Trial Evaluating the Efficacy and Safety of Oral Vadadustat Once Daily (QD) and Three Times Weekly (TIW) for the Maintenance Treatment of Anemia in Hemodialysis Subjects Converting From Erythropoiesis-Stimulating Agents (ESAs)

May 7, 2025 updated by: Akebia Therapeutics

Phase 3b, Randomized, Open-label, Active-controlled Trial Evaluating the Efficacy and Safety of Oral Vadadustat Once Daily (QD) and Three Times Weekly (TIW) for the Maintenance Treatment of Anemia in Hemodialysis Subjects Converting From Erythropoiesis-Stimulating Agents (ESAs)

This trial will be conducted to demonstrate the efficacy and safety of vadadustat compared to darbepoetin alfa for the maintenance treatment of anemia in hemodialysis participants after conversion from current erythropoiesis-stimulating agent (ESA) therapy.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This study consists of three periods:

  1. Screening Period
  2. Conversion and Maintenance Treatment Period
  3. Safety Follow-up Period

Individual participants will participate in total trial duration of approximately 64 weeks.

Study Type

Interventional

Enrollment (Actual)

319

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Czechia
      • Mariánské Lázně, Czechia
        • Research Site
      • Nový Jičín, Czechia
        • Research Site
      • Plzen, Czechia
        • Research Site
      • Praha 9, Czechia
        • Research Site
      • Příbram, Czechia
        • Research Site
      • Slaný, Czechia
        • Research Site
  • Hungary
      • Baja, Hungary
        • Research Site
      • Debrecen, Hungary
        • Research Site
      • Kaposvar, Hungary
        • Research Site
      • Kecskemét, Hungary
        • Research Site
      • Pécs, Hungary
        • Research Site
  • Italy
      • Pavia, Italy
        • Research Site
      • Vicenza, Italy
        • Research Site
  • Poland
      • Biała Podlaska, Poland
        • Research Site
      • Brodnica, Poland
        • Research Site
      • Lodz, Poland
        • Research Site
      • Pszczyna, Poland
        • Research Site
      • Sochaczew, Poland
        • Research Site
  • Spain
      • Barcelona, Spain
        • Research Site #2
      • Valencia, Spain
        • Research Site
  • United States
    • California
      • Chula Vista, California, United States, 91910
        • Research Site
      • Granada Hills, California, United States, 91344
        • Research Site
      • Los Angeles, California, United States, 90022
        • Research Site
      • Lynwood, California, United States, 90262
        • Research Site
      • Northridge, California, United States, 91324
        • Research Site
      • San Dimas, California, United States, 91773
        • Research Site
      • Whittier, California, United States, 90603
        • Research Site
    • Colorado
      • Denver, Colorado, United States, 80230
        • Research Site
    • Connecticut
      • Middlebury, Connecticut, United States, 06762
        • Research Site
    • Florida
      • Coral Gables, Florida, United States, 33134
        • Research Site
      • Tampa, Florida, United States, 33614
        • Research Site
      • Winter Park, Florida, United States, 32789
        • Research Site
    • Michigan
      • Pontiac, Michigan, United States, 48341
        • Research Site
      • Roseville, Michigan, United States, 48066
        • Research Site
    • Minnesota
      • Minneapolis, Minnesota, United States, 55404
        • Research Site
    • Mississippi
      • Brookhaven, Mississippi, United States, 39601
        • Research Site
      • Tupelo, Mississippi, United States, 38801
        • Research Site
    • Missouri
      • Kansas City, Missouri, United States, 64111
        • Research Site
      • Saint Louis, Missouri, United States, 63136
        • Research Site
    • Nevada
      • Las Vegas, Nevada, United States, 89128
        • Research Site
    • New Mexico
      • Albuquerque, New Mexico, United States, 87109
        • Research Site
    • North Carolina
      • Durham, North Carolina, United States, 27704
        • Research Site
      • Kinston, North Carolina, United States, 28504
        • Research Site
      • New Bern, North Carolina, United States, 28562
        • Research Site
    • Pennsylvania
      • Bethlehem, Pennsylvania, United States, 18017
        • Research Site
    • South Carolina
      • Orangeburg, South Carolina, United States, 29118
        • Research Site
    • Tennessee
      • Chattanooga, Tennessee, United States, 37404
        • Research Site
      • Knoxville, Tennessee, United States, 37920
        • Research Site
      • Knoxville, Tennessee, United States, 37923
        • Research Site
    • Texas
      • Austin, Texas, United States, 78758
        • Research Site
      • Austin, Texas, United States, 78751
        • Research Site
      • El Paso, Texas, United States, 79902
        • Research Site
      • Houston, Texas, United States, 77004
        • Research Site
      • Houston, Texas, United States, 77099
        • Research Site
      • McAllen, Texas, United States, 78503
        • Research Site
      • San Antonio, Texas, United States, 78229
        • Research Site
      • San Antonio, Texas, United States, 78212
        • Research Site
      • San Antonio, Texas, United States, 78204
        • Research Site
    • Virginia
      • Hampton, Virginia, United States, 23666
        • Research Site

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Receiving chronic, outpatient three times weekly (TIW) in-center hemodialysis for end-stage renal disease for at least 12 weeks prior to Screening
  • Hemodialysis adequacy as indicated by single-pool Kt/Vurea ≥ 1.2 using the most recent historical measurement within 8 weeks prior to or during Screening
  • Use of any approved erythropoiesis-stimulating agents (ESAs) for at least the 8 weeks prior to Screening Visit 2

  • Two hemoglobin (Hb) values, at least 4 days apart, measured by the central laboratory during Screening within the following prespecified ranges:

    1. Hb values between 8.0 and 11.0 grams per deciliter (g/dL) (inclusive) in the United States;
    2. Hb values between 9.0 and 12.0 g/dL (inclusive) in Europe
  • Serum ferritin ≥ 100 nanograms per milliliter (ng/mL) and transferrin saturation (TSAT) ≥ 20% during Screening
  • Folate and vitamin B12 measurements ≥ lower limit of normal during Screening

Exclusion Criteria:

  • Anemia due to a cause other than chronic kidney disease (e.g., sickle cell disease, myelodysplastic syndromes, bone marrow fibrosis, hematologic malignancy, myeloma, hemolytic anemia, thalassemia, or pure red cell aplasia)

  • Participants meeting cut-off of the following equivalent mean weekly doses calculated over 8 weeks prior to Screening Visit 2

    1. Methoxy polyethylene glycol-epoetin beta > 50 micrograms (µg)/week;
    2. Darbepoetin alfa > 100 µg/week;
    3. Epoetin analogues > 23000 International Units (IU)/week
  • Active bleeding or recent blood loss within 8 weeks prior to randomization
  • Red blood cell transfusion within 8 weeks prior to randomization
  • Current uncontrolled hypertension.
  • Acute coronary syndrome (hospitalization for unstable angina or myocardial infarction), surgical or percutaneous intervention for coronary, cerebrovascular or peripheral artery disease (aortic or lower extremity), surgical or percutaneous valvular replacement or repair, sustained ventricular tachycardia, hospitalization for heart failure (HF) or New York Heart Association Class IV HF, or stroke within 12 weeks prior to or during Screening.
  • Known hypersensitivity to vadadustat, darbepoetin alfa, or any of their excipients

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Darbepoetin alfa
Drug: Darbepoetin alfa
intravenous or subcutaneous solution
Experimental: Vadadustat once daily (QD)
Drug: Vadadustat
oral tablets
Experimental: Vadadustat three times weekly (TIW)
Drug: Vadadustat
oral tablets

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change From Baseline in Hb to the Average Over the Primary Evaluation Period (PEP) (Weeks 20 to 26)
Time Frame: Baseline; Weeks 20 to 26
The Baseline Hb was defined as the average of the last 2 central laboratory Hb values taken on or prior to the first dose date. The average for the PEP was calculated as the average of all Hb measurements from the central laboratory within the three visit windows during Weeks 20 through 26, regardless of intercurrent events. Analysis was conducted using an analysis of covariance (ANCOVA) model with multiple imputation for missing data with randomization stratification factors and Baseline Hb as covariates. Change from Baseline was calculated as PEP value minus the Baseline value.
Baseline; Weeks 20 to 26

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change From Baseline in Hb to the Average Over the Secondary Evaluation Period (SEP) (Weeks 46 to 52)
Time Frame: Baseline; Weeks 46 to 52
The Baseline Hb was defined as the average of the last 2 central laboratory Hb values taken on or prior to the first dose date. The average for the SEP was calculated as the average of all Hb measurements from the central laboratory within the three visit windows during Weeks 46 through 52, regardless of intercurrent events. Analysis was conducted using an ANCOVA model with multiple imputation for missing data with randomization stratification factors and Baseline Hb as covariates. Change from Baseline was calculated as SEP value minus the Baseline value.
Baseline; Weeks 46 to 52

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Akebia Therapeutics

Collaborators

Otsuka Pharmaceutical Development & Commercialization, Inc.

Investigators

  • Study Director: Chief Medical Officer, Akebia Therapeutics Inc.

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 27, 2020

Primary Completion (Actual)

November 26, 2021

Study Completion (Actual)

June 22, 2022

Study Registration Dates

First Submitted

March 16, 2020

First Submitted That Met QC Criteria

March 16, 2020

First Posted (Actual)

March 18, 2020

Study Record Updates

Last Update Posted (Actual)

May 22, 2025

Last Update Submitted That Met QC Criteria

May 7, 2025

Last Verified

May 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 404-201-00012
  • AKB-6548-CI-0036 (Other Identifier: Akebia Protocol Number)
  • 2019-004851-36 (EudraCT Number)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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