DS2330b Alone and With Sevelamer in Patients on Chronic Hemodialysis

• Sponsor: Daiichi Sankyo, Inc. (Industry)
• Overall Status: Completed
• CT.gov ID: NCT03305471
• Collaborator: (none)
• Enrollment: 40
• Locations: 4
• Arms: 7
• Actual Duration (Months): 16.6
• Patients Per Site: 10
• Patients Per Site Per Month: 0.6

Study Details

Study Description

Brief Summary

This three-part study will be performed with participants on chronic hemodialysis.

• Part A will assess plasma pharmacokinetics of DS2330a (free form of DS2330b) after a single dose of powder in bottle (PIB) or tablet formulations of DS2330b

• Part B will test the safety, tolerability, and effects on serum phosphate (Pi) of 14-day repeated oral doses of DS-2330b PIB when given alone and when given along with sevelamer carbonate three times a day

• Part C is optional, and will test the effects on serum phosphate (Pi) of 14-day repeated oral doses of DS-2330b tablets when given with sevelamer carbonate

After screening, participants should expect the study to last about 21 days for Part A, and 46 days for Parts B and C.

Condition or Disease	Intervention/Treatment	Phase
Hyperphosphatemia	Drug: DS-2330b PIB; Drug: Placebo; Drug: Sevelamer; Drug: DS-2330b Tablet	Phase 1

Study Design

• Study Type: Interventional
• Actual Enrollment: 40 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Intervention Model Description: Part A has a 2-period, open-label, randomized, 2-way crossover design with a single dose of Treatments A1 and A2 Part B participants are randomized with a 2:3:3:3 ratio to Treatment B1, B2, B3, and B4, respectively, using a double-blind, repeated dose, parallel design Part C is an optional, single-arm, open label, repeated dose designPart A has a 2-period, open-label, randomized, 2-way crossover design with a single dose of Treatments A1 and A2 Part B participants are randomized with a 2:3:3:3 ratio to Treatment B1, B2, B3, and B4, respectively, using a double-blind, repeated dose, parallel design Part C is an optional, single-arm, open label, repeated dose design
• Masking: Double (Participant, Investigator)
• Masking Description: Masking description is for Part B only - Parts A and C are Open Label, so have no masking
• Primary Purpose: Treatment
• Official Title: A Phase 1b Study, to Assess the Safety, Tolerability, Pharmacodynamics, and Pharmacokinetics of Repeated Doses of DS-2330b Alone and When Co-administered With Sevelamer in Patients on Chronic Hemodialysis
• Actual Study Start Date: Aug 17, 2017
• Actual Primary Completion Date: Jan 3, 2019
• Actual Study Completion Date: Jan 3, 2019

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Part A: DS-2330b PIB, then Tablet On a non-dialysis day, participants are given a single 250 mg dose of DS-2330b PIB [Treatment A1] right after breakfast. At least 3 days will be allowed to let the first dose wash out. Then on a non-dialysis day the participants are given a single 250 mg dose of DS-2330b in tablet form [Treatment A2] right after breakfast.	Drug: DS-2330b PIB; DS-2330b as powder in bottle with stock solution (PIB); Drug: DS-2330b Tablet; DS-2330b as tablet formulation
Experimental: Part A: DS-2330b Tablet, then PIB On a non-dialysis day, participants are given a single 250 mg dose of DS-2330b in tablet form [Treatment A2] right after breakfast. At least 3 days will be allowed to let the first dose wash out. Then on a non-dialysis day the participants are given a single 250 mg dose of DS-2330b PIB [Treatment A1] right after breakfast.	Drug: DS-2330b PIB; DS-2330b as powder in bottle with stock solution (PIB); Drug: DS-2330b Tablet; DS-2330b as tablet formulation
Placebo Comparator: Part B: Placebo Participants are given placebo three times daily [Treatment B1]	Drug: Placebo; Placebo matching stock solution in bottle
Experimental: Part B: DS-2330b PIB Participants are given 400 mg of DS-2330b PIB three times daily [Treatment B2]	Drug: DS-2330b PIB; DS-2330b as powder in bottle with stock solution (PIB)
Experimental: Part B: DS-2330b PIB + Sevelamer Participants are given 400 mg of DS-2330b PIB along with 1.6 grams of sevelamer three times daily [Treatment B3]	Drug: DS-2330b PIB; DS-2330b as powder in bottle with stock solution (PIB); Drug: Sevelamer; Sevelamer is a phosphate binder. It is used to decrease serum phosphate (Pi) level in people with chronic kidney disease who are on dialysis.; Other Names: Sevelamer carbonate
Experimental: Part B: Placebo + Sevelamer Participants are given placebo along with 1.6 grams of sevelamer three times daily [Treatment B4]	Drug: Placebo; Placebo matching stock solution in bottle; Drug: Sevelamer; Sevelamer is a phosphate binder. It is used to decrease serum phosphate (Pi) level in people with chronic kidney disease who are on dialysis.; Other Names: Sevelamer carbonate
Experimental: Part C: DS-2330b Tablet + Sevelamer Participants are given one 250 mg dose of DS-2330b in tablet form along with 1.6 grams of sevelamer three times daily [Treatment C]	Drug: Sevelamer; Sevelamer is a phosphate binder. It is used to decrease serum phosphate (Pi) level in people with chronic kidney disease who are on dialysis.; Other Names: Sevelamer carbonate ; Drug: DS-2330b Tablet; DS-2330b as tablet formulation

Outcome Measures

Primary Outcome Measures

1. Part A, Period 1: Maximum concentration (Cmax) of DS-2330a [Period 1, Pre-dose to 48 hours post-dose]

2. Part A, Period 2: Cmax of DS-2330a [Period 2, Pre-dose to 48 hours post-dose]

3. Part A, Period 1: Time to maximum concentration (Tmax) of DS-2330a [Period 1, Pre-dose to 48 hours post-dose]

4. Part A, Period 2: Tmax of DS-2330a [Period 2, Pre-dose to 48 hours post-dose]

5. Part A, Period 1: Area under the drug concentration curve (AUC) for DS-2330a over 24 hours (AUC-24) [Period 1, Pre-dose to 24 hours post-dose]

6. Part A, Period 2: AUC for DS-2330a for DS-2330a over 24 hours (AUC-24) [Period 2, Pre-dose to 24 hours post-dose]

7. Part A, Period 1: AUC at the last observable concentration (AUClast) and to infinity (AUCinf) for DS-2330a [Period 1, Pre-dose to 48 hours post-dose]

   Categories (with the same unit of measure ng*hr/mL): AUClast, AUCinf

8. Part A, Period 2: AUClast and AUCinf for DS-2330a [Period 2, Pre-dose to 48 hours post-dose]

   Categories (with the same unit of measure ng*hr/mL): AUClast, AUCinf

9. Parts B and C: Serum phosphate (Pi) levels before hemodialysis [within 15 days]

10. All Parts: Number of trial participants with treatment-emergent adverse events (TEAEs) [through trial completion (about 15 months)]

    TEAEs are adverse events (side effects) associated with taking an investigational product, whether or not they were caused by the investigational product. Clinically significant changes in physical exam findings, vital signs, electrocardiograms, clinical lab tests and thyroid function are recorded as TEAEs.

Secondary Outcome Measures

1. Parts B and C: Cmax of DS-2330a [within 24 hours on Day 1]

2. Parts B and C: Cmax of DS-2330a [within 24 hours on Day 13]

3. Parts B and C: Tmax of DS-2330a [within 24 hours, Day 1]

4. Parts B and C: Tmax of DS-2330a [within 24 hours, Day 13]

5. Parts B and C: AUC-24 for DS-2330a [Day 1]

6. Parts B and C: AUC-24 for DS-2330a [Day 13]

7. Parts B and C: AUCinf for DS-2330a [Day 1]

8. Parts B and C: AUCinf for DS-2330a [Day 13]

9. Parts B and C: Minimum concentration (Ctrough) of DS-2330a [within 11 days]

   Trough blood levels for DS-2330a will be collected before the morning dose (prior to breakfast)

10. Part B: Dialysis clearance of DS-2330a [on Day 11]

Eligibility Criteria

Criteria

• Ages Eligible for Study: 18 Years to 80 Years
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Inclusion Criteria:

• Has a body mass index (BMI) of 18 kg/m^{2 to 40 kg/m}2 (inclusive)

• Is on prescribed maintenance hemodialysis (three times a week) for at least 3 months before Screening with adequacy demonstrated by a dialysis clearance within 3 months before the first dose of the investigational medicinal product

• Has permanent vascular access [arteriovenous (A-V) fistula or graft]

• Is willing to comply with protocol-specified methods for family planning

• For Parts B and C only:

1. Has protocol-specified acceptable serum Pi levels at Screening and in serum Pi after up to 3 weeks of washout from all Pi binders

2. Has protocol-specified acceptable serum Ca^2+ level and intact parathyroid hormone (iPTH) level at screening

Exclusion Criteria:

• Is employed by the clinic or the sponsor

• Has family relationship with another study participant

• Has any history, current condition, or drug use that per protocol or in the opinion of the investigator might compromise:

1. safety of the participant or their children

2. safety of study staff

3. analysis of study results

• For Parts B and C only:

1. Is not able to take sevelamer carbonate

2. Has had partial or total parathyroidectomy within the last six months

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	DaVita Clinical Research	Lakewood	Colorado	United States	80228
2	Orlando Clinical Research Center	Orlando	Florida	United States	32809
3	DaVita Clinical Research	Minneapolis	Minnesota	United States	55404
4	Prism Clinical Research	Saint Paul	Minnesota	United States	55114

Sponsors and Collaborators

• Daiichi Sankyo, Inc.

Investigators

• Study Director: Global Clinical Leader, Daiichi Sankyo, Inc.

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.

• Responsible Party: Daiichi Sankyo, Inc.
• ClinicalTrials.gov Identifier: NCT03305471
• Other Study ID Numbers: DS2330-A-U103
• First Posted: Oct 10, 2017
• Last Update Posted: Mar 25, 2019
• Last Verified: Mar 1, 2019

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No
• Keywords provided by Daiichi Sankyo, Inc.: Chronic hemodialysis; Investigational drug
• Additional relevant MeSH terms: Hyperphosphatemia; Sevelamer

Study Results

No Results Posted as of Mar 25, 2019