Dose Ranging Study of Dialysate Containing Soluble Iron to Treat Subjects With End Stage Renal Disease (ESRD) Receiving Chronic Hemodialysis
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Purpose
The purpose of this study is to determine whether Dialysate containing soluble iron (Soluble Ferric Pyrophosphate) is safe and effective in maintaining physiological iron levels during chronic hemodialysis.
| Condition | Intervention | Phase |
|---|---|---|
|
Chronic Kidney Disease |
Device: Standard Bicarbonate Solution Drug: Soluble Ferric Pyrophosphate |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Treatment |
| Official Title: | A Dose Ranging Study of Dialysate Containing Soluble Ferric Pyrophosphate (SFP) Versus Control in Subjects With ESRD Receiving Chronic Hemodialysis. |
- Percent of Subjects Whose Hemoglobin (Hgb) Decreases by a Total of 1.0 Grams/ Deciliter (g/dL) (or More) From Baseline on Each of Two Successive Measurements. [ Time Frame: up to 26 weeks ] [ Designated as safety issue: No ]Efficacy of a Soluble Ferric Pyrophosphate (SFP)-containing dialysate solution in maintaining physiological iron levels during chronic HD, as measured by the percent of subjects whose hgb decreases by a total of 1.0 g/dL (or more) from baseline on each of two successive measurements. Hemoglobin was obtained weekly at the mid-week dialysis treatments and compared to baseline value (average of two hgb measurements obtained at the two consecutive baseline visits prior to randomization).
- Change From Baseline in Hemoglobin (Hgb) [ Time Frame: two time points: baseline and final evaluation (last post baseline assessment, up to 26 weeks) ] [ Designated as safety issue: No ]
- Time in Days for Hgb to Decrease by a Total of > = 1.0 g/dL From Baseline on Each of Two Successive Measurements in Each Treatment Group. [ Time Frame: Up to 26 weeks ] [ Designated as safety issue: No ]Kaplan-Meier Estimate of Time to First Hgb Decrease by >= 1.0 g/dL
- Reticulocyte Hemoglobin (CHr) Values Every Four Weeks, and at the End of the Subject's Treatment. [ Time Frame: Every 4 weeks ] [ Designated as safety issue: No ]Efficacy of SFP administration in dialysate solution as measured by Chr values every four weeks, and at the end of the Subject's Treatment (up to 26 weeks).
- Number of Subjects With Infection Episodes Requiring Antibiotic or Anti-fungal Therapy in Each Treatment Group. [ Time Frame: At each dialysis session for up to 26 weeks ] [ Designated as safety issue: No ]
- Estimate the Amount of SFP Transferred From the Dialysate to the Blood During a Dialysis Session. [ Time Frame: At each dialysis session for up to 26 weeks ] [ Designated as safety issue: No ]
- Number of Subjects With a Rise in Hemoglobin (Hgb) to 12.6 g/dL or More on Two Separate Occasions Measured One Week Apart. [ Time Frame: two separate sessions measured one week apart. ] [ Designated as safety issue: No ]
| Enrollment: | 131 |
| Study Start Date: | August 2007 |
| Study Completion Date: | January 2010 |
| Primary Completion Date: | October 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Placebo Comparator: 0 µg iron/dL of dialysate
Placebo 0 micrograms (µg) of iron/ deciliter (dL) of dialysate
|
Device: Standard Bicarbonate Solution
Patients received 0 micrograms (µg) of iron/ decilited (dL) of dialysate during dialysis 3 times/week for up to 26 weeks.
Other Name: Placebo
|
|
Experimental: 5 µg iron/dL of dialysate
5 micrograms (µg) of iron/ deciliter (dL) of dialysate
|
Drug: Soluble Ferric Pyrophosphate
Patients received 5 micrograms (µg) of iron/ decilited (dL) of dialysate during dialysis 3 times/week for up to 26 weeks.
Other Name: SFP
|
|
Experimental: 10 µg iron/dL of dialysate
10 micrograms (µg) of iron/ deciliter (dL) of dialysate
|
Drug: Soluble Ferric Pyrophosphate
Patients received 10 micrograms (µg) of iron/ decilited (dL) of dialysate during dialysis 3 times/week for up to 26 weeks.
Other Name: SFP
|
|
Experimental: 12 µg iron/dL of dialysate
12 micrograms (µg) of iron/ deciliter (dL) of dialysate
|
Drug: Soluble Ferric Pyrophosphate
Patients received 12 micrograms (µg) of iron/ decilited (dL) of dialysate during dialysis 3 times/week for up to 26 weeks.
Other Name: SFP
|
|
Experimental: 15 µg iron/dL of dialysate
15 micrograms (µg) of iron/ deciliter (dL) of dialysate
|
Drug: Soluble Ferric Pyrophosphate
Patients received 15 micrograms (µg) of iron/ decilited (dL) of dialysate during dialysis 3 times/week for up to 26 weeks.
Other Name: SFP
|
Detailed Description:
The study was designed to evaluate the efficacy of SFP-containing dialysate solution in maintaining physiological iron levels during chronic hemodialysis, as measured by the primary endpoint of the percent of patients whose Hemoglobin (Hgb) decreased by at least 1.0 gram/ deciliter (g/dL) from baseline. The efficacy and safety findings are to be used to determine the optimal concentration of SFP needed to safely maintain iron levels, compensating for iron losses during chronic hemodialysis.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Selected Inclusion Criteria:
- Adult subject ≥ 18 years of age undergoing chronic hemodialysis for end-stage renal disease (ESRD) three times a week
- Hemoglobin (Hgb) values on two successive screening/baseline measures immediately prior to the start of the study averaging 10.1 to 11.5 grams/ deciliter (g/dL), inclusive
- Transferrin Saturation (TSAT) values that average 20% or more, but not exceeding 35%, prior to dialysis measured during the screening period
- Ferritin values that average 200 to 800 micrograms/ liter (µg/L), inclusive, measured during the screening period. An average ferritin above 800 µg/L but no greater than 1200 µg/L is allowed if the average TSAT is 20% to no greater than 25%.
- Except for vascular access surgery, subject has no hospitalization in previous three months for a significant illness that, in the opinion of the Investigator, confers a significant risk of hospitalization during the course of the study. No blood transfusions within the last 4 weeks are allowed.
- Subject has an adequate dialyzer blood flow rate that is acceptable to the Principal Investigator
Exclusion Criteria:
- Hemoglobin (Hgb) values on two successive baseline/screening measurements that average ≥ 11.6g/dL
- Subject with a current malignancy involving a site other than skin
- Subject with a history of drug or alcohol abuse within the last six months
- Subject believed to be unable to complete the entire study (e.g., due to a concurrent disease, life expectancy of less than a year)
- Subject who the Principal Investigator considers will be placed at increased risk by the study procedures
- Subject requiring hemodialysis more than 3 times per week on a regular basis.
- Subject who is unable to discontinue oral iron or intravenous iron supplements for the duration of the study
- Subject who is pregnant
- Subject considered incompetent to give an informed consent
- Subject with a positive test for Hepatitis B Surface Antigen within the past 30 days or during screening
- Subject with known HIV infection (if this is not known, no HIV testing will be performed)
- Subject with cirrhosis of the liver based on histological criteria or clinical criteria (presence of ascites, esophageal varices, spider nevi, or history of hepatic encephalopathy). Subject with hepatitis C, in the absence of cirrhosis, is not excluded from participation in the study if ALT and AST levels are below 2 times the upper limit of normal consistently during the 2 months preceding enrollment
- Subject with active tuberculosis, fungal, viral, or parasitic infection
- Subject with active bacterial infection requiring antibiotic therapy
- Subject with pre-dialysis Corrected Q-wave to T-wave (QTc) interval ≥ 470 milliseconds (ms)
- Subject with a history of hypokalemia, decompensated heart failure, or family history of Long QT Syndrome that in the Investigator's judgment poses a risk for Torsades de Pointe during the study
- Subject using concomitant medications known to prolong QT/QTc interval (See Appendix I, TABLE A)
- Subject receiving more than 60,000 units or 120 micrograms of erythropoietin (Epogen®, Procrit®, or Aranesp®) per week
- Subject has participated in another clinical trial within 30 days of signing Informed Consent
Contacts and Locations
Show 28 Study Locations| Study Director: | Richard Yocum, MD | Rockwell Medical Technologies |
More Information
No publications provided
| Responsible Party: | Robert Chioini, President and CEO, Rockwell Medical Technologies, Inc. |
| ClinicalTrials.gov Identifier: | NCT00548249 History of Changes |
| Other Study ID Numbers: | RMTI-SFP-2 |
| Study First Received: | October 19, 2007 |
| Results First Received: | November 10, 2010 |
| Last Updated: | February 7, 2011 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Rockwell Medical Technologies, Inc.:
|
Subjects with ESRD receiving chronic Hemodialysis |
Additional relevant MeSH terms:
|
Kidney Diseases Kidney Failure, Chronic Renal Insufficiency, Chronic Urologic Diseases Renal Insufficiency Iron |
Trace Elements Micronutrients Growth Substances Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 16, 2013