokinetics of O-glucuronide-Roxadustat in urine: CLRUp to day 4
Pharmacokinetics of O-glucuronide-Roxadustat in urine: AeinfUp to day 4
Pharmacokinetics of O-glucuronide-Roxadustat in urine: AelastUp to day 4
Pharmacokinetics of O-glucuronide-Roxadustat in urine: MPR based on AeinfUp to day 4
Pharmacokinetics of O-glucoside-Roxadustat in urine: CLRUp to day 4
Pharmacokinetics of O-glucoside-Roxadustat in urine: AeinfUp to day 4
Pharmacokinetics of O-glucoside-Roxadustat in urine: AelastUp to day 4
Pharmacokinetics of O-glucoside-Roxadustat in urine: MPR based on AeinfUp to day 4
Pharmacokinetics of sulfate of hydroxy-Roxadustat in urine: CLRUp to day 4
Pharmacokinetics of sulfate of hydroxy-Roxadustat in urine: AeinfUp to day 4
Pharmacokinetics of sulfate of hydroxy-Roxadustat in urine: AelastUp to day 4
Pharmacokinetics of sulfate of hydroxy-Roxadustat in urine: MPR based on AeinfUp to day 4

Secondary

MeasureTime frameDescription
Pharmacodynamics of Roxadustat assessed by measuring erythropoietin (EPO): EmaxUp to day 6Emax: Maximum effect
Pharmacodynamics of Roxadustat assessed by measuring erythropoietin (EPO): Emax-baselineU to day 6Emax-baseline: Maximum effect from baseline
Pharmacodynamics of Roxadustat assessed by measuring erythropoietin (EPO): AUCE,lastUp to day 6AUCE,last: Area under the effect-time curve from the time of dosing to the last measurable effect
Pharmacodynamics of Roxadustat assessed by measuring erythropoietin (EPO): AUCE,last (baseline-corrected)Up to day 6AUCE,last (baseline-corrected): Area under the effect-time curve from the time of dosing to the last measurable effect baseline corrected
Pharmacodynamics of Roxadustat assessed by measuring erythropoietin (EPO): tmax, EPOUp to day 6tmax, EPO: Time to maximum EPO concentration
Safety assessed by nature, frequency, and severity of Adverse Events (AEs)Up to End of Study (EOS) (Up to day 15, period 2)
Number of participants with vital signs abnormalities and/or adverse events related to treatmentUp to EOS (Up to day 15, period 2)Vital signs include: blood pressure (systolic and diastolic) and pulse
Safety assessed by routine 12- lead electrocardiogram (ECG)Up to EOS (Up to day 15, period 2)Routine 12-lead ECG measurements will be performed for the different renal function groups, as applicable, after the subject has been in a supine position for at least 5 minutes. All routine 12-lead ECG data will be listed by subject
Safety assessed by continuous heart rate (HR) measurementUp to day 2 (period 1)Holter
Number of participants with laboratory value abnormalities and/or adverse events related to treatmentUp to EOS (Up to day 15, period 2)Safety laboratory tests include: hematology, biochemistry and urinalysis

Countries

Germany, United Kingdom

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 24, 2026