A Study of Intermittent Oral Dosing of ASP1517 in Hemodialysis Chronic Kidney Disease Patients With Anemia

A Phase 3, Multi-center, Randomized, 2-arm Parallel, Double-blind, Active-comparator (Darbepoetin Alfa) Conversion Study of Intermittent Oral Dosing of ASP1517 in Hemodialysis Chronic Kidney Disease Patients With Anemia

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.

Study Overview

• Status: Completed
• Conditions: Hemodialysis Chronic Kidney Disease Patients With Anemia
• Intervention / Treatment: Drug: roxadustat; Drug: Darbepoetin alfa

• Study Type: Interventional
• Enrollment (Actual): 303
• Phase: Phase 3

Contacts and Locations

Study Locations

• Japan
  • Aichi, Japan
    • Site JP00008
  • Aichi, Japan
    • Site JP00018
  • Aichi, Japan
    • Site JP00020
  • Aichi, Japan
    • Site JP00032
  • Aichi, Japan
    • Site JP00033
  • Aichi, Japan
    • Site JP00040
  • Ehime, Japan
    • Site JP00004
  • Ehime, Japan
    • Site JP00055
  • Fukui, Japan
    • Site JP00009
  • Fukui, Japan
    • Site JP00059
  • Fukuoka, Japan
    • Site JP00014
  • Fukuoka, Japan
    • Site JP00049
  • Fukushima, Japan
    • Site JP00010
  • Fukushima, Japan
    • Site JP00056
  • Fukushima, Japan
    • Site JP00057
  • Gifu, Japan
    • Site JP00030
  • Gifu, Japan
    • Site JP00050
  • Gunma, Japan
    • Site JP00011
  • Gunma, Japan
    • Site JP00026
  • Gunma, Japan
    • Site JP00037
  • Hokkaido, Japan
    • Site JP00003
  • Hokkaido, Japan
    • Site JP00038
  • Hokkaido, Japan
    • Site JP00031
  • Hokkaido, Japan
    • Site JP00048
  • Ibaraki, Japan
    • Site JP00017
  • Ibaraki, Japan
    • Site JP00041
  • Ibaraki, Japan
    • Site JP00042
  • Ibaraki, Japan
    • Site JP00045
  • Ibaraki, Japan
    • Site JP00046
  • Ibaraki, Japan
    • Site JP00047
  • Ibaraki, Japan
    • Site JP00054
  • Ibaraki, Japan
    • Site JP00058
  • Kagoshima, Japan
    • Site JP00043
  • Kanagawa, Japan
    • Site JP00005
  • Kumamoto, Japan
    • Site JP00028
  • Kumamoto, Japan
    • Site JP00029
  • Kyoto, Japan
    • Site JP00006
  • Nagano, Japan
    • Site JP00027
  • Nagano, Japan
    • Site JP00002
  • Nagano, Japan
    • Site JP00012
  • Nagano, Japan
    • Site JP00051
  • Nagasaki, Japan
    • Site JP00013
  • Niigata, Japan
    • Site JP00001
  • Niigata, Japan
    • Site JP00034
  • Okayama, Japan
    • Site JP00036
  • Osaka, Japan
    • Site JP00007
  • Osaka, Japan
    • Site JP00015
  • Saitama, Japan
    • Site JP00016
  • Saitama, Japan
    • Site JP00035
  • Tokushima, Japan
    • Site JP00044
  • Tokyo, Japan
    • Site JP00052
  • Tokyo, Japan
    • Site JP00053
  • Toyama, Japan
    • Site JP00021
  • Toyama, Japan
    • Site JP00022
  • Toyama, Japan
    • Site JP00039
  • Yamagata, Japan
    • Site JP00024
  • Yamaguchi, Japan
    • Site JP00025

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: ASP1517 Group; Subjects will take the study drug at two- or three-day intervals.	Drug: roxadustat; Oral; Other Names: ASP1517
Experimental: Darbepoetin alfa Group; Subjects will take the study drug once a week.	Drug: Darbepoetin alfa; Intravenous

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Change from baseline in the average hemoglobin (Hb)	Baseline and Weeks 18 to 24

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quality of life assessed by SF-36	SF-36: Medical Outcomes Study 36-Item Short-Form Health Survey	Up to Week 24
Quality of life assessed by FACT-An	FACT-An: Functional Assessment of Cancer Therapy-Anemia	Up to Week 24
Safety assessed by incidence of adverse events		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 Laboratory values and/or adverse events related to treatment		Up to Week 24
Plasma concentration of unchanged ASP1517		Up to Week 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
Proportion of participants with the target Hb level at each week		Up to Week 24
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 reticulocyte hemoglobin content level		Up to Week 24
Number of hospitalizations		Up to Week 24
Duration of hospitalizations		Up to Week 24
Average Hb from Week 18 to Week 24		Week 18 to 24
Proportion of participants with the target Hb level from Week 18 to Week 24		Week 18 to 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
Quality of life assessed by EQ-5D-5L	EQ-5D-5L: EuroQol 5 Dimension 5-Levels	Up to Week 24
Number of participants with abnormal 12-lead electrocardiogram (ECG) values	Any clinically significant adverse changes on the ECG will be reported as adverse events.	Up to Week 24
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

Collaborators and Investigators

• Sponsor: Astellas Pharma Inc
• Collaborators: FibroGen

Publications and helpful links

General Publications

• Natale P, Palmer SC, Jaure A, Hodson EM, Ruospo M, Cooper TE, Hahn D, Saglimbene VM, Craig JC, Strippoli GF. Hypoxia-inducible factor stabilisers for the anaemia of chronic kidney disease. Cochrane Database Syst Rev. 2022 Aug 25;8(8):CD013751. doi: 10.1002/14651858.CD013751.pub2.
• Akizawa T, Iwasaki M, Yamaguchi Y, Majikawa Y, Reusch M. Phase 3, Randomized, Double-Blind, Active-Comparator (Darbepoetin Alfa) Study of Oral Roxadustat in CKD Patients with Anemia on Hemodialysis in Japan. J Am Soc Nephrol. 2020 Jul;31(7):1628-1639. doi: 10.1681/ASN.2019060623. Epub 2020 Jun 3.

Helpful Links

• Link to results on Astellas Clinical Study Results website

Study record dates

Study Major Dates

• Study Start (Actual): November 30, 2016
• Primary Completion (Actual): March 13, 2018
• Study Completion (Actual): March 15, 2018

Study Registration Dates

• First Submitted: October 31, 2016
• First Submitted That Met QC Criteria: October 31, 2016
• First Posted (Estimate): November 2, 2016

Study Record Updates

• Last Update Posted (Actual): September 30, 2022
• Last Update Submitted That Met QC Criteria: September 28, 2022
• Last Verified: September 1, 2022

More Information

Terms related to this study

• Keywords: Hemodialysis; Roxadustat; Renal anemia; ASP1517
• Additional Relevant MeSH Terms: Urologic Diseases; Hematologic Diseases; Renal Insufficiency; Kidney Diseases; Renal Insufficiency, Chronic; Anemia; Hematinics; Darbepoetin alfa
• Other Study ID Numbers: 1517-CL-0307

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Access to anonymized individual participant level data will not be provided for this trial as it meets one or more of the exceptions described on www.clinicalstudydatarequest.com under "Sponsor Specific Details for Astellas."

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No