| Eligibility |
Inclusion Criteria:
1. Subjects who are willing to sign an informed consent form, fully understand the
objectives and significance of the trial, and are willing to comply with the trial
protocol before any of the study-related procedures start;
2. Aged = 18 and = 75 years old, male or female;
3. Patients with end-stage renal disease, who have received regular hemodialysis
(including hemodiafiltration) 3 times per week for at least 3 months prior to
screening (the judgment of regular hemodialysis is subject to the joint medical
comment of the investigator and the sponsor);
4. Dry weight at screening: 40.0-135.0 kg (inclusive);
5. On different days of hemodialysis within 6 months prior to administration, at least
two occurrences of single-pool urea clearance index (sp Kt/V) = 1.2 or at least two
occurrences of urea reduction ratios (URR) = 65%, or one occurrence of sp Kt/V = 1.2
and one occurrence of URR = 65%;
6. Having completed at least 4 assessments of the Worst Itch Numeric Rating Scale from
the lead-in period through D-1 and meeting the criteria of baseline itch intensity = 4
(defined as the average of all non-missing scores from the lead-in period to D-1;
scores 0-10 indicates the range from no itch to the worst imaginable itch);
7. Male subjects who agree to use condoms in sexual intercourse during the study and
within 3 months after the last dose; female subjects who have been menopausal for at
least one year, or who have been sterilized permanently (e.g., fallopian tube
occlusion, hysterectomy, bilateral salpingectomy); or women of childbearing potential
who agree to take effective contraceptive measures during the study and within 3
months after the last dose, such as oral contraceptives, condoms, and contraceptive
films.
Exclusion Criteria:
Exclusion criteria (those who meet any of the followings are ineligible):
1. Expecting to undergo renal transplantation and/or parathyroidectomy during the study;
2. Having a history of allergy to opioids, such as urticaria (Note: adverse effects
related to opioid use, such as constipation and nausea, are not included as the
exclusion criteria in this study);
3. Having used opioids within 7 days before screening, or being unable to avoid the use
of opioids other than the investigational drug during the study;
4. Having participated in any clinical trial of other drug or medical device within 1
month before screening (received study medication or treated by the medical device in
the clinical trial);
5. New or change of treatment received for hemoperfusion regimen within 3 months prior to
screening or anticipating to adjust hemoperfusion regimen during the study;
6. Upper extremity blood pressure in a supine position during screening: systolic blood
pressure < 90 mmHg, or diastolic blood pressure < 60 mmHg, or systolic blood pressure
> 180 mmHg, or diastolic blood pressure > 110 mmHg;
7. Alanine transaminase (ALT) or AST (aspartate transaminase) > 2.5 × upper limit of
normal (ULN), or total bilirubin > 2 × ULN at screening;
8. Blood sodium > 155 mmol/L at screening;
9. Hemoglobin < 80 g/L at screening;
10. Positive for hepatitis B surface antigen (HBsAg), hepatitis C antibody (HCVAb),
syphilis antibody, or human immunodeficiency virus (HIV) antibody at screening;
11. Pruritus that may or must not be caused by ESRD or its complications (e.g., patients
with pruritic dermatosis or cholestatic liver disease will be excluded);
12. New or change of treatment received including antihistamines (oral, intravenous, or
topical), systemic or topical corticosteroids (except for otic or ophthalmic
preparations) within 7 days prior to screening or anticipating inevitable treatment
regimen adjustment during the study;
13. New or change of treatment received including gabapentin, pregabalin, calcineurin
inhibitors that are within 5 half-lives prior to screening or anticipating inevitable
treatment regimen adjustment during the study;
14. New or change of medications that may affect the judgment of antipruritic efficacy,
including but not limited to antipsychotics, sedative-hypnotics, selective serotonin
reuptake inhibitors (SSRIs), anxiolytics, or tricyclic antidepressants within 14 days
prior to screening or anticipating inevitable treatment regimen adjustment during the
study;
15. Females who are pregnant or breastfeeding;
16. Any physiological or psychological diseases or conditions that may increase the risk
of the trial, affect the subject's compliance with the protocol, or affect the
subject's completion of the trial, as judged by the investigator, including but not
limited to:
1. Local pruritus limited to palms only;
2. Pruritus during hemodialysis only;
3. History of known or suspected abuse of or dependence on alcohol, narcotics or
other drugs within 12 months before screening;
4. Severe systolic or diastolic heart failure within 6 months prior to screening,
e.g., NYHA Class IV congestive heart failure (see Appendix 7 for NYHA functional
classification criteria);
5. Severe mental illness or cognitive impairment (e.g., dementia);
6. Any other relevant acute or chronic neurological or psychiatric condition within
3 months prior to screening that, at the discretion of the investigator, is not
suitable for enrollment (e.g., encephalopathy, coma, delirium);
7. Patients with malignancy, but excluding: curable cervical carcinoma in situ, skin
basal cell or squamous cell carcinoma, or any other tumors that have been cured
(no evidence of disease recurrence within 5 years).
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