Dose Ranging Study of Dialysate Containing Soluble Iron to Treat Subjects With End Stage Renal Disease (ESRD) Receiving Chronic Hemodialysis

Sponsor
Rockwell Medical Technologies, Inc. (Industry)
Overall Status
Completed
CT.gov ID
NCT00548249
Collaborator
(none)
131
28
5
29
4.7
0.2

Study Details

Study Description

Brief Summary

The purpose of this study is to determine whether Dialysate containing soluble iron (Soluble Ferric Pyrophosphate) is safe and effective in maintaining physiological iron levels during chronic hemodialysis.

Condition or Disease Intervention/Treatment Phase
  • Device: Standard Bicarbonate Solution
  • Drug: Soluble Ferric Pyrophosphate
  • Drug: Soluble Ferric Pyrophosphate
  • Drug: Soluble Ferric Pyrophosphate
  • Drug: Soluble Ferric Pyrophosphate
Phase 2

Detailed Description

The study was designed to evaluate the efficacy of SFP-containing dialysate solution in maintaining physiological iron levels during chronic hemodialysis, as measured by the primary endpoint of the percent of patients whose Hemoglobin (Hgb) decreased by at least 1.0 gram/ deciliter (g/dL) from baseline. The efficacy and safety findings are to be used to determine the optimal concentration of SFP needed to safely maintain iron levels, compensating for iron losses during chronic hemodialysis.

Study Design

Study Type:
Interventional
Actual Enrollment :
131 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Double (Participant, Investigator)
Primary Purpose:
Treatment
Official Title:
A Dose Ranging Study of Dialysate Containing Soluble Ferric Pyrophosphate (SFP) Versus Control in Subjects With ESRD Receiving Chronic Hemodialysis.
Study Start Date :
Aug 1, 2007
Actual Primary Completion Date :
Oct 1, 2009
Actual Study Completion Date :
Jan 1, 2010

Arms and Interventions

Arm Intervention/Treatment
Placebo Comparator: 0 µg iron/dL of dialysate

Placebo 0 micrograms (µg) of iron/ deciliter (dL) of dialysate

Device: Standard Bicarbonate Solution
Patients received 0 micrograms (µg) of iron/ decilited (dL) of dialysate during dialysis 3 times/week for up to 26 weeks.
Other Names:
  • Placebo
  • Experimental: 5 µg iron/dL of dialysate

    5 micrograms (µg) of iron/ deciliter (dL) of dialysate

    Drug: Soluble Ferric Pyrophosphate
    Patients received 5 micrograms (µg) of iron/ decilited (dL) of dialysate during dialysis 3 times/week for up to 26 weeks.
    Other Names:
  • SFP
  • Experimental: 10 µg iron/dL of dialysate

    10 micrograms (µg) of iron/ deciliter (dL) of dialysate

    Drug: Soluble Ferric Pyrophosphate
    Patients received 10 micrograms (µg) of iron/ decilited (dL) of dialysate during dialysis 3 times/week for up to 26 weeks.
    Other Names:
  • SFP
  • Experimental: 12 µg iron/dL of dialysate

    12 micrograms (µg) of iron/ deciliter (dL) of dialysate

    Drug: Soluble Ferric Pyrophosphate
    Patients received 12 micrograms (µg) of iron/ decilited (dL) of dialysate during dialysis 3 times/week for up to 26 weeks.
    Other Names:
  • SFP
  • Experimental: 15 µg iron/dL of dialysate

    15 micrograms (µg) of iron/ deciliter (dL) of dialysate

    Drug: Soluble Ferric Pyrophosphate
    Patients received 15 micrograms (µg) of iron/ decilited (dL) of dialysate during dialysis 3 times/week for up to 26 weeks.
    Other Names:
  • SFP
  • Outcome Measures

    Primary Outcome Measures

    1. Percent of Subjects Whose Hemoglobin (Hgb) Decreases by a Total of 1.0 Grams/ Deciliter (g/dL) (or More) From Baseline on Each of Two Successive Measurements. [up to 26 weeks]

      Efficacy of a Soluble Ferric Pyrophosphate (SFP)-containing dialysate solution in maintaining physiological iron levels during chronic HD, as measured by the percent of subjects whose hgb decreases by a total of 1.0 g/dL (or more) from baseline on each of two successive measurements. Hemoglobin was obtained weekly at the mid-week dialysis treatments and compared to baseline value (average of two hgb measurements obtained at the two consecutive baseline visits prior to randomization).

    Secondary Outcome Measures

    1. Change From Baseline in Hemoglobin (Hgb) [two time points: baseline and final evaluation (last post baseline assessment, up to 26 weeks)]

    2. Time in Days for Hgb to Decrease by a Total of > = 1.0 g/dL From Baseline on Each of Two Successive Measurements in Each Treatment Group. [Up to 26 weeks]

      Kaplan-Meier Estimate of Time to First Hgb Decrease by >= 1.0 g/dL

    3. Reticulocyte Hemoglobin (CHr) Values Every Four Weeks, and at the End of the Subject's Treatment. [Every 4 weeks]

      Efficacy of SFP administration in dialysate solution as measured by Chr values every four weeks, and at the end of the Subject's Treatment (up to 26 weeks).

    4. Number of Subjects With Infection Episodes Requiring Antibiotic or Anti-fungal Therapy in Each Treatment Group. [At each dialysis session for up to 26 weeks]

    5. Number of Subjects With a Rise in Hemoglobin (Hgb) to 12.6 g/dL or More on Two Separate Occasions Measured One Week Apart. [two separate sessions measured one week apart.]

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Selected Inclusion Criteria:
    1. Adult subject ≥ 18 years of age undergoing chronic hemodialysis for end-stage renal disease (ESRD) three times a week

    2. Hemoglobin (Hgb) values on two successive screening/baseline measures immediately prior to the start of the study averaging 10.1 to 11.5 grams/ deciliter (g/dL), inclusive

    3. Transferrin Saturation (TSAT) values that average 20% or more, but not exceeding 35%, prior to dialysis measured during the screening period

    4. Ferritin values that average 200 to 800 micrograms/ liter (µg/L), inclusive, measured during the screening period. An average ferritin above 800 µg/L but no greater than 1200 µg/L is allowed if the average TSAT is 20% to no greater than 25%.

    5. Except for vascular access surgery, subject has no hospitalization in previous three months for a significant illness that, in the opinion of the Investigator, confers a significant risk of hospitalization during the course of the study. No blood transfusions within the last 4 weeks are allowed.

    6. Subject has an adequate dialyzer blood flow rate that is acceptable to the Principal Investigator

    Exclusion Criteria:
    1. Hemoglobin (Hgb) values on two successive baseline/screening measurements that average ≥ 11.6g/dL

    2. Subject with a current malignancy involving a site other than skin

    3. Subject with a history of drug or alcohol abuse within the last six months

    4. Subject believed to be unable to complete the entire study (e.g., due to a concurrent disease, life expectancy of less than a year)

    5. Subject who the Principal Investigator considers will be placed at increased risk by the study procedures

    6. Subject requiring hemodialysis more than 3 times per week on a regular basis.

    7. Subject who is unable to discontinue oral iron or intravenous iron supplements for the duration of the study

    8. Subject who is pregnant

    9. Subject considered incompetent to give an informed consent

    10. Subject with a positive test for Hepatitis B Surface Antigen within the past 30 days or during screening

    11. Subject with known HIV infection (if this is not known, no HIV testing will be performed)

    12. Subject with cirrhosis of the liver based on histological criteria or clinical criteria (presence of ascites, esophageal varices, spider nevi, or history of hepatic encephalopathy). Subject with hepatitis C, in the absence of cirrhosis, is not excluded from participation in the study if ALT and AST levels are below 2 times the upper limit of normal consistently during the 2 months preceding enrollment

    13. Subject with active tuberculosis, fungal, viral, or parasitic infection

    14. Subject with active bacterial infection requiring antibiotic therapy

    15. Subject with pre-dialysis Corrected Q-wave to T-wave (QTc) interval ≥ 470 milliseconds (ms)

    16. Subject with a history of hypokalemia, decompensated heart failure, or family history of Long QT Syndrome that in the Investigator's judgment poses a risk for Torsades de Pointe during the study

    17. Subject using concomitant medications known to prolong QT/QTc interval (See Appendix I, TABLE A)

    18. Subject receiving more than 60,000 units or 120 micrograms of erythropoietin (Epogen®, Procrit®, or Aranesp®) per week

    19. Subject has participated in another clinical trial within 30 days of signing Informed Consent

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Investigator Tempe Arizona United States 85284
    2 Investigator Hacienda Heights California United States 91745
    3 Investigator Los Angeles California United States 90059
    4 Investigator Whittier California United States 90603
    5 Investigative Site Augusta Georgia United States 30901
    6 Investigator Meridian Idaho United States 83642
    7 Investigator Chicago Illinois United States 60617
    8 Investigative Site Louisville Kentucky United States 40202-1718
    9 Investigator New Orleans Louisiana United States 70115
    10 Investigator Springfield Massachusetts United States 01107
    11 Investigative Site Detroit Michigan United States 48202
    12 Investigator Hackensack New Jersey United States 07601
    13 Investigator Brooklyn New York United States 11212
    14 Investigator Great Neck New York United States 11021
    15 Investigator Mineola New York United States 11501
    16 Investigator New York New York United States 10013
    17 Investigator Ridgewood New York United States 11385
    18 Investigator Winston-Salem North Carolina United States 27103
    19 Investigative Site Canton Ohio United States 44718
    20 Investigator Cincinnati Ohio United States 45229
    21 Investigative Site Hershey Pennsylvania United States 17033
    22 Investigator Arlington Texas United States 76011
    23 Investigator Fort Worth Texas United States 76105
    24 Investigator McAllen Texas United States 78503
    25 Investigator San Antonio Texas United States 78207
    26 Investigator Arlington Virginia United States 22206
    27 Investigator Seattle Washington United States 92133
    28 Investigative Site Edmonton Alberta Canada T6G2B7

    Sponsors and Collaborators

    • Rockwell Medical Technologies, Inc.

    Investigators

    • Study Director: Richard Yocum, MD, Rockwell Medical Technologies

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Rockwell Medical Technologies, Inc.
    ClinicalTrials.gov Identifier:
    NCT00548249
    Other Study ID Numbers:
    • RMTI-SFP-2
    First Posted:
    Oct 23, 2007
    Last Update Posted:
    Dec 2, 2020
    Last Verified:
    Nov 1, 2020
    Keywords provided by Rockwell Medical Technologies, Inc.
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details 131 patients randomized and dosed between 27 Aug 2007 and 28 Apr 2009, across 29 study sites in U.S. and Canada.
    Pre-assignment Detail No run-in or transition.
    Arm/Group Title 0 µg Iron/dL of Dialysate 5 µg Iron/dL of Dialysate 10 µg Iron/dL of Dialysate 12 µg Iron/dL of Dialysate 15 µg Iron/dL of Dialysate
    Arm/Group Description Placebo; 0 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 5 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 10 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 12 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 15 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week
    Period Title: Overall Study
    STARTED 26 26 29 22 28
    COMPLETED 10 13 9 9 7
    NOT COMPLETED 16 13 20 13 21

    Baseline Characteristics

    Arm/Group Title 0 µg Iron/dL of Dialysate 5 µg Iron/dL of Dialysate 10 µg Iron/dL of Dialysate 12 µg Iron/dL of Dialysate 15 µg Iron/dL of Dialysate Total
    Arm/Group Description Placebo; 0 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 5 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 10 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 12 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 15 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week Total of all reporting groups
    Overall Participants 26 26 29 22 28 131
    Age (Count of Participants)
    <=18 years
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Between 18 and 65 years
    20
    76.9%
    19
    73.1%
    19
    65.5%
    15
    68.2%
    14
    50%
    87
    66.4%
    >=65 years
    6
    23.1%
    7
    26.9%
    10
    34.5%
    7
    31.8%
    14
    50%
    44
    33.6%
    Age (years) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [years]
    57.7
    (10.68)
    57.3
    (15.48)
    57.3
    (13.97)
    57.9
    (12.79)
    59.8
    (16.96)
    58
    (14.07)
    Sex: Female, Male (Count of Participants)
    Female
    8
    30.8%
    11
    42.3%
    13
    44.8%
    7
    31.8%
    11
    39.3%
    50
    38.2%
    Male
    18
    69.2%
    15
    57.7%
    16
    55.2%
    15
    68.2%
    17
    60.7%
    81
    61.8%
    Region of Enrollment (participants) [Number]
    United States
    22
    84.6%
    24
    92.3%
    25
    86.2%
    21
    95.5%
    25
    89.3%
    117
    89.3%
    Canada
    4
    15.4%
    2
    7.7%
    4
    13.8%
    1
    4.5%
    3
    10.7%
    14
    10.7%

    Outcome Measures

    1. Primary Outcome
    Title Percent of Subjects Whose Hemoglobin (Hgb) Decreases by a Total of 1.0 Grams/ Deciliter (g/dL) (or More) From Baseline on Each of Two Successive Measurements.
    Description Efficacy of a Soluble Ferric Pyrophosphate (SFP)-containing dialysate solution in maintaining physiological iron levels during chronic HD, as measured by the percent of subjects whose hgb decreases by a total of 1.0 g/dL (or more) from baseline on each of two successive measurements. Hemoglobin was obtained weekly at the mid-week dialysis treatments and compared to baseline value (average of two hgb measurements obtained at the two consecutive baseline visits prior to randomization).
    Time Frame up to 26 weeks

    Outcome Measure Data

    Analysis Population Description
    Modified intent-to-treat population, consisting of all subjects who received any amount of randomized study medication
    Arm/Group Title 0 µg Iron/dL of Dialysate 5 µg Iron/dL of Dialysate 10 µg Iron/dL of Dialysate 12 µg Iron/dL of Dialysate 15 µg Iron/dL of Dialysate
    Arm/Group Description Placebo; 0 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 5 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 10 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 12 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 15 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week
    Measure Participants 26 26 29 22 28
    Number [Percent of subjects]
    5
    6
    5
    4
    10
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection 0 µg Iron/dL of Dialysate, 5 µg Iron/dL of Dialysate
    Comments Hazard ratio with 95% confidence intervals comparing each SFP treatment group to placebo, and p-value from cox proportional hazards model
    Type of Statistical Test Superiority or Other (legacy)
    Comments
    Statistical Test of Hypothesis p-Value 0.999
    Comments p-value not adjusted for multiple comparisons
    Method Log Rank
    Comments
    Method of Estimation Estimation Parameter Cox Proportional Hazard
    Estimated Value 1.00
    Confidence Interval (2-Sided) 95%
    0.30 to 3.32
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection 0 µg Iron/dL of Dialysate, 10 µg Iron/dL of Dialysate
    Comments
    Type of Statistical Test Superiority or Other (legacy)
    Comments
    Statistical Test of Hypothesis p-Value 0.807
    Comments
    Method Log Rank
    Comments
    Method of Estimation Estimation Parameter Cox Proportional Hazard
    Estimated Value 1.17
    Confidence Interval (2-Sided) 95%
    0.33 to 4.09
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection 0 µg Iron/dL of Dialysate, 12 µg Iron/dL of Dialysate
    Comments
    Type of Statistical Test Superiority or Other (legacy)
    Comments
    Statistical Test of Hypothesis p-Value 0.748
    Comments
    Method Log Rank
    Comments
    Method of Estimation Estimation Parameter Cox Proportional Hazard
    Estimated Value 0.80
    Confidence Interval (2-Sided) 95%
    0.21 to 3.02
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 4
    Statistical Analysis Overview Comparison Group Selection 0 µg Iron/dL of Dialysate, 15 µg Iron/dL of Dialysate
    Comments
    Type of Statistical Test Superiority or Other (legacy)
    Comments
    Statistical Test of Hypothesis p-Value 0.299
    Comments
    Method Log Rank
    Comments
    Method of Estimation Estimation Parameter Cox Proportional Hazard
    Estimated Value 1.77
    Confidence Interval (2-Sided) 95%
    0.60 to 5.19
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    2. Secondary Outcome
    Title Change From Baseline in Hemoglobin (Hgb)
    Description
    Time Frame two time points: baseline and final evaluation (last post baseline assessment, up to 26 weeks)

    Outcome Measure Data

    Analysis Population Description
    Modified intent-to-treat population, consisting of all subjects who received any amount of randomized study medication
    Arm/Group Title 0 µg Iron/dL of Dialysate 5 µg Iron/dL of Dialysate 10 µg Iron/dL of Dialysate 12 µg Iron/dL of Dialysate 15 µg Iron/dL of Dialysate
    Arm/Group Description Placebo; 0 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 5 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 10 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 12 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 15 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week
    Measure Participants 26 26 29 22 28
    Mean (Standard Deviation) [grams/ deciliter (g/dL)]
    -0.177
    (1.1151)
    0.258
    (1.4643)
    0.462
    (1.2214)
    0.173
    (1.5806)
    -0.018
    (1.2532)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection 0 µg Iron/dL of Dialysate, 5 µg Iron/dL of Dialysate
    Comments Each dose was compared to placebo using an ANOVA model with treatment as the effect.
    Type of Statistical Test Superiority or Other (legacy)
    Comments
    Statistical Test of Hypothesis p-Value 0.234
    Comments Threshold for statistical significance p < 0.05
    Method ANOVA
    Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection 0 µg Iron/dL of Dialysate, 10 µg Iron/dL of Dialysate
    Comments Each dose was compared to placebo using an ANOVA model with treatment as the effect
    Type of Statistical Test Superiority or Other (legacy)
    Comments
    Statistical Test of Hypothesis p-Value 0.049
    Comments Threshold for statistical significance p < 0.05
    Method ANOVA
    Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection 0 µg Iron/dL of Dialysate, 12 µg Iron/dL of Dialysate
    Comments Each dose was compared to placebo using an ANOVA model with treatment as the effect
    Type of Statistical Test Superiority or Other (legacy)
    Comments
    Statistical Test of Hypothesis p-Value 0.375
    Comments Threshold for statistical significance p < 0.05
    Method ANOVA
    Comments
    Statistical Analysis 4
    Statistical Analysis Overview Comparison Group Selection 0 µg Iron/dL of Dialysate, 15 µg Iron/dL of Dialysate
    Comments Each dose was compared to placebo using an ANOVA model with treatment as the effect
    Type of Statistical Test Superiority or Other (legacy)
    Comments
    Statistical Test of Hypothesis p-Value 0.625
    Comments Threshold for statistical significance p < 0.05
    Method ANOVA
    Comments
    3. Secondary Outcome
    Title Time in Days for Hgb to Decrease by a Total of > = 1.0 g/dL From Baseline on Each of Two Successive Measurements in Each Treatment Group.
    Description Kaplan-Meier Estimate of Time to First Hgb Decrease by >= 1.0 g/dL
    Time Frame Up to 26 weeks

    Outcome Measure Data

    Analysis Population Description
    Modified intent-to-treat population, consisting of all subjects who received any amount of randomized study medication. Because of the small number of patients reaching the endpoint of decrease in Hgb >= 1.0 g/dL, the Kaplan-Meier analysis could not estimate the number of days for at least one treatment group for the 50th percentile and higher.
    Arm/Group Title 0 µg Iron/dL of Dialysate 5 µg Iron/dL of Dialysate 10 µg Iron/dL of Dialysate 12 µg Iron/dL of Dialysate 15 µg Iron/dL of Dialysate
    Arm/Group Description Placebo; 0 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 5 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 10 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 12 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 15 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week
    Measure Participants 26 26 29 22 28
    5th Percentile
    59
    (0.3267)
    24
    (0.6674)
    10
    (0.4402)
    31
    (0.3697)
    31
    (0.6609)
    10th Percentile
    94
    31
    106
    45
    31
    15th Percentile
    94
    66
    106
    115
    38
    20th Percentile
    115
    87
    106
    115
    80
    25th Percentile
    115
    108
    115
    150
    94
    4. Secondary Outcome
    Title Reticulocyte Hemoglobin (CHr) Values Every Four Weeks, and at the End of the Subject's Treatment.
    Description Efficacy of SFP administration in dialysate solution as measured by Chr values every four weeks, and at the end of the Subject's Treatment (up to 26 weeks).
    Time Frame Every 4 weeks

    Outcome Measure Data

    Analysis Population Description
    Modified intent-to-treat population, consisting of all subjects who received any amount of randomized study medication
    Arm/Group Title 0 µg Iron/dL of Dialysate 5 µg Iron/dL of Dialysate 10 µg Iron/dL of Dialysate 12 µg Iron/dL of Dialysate 15 µg Iron/dL of Dialysate
    Arm/Group Description Placebo; 0 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 5 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 10 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 12 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 15 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week
    Measure Participants 26 26 29 22 28
    Baseline Reticulocyte Hemoglobin
    32.55
    (2.084)
    32.98
    (1.763)
    32.86
    (3.192)
    32.34
    (2.975)
    32.64
    (1.858)
    Reticulocyte Hemoglobin/ Week 1
    32.42
    (2.852)
    32.58
    (1.932)
    32.69
    (3.019)
    31.87
    (2.963)
    32.40
    (2.006)
    Reticulocyte Hemoglobin/ Week 4
    32.00
    (2.668)
    32.27
    (2.090)
    32.69
    (2.931)
    31.82
    (2.515)
    32.05
    (1.837)
    Reticulocyte Hemoglobin/ Week 8
    32.14
    (2.664)
    32.28
    (2.135)
    32.75
    (2.985)
    31.75
    (2.473)
    32.35
    (1.917)
    Reticulocyte Hemoglobin/ Week 12
    31.83
    (2.347)
    32.13
    (1.792)
    32.78
    (1.560)
    31.82
    (3.150)
    32.48
    (1.894)
    Reticulocyte Hemoglobin/ Week 16
    31.45
    (2.546)
    31.95
    (1.866)
    33.05
    (2.396)
    31.86
    (3.410)
    32.25
    (2.382)
    Reticulocyte Hemoglobin/ Week 20
    31.13
    (2.172)
    31.81
    (1.860)
    32.81
    (2.328)
    30.68
    (2.026)
    31.64
    (1.338)
    Reticulocyte Hemoglobin/ Week 24
    30.93
    (2.127)
    31.85
    (1.820)
    32.08
    (2.680)
    30.53
    (2.071)
    31.40
    (1.949)
    Reticulocyte Hemoglobin/ Week 26
    30.78
    (2.638)
    31.32
    (2.404)
    32.20
    (2.372)
    30.72
    (2.515)
    30.43
    (2.600)
    Reticulocyte Hemoglobin/ End of Trial
    30.06
    (1.841)
    31.50
    (2.348)
    31.46
    (2.352)
    30.55
    (2.523)
    30.11
    (2.361)
    Reticulocyte Hemoglobin/ Final Evaluation
    31.85
    (2.796)
    31.68
    (2.386)
    32.19
    (3.026)
    31.65
    (3.409)
    32.13
    (2.246)
    5. Secondary Outcome
    Title Number of Subjects With Infection Episodes Requiring Antibiotic or Anti-fungal Therapy in Each Treatment Group.
    Description
    Time Frame At each dialysis session for up to 26 weeks

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title 0 µg Iron/dL of Dialysate 5 µg Iron/dL of Dialysate 10 µg Iron/dL of Dialysate 12 µg Iron/dL of Dialysate 15 µg Iron/dL of Dialysate
    Arm/Group Description Placebo; 0 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 5 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 10 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 12 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 15 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week
    Measure Participants 26 26 29 22 28
    Number [Subjects]
    2
    1
    2
    0
    1
    6. Secondary Outcome
    Title Number of Subjects With a Rise in Hemoglobin (Hgb) to 12.6 g/dL or More on Two Separate Occasions Measured One Week Apart.
    Description
    Time Frame two separate sessions measured one week apart.

    Outcome Measure Data

    Analysis Population Description
    Modified intent-to-treat population, consisting of all subjects who received any amount of randomized study medication
    Arm/Group Title 0 µg Iron/dL of Dialysate 5 µg Iron/dL of Dialysate 10 µg Iron/dL of Dialysate 12 µg Iron/dL of Dialysate 15 µg Iron/dL of Dialysate
    Arm/Group Description Placebo; 0 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 5 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 10 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 12 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 15 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week
    Measure Participants 26 26 29 22 28
    Number [Subjects]
    6
    6
    9
    7
    8

    Adverse Events

    Time Frame Up to 26 weeks
    Adverse Event Reporting Description
    Arm/Group Title 0 µg Iron/dL of Dialysate 5 µg Iron/dL of Dialysate 10 µg Iron/dL of Dialysate 12 µg Iron/dL of Dialysate 15 µg Iron/dL of Dialysate
    Arm/Group Description Placebo; 0 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 5 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 10 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 12 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week 15 micrograms (µg) iron/deciliter (dL) of dialysate during dialysis 3 times/ week
    All Cause Mortality
    0 µg Iron/dL of Dialysate 5 µg Iron/dL of Dialysate 10 µg Iron/dL of Dialysate 12 µg Iron/dL of Dialysate 15 µg Iron/dL of Dialysate
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total / (NaN) / (NaN) / (NaN) / (NaN) / (NaN)
    Serious Adverse Events
    0 µg Iron/dL of Dialysate 5 µg Iron/dL of Dialysate 10 µg Iron/dL of Dialysate 12 µg Iron/dL of Dialysate 15 µg Iron/dL of Dialysate
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 7/26 (26.9%) 2/26 (7.7%) 5/29 (17.2%) 7/22 (31.8%) 5/28 (17.9%)
    Cardiac disorders
    Angina pectoris 1/26 (3.8%) 0/26 (0%) 0/29 (0%) 0/22 (0%) 1/28 (3.6%)
    Bradycardia 0/26 (0%) 0/26 (0%) 0/29 (0%) 1/22 (4.5%) 0/28 (0%)
    Cardio-respiratory arrest 0/26 (0%) 0/26 (0%) 0/29 (0%) 0/22 (0%) 1/28 (3.6%)
    Coronary artery disease 0/26 (0%) 1/26 (3.8%) 0/29 (0%) 0/22 (0%) 0/28 (0%)
    Eye disorders
    Eyelid oedema 1/26 (3.8%) 0/26 (0%) 0/29 (0%) 0/22 (0%) 0/28 (0%)
    Gastrointestinal disorders
    Gastric ulcer 0/26 (0%) 1/26 (3.8%) 0/29 (0%) 0/22 (0%) 0/28 (0%)
    Gastrointestinal haemorrhage 0/26 (0%) 0/26 (0%) 0/29 (0%) 1/22 (4.5%) 0/28 (0%)
    Impaired gastric emptying 0/26 (0%) 0/26 (0%) 1/29 (3.4%) 0/22 (0%) 0/28 (0%)
    Vomiting 0/26 (0%) 0/26 (0%) 0/29 (0%) 0/22 (0%) 1/28 (3.6%)
    Hepatobiliary disorders
    Hepatic failure 0/26 (0%) 1/26 (3.8%) 0/29 (0%) 0/22 (0%) 0/28 (0%)
    Infections and infestations
    Catheter bacteraemia 1/26 (3.8%) 0/26 (0%) 0/29 (0%) 0/22 (0%) 0/28 (0%)
    Cellulitis 1/26 (3.8%) 0/26 (0%) 0/29 (0%) 0/22 (0%) 0/28 (0%)
    Clostridium difficile colitis 0/26 (0%) 0/26 (0%) 1/29 (3.4%) 0/22 (0%) 0/28 (0%)
    Cystitis 0/26 (0%) 0/26 (0%) 0/29 (0%) 1/22 (4.5%) 0/28 (0%)
    Necrotising fasciitis 0/26 (0%) 0/26 (0%) 0/29 (0%) 1/22 (4.5%) 0/28 (0%)
    Osteomyelitis 0/26 (0%) 0/26 (0%) 1/29 (3.4%) 0/22 (0%) 0/28 (0%)
    Staphylococcal bacteraemia 0/26 (0%) 0/26 (0%) 0/29 (0%) 1/22 (4.5%) 0/28 (0%)
    Injury, poisoning and procedural complications
    Graft dysfunction 1/26 (3.8%) 0/26 (0%) 0/29 (0%) 1/22 (4.5%) 0/28 (0%)
    Metabolism and nutrition disorders
    Fluid overload 0/26 (0%) 1/26 (3.8%) 0/29 (0%) 0/22 (0%) 0/28 (0%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Renal cell carcinoma 1/26 (3.8%) 0/26 (0%) 0/29 (0%) 0/22 (0%) 0/28 (0%)
    Nervous system disorders
    Cognitive disorder 1/26 (3.8%) 0/26 (0%) 0/29 (0%) 0/22 (0%) 0/28 (0%)
    Thalamic infarction 0/26 (0%) 0/26 (0%) 1/29 (3.4%) 0/22 (0%) 0/28 (0%)
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea 0/26 (0%) 0/26 (0%) 0/29 (0%) 2/22 (9.1%) 0/28 (0%)
    Chronic obstructive pulmonary 0/26 (0%) 0/26 (0%) 0/29 (0%) 1/22 (4.5%) 0/28 (0%)
    Pleural effusion 0/26 (0%) 0/26 (0%) 0/29 (0%) 0/22 (0%) 1/28 (3.6%)
    Pulmonary oedema 0/26 (0%) 0/26 (0%) 1/29 (3.4%) 0/22 (0%) 0/28 (0%)
    Skin and subcutaneous tissue disorders
    Leukocytoclastic vasculitis 0/26 (0%) 0/26 (0%) 0/29 (0%) 1/22 (4.5%) 0/28 (0%)
    Vascular disorders
    Aortic stenosis 0/26 (0%) 0/26 (0%) 1/29 (3.4%) 0/22 (0%) 0/28 (0%)
    Hypertensive emergency 0/26 (0%) 0/26 (0%) 0/29 (0%) 0/22 (0%) 1/28 (3.6%)
    Other (Not Including Serious) Adverse Events
    0 µg Iron/dL of Dialysate 5 µg Iron/dL of Dialysate 10 µg Iron/dL of Dialysate 12 µg Iron/dL of Dialysate 15 µg Iron/dL of Dialysate
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 20/26 (76.9%) 17/26 (65.4%) 20/29 (69%) 16/22 (72.7%) 17/28 (60.7%)
    Cardiac disorders
    Tachycardia 0/26 (0%) 0/26 (0%) 1/29 (3.4%) 1/22 (4.5%) 1/28 (3.6%)
    Gastrointestinal disorders
    Diarrhoea 3/26 (11.5%) 3/26 (11.5%) 7/29 (24.1%) 2/22 (9.1%) 4/28 (14.3%)
    Nausea 4/26 (15.4%) 3/26 (11.5%) 2/29 (6.9%) 6/22 (27.3%) 4/28 (14.3%)
    Vomiting 3/26 (11.5%) 3/26 (11.5%) 2/29 (6.9%) 4/22 (18.2%) 1/28 (3.6%)
    Constipation 2/26 (7.7%) 0/26 (0%) 0/29 (0%) 2/22 (9.1%) 2/28 (7.1%)
    Abdominal pain upper 1/26 (3.8%) 0/26 (0%) 2/29 (6.9%) 1/22 (4.5%) 1/28 (3.6%)
    Dysphagia 0/26 (0%) 0/26 (0%) 0/29 (0%) 2/22 (9.1%) 0/28 (0%)
    Toothache 1/26 (3.8%) 0/26 (0%) 0/29 (0%) 1/22 (4.5%) 0/28 (0%)
    General disorders
    Pyrexia 1/26 (3.8%) 3/26 (11.5%) 0/29 (0%) 2/22 (9.1%) 1/28 (3.6%)
    Oedema peripheral 5/26 (19.2%) 0/26 (0%) 0/29 (0%) 0/22 (0%) 1/28 (3.6%)
    Fatigue 2/26 (7.7%) 0/26 (0%) 0/29 (0%) 1/22 (4.5%) 1/28 (3.6%)
    Non-cardiac chest pain 1/26 (3.8%) 0/26 (0%) 1/29 (3.4%) 1/22 (4.5%) 1/28 (3.6%)
    Asthenia 2/26 (7.7%) 0/26 (0%) 0/29 (0%) 0/22 (0%) 1/28 (3.6%)
    Chest discomfort 1/26 (3.8%) 0/26 (0%) 0/29 (0%) 0/22 (0%) 1/28 (3.6%)
    Chest pain 0/26 (0%) 0/26 (0%) 1/29 (3.4%) 0/22 (0%) 1/28 (3.6%)
    Chills 0/26 (0%) 0/26 (0%) 0/29 (0%) 2/22 (9.1%) 0/28 (0%)
    Feeling hot 0/26 (0%) 1/26 (3.8%) 1/29 (3.4%) 0/22 (0%) 0/28 (0%)
    Immune system disorders
    Seasonal allergy 1/26 (3.8%) 0/26 (0%) 1/29 (3.4%) 0/22 (0%) 0/28 (0%)
    Infections and infestations
    Upper respiratory tract infection 0/26 (0%) 1/26 (3.8%) 0/29 (0%) 3/22 (13.6%) 1/28 (3.6%)
    Bacteraemia 1/26 (3.8%) 0/26 (0%) 0/29 (0%) 1/22 (4.5%) 2/28 (7.1%)
    Bronchitis 0/26 (0%) 2/26 (7.7%) 0/29 (0%) 1/22 (4.5%) 1/28 (3.6%)
    Cellulitis 0/26 (0%) 3/26 (11.5%) 0/29 (0%) 0/22 (0%) 0/28 (0%)
    Nasopharyngitis 0/26 (0%) 1/26 (3.8%) 1/29 (3.4%) 0/22 (0%) 1/28 (3.6%)
    Urinary tract infection 1/26 (3.8%) 1/26 (3.8%) 0/29 (0%) 0/22 (0%) 1/28 (3.6%)
    Wound infection 0/26 (0%) 1/26 (3.8%) 0/29 (0%) 0/22 (0%) 1/28 (3.6%)
    Contusion 0/26 (0%) 1/26 (3.8%) 0/29 (0%) 1/22 (4.5%) 1/28 (3.6%)
    Injury, poisoning and procedural complications
    Procedural hypotension 2/26 (7.7%) 4/26 (15.4%) 5/29 (17.2%) 2/22 (9.1%) 4/28 (14.3%)
    Thrombosis in device 1/26 (3.8%) 1/26 (3.8%) 0/29 (0%) 2/22 (9.1%) 1/28 (3.6%)
    Vascular graft complication 2/26 (7.7%) 0/26 (0%) 0/29 (0%) 1/22 (4.5%) 1/28 (3.6%)
    Arteriovenous fistula occlusion 0/26 (0%) 1/26 (3.8%) 1/29 (3.4%) 0/22 (0%) 1/28 (3.6%)
    Procedural hypertension 0/26 (0%) 0/26 (0%) 3/29 (10.3%) 0/22 (0%) 0/28 (0%)
    Thermal burn 0/26 (0%) 0/26 (0%) 3/29 (10.3%) 0/22 (0%) 0/28 (0%)
    Excoriation 1/26 (3.8%) 1/26 (3.8%) 0/29 (0%) 0/22 (0%) 0/28 (0%)
    Fall 0/26 (0%) 1/26 (3.8%) 0/29 (0%) 1/22 (4.5%) 0/28 (0%)
    Procedural pain 1/26 (3.8%) 0/26 (0%) 0/29 (0%) 0/22 (0%) 1/28 (3.6%)
    Skin laceration 1/26 (3.8%) 1/26 (3.8%) 0/29 (0%) 0/22 (0%) 0/28 (0%)
    Wound 1/26 (3.8%) 0/26 (0%) 0/29 (0%) 1/22 (4.5%) 0/28 (0%)
    Investigations
    Serum ferritin increased 1/26 (3.8%) 0/26 (0%) 1/29 (3.4%) 0/22 (0%) 1/28 (3.6%)
    Blood iron decreased 0/26 (0%) 1/26 (3.8%) 0/29 (0%) 0/22 (0%) 1/28 (3.6%)
    Iron binding capacity unsaturated decreased 0/26 (0%) 1/26 (3.8%) 0/29 (0%) 0/22 (0%) 1/28 (3.6%)
    Metabolism and nutrition disorders
    Hyperglycaemia 1/26 (3.8%) 0/26 (0%) 1/29 (3.4%) 0/22 (0%) 1/28 (3.6%)
    Decreased appetite 1/26 (3.8%) 0/26 (0%) 0/29 (0%) 1/22 (4.5%) 0/28 (0%)
    Gout 0/26 (0%) 0/26 (0%) 0/29 (0%) 0/22 (0%) 2/28 (7.1%)
    Musculoskeletal and connective tissue disorders
    Muscle spasms 4/26 (15.4%) 0/26 (0%) 4/29 (13.8%) 3/22 (13.6%) 1/28 (3.6%)
    Pain in extremity 3/26 (11.5%) 2/26 (7.7%) 1/29 (3.4%) 2/22 (9.1%) 3/28 (10.7%)
    Arthralgia 1/26 (3.8%) 2/26 (7.7%) 2/29 (6.9%) 1/22 (4.5%) 0/28 (0%)
    Back pain 2/26 (7.7%) 0/26 (0%) 0/29 (0%) 1/22 (4.5%) 0/28 (0%)
    Musculoskeletal pain 2/26 (7.7%) 0/26 (0%) 0/29 (0%) 1/22 (4.5%) 0/28 (0%)
    Muscular weakness 0/26 (0%) 0/26 (0%) 0/29 (0%) 2/22 (9.1%) 0/28 (0%)
    Neck pain 2/26 (7.7%) 0/26 (0%) 0/29 (0%) 0/22 (0%) 0/28 (0%)
    Nervous system disorders
    Headache 5/26 (19.2%) 2/26 (7.7%) 5/29 (17.2%) 3/22 (13.6%) 2/28 (7.1%)
    Dizziness 2/26 (7.7%) 3/26 (11.5%) 4/29 (13.8%) 1/22 (4.5%) 2/28 (7.1%)
    Psychiatric disorders
    Insomnia 1/26 (3.8%) 0/26 (0%) 1/29 (3.4%) 0/22 (0%) 0/28 (0%)
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea 3/26 (11.5%) 1/26 (3.8%) 3/29 (10.3%) 4/22 (18.2%) 2/28 (7.1%)
    Pharyngolaryngeal pain 3/26 (11.5%) 0/26 (0%) 0/29 (0%) 0/22 (0%) 0/28 (0%)
    Wheezing 1/26 (3.8%) 0/26 (0%) 1/29 (3.4%) 0/22 (0%) 0/28 (0%)
    Skin and subcutaneous tissue disorders
    Pruritus 0/26 (0%) 0/26 (0%) 1/29 (3.4%) 1/22 (4.5%) 0/28 (0%)
    Skin ulcer 0/26 (0%) 1/26 (3.8%) 0/29 (0%) 0/22 (0%) 1/28 (3.6%)
    Swelling face 1/26 (3.8%) 0/26 (0%) 0/29 (0%) 1/22 (4.5%) 0/28 (0%)
    Rash 0/26 (0%) 1/26 (3.8%) 1/29 (3.4%) 0/22 (0%) 0/28 (0%)
    Vascular disorders
    Hypertension 0/26 (0%) 0/26 (0%) 2/29 (6.9%) 0/22 (0%) 1/28 (3.6%)
    Hypotension 1/26 (3.8%) 0/26 (0%) 0/29 (0%) 0/22 (0%) 1/28 (3.6%)

    Limitations/Caveats

    AE tabulation best summarizes the primary safety outcome. Lack of accuracy in analytical method for measuring iron concentration in inflow and outflow from dialysis machine impaired ability to assess secondary outcome of amount SFP transferred.

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

    Results Point of Contact

    Name/Title Richard C. Yocum, MD
    Organization Rockwell Medical
    Phone 858-229-8585
    Email ryocum@rockwellmed.com
    Responsible Party:
    Rockwell Medical Technologies, Inc.
    ClinicalTrials.gov Identifier:
    NCT00548249
    Other Study ID Numbers:
    • RMTI-SFP-2
    First Posted:
    Oct 23, 2007
    Last Update Posted:
    Dec 2, 2020
    Last Verified:
    Nov 1, 2020