Phase 4
N=2,825
A Study to Assess All-Cause Mortality and Cardiovascular Morbidity in Participants With Chronic Kidney Disease (CKD) on Dialysis and Those Not on Renal Replacement Therapy Receiving Methoxy Polyethylene Glycol-Epoetin Beta (Mircera) or Reference Erythropoietin Stimulating Agents (ESAs)
Chronic Renal Anemia
Bottom Line
View on ClinicalTrials.gov: NCT00773513 ↗Enrolled (actual)
2,825
Serious AEs
78.8%
Results posted
Aug 2018
Primary outcome: Primary: Time to Composite of All-Cause Mortality and Non-Fatal Cardiovascular Events (Myocardial Infarction, Stroke) Defined as Time Between First Dose of Study Medication and Date of Death or Non-Fatal Cardiovascular Events, Whichever Occurred First — 5.1; 5.1 years — p=0.0039
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 4
- Interventions
- Darbepoetin Alfa (Drug); Epoetin Alfa (Drug); Epoetin Beta (Drug); methoxy polyethylene glycol-epoetin beta (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Hoffmann-La Roche
- Primary completion
- Jul 2017
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Time to Composite of All-Cause Mortality and Non-Fatal Cardiovascular Events (Myocardial Infarction, Stroke) Defined as Time Between First Dose of Study Medication and Date of Death or Non-Fatal Cardiovascular Events, Whichever Occurred First |
5.1; 5.1 | 0.0039 sig |
| SECONDARY Time to All-Cause Mortality |
6.1; 5.9 | 0.0166 sig |
| SECONDARY Time to Non-Fatal and Fatal Myocardial Infarction |
NA; NA | 0.0219 sig |
| SECONDARY Time to Non-Fatal and Fatal Stroke |
NA; NA | 0.0459 sig |
| SECONDARY Time to Non-Fatal Cardiovascular Events (Myocardial Infarction or Stroke, Whichever Occurred First) |
NA; NA | 0.0048 sig |
| SECONDARY Percentage of Participants With Anti-Erythropoietin Antibody-Mediated Pure Red Cell Aplasia (PRCA) |
0; 0 | — |
| SECONDARY Percentage of Participants With Gastrointestinal Bleeding |
11.1; 11.7 | — |
| SECONDARY Percentage of Participants With Thromboembolic Events |
34.5; 32.8 | — |
Summary
This 2 arm safety study will compare the outcome with respect to a composite endpoint of all-cause mortality and non-fatal cardiovascular events (myocardial infarction, stroke) in CKD participants either on dialysis or not receiving renal replacement therapy under treatment with methoxy polyethylene glycol-epoetin beta or reference ESAs. Participants will be randomized to receive intravenous (iv) or subcutaneous (sc) methoxy polyethylene glycol-epoetin beta at the following doses: for participants not already receiving ESA treatment, methoxy polyethylene glycol-epoetin beta will be administered at a starting dose of 0.6 micrograms per kilograms every 2 weeks (mcg/kg/2wks) iv or sc; for participants receiving maintenance ESA treatment, iv or sc methoxy polyethylene glycol-epoetin beta will be administered at an initial monthly dose of 120, 200 or 360 micrograms (mcg) depending on the weekly dose of ESA received prior to first methoxy polyethylene glycol-epoetin beta administration. Participants randomized to reference ESA treatment will receive iv or sc ESAs in accordance with their prescribed dosing information.
Eligibility Criteria
Inclusion Criteria
- Male or female participants with symptomatic anemia associated with CKD
- Participants with renal anemia who are not treated with an ESA:
- Anemia was defined as hemoglobin (Hb) concentration less than (<) 11.0 grams per deciliter (g/dL) (mean of 2 screening values with at least one day and a maximum of 2 weeks between measurements) with clinical indication for ESA treatment
- Participants with renal anemia who are on maintenance ESA therapy:
- If on dialysis: regular long-term hemodialysis or peritoneal dialysis therapy with the same mode of dialysis for at least 3 months before screening
- Hb concentration between 10 and 12 g/dL (mean of 2 screening values with at least one day and a maximum of 2 weeks between measurements)
- Participants with adequate iron status defined as: serum ferritin above or equal to 100 micrograms per liter or transferrin saturation above or equal to 20 percent
Exclusion Criteria
- Contraindications to ESA treatment: uncontrolled hypertension, hypersensitivity to the active substance or any of the excipients, any other contraindication to ESA therapy
- Conditions known to cause inadequate response to ESA treatment or anemia other than symptomatic anemia associated with CKD:
- History of hemoglobinopathy
- Anemia due to hemolysis
- Pure red cell aplasia
- High likelihood of early withdrawal (for example, within 1 year) or interruption of the study
- Pregnancy or breast-feeding
- Women of childbearing potential without effective contraception
- Administration of another investigational drug within 1 month before screening or planned during the study period
Data sourced from ClinicalTrials.gov (NCT00773513). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.