Ferric Citrate for the Treatment of Hyperphosphatemia in Patients With Chronic Kidney Disease Undergoing Hemodialysis

Sponsor

Panion & BF Biotech Inc. (Industry)

Overall Status

Completed

CT.gov ID

NCT03984760

Collaborator

Shandong Weigao Panion Pharmaceutical Co. Ltd. (Other)

240

Enrollment

Locations

Arms

20.1

Actual Duration (Months)

Patients Per Site

0.5

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

To evaluate the efficacy and safety of ferric citrate capsules for the treatment of hyperphosphatemia in patients with chronic kidney disease undergoing hemodialysis

Condition or Disease	Intervention/Treatment	Phase
Hyperphosphatemia End Stage Renal Disease ESRD	Drug: Ferric Citrate Drug: Sevelamer Carbonate	Phase 3

Detailed Description

This is a multicenter, randomized, open-label, active-controlled, parallel, phase III study which aims to assess the efficacy and safety of ferric citrate capsules for the treatment of hyperphosphatemia in patients with chronic kidney disease undergoing hemodialysis. This study is consisting of a Screening/Washout period (14 days) and a Treatment/Observation period (12 weeks). During the Treatment period, the subjects will be randomly assigned to the ferric citrate capsule group (study group) or sevelamer carbonate tablet group (control group) in the ratio of 1:1.

Study Design

Study Type:

Interventional

Actual Enrollment :

240 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

None (Open Label)

Primary Purpose:

Treatment

Official Title:

A Multicenter, Randomized, Open-Label, Active-Controlled, Parallel Study to Assess the Efficacy and Safety of Ferric Citrate Capsules for the Treatment of Hyperphosphatemia in Patients With Chronic Kidney Disease Undergoing Hemodialysis

Actual Study Start Date :

Jun 19, 2019

Actual Primary Completion Date :

Feb 20, 2021

Actual Study Completion Date :

Feb 20, 2021

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Ferric Citrate Capsule Ferric Citrate Capsule, product specification: 500 mg/cap, manufactured by Panion & BF Biotech Inc.	Drug: Ferric Citrate Take the capsules with meals or immediately after meals.
Active Comparator: Sevelamer Carbonate Tablet Sevelamer carbonate tablet group, product specification: 800 mg/tablet, manufactured by Genzyme Ireland Limited	Drug: Sevelamer Carbonate Take the tablets with meals.

Arm

Intervention/Treatment

Experimental: Ferric Citrate Capsule

Ferric Citrate Capsule, product specification: 500 mg/cap, manufactured by Panion & BF Biotech Inc.

Drug: Ferric Citrate

Take the capsules with meals or immediately after meals.

Active Comparator: Sevelamer Carbonate Tablet

Sevelamer carbonate tablet group, product specification: 800 mg/tablet, manufactured by Genzyme Ireland Limited

Drug: Sevelamer Carbonate

Take the tablets with meals.

Outcome Measures

Primary Outcome Measures

The change in serum phosphorus levels [12 Weeks]
The change in serum phosphorus levels at the end of treatment (Visit 10 or ET) as compared to baseline (before the first dose).

Secondary Outcome Measures

Serum phosphorus levels [12 Weeks]
Serum phosphorus levels at the end of treatment;
The proportion of subjects whose serum phosphorus levels reached the target range. [12 Weeks]
The proportion of subjects whose serum phosphorus levels reached the target range (3.5 to 5.5 mg/dL, 1.13 to 1.78 mmol/L) at the end of the treatment;
The response rate of serum phosphorus [12 Weeks]
The response rate of serum phosphorus at the end of treatment (defined as reduction of the serum phosphorus level exceeds 25% as compared to baseline);
The change in serum calcium (corrected) levels [12 Weeks]
The change in serum calcium (corrected) levels at the end of treatment as compared to baseline;
The change in the [Ca] × [P] product relative [12 Weeks]
The change in the [Ca] × [P] product relative at the end of treatment as compared to baseline;
The change in the level of intact-PTH levels [12 Weeks]
The change in the level of intact-PTH levels at the end of treatment as compared to baseline.

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years to 75 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Willing to give written informed consent.;
Between the age of 18 and 75 years (including the boundary value);
Patients who maintain the hemodialysis schedule as 3 times a week and the dialysis schedule should remain unchanged during the study period;
At Screening, patients who have received phosphate binder for at least 4 weeks and have a serum phosphorus level between 2.5 and 8.0 mg/dL (0.81 to 2.58 mmol/L) (excluding the boundary value) after treatment;
Patients with a serum phosphorus level between 5.5 and 10.0 mg/dL (1.78 to 3.23 mmol/L) (excluding the boundary value) after washout.

Exclusion Criteria:

Patients with severe gastrointestinal diseases (such as acute peptic ulcer, chronic ulcerative colitis, regional enteritis, ileus) or patients with dysphagia;
Patients with a history of gastrectomy or enterectomy (excluding endoscopic excision or caecectomy) or patients who had undergone gastrointestinal surgery within 3 months prior to Screening;
Patients with severe constipation (times of bowel movement≤ 1 time/week), chronic diarrhea (times of bowel movement≥ 4 times/day), severe gastrointestinal motility disorder;
Patients with hemochromatosis or patients receiving treatment for iron overload, or patients with a serum ferritin level >800 ng/mL or TSAT >50% at Screening;
Patients with a serum calcium level (corrected) <8.0 mg/dL (2.0 mmol/L) or >11.0 mg/dL (2.75 mmol/L) after washout;
Patients with intact-PTH>800pg/mL at Screening, or patients undergone parathyroid surgery within 6 months prior to Screening or requiring parathyroid surgery;
Patients who received blood transfusions for treating anemia within 3 months prior to Screening;
Patients who require phosphorus-binding agents containing aluminum, magnesium, calcium and lanthanum in addition to the study drug or patients who require an antacid with a phosphorus binding effect during the study period;
Patients who require citrate preparation as an anticoagulant during hemodialysis treatment during the study period;
Patients with impaired liver function (hepatic dysfunction or serum total bilirubin, aspartate aminotransferase or alanine aminotransferase ≥ 2 times the upper limit of normal) or patients with cirrhosis;
Patients with cerebrovascular disease (cerebral infarction, cerebral hemorrhage, etc.) or cardiovascular disease (congestive heart failure of Class III or severer in NYHA classification, acute myocardial infarction, unstable angina, etc.) requiring hospitalization within 6 months prior to Screening;
Patients who are known to be intolerant to sevelamer carbonate tablet;
Patients with a history of allergies to iron preparations or those who are intolerant to iron preparations;
Patients who are scheduled to have a kidney transplant during the study period;
Patients with a current or past history of malignancy within 5 years prior to Screening;
Women who are pregnant or lactating, or patients who are unable to take effective contraception from screening to 6 months after discontinuation (including male subjects and their female spouses);
Patients who had participated in other clinical studies and other received investigational drug product within 1 month or 5 half-lives of the drug product (whichever is longer) prior to Screening;
Patients who are not suitable for participating in the trial according to the investigator's judgment;
Patients who are unwilling or unable to follow the protocol process.

Contacts and Locations

Locations

	Site	City	Country
1	Baotou Central Hospital	Baotou	China
2	The General Hospital of the People's Liberation Army (PLAGH)	Beijing	China
3	The Second Hospital of Jilin University	Changchun	China
4	Daping Hospital	Chongqing	China
5	The First Affiliated Hospital of Dalian Medical University	Dalian	China
6	The Fifth Affiliated Hospital of Guangzhou Medical University	Guangzhou	China
7	The First Affiliated Hospital/School Of Clinical Medicine of Guangdong Pharmaceutical University	Guangzhou	China
8	Jilin Guowen Hospital	Jilin	China
9	Jiujiang University Affiliated Hospital	Jiujiang	China
10	Meihekou Central Hospital	Meihekou	China
11	Jiangxi Provincial People's Hospital	Nanchang	China
12	The First Affiliated Hospital of Nanchang University	Nanchang	China
13	BenQ Medical Center	Nanjing	China
14	JiangSu Province Hospital (The First Affiliated Hospital of Nanjing Medical University)	Nanjing	China
15	The Second Affiliated Hospital of Nanjing Medical University	Nanjing	China
16	The Affiliated Hospital of Qingdao University	Qingdao	China
17	Changhai Hospital	Shanghai	China
18	Shengjing Hospital of China Medical University	Shenyang	China
19	Tonghua Central Hospital	Tonghua	China
20	Fifth Hospital in Wuhan	Wuhan	China
21	Renmin Hospital of Wuhan University	Wuhan	China
22	Zhongnan Hospital of Wuhan University	Wuhan	China
23	Henan Provincial People's Hospital	Zhengzhou	China
24	Affiliated Hospital of Zunyi Medical University	Zunyi	China