Dose Ranging Study of Dialysate Containing Soluble Iron to Treat Subjects With End Stage Renal Disease (ESRD) Receiving Chronic Hemodialysis

End-Stage Renal Disease (ESRD) Clinical Trial

Official title:

A Dose Ranging Study of Dialysate Containing Soluble Ferric Pyrophosphate (SFP) Versus Control in Subjects With ESRD Receiving Chronic Hemodialysis.

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00548249
• Other study ID #: RMTI-SFP-2
• Status: Completed
• Phase: Phase 2
• Start date: August 2007
• Est. completion date: January 2010

Study information

• Verified date: November 2020
• Source: Rockwell Medical Technologies, Inc.
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

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.

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 131
• Est. completion date: January 2010
• Est. primary completion date: October 2009
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Selected Inclusion Criteria:

1. Adult subject = 18 years of age undergoing chronic hemodialysis for end-stage renal disease (ESRD) three times a week

2. 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

3. Transferrin Saturation (TSAT) values that average 20% or more, but not exceeding 35%, prior to dialysis measured during the screening period

4. 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%.

5. 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.

6. Subject has an adequate dialyzer blood flow rate that is acceptable to the Principal Investigator

Exclusion Criteria:

1. Hemoglobin (Hgb) values on two successive baseline/screening measurements that average = 11.6g/dL

2. Subject with a current malignancy involving a site other than skin

3. Subject with a history of drug or alcohol abuse within the last six months

4. Subject believed to be unable to complete the entire study (e.g., due to a concurrent disease, life expectancy of less than a year)

5. Subject who the Principal Investigator considers will be placed at increased risk by the study procedures

6. Subject requiring hemodialysis more than 3 times per week on a regular basis.

7. Subject who is unable to discontinue oral iron or intravenous iron supplements for the duration of the study

8. Subject who is pregnant

9. Subject considered incompetent to give an informed consent

10. Subject with a positive test for Hepatitis B Surface Antigen within the past 30 days or during screening

11. Subject with known HIV infection (if this is not known, no HIV testing will be performed)

12. 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

13. Subject with active tuberculosis, fungal, viral, or parasitic infection

14. Subject with active bacterial infection requiring antibiotic therapy

15. Subject with pre-dialysis Corrected Q-wave to T-wave (QTc) interval = 470 milliseconds (ms)

16. 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

17. Subject using concomitant medications known to prolong QT/QTc interval (See Appendix I, TABLE A)

18. Subject receiving more than 60,000 units or 120 micrograms of erythropoietin (Epogen®, Procrit®, or Aranesp®) per week

19. Subject has participated in another clinical trial within 30 days of signing Informed Consent

Related Conditions & MeSH terms

• End-Stage Renal Disease (ESRD)
• Kidney Diseases
• Kidney Failure, Chronic

Intervention

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.

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.
• Soluble Ferric Pyrophosphate
Patients received 10 micrograms (µg) of iron/ decilited (dL) of dialysate during dialysis 3 times/week for up to 26 weeks.
• Soluble Ferric Pyrophosphate
Patients received 12 micrograms (µg) of iron/ decilited (dL) of dialysate during dialysis 3 times/week for up to 26 weeks.
• Soluble Ferric Pyrophosphate
Patients received 15 micrograms (µg) of iron/ decilited (dL) of dialysate during dialysis 3 times/week for up to 26 weeks.

Locations

Country	Name	City	State
Canada	Investigative Site	Edmonton	Alberta
United States	Investigator	Arlington	Virginia
United States	Investigator	Arlington	Texas
United States	Investigative Site	Augusta	Georgia
United States	Investigator	Brooklyn	New York
United States	Investigative Site	Canton	Ohio
United States	Investigator	Chicago	Illinois
United States	Investigator	Cincinnati	Ohio
United States	Investigative Site	Detroit	Michigan
United States	Investigator	Fort Worth	Texas
United States	Investigator	Great Neck	New York
United States	Investigator	Hacienda Heights	California
United States	Investigator	Hackensack	New Jersey
United States	Investigative Site	Hershey	Pennsylvania
United States	Investigator	Los Angeles	California
United States	Investigative Site	Louisville	Kentucky
United States	Investigator	McAllen	Texas
United States	Investigator	Meridian	Idaho
United States	Investigator	Mineola	New York
United States	Investigator	New Orleans	Louisiana
United States	Investigator	New York	New York
United States	Investigator	Ridgewood	New York
United States	Investigator	San Antonio	Texas
United States	Investigator	Seattle	Washington
United States	Investigator	Springfield	Massachusetts
United States	Investigator	Tempe	Arizona
United States	Investigator	Whittier	California
United States	Investigator	Winston-Salem	North Carolina

Sponsors (1)

Lead Sponsor	Collaborator
Rockwell Medical Technologies, Inc.

Countries where clinical trial is conducted

United States,  Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	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.	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).	up to 26 weeks
Secondary	Change From Baseline in Hemoglobin (Hgb)		two time points: baseline and final evaluation (last post baseline assessment, up to 26 weeks)
Secondary	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.	Kaplan-Meier Estimate of Time to First Hgb Decrease by >= 1.0 g/dL	Up to 26 weeks
Secondary	Reticulocyte Hemoglobin (CHr) Values Every Four Weeks, and at the End of the Subject's Treatment.	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).	Every 4 weeks
Secondary	Number of Subjects With Infection Episodes Requiring Antibiotic or Anti-fungal Therapy in Each Treatment Group.		At each dialysis session for up to 26 weeks
Secondary	Number of Subjects With a Rise in Hemoglobin (Hgb) to 12.6 g/dL or More on Two Separate Occasions Measured One Week Apart.		two separate sessions measured one week apart.