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出境医 / 临床实验 / Ferric Citrate for the Treatment of Hyperphosphatemia in Patients With Chronic Kidney Disease Undergoing Hemodialysis

Ferric Citrate for the Treatment of Hyperphosphatemia in Patients With Chronic Kidney Disease Undergoing Hemodialysis

Study Description
Brief Summary:
To evaluate the efficacy and safety of ferric citrate capsules for the treatment of hyperphosphatemia in patients with chronic kidney disease undergoing hemodialysis

Condition or disease Intervention/treatment Phase
Hyperphosphatemia End Stage Renal Disease ESRD Drug: Ferric Citrate Drug: Sevelamer Carbonate Phase 3

Detailed Description:
This is a multicenter, randomized, open-label, active-controlled, parallel, phase III study which aims to assess the efficacy and safety of ferric citrate capsules for the treatment of hyperphosphatemia in patients with chronic kidney disease undergoing hemodialysis. This study is consisting of a Screening/Washout period (14 days) and a Treatment/Observation period (12 weeks). During the Treatment period, the subjects will be randomly assigned to the ferric citrate capsule group (study group) or sevelamer carbonate tablet group (control group) in the ratio of 1:1.
Study Design
Layout table for study information
Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 240 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Multicenter, Randomized, Open-Label, Active-Controlled, Parallel Study to Assess the Efficacy and Safety of Ferric Citrate Capsules for the Treatment of Hyperphosphatemia in Patients With Chronic Kidney Disease Undergoing Hemodialysis
Actual Study Start Date : June 19, 2019
Actual Primary Completion Date : February 20, 2021
Actual Study Completion Date : February 20, 2021
Arms and Interventions
Arm Intervention/treatment
Experimental: Ferric Citrate Capsule
Ferric Citrate Capsule, product specification: 500 mg/cap, manufactured by Panion & BF Biotech Inc.
Drug: Ferric Citrate
Take the capsules with meals or immediately after meals.

Active Comparator: Sevelamer Carbonate Tablet
Sevelamer carbonate tablet group, product specification: 800 mg/tablet, manufactured by Genzyme Ireland Limited
Drug: Sevelamer Carbonate
Take the tablets with meals.

Outcome Measures
Primary Outcome Measures :
  1. The change in serum phosphorus levels [ Time Frame: 12 Weeks ]
    The change in serum phosphorus levels at the end of treatment (Visit 10 or ET) as compared to baseline (before the first dose).


Secondary Outcome Measures :
  1. Serum phosphorus levels [ Time Frame: 12 Weeks ]
    Serum phosphorus levels at the end of treatment;

  2. The proportion of subjects whose serum phosphorus levels reached the target range. [ Time Frame: 12 Weeks ]
    The proportion of subjects whose serum phosphorus levels reached the target range (3.5 to 5.5 mg/dL, 1.13 to 1.78 mmol/L) at the end of the treatment;

  3. The response rate of serum phosphorus [ Time Frame: 12 Weeks ]
    The response rate of serum phosphorus at the end of treatment (defined as reduction of the serum phosphorus level exceeds 25% as compared to baseline);

  4. The change in serum calcium (corrected) levels [ Time Frame: 12 Weeks ]
    The change in serum calcium (corrected) levels at the end of treatment as compared to baseline;

  5. The change in the [Ca] × [P] product relative [ Time Frame: 12 Weeks ]
    The change in the [Ca] × [P] product relative at the end of treatment as compared to baseline;

  6. The change in the level of intact-PTH levels [ Time Frame: 12 Weeks ]
    The change in the level of intact-PTH levels at the end of treatment as compared to baseline.


Eligibility Criteria
Layout table for eligibility information
Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Willing to give written informed consent.;
  2. Between the age of 18 and 75 years (including the boundary value);
  3. Patients who maintain the hemodialysis schedule as 3 times a week and the dialysis schedule should remain unchanged during the study period;
  4. At Screening, patients who have received phosphate binder for at least 4 weeks and have a serum phosphorus level between 2.5 and 8.0 mg/dL (0.81 to 2.58 mmol/L) (excluding the boundary value) after treatment;
  5. Patients with a serum phosphorus level between 5.5 and 10.0 mg/dL (1.78 to 3.23 mmol/L) (excluding the boundary value) after washout.

Exclusion Criteria:

  1. Patients with severe gastrointestinal diseases (such as acute peptic ulcer, chronic ulcerative colitis, regional enteritis, ileus) or patients with dysphagia;
  2. Patients with a history of gastrectomy or enterectomy (excluding endoscopic excision or caecectomy) or patients who had undergone gastrointestinal surgery within 3 months prior to Screening;
  3. Patients with severe constipation (times of bowel movement≤ 1 time/week), chronic diarrhea (times of bowel movement≥ 4 times/day), severe gastrointestinal motility disorder;
  4. Patients with hemochromatosis or patients receiving treatment for iron overload, or patients with a serum ferritin level >800 ng/mL or TSAT >50% at Screening;
  5. Patients with a serum calcium level (corrected) <8.0 mg/dL (2.0 mmol/L) or >11.0 mg/dL (2.75 mmol/L) after washout;
  6. Patients with intact-PTH>800pg/mL at Screening, or patients undergone parathyroid surgery within 6 months prior to Screening or requiring parathyroid surgery;
  7. Patients who received blood transfusions for treating anemia within 3 months prior to Screening;
  8. Patients who require phosphorus-binding agents containing aluminum, magnesium, calcium and lanthanum in addition to the study drug or patients who require an antacid with a phosphorus binding effect during the study period;
  9. Patients who require citrate preparation as an anticoagulant during hemodialysis treatment during the study period;
  10. Patients with impaired liver function (hepatic dysfunction or serum total bilirubin, aspartate aminotransferase or alanine aminotransferase ≥ 2 times the upper limit of normal) or patients with cirrhosis;
  11. Patients with cerebrovascular disease (cerebral infarction, cerebral hemorrhage, etc.) or cardiovascular disease (congestive heart failure of Class III or severer in NYHA classification, acute myocardial infarction, unstable angina, etc.) requiring hospitalization within 6 months prior to Screening;
  12. Patients who are known to be intolerant to sevelamer carbonate tablet;
  13. Patients with a history of allergies to iron preparations or those who are intolerant to iron preparations;
  14. Patients who are scheduled to have a kidney transplant during the study period;
  15. Patients with a current or past history of malignancy within 5 years prior to Screening;
  16. Women who are pregnant or lactating, or patients who are unable to take effective contraception from screening to 6 months after discontinuation (including male subjects and their female spouses);
  17. Patients who had participated in other clinical studies and other received investigational drug product within 1 month or 5 half-lives of the drug product (whichever is longer) prior to Screening;
  18. Patients who are not suitable for participating in the trial according to the investigator's judgment;
  19. Patients who are unwilling or unable to follow the protocol process.
Contacts and Locations

Locations
Show Show 24 study locations
Sponsors and Collaborators
Panion & BF Biotech Inc.
Shandong Weigao Panion Pharmaceutical Co. Ltd.
Investigators
Layout table for investigator information
Principal Investigator: Xiangmei Chen The General Hospital of the People's Liberation Army (PLAGH)
Tracking Information
First Submitted Date  ICMJE June 5, 2019
First Posted Date  ICMJE June 13, 2019
Last Update Posted Date March 10, 2021
Actual Study Start Date  ICMJE June 19, 2019
Actual Primary Completion Date February 20, 2021   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: June 11, 2019)
The change in serum phosphorus levels [ Time Frame: 12 Weeks ]
The change in serum phosphorus levels at the end of treatment (Visit 10 or ET) as compared to baseline (before the first dose).
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: June 11, 2019)
  • Serum phosphorus levels [ Time Frame: 12 Weeks ]
    Serum phosphorus levels at the end of treatment;
  • The proportion of subjects whose serum phosphorus levels reached the target range. [ Time Frame: 12 Weeks ]
    The proportion of subjects whose serum phosphorus levels reached the target range (3.5 to 5.5 mg/dL, 1.13 to 1.78 mmol/L) at the end of the treatment;
  • The response rate of serum phosphorus [ Time Frame: 12 Weeks ]
    The response rate of serum phosphorus at the end of treatment (defined as reduction of the serum phosphorus level exceeds 25% as compared to baseline);
  • The change in serum calcium (corrected) levels [ Time Frame: 12 Weeks ]
    The change in serum calcium (corrected) levels at the end of treatment as compared to baseline;
  • The change in the [Ca] × [P] product relative [ Time Frame: 12 Weeks ]
    The change in the [Ca] × [P] product relative at the end of treatment as compared to baseline;
  • The change in the level of intact-PTH levels [ Time Frame: 12 Weeks ]
    The change in the level of intact-PTH levels at the end of treatment as compared to baseline.
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Ferric Citrate for the Treatment of Hyperphosphatemia in Patients With Chronic Kidney Disease Undergoing Hemodialysis
Official Title  ICMJE A Multicenter, Randomized, Open-Label, Active-Controlled, Parallel Study to Assess the Efficacy and Safety of Ferric Citrate Capsules for the Treatment of Hyperphosphatemia in Patients With Chronic Kidney Disease Undergoing Hemodialysis
Brief Summary To evaluate the efficacy and safety of ferric citrate capsules for the treatment of hyperphosphatemia in patients with chronic kidney disease undergoing hemodialysis
Detailed Description This is a multicenter, randomized, open-label, active-controlled, parallel, phase III study which aims to assess the efficacy and safety of ferric citrate capsules for the treatment of hyperphosphatemia in patients with chronic kidney disease undergoing hemodialysis. This study is consisting of a Screening/Washout period (14 days) and a Treatment/Observation period (12 weeks). During the Treatment period, the subjects will be randomly assigned to the ferric citrate capsule group (study group) or sevelamer carbonate tablet group (control group) in the ratio of 1:1.
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 3
Study Design  ICMJE Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE
  • Hyperphosphatemia
  • End Stage Renal Disease
  • ESRD
Intervention  ICMJE
  • Drug: Ferric Citrate
    Take the capsules with meals or immediately after meals.
  • Drug: Sevelamer Carbonate
    Take the tablets with meals.
Study Arms  ICMJE
  • Experimental: Ferric Citrate Capsule
    Ferric Citrate Capsule, product specification: 500 mg/cap, manufactured by Panion & BF Biotech Inc.
    Intervention: Drug: Ferric Citrate
  • Active Comparator: Sevelamer Carbonate Tablet
    Sevelamer carbonate tablet group, product specification: 800 mg/tablet, manufactured by Genzyme Ireland Limited
    Intervention: Drug: Sevelamer Carbonate
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Completed
Actual Enrollment  ICMJE
 (submitted: June 11, 2019)
240
Original Estimated Enrollment  ICMJE Same as current
Actual Study Completion Date  ICMJE February 20, 2021
Actual Primary Completion Date February 20, 2021   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  1. Willing to give written informed consent.;
  2. Between the age of 18 and 75 years (including the boundary value);
  3. Patients who maintain the hemodialysis schedule as 3 times a week and the dialysis schedule should remain unchanged during the study period;
  4. At Screening, patients who have received phosphate binder for at least 4 weeks and have a serum phosphorus level between 2.5 and 8.0 mg/dL (0.81 to 2.58 mmol/L) (excluding the boundary value) after treatment;
  5. Patients with a serum phosphorus level between 5.5 and 10.0 mg/dL (1.78 to 3.23 mmol/L) (excluding the boundary value) after washout.

Exclusion Criteria:

  1. Patients with severe gastrointestinal diseases (such as acute peptic ulcer, chronic ulcerative colitis, regional enteritis, ileus) or patients with dysphagia;
  2. Patients with a history of gastrectomy or enterectomy (excluding endoscopic excision or caecectomy) or patients who had undergone gastrointestinal surgery within 3 months prior to Screening;
  3. Patients with severe constipation (times of bowel movement≤ 1 time/week), chronic diarrhea (times of bowel movement≥ 4 times/day), severe gastrointestinal motility disorder;
  4. Patients with hemochromatosis or patients receiving treatment for iron overload, or patients with a serum ferritin level >800 ng/mL or TSAT >50% at Screening;
  5. Patients with a serum calcium level (corrected) <8.0 mg/dL (2.0 mmol/L) or >11.0 mg/dL (2.75 mmol/L) after washout;
  6. Patients with intact-PTH>800pg/mL at Screening, or patients undergone parathyroid surgery within 6 months prior to Screening or requiring parathyroid surgery;
  7. Patients who received blood transfusions for treating anemia within 3 months prior to Screening;
  8. Patients who require phosphorus-binding agents containing aluminum, magnesium, calcium and lanthanum in addition to the study drug or patients who require an antacid with a phosphorus binding effect during the study period;
  9. Patients who require citrate preparation as an anticoagulant during hemodialysis treatment during the study period;
  10. Patients with impaired liver function (hepatic dysfunction or serum total bilirubin, aspartate aminotransferase or alanine aminotransferase ≥ 2 times the upper limit of normal) or patients with cirrhosis;
  11. Patients with cerebrovascular disease (cerebral infarction, cerebral hemorrhage, etc.) or cardiovascular disease (congestive heart failure of Class III or severer in NYHA classification, acute myocardial infarction, unstable angina, etc.) requiring hospitalization within 6 months prior to Screening;
  12. Patients who are known to be intolerant to sevelamer carbonate tablet;
  13. Patients with a history of allergies to iron preparations or those who are intolerant to iron preparations;
  14. Patients who are scheduled to have a kidney transplant during the study period;
  15. Patients with a current or past history of malignancy within 5 years prior to Screening;
  16. Women who are pregnant or lactating, or patients who are unable to take effective contraception from screening to 6 months after discontinuation (including male subjects and their female spouses);
  17. Patients who had participated in other clinical studies and other received investigational drug product within 1 month or 5 half-lives of the drug product (whichever is longer) prior to Screening;
  18. Patients who are not suitable for participating in the trial according to the investigator's judgment;
  19. Patients who are unwilling or unable to follow the protocol process.
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years to 75 Years   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE China
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03984760
Other Study ID Numbers  ICMJE WG-PBB00302
Has Data Monitoring Committee No
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party Panion & BF Biotech Inc.
Study Sponsor  ICMJE Panion & BF Biotech Inc.
Collaborators  ICMJE Shandong Weigao Panion Pharmaceutical Co. Ltd.
Investigators  ICMJE
Principal Investigator: Xiangmei Chen The General Hospital of the People's Liberation Army (PLAGH)
PRS Account Panion & BF Biotech Inc.
Verification Date March 2021

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP