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NCT00559273 · CITED IN SOURCE DOCUMENTS

A Study of Subcutaneous Mircera Once Monthly in the Treatment of Anemia in Participants With Chronic Kidney Disease Not on Dialysis

An NCI or FDA source cites this study. A citation does not establish that it applies to an individual diagnosis.

Phase
PHASE3
Status at capture
COMPLETED
Registry last update
2016-11-01

This study will compare the efficacy and safety of subcutaneous Mircera and subcutaneous darbepoetin in the treatment of renal anemia in participants with chronic kidney disease who are not on dialysis and not receiving erythropoiesis-stimulating agents (ESA). Participants will be randomized to receive either Mircera once every 4 weeks, at a starting dose of 1.2 micrograms/kilogram (mcg/kg), or darbepoetin alfa once weekly, at a starting dose of 0.45 mcg/kg (or once every two weeks, 0.75 mcg/kg). The anticipated time on study treatment is 3-12 months.

Open the original ClinicalTrials.gov record → · Download preserved record

What did the study report?

Outcomes, safety and baseline populations are separate source sections. Quality-of-life measures appear under their original outcome titles.

Who could take part
eligibility Criteria
Inclusion Criteria: * Participants with chronic kidney disease (CKD) stage 3 (creatinine clearance \[CrCl\]/ glomerular filtration rate \[GFR\] 30 to 59 milliliter per minutes per 1.73 meter square \[mL/min/1.73m\^2\]) or Stage 4 (CrCl/GFR 15-29 mL/min/1.73m\^2) who did not require dialysis. CrCl/GFR was estimated with the Cockcroft-Gault equation or the abbreviated Modification of Diet in Renal Disease (MDRD) equation * Anemia defined as baseline Hb concentration less than (\<) 10.5 gram per deciliter (g/dL) Exclusion Criteria: * Previous therapy with any ESA within 12 weeks prior to screening * Renal allograft in place * Immunosuppressive therapy in the 12 weeks prior to screening * Overt gastrointestinal bleeding and red blood cells (RBC) transfusions within 8 weeks before screening
healthy Volunteers
false
minimum Age
18 Years
sex
ALL
std Ages
  1. ADULT
  2. OLDER_ADULT
Treatment arms and interventions
arm Groups
  1. description
    Participants will receive Mircera (Methoxy polyethylene glycol-epoetin beta), administered subcutaneously (SC) at a starting dose of 1.2 mcg/kg once every 4 weeks for 28 weeks.
    intervention Names
    1. Drug: Methoxy polyethylene glycol-epoetin beta
    label
    Mircera
    type
    EXPERIMENTAL
  2. description
    Participants will receive darbepoetin alfa, administered SC once weekly or once every 2 weeks according to local labeling specifications for 28 weeks.
    intervention Names
    1. Drug: Darbepoetin alfa
    label
    Darbepoetin Alfa
    type
    ACTIVE_COMPARATOR
interventions
  1. arm Group Labels
    1. Mircera
    description
    1.2 mcg/kg SC monthly, starting dose
    name
    Methoxy polyethylene glycol-epoetin beta
    other Names
    1. Mircera
    2. RO0503821
    type
    DRUG
  2. arm Group Labels
    1. Darbepoetin Alfa
    description
    0.45 mcg/kg SC weekly or 0.75 mcg/kg every 2 weeks, starting dose
    name
    Darbepoetin alfa
    type
    DRUG
Study design
allocation
RANDOMIZED
intervention Model
PARALLEL
masking Info
masking
NONE
primary Purpose
TREATMENT
Enrollment
count
307
type
ACTUAL
Registered outcome plans (not posted results)
primary Outcomes
  1. description
    Hb response was an observed increase in Hb greater than or equal to (\>=) 1.0 gram per deciliter (g/dL) from baseline and an Hb concentration \>= 10.0 g/dL before the end of the study without red blood cells (RBC) transfusion before response.
    measure
    Percentage of Participants With Hemoglobin (Hb) Response
    time Frame
    Baseline up to Week 28
  2. description
    A time adjusted average baseline Hb concentration was calculated using the trapezoid rule from all available Hb measurements taken during the baseline period. The average evaluation period Hb concentration for each individual was calculated using the same method, from all their available measurements taken during the 2 month evaluation period (Week 21 to 28). The change in Hb concentration between the baseline and evaluation period was calculated by subtracting the baseline Hb from the evaluation period Hb. All blood samples for Hb measurements were taken prior to study drug administration.
    measure
    Change in Hemoglobin (Hb) Concentration Between Baseline and Evaluation Period
    time Frame
    Baseline (measurements at Week -2, Week -1 and Day 1) and Evaluation Period (Week 22, Week 24, Week 26, Week 28)
secondary Outcomes
  1. description
    The hemoglobin concentration was measured in g/dL every 2 weeks and at final visit.
    measure
    Hemoglobin (Hb) Concentration Over the Time
    time Frame
    Baseline, Weeks 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 26, 28, and final visit (Week 29)
  2. description
    Time to Hb response is defined as the number of study days until the first occurrence of an Hb response. Participants without events were censored at the time of evaluation. Median and 95 percent (%) confidence interval (CI) were estimated using Kaplan-Meier Survival Analysis. Hb response was an observed increase in Hb \>=1.0 g/dL from baseline and an Hb concentration \>= 10.0 g/dL before the end of the study without RBC transfusion before response.
    measure
    Time to Hemoglobin Response
    time Frame
    Baseline up to Week 28
  3. description
    The percentage of participants who received RBC transfusions during the titration and evaluation periods were reported.
    measure
    Percentage of Participants With Red Blood Cell (RBC) Transfusions
    time Frame
    Baseline up to Week 28
  4. description
    Percentage of participants having at least one Hb value greater than (\>) 12 g/dL during the first 8 weeks of the study was reported.
    measure
    Percentage of Participants Who Had at Least 1 Hemoglobin Value Exceeding 12.0 g/dL
    time Frame
    Baseline to Week 8
  5. description
    A participant was defined as having achieved a stable Hb response, if at least 75 percent (%) of the scheduled Hb values were between 10.0 g/dL and 12.0 g/dL and \>=1.0 g/dL from baseline for any 8-week time period, regardless of the requirement for dose adjustment for Hb maintenance. Achievement of stable response was determined using a moving 8-week time window, moving forward by 14 days in each iteration starting at Day 15, searching to see if the following conditions were met: 1) At least 3 scheduled Hb values (75% of the scheduled Hb values) in any 8-week time window were \>=1.0 g/dL from baseline (as calculated above) and within the range of 10.0 g/dL to 12.0 g/dL. 2). There were at least 3 recorded Hb values within the time window.
    measure
    Percentage of Participants With Stable Hemoglobin Response
    time Frame
    Baseline to Week 28
  6. description
    The total number of dose adjustments needed to achieve stabilized response was calculated from Day 1 until the first 8-week time window in which response was achieved. A participant was defined as having achieved a stable Hb response, if at least 75% of the scheduled Hb values were between 10.0 g/dL and 12.0 g/dL and \>=1.0 g/dL from baseline for any 8-week time period, regardless of the requirement for dose adjustment for Hb maintenance. Achievement of stable response was determined using a moving 8-week time window, moving forward by 14 days in each iteration starting at Day 15, searching to see if the following conditions were met: 1) At least 3 scheduled Hb values (75% of the scheduled Hb values) in any 8-week time window were \>=1.0 g/dL from baseline (as calculated above) and within the range of 10.0 g/dL to 12.0 g/dL. 2) There were at least 3 recorded Hb values within the time window.
    measure
    Percentage of Participants Who Required Dose Adjustments to Achieve a Stabilized Response
    time Frame
    Baseline to Week 28
Full study description
brief Summary
This study will compare the efficacy and safety of subcutaneous Mircera and subcutaneous darbepoetin in the treatment of renal anemia in participants with chronic kidney disease who are not on dialysis and not receiving erythropoiesis-stimulating agents (ESA). Participants will be randomized to receive either Mircera once every 4 weeks, at a starting dose of 1.2 micrograms/kilogram (mcg/kg), or darbepoetin alfa once weekly, at a starting dose of 0.45 mcg/kg (or once every two weeks, 0.75 mcg/kg). The anticipated time on study treatment is 3-12 months.
Source references
references
  1. citation
    Chung EY, Palmer SC, Saglimbene VM, Craig JC, Tonelli M, Strippoli GF. Erythropoiesis-stimulating agents for anaemia in adults with chronic kidney disease: a network meta-analysis. Cochrane Database Syst Rev. 2023 Feb 13;2(2):CD010590. doi: 10.1002/14651858.CD010590.pub3.
    pmid
    36791280
    type
    DERIVED
Source notices and limitations
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      occurrences
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        .5 Darbepoetin alfa (n=162) 96 (92, 99) 2.0 6.8 Study 2 Mircera (n=135) 93 (88, 97) 2.7 5.2 Epoetin alfa/beta (n=46) 91 (79, 98) 2.6 4.3 In the CORDATUS trial (NCT00559273), a randomized controlled study in patients with CKD not on dialysis and not currently treated with an ESA, Mircera, administered once monthly, was compared to
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    Preserved source evidence · Not medical advice