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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02648347
Other study ID # AKB-6548-CI-0014
Secondary ID 2015-004265-81
Status Completed
Phase Phase 3
First received
Last updated
Start date December 2015
Est. completion date July 31, 2020

Study information

Verified date June 2022
Source Akebia Therapeutics
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

A multicenter, randomized, open-label, active-controlled Phase 3 study for the correction of anemia and maintenance of hemoglobin (Hb) in participants with Non-Dialysis-Dependent Chronic Kidney Disease (NDD-CKD)


Description:

This is a multicenter, randomized, open-label, active-controlled Phase 3 study of the efficacy and safety of vadadustat versus Darbepoetin alfa for the correction of anemia and maintenance of Hb in participants with NDD-CKD


Recruitment information / eligibility

Status Completed
Enrollment 1751
Est. completion date July 31, 2020
Est. primary completion date June 4, 2020
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - =18 years of age - Diagnosis of chronic kidney disease (CKD) with an estimated glomerular filtration rate =60 milliliters per minute per 1.73 square meter (mL/min/1.73 m^2) at Screening and not expected to start dialysis within 6 months of Screening - Mean Screening hemoglobin <10.0 grams per deciliter (g/dL) - Serum ferritin =100 nanograms per milliliter (ng/mL) and transferrin saturation (TSAT) =20% during Screening Exclusion Criteria: - Anemia due to a cause other than CKD or participants with active bleeding or recent blood loss - Red blood cell transfusion within 8 weeks prior to randomization. - Any erythropoietic stimulating agent within 8 weeks prior to randomization - Uncontrolled hypertension - Severe heart failure at Screening (New York Heart Association Class IV) - 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, or stroke within 12 weeks prior to or during Screening - Hypersensitivity to Darbepoetin or Vadadustat or to any of their excipients

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Vadadustat
Oral dose administered once daily for =36 weeks. Dose adjustment based on hemoglobin level as defined in the protocol.
Darbepoetin alfa
Subcutaneous or intravenous dose administered for =36 weeks. Initial dose based on the current package insert for investigational sites in the United States (US), and the Summary of Product Characteristics for all other investigational sites (non-US) for adult participants with chronic kidney disease not on dialysis.

Locations

Country Name City State
Argentina Research Site Bahia Blanca Buenos Aires
Argentina Research Site Ciudad Autonoma Buenos Aires
Argentina Research Site Ciudad Autonoma Buenos Aires
Argentina Research Site Cordoba
Argentina Research Site Cordoba
Argentina Research Site Cordoba
Argentina Research Site Cordoba
Argentina Research Site Corrientes
Argentina Research Site Godoy Cruz Mendoza
Argentina Research Site Junin Buenos Aires
Argentina Research Site Junin Buenos Aires
Argentina Research Site Mar del Plata Buenos Aires
Argentina Research Site Mar del Plata Buenos Aires
Argentina Research Site Pergamino Buenos Aires
Argentina Research Site Ramos Mejia Buenos Aires
Argentina Research Site Rosario Santa Fe
Argentina Research Site Salta
Argentina Research Site San Luis
Argentina Research Site San Miguel Buenos Aires
Argentina Research Site San Miguel de Tucuman Tucuman
Argentina Research Site San Miguel de Tucuman Tucuman
Argentina Research Site San Miguel de Tucuman Tucuman
Argentina Research Site San Miguel de Tucuman Tucuman
Argentina Research Site San Nicolas Buenos Aires
Argentina Research Site Sarandi Buenos Aires
Argentina Research Site Temperley Buenos Aires
Australia Research Site Adelaide South Australia
Australia Research Site Bedford Park South Australia
Australia Research Site Box Hill Victoria
Australia Research Site Cairns Queensland
Australia Research Site Camperdown New South Wales
Australia Research Site Gold Coast Queensland
Australia Research Site Herston Queensland
Australia Research Site Liverpool New South Wales
Australia Research Site Nedlands Western Australia
Australia Research Site Perth Western Australia
Brazil Research Site Belo Horizonte Minas Gerais
Brazil Research Site Botucatu Sao Paulo
Brazil Research Site Campinas Sao Paulo
Brazil Research Site Canoas Rio Grande Do Sul
Brazil Research Site Caxias do Sul Rio Grande Do Sul
Brazil Research Site Criciúma Santa Catarina
Brazil Research Site Curitiba Paraná
Brazil Research Site #1 Curitiba Paraná
Brazil Research Site #2 Curitiba Paraná
Brazil Research Site Feira de Santana Bahia
Brazil Research Site Fortaleza Ceará
Brazil Research Site Fortaleza Ceará
Brazil Research Site Itabuna Bahia
Brazil Research Site Joinville Santa Catarina
Brazil Research Site Juiz de Fora Minas Gerais
Brazil Research Site Maringá Paraná
Brazil Research Site Passo Fundo Rio Grande Do Sul
Brazil Research Site Porto Alegre Rio Grande Do Sul
Brazil Research Site Porto Alegre Rio Grande Do Sul
Brazil Research Site Porto Alegre Rio Grande Do Sul
Brazil Research Site Porto Alegre Rio Grande Do Sul
Brazil Research Site Rio de Janeiro Rio Do Janeiro
Brazil Research Site Santo André Sao Paulo
Brazil Research Site Santo André Sao Paulo
Brazil Research Site São Bernardo do Campo Sao Paulo
Brazil Research Site São Paulo Sao Paulo
Brazil Research Site São Paulo Sao Paulo
Brazil Research Site São Paulo Sao Paulo
Brazil Research Site Vitória Espírito Santo
Bulgaria Research Site Dobrich
Bulgaria Research Site Lom
Bulgaria Research Site Silistra
Bulgaria Research Site Sliven
Bulgaria Research Site Smolyan
Bulgaria Research Site Sofia
Bulgaria Research Site Sofia
Bulgaria Research Site Sofia
Bulgaria Research Site Sofia
Bulgaria Research Site #1 Sofia
Bulgaria Research Site #2 Sofia
Bulgaria Research Site Stara Zagora
Bulgaria Research Site Stara Zagora
Bulgaria Research Site Varna
Bulgaria Research Site Varna
Bulgaria Research Site #1 Veliko Tarnovo
Bulgaria Research Site #2 Veliko Tarnovo
Bulgaria Research Site Vidin
France Research Site Pontoise Val d'Oise
Hungary Research Site #1 Baja
Hungary Research Site #2 Baja
Hungary Research Site Balatonfured
Hungary Research Site Budapest
Hungary Research Site Budapest
Hungary Research Site Debrecen
Hungary Research Site Hodmezovasarhely
Hungary Research Site Kalocsa
Hungary Research Site Kaposvar
Hungary Research Site Kecskemet
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Hungary Research Site Nyiregyhaza
Hungary Research Site Pecs
Hungary Research Site Szeged
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Israel Research Site Ashkelon
Israel Research Site Haifa
Israel Research Site Nahariya
Israel Research Site Ramat Gan
Israel Research Site Rishon Lezion
Italy Research Site Bari
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Italy Research Site Cremona
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Italy Research Site Napoli
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Italy Research Site Parma
Italy Research Site Pavia
Italy Research Site Piedimonte Matese Caserta
Italy Research Site Roma
Italy Research Site San Giovanni Rotondo Foggia
Italy Research Site Siena
Korea, Republic of Research Site Bucheon-si Gyeonggi-do
Korea, Republic of Research Site Busan
Korea, Republic of Research Site Busan
Korea, Republic of Research Site Daegu
Korea, Republic of Research Site Guri-si Gyeonggi-do
Korea, Republic of Research Site Seoul
Korea, Republic of Research Site Seoul
Malaysia Research Site Kota Bahru Kelantan
Malaysia Research Site Kuantan Pahang
Mexico Research Site Acapulco de Juarez Guerrero
Mexico Research Site Chihuahua
Mexico Research Site Chihuahua
Mexico Research Site Culiacan Sinaloa
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South Africa Research Site Bloemfontein Free State
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South Africa Research Site #1 Durban KwaZulu-Natal
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United States Research Site #1 McAllen Texas
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United States Research Site #1 Merrillville Indiana
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United States Research Site #1 Miami Florida
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United States Research Site Miami Beach Florida
United States Research Site Miami Lakes Florida
United States Research Site Miami Lakes Florida
United States Research Site Miami Springs Florida
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United States Research Site New Orleans Louisiana
United States Research Site New York New York
United States Research Site Newport News Virginia
United States Research Site Norfolk Virginia
United States Research Site Northridge California
United States Research Site #2 Northridge California
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United States Research Site Peoria Illinois
United States Research Site Philadelphia Pennsylvania
United States Research Site Phoenix Arizona
United States Research Site Plano Texas
United States Research Site Plymouth Massachusetts
United States Research Site Pompano Beach Florida
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United States Research Site Portland Maine
United States Research Site Portland Oregon
United States Research Site Portsmouth New Hampshire
United States Research Site Riverside California
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United States Research Site Sacramento California
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United States Research Site San Antonio Texas
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United States Research Site #1 San Dimas California
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United States Research Site Santa Fe New Mexico
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United States Research Site Sherman Texas
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United States Research Site #1 Shreveport Louisiana
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United States Research Site Westminster Colorado
United States Research Site #1 Whittier California
United States Research Site #2 Whittier California
United States Research Site Winston-Salem North Carolina
United States Research Site Woodbridge Virginia

Sponsors (1)

Lead Sponsor Collaborator
Akebia Therapeutics

Countries where clinical trial is conducted

United States,  Argentina,  Australia,  Brazil,  Bulgaria,  France,  Hungary,  Israel,  Italy,  Korea, Republic of,  Malaysia,  Mexico,  New Zealand,  Poland,  Puerto Rico,  Russian Federation,  South Africa,  Spain,  Ukraine,  United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Other Exploratory - Proportion of Participants With Hb Values Within the Target Range During the Primary Evaluation Period (Weeks 24 to 36) Weeks 24 to 36
Other Exploratory - Proportion of Time With Hb Values Within the Target Range During the Primary Evaluation Period (Weeks 24 to 36) Weeks 24 to 36
Other Exploratory - Proportion of Time With Hb Values Within the Target Range During the Secondary Evaluation Period (Weeks 40 to 52) Weeks 40 to 52
Other Exploratory - Proportion of Participants With Hb Values Within the Target Range During the Secondary Evaluation Period (Weeks 40 to 52) Weeks 40 to 52
Other Exploratory - Proportion of Participants With an Hb Increase of >1.0 g/dL From Baseline Visit Baseline; up to Week 52
Other Exploratory - Time to Achieve Hb Increase of >1.0 g/dL From Baseline Visit Baseline; up to Week 52
Other Exploratory - Mean Change in Hb Between Baseline (Mean Pretreatment Hb) and the Primary Evaluation Period (Mean Hb From Weeks 24 to 36) Stratified by Pre-baseline Erythropoiesis-stimulating Agent (ESA) Exposure Baseline; Weeks 24 to 36
Other Exploratory - Mean Monthly Dose of Intravenous (IV) Elemental Iron Administered in Participants Who Have Received IV Iron Up to Week 52
Other Exploratory - Proportion of Participants Receiving IV Iron Therapy Up to Week 52
Other Exploratory - Proportion of Participants Receiving Red Blood Cells (RBCs) Transfusion(s) Up to Week 52
Primary Change From Baseline in Hemoglobin (Hb) to the Average Over the Primary Efficacy Period (Weeks 24 to 36) The Baseline average was calculated as the average of the Hb values obtained at the screening visit closest to the date of randomization and the randomization visit. The average for the Primary Efficacy Period was calculated as the average Hb value over Weeks 24 to 36. Analysis was conducted using an analysis of covariance (ANCOVA) model with multiple imputation for missing data with Baseline Hb concentration (<9.5 versus =9.5 grams per deciliter [g/dL]), geographic region (United States [US] versus European Union [EU] versus Rest of World [ROW]), and New York Heart Association congestive heart failure (NYHA CHF) class (Class 0 [no CHF] or I versus II or III) as covariates. Baseline; Weeks 24 to 36
Primary Median Time to First Major Adverse Cardiovascular Event (MACE) MACE was defined as all-cause mortality, non-fatal myocardial infarction (MI), or non-fatal stroke. The primary safety outcome was positively adjudicated first MACE, which was defined as any death, Endpoint Adjudication Committee (EAC)-confirmed non-fatal MI, or EAC-confirmed non-fatal stroke occurring between the first dose date and each participant's last participation date. PROTECT MACE results and analysis, by design, was performed on pooled data from studies AKB-6548-CI-0014 (NCT02648347) and AKB-6548-CI-0015 (NCT02680574). Results and statistical analysis from study AKB-6548-CI-0014 has been reported in below table and under section "Statistical Analysis 1". Results and statistical analysis of the pooled data from studies AKB-6548-CI-0014 and AKB-6548-CI-0015 has been reported under section "Statistical Analysis 2" of this outcome measure. Up to Week 208
Secondary Change From Baseline in Hb to the Average Over the Secondary Efficacy Period (Weeks 40 to 52) The Baseline average was calculated as the average of the Hb values obtained at the screening visit closest to the date of randomization and the randomization visit. The average for the Secondary Efficacy Period was calculated as the average Hb value over Weeks 40 to 52. Analysis was conducted using an ANCOVA model with multiple imputation for missing data with Baseline Hb concentration (<9.5 versus =9.5 g/dL), geographic region (US versus EU versus ROW), and NYHA CHF class (Class 0 [no CHF] or I versus II or III) as covariates. Baseline; Weeks 40 to 52
Secondary Median Time to First MACE Plus Hospitalization for Heart Failure or Thromboembolic Event Excluding Vascular Access Thrombosis MACE was defined as all-cause mortality, non-fatal MI, or non-fatal stroke. Hospitalization for EAC adjudicated heart failure included presentation of participants to an acute care facility requiring an overnight hospitalization (change in calendar day) with an exacerbation of heart failure requiring treatment. EAC confirmed thromboembolic events for this secondary outcome measure included arterial thrombosis, deep vein thrombosis, and pulmonary embolism. PROTECT MACE results and analysis, by design, was performed on pooled data from studies AKB-6548-CI-0014 (NCT02648347) and AKB-6548-CI-0015 (NCT02680574). Results and statistical analysis from study AKB-6548-CI-0014 has been reported in below table and under section "Statistical Analysis 1". Results and statistical analysis of the pooled data from studies AKB-6548-CI-0014 and AKB-6548-CI-0015 has been reported under section "Statistical Analysis 2" of this outcome measure. Up to Week 208
Secondary Median Time to First Cardiovascular MACE MACE was defined as all-cause mortality, non-fatal MI, or non-fatal stroke. Cardiovascular MACE analysis differed from the primary MACE endpoint as it included only deaths adjudicated by the EAC as cardiovascular deaths (i.e, only EAC-confirmed cardiovascular deaths) in addition to first events of non-fatal MI or non-fatal stroke. PROTECT MACE results and analysis, by design, was performed on pooled data from studies AKB-6548-CI-0014 (NCT02648347) and AKB-6548-CI-0015 (NCT02680574). Results and statistical analysis from study AKB-6548-CI-0014 has been reported in below table and under section "Statistical Analysis 1". Results and statistical analysis of the pooled data from studies AKB-6548-CI-0014 and AKB-6548-CI-0015 has been reported under section "Statistical Analysis 2" of this outcome measure. Up to Week 208
Secondary Median Time to First Cardiovascular Death Cardiovascular death included EAC adjudicated fatal MI, pump failure, sudden death, presumed sudden death, fatal stroke, fatal pulmonary embolism, cardiovascular procedure-related death, other cardiovascular death, and presumed cardiovascular death. PROTECT MACE results and analysis, by design, was performed on pooled data from studies AKB-6548-CI-0014 (NCT02648347) and AKB-6548-CI-0015 (NCT02680574). Results and statistical analysis from study AKB-6548-CI-0014 has been reported in below table and under section "Statistical Analysis 1". Results and statistical analysis of the pooled data from studies AKB-6548-CI-0014 and AKB-6548-CI-0015 has been reported under section "Statistical Analysis 2" of this outcome measure. Up to Week 208
Secondary Median Time to First All-cause Mortality Only events that were positively adjudicated and confirmed by the EAC were included in the MACE analyses. PROTECT MACE results and analysis, by design, was performed on pooled data from studies AKB-6548-CI-0014 (NCT02648347) and AKB-6548-CI-0015 (NCT02680574). Results and statistical analysis from study AKB-6548-CI-0014 has been reported in below table and under section "Statistical Analysis 1". Results and statistical analysis of the pooled data from studies AKB-6548-CI-0014 and AKB-6548-CI-0015 has been reported under section "Statistical Analysis 2" of this outcome measure. Up to Week 208
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