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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT01887600
Other study ID # 1517-CL-0608
Secondary ID 2012-005180-27
Status Completed
Phase Phase 3
First received
Last updated
Start date September 3, 2013
Est. completion date November 1, 2017

Study information

Verified date February 2021
Source Astellas Pharma Inc
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This study was conducted to treat anemia in patients with chronic kidney disease. Anemia is a reduced number of red blood cells or hemoglobin. Hemoglobin is important for the transport of oxygen in your blood. The purpose of the study was to see if Roxadustat is both effective and safe as a treatment for anemia in patients with chronic kidney disease.


Description:

The study consisted of three study periods as follows: - Screening period: up to 6 weeks - Treatment period: minimum 52 weeks (primary treatment period) up to a maximum of 104 weeks (extended treatment period) - Post-Treatment Follow-Up period: 4 weeks


Recruitment information / eligibility

Status Completed
Enrollment 594
Est. completion date November 1, 2017
Est. primary completion date November 1, 2017
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion criteria: - Participant has a diagnosis of chronic kidney disease, with Kidney Disease Outcomes Quality Initiative (KDOQI) Stage 3, 4 or 5, not receiving dialysis; with an Estimated Glomerular Filtration Rate (eGFR) <60 mL/min/1.73 m^2 estimated using the abbreviated 4-variable Modification of Diet in Renal Disease (MDRD) equation. - The mean of the Participant's three most recent Hb values during the Screening period, obtained at least 4 days apart, must be less than or equal to 10.0 g/dL, with a difference of less than or equal to 1.0 g/dL between the highest and the lowest values. The last Hb value must be within 10 days prior to randomization. - Participant has a ferritin level greater than or equal to 30 ng/mL (greater than or equal to 67.4 pmol/L) at screening. - Participant has a transferrin saturation (TSAT) level greater than or equal to 5% at screening. - Participant has a serum folate level greater than or equal to lower limit of normal at screening. - Participant has a serum vitamin B12 level greater than or equal to lower limit of normal at screening. - Participant's alanine aminotransferase (ALT), aspartate aminotransferase (AST) levels are less than or equal to 3 x upper limit of normal (ULN), and total bilirubin (TBL) is less than or equal to 1.5 x ULN. - Participant's body weight is 45.0 kg up to a maximum of 160.0 kg. Exclusion criteria: - Participant has received any ESA treatment within 12 weeks prior to randomization. - Participant has had more than one dose of IV iron within 12 weeks prior to randomization. - Participant has received a RBC transfusion within 8 weeks prior to randomization. - Participant has a known history of myelodysplastic syndrome or multiple myeloma. - Participant has a known hereditary hematologic disease such as thalassemia or sickle cell anemia, pure red cell aplasia, or other known causes for anemia other than CKD. - Participant has a known hemosiderosis, hemochromatosis, coagulation disorder, or hypercoagulable condition. - Participant has chronic inflammatory disease that could impact erythropoiesis (e.g., systemic lupus erythematosus, rheumatoid arthritis, celiac disease) even if it is currently in remission. - Participant is anticipated to have elective surgery that is expected to lead to significant blood loss or anticipated elective coronary revascularization. - Participant has active or chronic gastrointestinal bleeding. - Participant has received any prior treatment with roxadustat or a hypoxia-inducible factor Prolyl Hydroxylase Inhibitor (HIF-PHI). - Participant has been treated with iron-chelating agents within 4 weeks prior to randomization. - Participant has a history of chronic liver disease (e.g., cirrhosis or fibrosis of the liver) - Participant has a known New York Heart Association Class III or Intravenous (IV) congestive heart failure. - Participant has had a myocardial infarction, acute coronary syndrome, stroke, seizure, or a thrombotic/thromboembolic event (e.g., pulmonary embolism) within 12 weeks prior to randomization. - Uncontrolled hypertension or two or more blood pressure (BP) values of systolic BP (SBP) greater than or equal to 160 mmHg or diastolic BP (DBP) greater than or equal to 95 mmHg confirmed by repeat measurement within 2 weeks prior to randomization. - Participant has a diagnosis or suspicion (e.g., complex kidney cyst of Bosniak Category 2F or higher) of renal cell carcinoma on renal ultrasound within 12 weeks prior to randomization. - Participant has a history of malignancy, except the following: cancers determined to be cured or in remission for greater than or equal to 5 years, curatively resected basal cell or squamous cell skin cancers, cervical cancer in situ, or resected colonic polyps. - Participant is positive for any of the following: Human Immunodeficiency Virus (HIV); hepatitis B surface antigen (HBsAg); or anti-hepatitis C virus antibody (anti-HCV Ab). - Participant has an active clinically significant infection manifested by White Blood Count (WBC) > ULN, and/or fever, in conjunction with clinical signs or symptoms of infection within one week prior to randomization. - Participant has a known untreated proliferative diabetic retinopathy, diabetic macular edema, macular degeneration and retinal vein occlusion. - Participant has had any prior organ transplant (that has not been explanted) or a scheduled organ transplantation. - Participant has participated in any interventional clinical study or has been treated with any investigational drugs within 30 days or 5 half lives or limit set by national law, whichever is longer, prior to the initiation of Screening. - Participant has an anticipated use of dapsone in any dose amount or chronic use of acetaminophen (paracetamol) > 2.0 g/day during the treatment or follow-up period of the study. - Participant has a history of alcohol or drug abuse within 2 years prior to randomization.

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Roxadustat
Roxadustat was administered initially according to the tiered weight-based dosing, where participants with weight from = 45 to = 70 kg received 70 mg and participants with > 70 to = 160 kg received 100 mg of roxadustat. Dose-titration based upon regular measurement of Hb levels was performed until participants achieved central Hb value of = 11.0 g/dL and Hb increase from baseline (BL) of = 1.0 g/dL at two consecutive study visits, separated by at least 5 days. Once target Hb level was reached participants entered maintenance period during which roxadustat dosage was adjusted every 4 weeks to maintain participants Hb level within the target range of 10.0 g/dL and 12.0 g/dL.
Placebo
Placebo was administered initially according to the tiered weight-based dosing, where participants with weight from = 45 to = 70 kg received 70 mg and participants with > 70 to = 160 kg received 100 mg of roxadustat. Dose-titration based upon regular measurement of Hb levels was performed until participants achieved central Hb value of = 11.0 g/dL and Hb increase from baseline (BL) of = 1.0 g/dL at two consecutive study visits, separated by at least 5 days. Once target Hb level was reached participants entered maintenance period during which roxadustat dosage was adjusted every 4 weeks to maintain participants Hb level within the target range of 10.0 g/dL and 12.0 g/dL.

Locations

Country Name City State
Belarus Site BY37503 Brest
Belarus Site BY37504 Gomel
Belarus Site BY37501 Grodno
Belarus Site BY37505 Minsk
Belarus Site BY37506 Minsk
Belarus Site BY37507 Minsk
Belarus Site BY37502 Vitebsk
Belgium Site BE32002 Antwerp
Belgium Site BE32012 Baudour
Belgium Site BE32017 Bonheiden
Belgium Site BE32004 Brussels Flemish Brabant
Belgium Site BE32014 Ieper
Belgium Site BE32013 Liege
Bulgaria Site BG35923 Pazardjik
Bulgaria Site BG35906 Sofia
Bulgaria Site BG35908 Sofia
Bulgaria Site BG35910 Sofia
Bulgaria Site BG35907 Stara Zagora
Bulgaria Site BG35916 Varna
Bulgaria Site BG35903 Veliko Tarnovo
Colombia Site CO57007 Barranquilla
Colombia Site CO57008 Barranquilla
Colombia Site CO57002 Pereira
Dominican Republic Site DO17101 La Fe Santo Domingo
Dominican Republic Site DO17102 Santiago de los Caballeros
Dominican Republic Site DO17103 Santo Domingo
Dominican Republic Site DO17104 Santo Domingo
Estonia Site EE37201 Tallinn
Georgia Site GE99502 Tbilisi
Georgia Site GE99503 Tbilisi
Georgia Site GE99504 Tbilisi
Greece Site GR30003 Heraklion
Greece Site GR30002 Patras
Greece Site GR30001 Thessaloniki
Guatemala Site GT50209 Chiquimula
Guatemala Site GT50201 Ciudad de Guatemala
Guatemala Site GT50202 Ciudad de Guatemala
Guatemala Site GT50207 Ciudad de Guatemala
Guatemala Site GT50208 Ciudad de Guatemala
Guatemala Site GT50203 Guatemala
Guatemala Site GT50205 Guatemala
Guatemala Site GT50206 Guatemala
Hungary Site HU36029 Budapest
Hungary Site HU36025 Gyor
Hungary Site HU36026 Kaposvar
Hungary Site HU36027 Kistarcsa
Hungary Site HU36008 Pecs
Hungary Site HU36028 Szent
Hungary Site HU36003 Zalsaegerszeg
Italy Site IT39001 Bari
Italy Site IT39008 Lecco
Italy Site IT39006 Milano
Italy Site IT39037 Modena
Italy Site IT39036 Pavia
Panama Site PA50703 Ciudad de Colon
Panama Site PA50701 Ciudad de Panama
Peru Site PE51001 Iquitos
Peru Site PE51002 Trujillo
Poland Site PL48002 Katowice
Poland Site PL48001 Krakow Malopolska
Poland Site PL48008 Lodz
Poland Site PL48012 Lodz
Poland Site PL48057 Nowy Tomysl
Poland Site PL48013 Szczecin
Poland Site PL48007 Tarnow
Poland Site PL48004 Warszawa
Poland Site PL48005 Warszawa
Poland Site PL48006 Wroclaw
Poland Site PL48014 Zamosc
Romania Site RO40001 Brasov
Romania Site RO40021 Bucharest
Romania Site RO40003 Bucuresti
Romania Site RO40012 Bucuresti
Romania Site RO40004 Oradea
Romania Site RO40005 Timisoara Timis
Russian Federation Site RU70024 Chelyabinsk
Russian Federation Site RU70054 Irkutsk
Russian Federation Site RU70008 Kaluga
Russian Federation Site RU70005 Moscow
Russian Federation Site RU70007 Moscow
Russian Federation Site RU70047 Moscow
Russian Federation Site RU70048 Moscow
Russian Federation Site RU70051 Moscow
Russian Federation Site RU70003 Nizhny Novgorod
Russian Federation Site RU70004 Omsk
Russian Federation Site RU70043 Petrozavodsk
Russian Federation Site RU70014 Rostov-on-don
Russian Federation Site RU70002 Saint Petersburg
Russian Federation Site RU70011 Saint Petersburg
Russian Federation Site RU70022 Saint Petersburg
Russian Federation Site RU70045 Saint-Petersburg
Russian Federation Site RU70060 Saratov
Russian Federation Site RU70006 Smolensk
Russian Federation Site RU70001 Yaroslavl
Russian Federation Site RU70057 Yaroslavl
Serbia Site RS38102 Belgrade
Serbia Site RS38103 Belgrade
Serbia Site RS38104 Belgrade
Serbia Site RS38105 Belgrade
Serbia Site RS38117 Krusevac
Serbia Site RS38101 Nis
Serbia Site RS38116 Zrenjanin
South Africa Site ZA27004 Bloemfontein Free State
South Africa Site ZA27002 Durban Kwa Zulu Natal
South Africa Site ZA27008 Durban
South Africa Site ZA27001 Observatory Cape Town
South Africa Site ZA27006 Parow
South Africa Site ZA27007 Port Elizabeth
Spain Site ES34010 Alcorcon Madrid
Spain Site ES34002 Badalona-Barcelona
Spain Site ES34003 Barcelona
Spain Site ES34006 Barcelona
Spain Site ES34007 Ciudad Real
Spain Site ES34011 Galdakao Vizcaya
Turkey Site TR90003 Ankara
Turkey Site TR90016 Edirne
Turkey Site TR90024 Kocaeli
Turkey Site TR90020 Malatya
Ukraine Site UA38021 Cherkasy
Ukraine Site UA38003 Chernivtsi
Ukraine Site UA38006 Dnepropetrovsk
Ukraine Site UA38016 Ivano-Frankivsk
Ukraine Site UA38011 Kharkiv
Ukraine Site UA38015 Kherson
Ukraine Site UA38010 Kyiv
Ukraine Site UA38012 Kyiv
Ukraine Site UA38017 Kyiv
Ukraine Site UA38009 Lviv Lvivska
Ukraine Site UA38007 Mykolaiv
Ukraine Site UA38008 Odessa
Ukraine Site UA38019 Odessa
Ukraine Site UA38001 Ternopil
Ukraine Site UA38018 Uzhgorod
Ukraine Site UA38002 Zaporizhzhya
United Kingdom Site GB44008 Cambridge
United Kingdom Site GB44001 Swansea
United Kingdom Site GB44005 Welwyn Garden City
United Kingdom Site GB44004 Westcliff-on-Sea

Sponsors (2)

Lead Sponsor Collaborator
Astellas Pharma Europe B.V. FibroGen

Countries where clinical trial is conducted

Belarus,  Belgium,  Bulgaria,  Colombia,  Dominican Republic,  Estonia,  Georgia,  Greece,  Guatemala,  Hungary,  Italy,  Panama,  Peru,  Poland,  Romania,  Russian Federation,  Serbia,  South Africa,  Spain,  Turkey,  Ukraine,  United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Primary Percentage of Participants With a Hemoglobin (Hb) Response to Treatment at Two Consecutive Visits During the First 24 Weeks of Treatment Without Rescue Therapy Prior to Hb Response Hemoglobin (Hb) response was measured as Yes or No. Response Yes (responders) was defined as: Hb =11.0 g/dL and Hb increase from baseline by = 1.0 g/dL, for participants with baseline Hb > 8.0 g/dL; or Hb increase from baseline by = 2.0 g/dL, for participants with baseline Hb = 8.0 g/dL at two consecutive visits with available data separated at least 5 days during the first 24 weeks of treatment without having received rescue therapy (red blood cell (RBC) transfusion, erythropoiesis-stimulating agent (ESA), or intravenous (IV) iron prior to Hb response. This was the primary efficacy endpoint for EU (EMA). Baseline to week 24
Primary Hb Change From Baseline (BL) to the Average Hb in Weeks 28-52 Regardless of Rescue Therapy The change from baseline to the average Hb values across weeks 28 to 52 without having received rescue therapy. The Hb values from visit windows at weeks 28, 32, 36, 40, 44, 48 and 52 were used for the calculation of the average of weeks 28 to 52. This was the primary efficacy endpoint for US (FDA). Baseline and weeks 28 to 52
Secondary Hb Change From BL to the Average Hb in Weeks 28-36 Without Having Received Rescue Therapy Within 6 Weeks Prior to and During 8-Week Evaluation Period The Hb values from visit windows at weeks 28, 32 and 36 were used for the calculation of the average of weeks 28 to 36. Baseline and weeks 28 to 36
Secondary Change From BL in Low-Density Lipoprotein (LDL) Cholesterol (Regardless of Fasting Status) to the Average LDL Cholesterol of Weeks 12 to 28 Analysis was completed on all values collected on day 1 and weeks 12, 20 and 28. Baseline and weeks 12 to 28
Secondary Time to First Use of Rescue Therapy (Composite of Red Blood Cell (RBC) Transfusions, Erythropoiesis-stimulating Agent (ESA) Use, and Intravenous (IV) Iron) The time to first use of rescue therapy was calculated (in years) as: (First event date - Analysis date of first dose intake + 1) / 365.25. The First event date was defined as Date of first dose of rescue medication during the efficacy emergent period and Analysis date of first dose intake was defined as date of first study drug dose intake collected on day 1. The Efficacy Emergent Period was defined as the evaluation period from the analysis date of first dose intake up to 7 days after the analysis date of last dose or the end of treatment (EOT) visit, whichever occurred first. Data reported was analysed by Kaplan-Meier estimate for cumulative proportion. Medication onset date was the date of the first use of rescue medication. Baseline to week 104 (End of Treatment [EOT])
Secondary Change From BL in Short Form (SF)-36 Vitality (VT) Sub-score to the Average VT Sub-score of Weeks 12 to 28 Change from BL in SF-36 VT sub-score to the average value in weeks 12-28 was calculated using the physical component scores (PCS) of SF-36. The multi-purpose, short-form health survey has 36 questions with an 8-scale profile of functional health and well-being scores as well as psychometrically-based physical and mental health summary measures. The survey measures eight dimensions or scales: (1) physical functioning (PF) (10 items); (2) role limitations due to physical health problems (RP) (3 items); (3) bodily pain (BP) (2 items); (4) social functioning (SF) (2 items); (5) general health perceptions (GH) (5 items); (6) role limitations due to emotional problems (RE) (3 items); (7) vitality, energy or fatigue (VT) (4 items); and (8) mental health (MH) (5 items). The SF-36 scores ranged from 0-100 with higher scores indicating better health status. Baseline and weeks 12 to 28
Secondary Change From BL in SF-36 Physical Functioning (PF) Sub-score to the Average PF Sub-score of Weeks 12 to 28 Change from baseline in SF-36 PF normalized sub-score compared to the average PF sub-score of weeks 12 to 28. The multi-purpose, short-form health survey has 36 questions with an 8-scale profile of functional health and well-being scores as well as psychometrically-based physical and mental health summary measures. Change from baseline in PF sub score of SF-36 to the average of weeks 12-28 was compared by treatment arm for all participants (primary analysis) and in the subsets of participants with baseline PF sub score below 35 and equal or above 35. The SF-36 scores ranged from 0-100 with higher scores indicating better health status. All available SF-36 PF values were used i.e., both scheduled and unscheduled for the calculation of the average PF sub-score of weeks 12 to 28. Baseline and weeks 12 to 28
Secondary Change From BL in Mean Arterial Pressure (MAP) to the Average MAP of Weeks 20 to 28 The MAP was derived for each visit from the average systolic (SBP) and diastolic blood pressure (DBP) calculated for each visit using the three readings and the following equation: MAP = (2/3) * DBP + (1/3) * SBP. Baseline assessment was the assessment on day 1 (average of the three readings). If the baseline assessment was missing, then the latest available value prior to first drug administration was used. Baseline and weeks 20 to 28
Secondary Time to First Occurrence of Hypertension Occurrence of hypertension was defined as SBP increase from BL =20 mmHg and SBP >170 mmHg or DBP increase from BL =15 mmHg and DBP =110 mmHg. Time to first occurrence of hypertension was defined as first date where SBP criterion or DBP criterion is met, whichever occurred first. Data was analysed using Kaplan-Meier estimate for cumulative proportion. Baseline and year 0.5, year 1, year 1.5 and year 2
Secondary Rate of Progression of CKD Measured by Annualized Estimated Glomerular Filtration Rate (eGFR) Slope Over Time Annualized eGFR slope over time was estimated by a random slopes and intercepts model using all available eGFR values (one baseline and all post-treatment values up to EOT period or start of dialysis adjusted on baseline Hb, region, CV history at baseline and the interaction terms (baseline eGFR by timepoint and baseline Hb by timepoint). All assessments collected after initiation of chronic dialysis (acute or chronic) are excluded from the analysis. Baseline assessment was the assessment from day 1 visit. If this value was missing, the value from screening visit was used. Baseline to week 108
Secondary Average Level of Hb Over Weeks 28 to 36 Without Use of Rescue Therapy Within 6 Weeks Prior to and During the Evaluation Period All scheduled and unscheduled hemoglobin values from weeks 28 to 36 were taken into account for calculating the average values. Weeks 28 to 36
Secondary Average Level of Hb Over Weeks 44 to 52 Without Use of Rescue Therapy Within 6 Weeks Prior to and During the Evaluation Period All scheduled and unscheduled hemoglobin values from weeks 44 to 52 were taken into account for calculating the average values. Weeks 44 to 52
Secondary Average Level of Hb Over Weeks 96 to 104 Without Use of Rescue Therapy Within 6 Weeks Prior to and During the Evaluation Period All scheduled and unscheduled hemoglobin values from weeks 96 to 104 were taken into account for calculating the average values. Weeks 96 to 104
Secondary Time to Achieve the First Hb Response Without Rescue Therapy, as Defined by Primary Endpoint Hb response was measured as Yes or No; Yes was defined as Hb =11.0 g/dL and Hb increase from baseline by = 1.0 g/dL, for participants with baseline Hb > 8.0 g/dL; or Hb increase from baseline by = 2.0 g/dL, for participants with baseline Hb = 8.0 g/dL. For a participant without rescue therapy before Hb response (defined in 1 primary outcome), the time to achieve Hb response was calculated (in weeks) as: (First event date - Analysis date of first dose intake + 1) / 7 where First event date was defined as First date of both values that met the criteria for response. Participants who discontinued or received rescue therapy prior to the first Hb response or before the second consecutive Hb value defined as a response were classified as non responders and were censored at week 24 or end of efficacy emergent period, whichever came first. Data analysis was completed using Kaplan-Meier estimate for cumulative proportion. Baseline to week 24
Secondary Hb Change From BL to Each Post-Dosing Time Point All scheduled and unscheduled hemoglobin values that belong to each visit window were taken into account using one value per analysis window. Baseline Hb was defined as the mean of four latest central laboratory Hb values prior or on the same date as first study drug intake (pre-dose). Baseline (day 1) and weeks 1, 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, 76, 80, 84, 88, 92, 96, 100, 104
Secondary Hb Change From BL to the Average Hb Value of Weeks 28-36 Regardless of the Use of Rescue Therapy The Hb values from visit windows from weeks 28 to 36 were used for the calculation of the average regardless of rescue therapy. Baseline Hb was defined as the mean of four latest central laboratory Hb values prior or on the same date as first study drug intake (pre-dosing). Baseline and weeks 28 to 36
Secondary Hb Change From BL to the Average Hb Value of Weeks 44-52 Regardless of the Use of Rescue Therapy The Hb values from visit windows from weeks 44 to 52 were used for the calculation of the average regardless of rescue therapy. Baseline Hb was defined as the mean of four latest central laboratory Hb values prior or on the same date as first study drug intake (pre-dosing). Baseline and weeks 44 to 52
Secondary Hb Change From BL to the Average Hb Value of Weeks 96-104 Regardless of the Use of Rescue Therapy The Hb values from visit windows from weeks 96 to 104 were used for the calculation of the average regardless of rescue therapy. Baseline Hb was defined as the mean of four latest central laboratory Hb values prior or on the same date as first study drug intake (pre-dosing). Baseline and weeks 96 to 104
Secondary Percentage of Hb Values Within 10.0-12.0 g/dL in Weeks 28-36 Without Use of Rescue Therapy The percentage of Hb values measured during weeks 28-36 within 10.0 -12.0 g/dL, without having received rescue therapy within 6 weeks prior to and during the 8-week evaluation period is reported. Baseline and weeks 28 to 36
Secondary Percentage of Hb Values Within 10.0-12.0 g/dL in Weeks 44-52 Without Use of Rescue Therapy The percentage of Hb values measured during weeks 44-52 with values within 10.0 - 12.0 g/dL, without having received rescue therapy within 6 weeks prior to and during the 8-week evaluation period is reported. Baseline and weeks 44 to 52
Secondary Percentage of Hb Values Within 10.0-12.0 g/dL in Weeks 96-104 Without Use of Rescue Therapy The percentage of Hb values measured during weeks 96-104 within 10.0 -12.0 g/dL, without having received rescue therapy within 6 weeks prior to and during the 8-week evaluation period is reported. Baseline and weeks 96 to 104
Secondary Time to First Hospitalization Time to first hospitalization was defined in years as the First event date during the Efficacy Emergent Period - (Analysis date of first dose intake +1)/365.25. The first event date was defined as the Date of first admission. The Efficacy Emergent Period was defined as the evaluation period from the analysis date of first dose intake up to 7 days after the analysis date of last dose or EOT visit, whichever occured first. Analysis date of first dose intake was defined as the date of first study drug intake collected on day 1 visit. For participants who experienced more than one hospitalization, only their first event following study treatment was used. Data analysis was completed using Kaplan-Meier estimate for cumulative proportion. Baseline to week 104
Secondary Number of Days of Hospitalization Per Patient Exposure Year (PEY) The sum of the durations of all hospitalizations in days was adjusted for the duration of exposure. Derived only for participants with at least one hospitalization. The number of days of hospitalization per PEY was calculated as the sum of the durations of all hospitalizations in days [Minimum (Date of discharge, End of Efficacy Emergent Period) - Date of admission + 1] / [Duration of Efficacy Emergent Period in days / 365.25]. Participants can have more than one hospitalization. Baseline to week 104
Secondary Time to First Use of Rescue Therapy (Composite of RBC, Transfusions, ESA Use, and IV Iron) in the First 24 Weeks of Treatment Time to first use of rescue therapy in years. Data analysis was completed using Kaplan-Meier estimate for cumulative proportion. Baseline to week 24
Secondary Time to First Use of RBC Transfusions Time to First Use of RBC Transfusions during efficacy emergent period. For participants who have experienced more than one RBC transfusion, only their first event following study treatment was used. The efficacy emergent period was defined as the evaluation period from the analysis date of first dose intake up to 7 days after the analysis date of last dose or EOT visit, whichever occured first. Data analysis was completed using Kaplan-Meier estimate for cumulative proportion. Baseline to week 104
Secondary Mean Monthly Number of RBC Packs During efficacy emergent period, the mean monthly number of RBC packs was calculated as the sum of units transfused between the first dose and up to the last dose in the period divided by duration of efficacy emergent period (in days) divided by 28 days. The efficacy emergent period was defined as the evaluation period from the analysis date of first dose intake up to 7 days after the analysis date of last dose or EOT visit, whichever occured first. In case of missing number of packs, values were estimated based on 1 unit for packed cells = 250 mL or 1 unit for whole blood = 500 mL. Participants without RBC transfusion were included with a value of zero. No estimation if values were missing. Baseline to week 104
Secondary Mean Monthly Volume of Blood Transfused During efficacy emergent period, the mean monthly volume of blood transfused was calculated as the sum of blood volume transfused between the first dose and up to the last dose in the period divided by duration of efficacy emergent period (in days) divided by 28 days. The efficacy emergent period was defined as the evaluation period from the analysis date of first dose intake up to 7 days after the analysis date of last dose or EOT visit, whichever occurred first. The mean monthly volume transfused was calculated as the sum of the volume transfused between the first dose and up to the last dose in the period divided by duration (in days) and multiplied by 28 days. Participants without RBC transfusion were included with a value of zero. Baseline to week 104
Secondary Time to First Use of ESA Rescue Therapy Time to First Use of ESA Rescue Therapy during efficacy emergent period. For participants with use of ESA, the time to first use of ESA was calculated as (First event date - Analysis date of first dose intake + 1) / 365.25. The efficacy emergent period was defined as the evaluation period from the analysis date of first dose intake up to 7 days after the analysis date of last dose or EOT visit, whichever occured first. Data analysis was completed using Kaplan-Meier estimate for cumulative proportion. Participants without ESA rescue were censored at the end of treatment. Baseline to week 104
Secondary Time to First Use of IV Iron Time to first use of IV iron during efficacy emergent period in years. For participants with use of IV iron, the time to first use of IV iron was calculated as (First event date - Analysis date of first dose intake + 1) / 365.25. The efficacy emergent period was defined as the evaluation period from the analysis date of first dose intake up to 7 days after the analysis date of last dose or EOT visit, whichever occurred first.Data analysis was completed using Kaplan-Meier estimate for cumulative proportion. Baseline to week 104
Secondary Change From BL to Each Post-Dosing Visit in Total Cholesterol Change from baseline to each planned assessment for total cholesterol is reported. Baseline was defined as the value on day 1. If the value was missing, the latest value prior to first study drug administration was used. Baseline and weeks 4, 8, 12, 20, 28, 36, 44, 52, 68, 84, 104
Secondary Change From BL to Each Post-Dosing Visit in Low Density Lipoprotein (LDL)/High-Density Lipoprotein (HDL) Ratio Change from baseline to each planned assessment for LDL/HDL ratio is reported. Baseline was defined as the value on Day 1. If this value was missing, the latest value prior to first study drug administration was used. Baseline and weeks 4, 8, 12, 20, 28, 36, 44, 52, 68, 84, 104
Secondary Change From BL to Each Post-Dosing Visit in Non-HDL Cholesterol Change from baseline to each planned assessment for non-HDL is reported. Baseline was defined as the value on day 1. If this value was missing, the latest value prior to first study drug administration was used. Baseline and weeks 4, 8, 12, 20, 28, 36, 44, 52, 68, 84, 104
Secondary Change From BL to Each Post-Dosing Visit in Apolipoproteins A1 (ApoA1) Change from baseline to each planned assessment for apolipoproteins A1 is reported. Baseline was defined as the value on day 1. If this value was missing, the latest value prior to first study drug administration was used. Baseline and weeks 4, 8, 12, 20, 28, 36, 44, 52, 68, 84, 104
Secondary Change From BL to Each Post-Dosing Visit in Apolipoproteins B (ApoB) Change from baseline to each planned assessment for apolipoproteins B is reported. Baseline was defined as the value on day 1. If this value was missing, the latest value prior to first study drug administration was used. Baseline and weeks 4, 8, 12, 20, 28, 36, 44, 52, 68, 84, 104
Secondary Change From BL to Each Post-Dosing Visit in Ratio ApoB/ApoA1 Change from baseline to each planned assessment for ratio of ApoB/ApoA1 is reported. Baseline was defined as the value on day 1. If this value was missing, the latest value prior to first study drug administration was used. Baseline and weeks 4, 8, 12, 20, 28, 36, 44, 52, 68, 84, 104
Secondary Percentage of Participants With Mean LDL Cholesterol <100 mg/dL Calculated Over Weeks 12 to 28 Mean LDL cholesterol <100 mg/dL over weeks 12 to 28 was defined as a binary variable (Yes/No), where Yes was defined as mean LDL cholesterol <100 mg/dL over weeks 12 to 28. Participants without any LDL value within this duration were excluded. Weeks 12 to 28
Secondary Percentage of Participants Who Have Achieved Antihypertensive Treatment Goal in CKD Participants Over Weeks 12-28 Occurrence of achieved antihypertensive treatment goal was defined as the average SBP < 130 mmHg and the average DBP < 80 mmHg over the period of weeks 12-28. Participants without any blood pressure measurement were excluded. Weeks 12 to 28
Secondary Change From BL to the Average Value of Weeks 12-28 in Quality of Life (QoL) SF-36 Physical Component Score (PCS) The 36-Item short-form health survey (SF-36) is a multi-purpose survey with 36 questions. It provides an 8-scale profile of functional health and well-being scores as well as psychometrically-based physical and mental health summary measures. For each scale scores range from 0-100. The physical component score was calculated based on the results of the SF-36 scores. Higher scores indicate better health status. Baseline and weeks 12 to 28
Secondary Change From BL to the Average Value of Weeks 12-28 in Anemia Subscale (Ans) of Functional Assessment of Cancer Therapy (FACT-An) Score Baseline FACT-An AnS was defined as the FACT-An AnS value on Day 1. Together with the Functional Assessment of Cancer Therapy - General (FACT-G), the Anemia Subscale (AnS) is referred to as the FACT-An Total. The AnS scale contains 13 fatigue specific items (the Fatigue Score) plus 7 items related to anemia. The Anemia AnS score range is 0 to 80. For the above score, a higher score indicates better QoL. Baseline and weeks 12 to 28
Secondary Change From BL to the Average Value of Weeks 12-28 in Total FACT-An Score Baseline FACT-An Total Score was defined as the FACT-An Total score on Day 1. Total Fact-An score is composed of FACT-G and Ans scales. FACT-G contains 27 items that cover four dimensions of well-being: physical (PWB) - 7 items, functional (FWB) - 7 items, social/family (SWB) - 7 items, and emotional (EWB) - 6 items. The AnS scale contains 13 fatigue specific items (the Fatigue Score) plus 7 items related to anemia. The total score is obtained by summation of the scores from PWB, SWB, EWB, FWB and AnS. The FACT-An Total Score scale range is 0-188. A higher score indicates better QoL. Baseline and weeks 12 to 28
Secondary Change From BL to the Average Value of Weeks 12-28 in the Euroqol Questionnaire - 5 Dimensions 5 Levels (EQ-5D 5L) Visual Analogue Scale (VAS) Score The Euroqol Questionnaire - 5 Dimensions 5 Levels (EQ-5D 5L) is a self-reported questionnaire. The EQ-5D 5L is used as a measure of respondents' Health Related Quality of Life (HRQoL). The EQ-5D 5L consists of the EQ-5D descriptive system and the EQ visual analogue scale (VAS). The EQ-5D 5L descriptive system comprises of 5 dimensions of health: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems, extreme problems. The VAS records the respondent's self-rated health status on a graduated (0-100) scale, where the answers are labeled 'Best imaginable health state' and 'Worst imaginable health state' with higher scores for higher HRQoL. Baseline and weeks 12 to 28
Secondary Change From BL to the Average Value of Weeks 12-28 in Overall Work Impairment Due to Anaemic Symptoms Work productivity and activity impairment: anemic symptoms (WPAI:ANS) questionnaire version 2 was used to measure work and activity impairment during the last seven days due to anemia. It is self-assessed questionnaire which consists of 6 questions covering work and daily activities. Questions include asking if participant is working, how many hours the person missed work due to anemic symptoms, how many hours the person missed work due to other reasons, how many hours participant actually worked and how the anemic symptoms impacted their productivity and ability to do daily activities. For the last 2 questions, they were scored from 0-10 with 0 identifying no effect on work and 10 completely prevented from working. Overall work impairment due to ANS was calculated as 100 x Q2/(Q2+Q4)+[(1-Q2/(Q2+Q4))x(Q5/10)]. Scores were calculated with the formula to derive the overall work impairment on each timepoints in percentage, and then changes of the percentage from baseline are reported. Baseline and weeks 12 to 28
Secondary Percentage of Participants in Each Category in Patients' Global Impression of Change (PGIC) The Patients' Global Impression of Change (PGIC) is a participant-rated instrument that measures change in participants overall status on a 7-point scale ranging from 1 (very much improved) to 7 (very much worse). Week 12 to 28
Secondary Change From BL to Each Study Visit in Serum Hepcidin Baseline was assessed on Day 1 visit. If baseline value was missing, the value from screening visit was used. In case of missing data, no imputation rules were applied. Baseline and weeks 4,12,20,36,52,104
Secondary Change From BL to Each Study Visit in Serum Ferritin Baseline assessment was assessment from Day 1 visit. If baseline value was missing, the value from screening visit was used. In case of missing data, no imputation rules were applied. Baseline and weeks 4, 8, 12, 20, 28, 36, 44, 52, 60, 68, 76, 84, 92, 100, 104
Secondary Change From BL to Each Study Visit in Serum Transferrin Saturation (TSAT) Baseline was assessed on Day 1 visit. If baseline value was missing, the value from screening visit was used. In case of missing data, no imputation rules were applied. Baseline and weeks 4, 8, 12, 20, 28, 36, 44, 52, 60, 68, 76, 84, 92, 100, 104
Secondary Change From BL to Each Study Visit in Serum HbA1c Level HbA1c was measured at each timepoint and presented in 'fraction of 1' unit by dividing the values in percentage by 100, in order to fit for CDISC (Clinical Data Interchange Standards Consortium) standard terminology. Changes from baseline to each timepoint were reported in unit 'fraction of 1'. Baseline was assessed on Day 1 visit. If baseline value was missing, the value from screening visit was used. In case of missing data, no imputation rules were applied. Baseline and weeks 12, 28, 36, 44, 60, 84, 104
Secondary Change From BL to Each Study Visit in Fasting Blood Glucose Baseline was assessed on Day 1 visit. If baseline value was missing, the value from screening visit was used. In case of missing data, no imputation rules were applied. Baseline and weeks 4, 8, 12, 20, 28, 36, 44, 52, 60, 68, 76, 84, 92, 100, 104
Secondary Change From BL to Each Study Visit in Albumin/Creatinine Ratio in Urine Baseline assessment was the assessment from day 1 visit. If baseline value was missing, value from screening visit was used. In case of missing data, no imputation rules were applied. To compute the geometric mean of albumin/creatinine ratio in urine and associated 95% CI, the mean of log-transformed albumin/creatinine ratio in urine values (ratio) and associated 95% CI are back-transformed to the raw scale. All assessments collected after initiation of dialysis (acute or chronic) were excluded from the analysis. Baseline and weeks 12, 24, 36, 52, 64, 76, 88, 104
Secondary Change From BL to Each Study Visit in Serum Creatinine (Cr) Ratio Baseline assessment was the assessment from day 1 visit. If baseline value was missing, the value from screening visit was used. In case of missing data, no imputation rules were applied. To compute the geometric mean of serum Cr (ratio) and associated 95% CI, the mean of log-transformed serum Cr (ratio) values and associated 95% CI are back-transformed to the raw scale. All assessments collected after initiation of dialysis (acute or chronic) were excluded from the analysis. Baseline and weeks 4, 8, 12, 20, 28, 36, 44, 52, 60, 68, 76, 84, 92, 100, 104
Secondary Time to Doubling of Serum Creatinine or Chronic Dialysis or Renal Transplant Compared to Baseline The endpoint was defined as time to doubling serum creatinine or chronic dialysis or renal transplant what ever came first. Time to event was defined as (First event date - Analysis date of first dose intake + 1) / 365.25. First event date was defined as date of dialysis or date of renal transplant (whichever occurred first) and analysis date of first dose intake was defined as date of first study drug dose intake collected on day 1 visit. Data analysis was completed using Kaplan-Meier estimate for cumulative proportion. The data evaluated until the safety emergent period, which was defined as the evaluation period from analysis date of first drug intake up to 28 days after the analysis last dose, and results were presented for every 6 months up to 2 years. Baseline and year 0.5, year 1, year 1.5 and year 2
Secondary Time to CKD Progression (Composite of Doubling Serum Creatinine, Chronic Dialysis or Renal Transplant, and Death) CKD progression was defined as date of occurrence of chronic dialysis or date of renal transplant or doubled serum creatinine or date of death, whichever came first. The time to CKD progression was calculated (in years) as (First event date - Analysis date of first dose intake + 1) / 365.25. First event date was defined as first occurrence of serum creatinine being doubled compared with baseline, first occurrence of chronic dialysis or renal transplant, occurrence of participants who died (whichever occurred first). Analysis date of first dose intake was defined as date of first study drug dose intake collected on day 1 visit. Data analysis was completed using Kaplan-Meier estimate for cumulative proportion. The data evaluated until the safety emergent period, which was defined as the evaluation period from analysis date of first drug intake up to 28 days after the analysis last dose, and results were presented for every 6 months up to 2 years. Baseline and year 0.5, year 1, year 1.5 and year 2
Secondary Time to at Least 40% Decrease in eGFR From Baseline, Chronic Dialysis or Renal Transplant All eGFR values collected during the safety emergent period are considered, excluding those collected on or after initiation of dialysis (acute or chronic). The First event date was defined as First occurrence of 40% decrease in eGFR from baseline, first occurrence of chronic dialysis or renal transplant (whichever occurred first and Analysis date of first dose intake was defined as date of first study drug dose intake collected on day 1 visit. The safety emergent period was defined as the evaluation period from the analysis date of first drug intake up to 28 days after the analysis date of last dose or end of study (EOS), whichever occurred first. Data analysis was completed using Kaplan-Meier estimate for cumulative proportion. The data evaluated until the safety emergent period, which was defined as the evaluation period from analysis date of first drug intake up to 28 days after the analysis last dose, and results were presented for every 6 months up to 2 years. Baseline and year 0.5, year 1, year 1.5 and year 2
See also
  Status Clinical Trial Phase
Completed NCT02021318 - Roxadustat in the Treatment of Anemia in Chronic Kidney Disease (CKD) Patients, Not on Dialysis, in Comparison to Darbepoetin Alfa Phase 3