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Phase 3 Completed N=355 Randomized Treatment

Phase III Study of GSK1278863 in Japanese Non-dialysis (ND) and Peritoneal Dialysis (PD) Subjects With Renal Anemia

Source: ClinicalTrials.gov NCT02791763 ↗
Enrolled (actual)
355
Serious AEs
29.0%
Results posted
Nov 2019
Primary outcomePrimary: Mean Hemoglobin (Hgb) During the Primary Efficacy Evaluation Period (Weeks 40 to 52) in ND Participants — 11.97; 11.86 Grams per deciliter (g/dL) — p=<.0001
◆ Published Evidence
Established
61citations · ~12 / year
Daprodustat Compared with Epoetin Beta Pegol for Anemia in Japanese Patients Not on Dialysis: A 52-Week Randomized Open-Label Phase 3 Trial.
American journal of nephrology · 2021 · Open access · Likely link

Summary

This is a Phase III, open-label, active-controlled, parallel-group, multi-center study to compare the efficacy and safety of GSK1278863 administered for 52 weeks versus epoetin beta pegol in approximately 286 Japanese ND and 50 PD subjects with renal anemia. The study will consist of three cohorts. Cohort 1 and Cohort 3 will consist of ND subjects (Erythropoiesis-Stimulating Agent [ESA] users and ESA non-users) randomized to receive GSK1278863 or epoetin beta pegol in a ratio of 1:1. PD subjects will be enrolled into Cohort 2 and will receive GSK1278863. This study consists of a 4-week screening phase, a 52-week treatment phase (including primary efficacy evaluation period [Weeks 40 to 52]), and a 4-week follow-up phase following the treatment phase. The primary objective of this study is to demonstrate non-inferiority of GSK1278863 to epoetin beta pegol based on mean hemoglobin (Hgb) during the primary efficacy evaluation period in ND subjects. ESA non-users from Cohort 1 will be excluded from the primary efficacy analysis. Study results will be used as pivotal study data for an NDA submitted for GSK1278863 for the treatment of renal anemia in Japan.

Linked Publications (2)

  • Daprodustat Compared with Epoetin Beta Pegol for Anemia in Japanese Patients Not on Dialysis: A 52-Week Randomized Open-Label Phase 3 Trial.
    American journal of nephrology · 2021 · 61 citations · Open access · Likely link
  • Hypoxia-inducible factor stabilisers for the anaemia of chronic kidney disease.
    The Cochrane database of systematic reviews · 2022 · 49 citations · Open access · Likely link

Outcome Measures

OutcomeResultp-value
PRIMARY
Mean Hemoglobin (Hgb) During the Primary Efficacy Evaluation Period (Weeks 40 to 52) in ND Participants
11.97; 11.86 <.0001 sig
SECONDARY
Number of ND Participants With Mean Hgb in the Target Range (11.0-13.0 g/dL) During the Primary Efficacy Evaluation Period (Weeks 40 to 52)
81; 80; 7; 7 0.4941
SECONDARY
Percentage of ND Participants With Mean Hgb in the Target Range (11.0-13.0 g/dL) During the Primary Efficacy Evaluation Period (Weeks 40 to 52)
92; 92; 8; 8 0.4941
SECONDARY
Change From Baseline in Hgb at Week 4 in ND Participants
0.47; 0.26
SECONDARY
Change From Baseline in Hgb at Week 4 in PD Participants
-0.09
SECONDARY
Number of ND Participants by Hgb Change From Baseline Category at Week 4
1; 2; 4; 3; 28; 33
SECONDARY
Percentage of ND Participants by Hgb Change From Baseline Category at Week 4
1; 2; 4; 3; 26; 30
SECONDARY
Number of PD Participants by Hgb Change From Baseline Category at Week 4
0; 10; 20; 20; 4; 1
SECONDARY
Percentage of PD Participants by Hgb Change From Baseline Category at Week 4
0; 18; 36; 36; 7; 2
SECONDARY
Daprodustat Dose Level by Visit in ND Participants
4.0; 4.0; 4.0; 4.0; 4.0; 4.0
SECONDARY
Epoetin Beta Pegol Dose Level by Visit in ND Participants
50.0; 75.0; 100.0; 100.0; 75.0; 75.0
SECONDARY
Daprodustat Dose Level by Visit in PD Participants
4.0; 6.0; 6.0; 6.0; 6.0; 6.0
SECONDARY
Duration of Treatment Interruption Due to Hgb >13 g/dL in ND Participants
28.0; 28.0
SECONDARY
Duration of Treatment Interruption Due to Hgb >13 g/dL in PD Participants
28.0
SECONDARY
Number of Dose Adjustments in ND Participants
5.0; 6.0
SECONDARY
Number of Dose Adjustments in PD Participants
5.0
SECONDARY
Hgb Values at Each Assessment Visit in ND Participants
10.48; 10.68; 10.95; 10.94; 11.19; 11.34
SECONDARY
Hgb Values at Each Assessment Visit in PD Participants
10.85; 10.77; 10.83; 11.36; 11.42; 11.54
SECONDARY
Change From Baseline in Hgb Values at Each Assessment Visit in ND Participants
0.47; 0.26; 0.71; 0.66; 1.04; 1.18
SECONDARY
Change From Baseline in Hgb Values at Each Assessment Visit in PD Participants
-0.09; -0.06; 0.44; 0.52; 0.63; 0.74
SECONDARY
Number of ND Participants Who Had Hgb Level Within the Target Range (11.0-13.0 g/dL) at Each Assessment Visit
29; 36; 43; 48; 64; 73
SECONDARY
Percentage of ND Participants Who Had Hgb Level Within the Target Range (11.0-13.0 g/dL) at Each Assessment Visit
27; 33; 40; 44; 60; 67
SECONDARY
Number of PD Participants Who Had Hgb Level Within the Target Range (11.0-13.0 g/dL) at Each Assessment Visit
28; 25; 26; 32; 32; 38
SECONDARY
Percentage of PD Participants Who Had Hgb Level Within the Target Range (11.0-13.0 g/dL) at Each Assessment Visit
51; 45; 48; 62; 63; 76
SECONDARY
Percentage of Time With Hgb Within the Target Range (11.0 to 13.0 g/dL) During the Primary Efficacy Evaluation Period (Weeks 40 to 52) in ND Participants
85.44; 80.57
SECONDARY
Percentage of Time With Hgb Within the Target Range (11.0 to 13.0 g/dL) During the Primary Efficacy Evaluation Period (Weeks 40 to 52) in PD Participants
85.73
SECONDARY
Time to Reach the Lower Target Hgb Level (11.0 g/dL) in ND Participants
58.0; 57.0
SECONDARY
Time to Reach the Lower Target Hgb Level (11.0 g/dL) in PD Participants
84.0
SECONDARY
Number of ND Participants Who Had an Hgb Level of Less Than 7.5 g/dL
1; 0
SECONDARY
Percentage of ND Participants Who Had an Hgb Level of Less Than 7.5 g/dL
1; 0
SECONDARY
Number of PD Participants Who Had an Hgb Level of Less Than 7.5 g/dL
SECONDARY
Percentage of PD Participants Who Had an Hgb Level of Less Than 7.5 g/dL
SECONDARY
Number of ND Participants Who Had an Hgb Increase of More Than 2 g/dL Over Any 4 Weeks
17; 11
SECONDARY
Percentage of ND Participants Who Had an Hgb Increase of More Than 2 g/dL Over Any 4 Weeks
16; 10
SECONDARY
Number of PD Participants Who Had an Hgb Increase of More Than 2 g/dL Over Any 4 Weeks
11
SECONDARY
Percentage of PD Participants Who Had an Hgb Increase of More Than 2 g/dL Over Any 4 Weeks
20
SECONDARY
Number of ND Participants Who Had an Hgb Level of More Than 13.0 g/dL
49; 52
SECONDARY
Percentage of ND Participants Who Had an Hgb Level of More Than 13.0 g/dL
45; 48
SECONDARY
Number of PD Participants Who Had an Hgb Level of More Than 13.0 g/dL
28
SECONDARY
Percentage of PD Participants Who Had an Hgb Level of More Than 13.0 g/dL
51
SECONDARY
Number of Episodes With Hgb Level of More Than 13.0 g/dL in ND Participants
76; 88
SECONDARY
Number of Episodes With Hgb Level of More Than 13.0 g/dL in PD Participants
43
SECONDARY
Monthly Average Dose of Oral Iron During the Treatment Period in ND Participants
837.37; 747.04
SECONDARY
Monthly Average Dose of Oral Iron During the Treatment Period in PD Participants
2468.68
SECONDARY
Monthly Average Dose of Oral Iron During the Primary Efficacy Evaluation Period in ND Participants
967.41; 777.69
SECONDARY
Monthly Average Dose of Oral Iron During the Primary Efficacy Evaluation Period in PD Participants
3038.67
SECONDARY
Number of ND Participants Who Used Oral Iron During the Treatment Period
56; 49
SECONDARY
Number of PD Participants Who Used Oral Iron During the Treatment Period
33
SECONDARY
Percentage of ND Participants Who Used Oral Iron During the Treatment Period
52; 45
SECONDARY
Percentage of PD Participants Who Used Oral Iron During the Treatment Period
60
SECONDARY
Number of ND Participants Who Used Oral Iron During the Primary Efficacy Evaluation Period
34; 28
SECONDARY
Number of PD Participants Who Used Oral Iron During the Primary Efficacy Evaluation Period
22
SECONDARY
Percentage of ND Participants Who Used Oral Iron During the Primary Efficacy Evaluation Period
39; 32
SECONDARY
Percentage of PD Participants Who Used Oral Iron During the Primary Efficacy Evaluation Period
50
SECONDARY
Change From Baseline in Ferritin in ND Participants
-41.4; -29.0; -83.4; -29.3; -80.1; -16.6
SECONDARY
Change From Baseline in Ferritin in PD Participants
-36.4; -81.8; -89.1; -74.6; -63.6
SECONDARY
Percent Change From Baseline in Transferrin Saturation (TSAT) in ND Participants
-12.4; -5.4; -16.3; -0.3; -17.5; 10.6
SECONDARY
Percent Change From Baseline in TSAT in PD Participants
-19.2; -29.1; -22.6; -19.5; -14.7
SECONDARY
Percent Change From Baseline in Hepcidin in ND Participants
-49.13; -19.20; -55.67; -3.73; -56.67; 7.61
SECONDARY
Percent Change From Baseline in Hepcidin in PD Participants
-49.79; -62.59; -65.37; -67.91; -54.77
SECONDARY
Change From Baseline in Serum Iron in ND Participants
0.5; -0.8; 0.3; 0.6; 0.3; 2.0
SECONDARY
Change From Baseline in Serum Iron in PD Participants
-1.2; -2.4; -1.0; -0.4; 1.0
SECONDARY
Change From Baseline in Total Iron Binding Capacity (TIBC) in ND Participants
6.9; 0.5; 9.9; 1.9; 9.9; 1.4
SECONDARY
Change From Baseline in TIBC in PD Participants
6.9; 9.5; 11.0; 11.0; 9.6
SECONDARY
Area Under the Concentration-time Curve From Time Zero Extrapolated to 4 Hours (AUC[0-4]) of Daprodustat for All Dose Levels in ND and PD Participants
35.3199; 63.0175; 101.9293; 152.4966; 167.6515; 190.0962
SECONDARY
Maximum Observed Concentration (Cmax) of Daprodustat for All Dose Levels in ND and PD Participants
17.6522; 35.0709; 58.6098; 81.1851; 91.0731; 94.1242

Eligibility Criteria

Inclusion Criteria

  • Age (at the time of informed consent): >=20 years of age
  • Screening verification only: Stage of chronic kidney disease (CKD) (ND subjects only): CKD stages 3, 4, and 5 defined by estimated glomerular filtration rate (eGFR) using the Japanese Society of Nephrology-Chronic Kidney Disease Initiatives (JSN-CKDI) formula
  • Dialysis:
  • Not on dialysis for at least 12 weeks prior to screening (ND subjects)
  • On peritoneal dialysis (PD subjects)
  • Use of ESA:
  • ESA non-users: Have not used ESAs for 8 weeks prior to screening
  • ESA users: Have used the same ESA for 8 weeks prior to screening. However, in the ND subjects, the dose of darbepoetin alfa or epoetin beta pegol must be stable (administered once every 4 weeks and up to one-step dose change during 8 weeks prior to screening).
  • Hgb: Determined at the site using an Hgb analyzer
  • ESA non-users: >=8.0 g/dL and =9.0 g/dL and 100 nanograms per milliliters (ng/mL) or transferrin saturation (TSAT) >20% (screening verification only)
  • Gender (screening verification only): Female or male. Females: Not pregnant [demonstrated to be negative for human chorionic gonadotropin (hCG) in urine or serum], not breast-feeding, and meet at least one of the following:
  • Females of non-childbearing potential are defined as follows:
  • Pre-menopausal with at least one of the following and no plans to utilize assisted reproductive techniques (e.g., in vitro fertilization or donor embryo transfer):
  • History of bilateral tubal ligation or salpingectomy
  • History of hysteroscopic tubal occlusion and postoperatively documented bilateral tubal obstruction
  • History of hysterectomy
  • History of bilateral oophorectomy
  • Postmenopausal defined as: females 60 years of age or older or ; In females 500 milliseconds (msec) or QTc >530 msec in subjects with bundle branch block Note: QT interval corrected using the Bazett's formula (QTcB) will be used, and Electrocardiogram (ECG) can be mechanically or manually read.

Other disease-related criteria

  • Liver disease (if any of the following occurs):
  • (Screening verification only) Alanine transaminase (ALT) >2 times upper limit of normal (ULN)
  • (Screening verification only) Bilirubin >1.5 times ULN (isolated bilirubin >1.5 times ULN is acceptable if bilirubin is fractionated and direct bilirubin is 3 centimeters (cm) (II F, III or IV based on the Bosniak classification) Note (ND subjects and PD subjects): The only exception is squamous cell or basal cell carcinoma of the skin that has been definitively treated >=8 weeks before screening.
  • In the opinion of the investigator, Hgb increase to the target range (11.0-13.0 g/dL) is medically risky.

Concomitant medication and other study treatment-related criteria

  • Iron: Planned use of intravenous iron during the screening phase or during a period from Day 1 to Week 4 Note: Oral iron is acceptable. However, the same dose regimen must be used throughout the screening phase and from Day 1 to Week 4. Antihyperphosphatemic agents containing iron (e.g., ferric citrate hydrate) are also acceptable only if used for at least 12 weeks prior to screening. However, they must be continued throughout the screening phase from Day 1 to Week 4.
  • Severe allergic reactions: History of severe allergic or anaphylactic reactions or hypersensitivity to excipients in the investigational product or epoetin beta pegol
  • Drugs and supplements: Use or planned use of any prescription or non-prescription drugs or dietary supplements that are prohibited during the study period (prohibited medications: strong inducers and inhibitor of Cytochrome P450 2C8 [CYP2C8])
  • Prior investigational product exposure: Use of an investigational agent within 30 days or five half lives of the investigational agent (whichever is longer)
  • Prior treatment with GSK1278863: Any prior treatment with GSK1278863 for a treatment duration of >30 days

General health-related criteria

  • Other conditions: Any other condition, clinical or labor
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02791763) and the linked publication. 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. Informational only — not medical advice.

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