Phase 3
Completed N=355
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.
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)
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Daprodustat Compared with Epoetin Beta Pegol for Anemia in Japanese Patients Not on Dialysis: A 52-Week Randomized Open-Label Phase 3 Trial.
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Hypoxia-inducible factor stabilisers for the anaemia of chronic kidney disease.
Outcome Measures
| Outcome | Result | p-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
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.