CRUISE 1: Continuous Soluble Ferric Pyrophosphate (SFP) Iron Delivery Via Dialysate in Hemodialysis Patients

Sponsor
Rockwell Medical Technologies, Inc. (Industry)
Overall Status
Completed
CT.gov ID
NCT01320202
Collaborator
(none)
305
47
2
32.1
6.5
0.2

Study Details

Study Description

Brief Summary

The purpose of this study is to confirm the safety and efficacy of Soluble Ferric Pyrophosphate (SFP) dialysate solution in maintaining iron delivery for erythropoiesis in anemic adult patients with chronic kidney disease (CKD) receiving hemodialysis. Efficacy will be measured primarily by the change from baseline in hemoglobin (Hgb).

Condition or Disease Intervention/Treatment Phase
  • Drug: Soluble Ferric Pyrophosphate (SFP)
  • Device: Standard dialysate
Phase 3

Detailed Description

Screening: 2-3 weeks prior to enrollment in Stage 1.

Stage 1 (Run-In): 1-4 weeks depending on qualification for Stage 2.

Stage 2 (Randomized Blinded Treatment): 12 months unless withdrawn prematurely.

Stage 3 (Open-Label Treatment): The duration of Stage 2 plus Stage 3 is intended to be 18 months regardless of treatment assignment in Stage 2.

Study Design

Study Type:
Interventional
Actual Enrollment :
305 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Single (Participant)
Primary Purpose:
Treatment
Official Title:
A Randomized, Placebo-Controlled, Phase III Study of Dialysate Containing Soluble Ferric Pyrophosphate (SFP) in Chronic Kidney Disease Patients Receiving Hemodialysis: The Continuous Replacement Using Iron Soluble Equivalents (CRUISE 1) Study
Study Start Date :
Mar 1, 2011
Actual Primary Completion Date :
May 1, 2013
Actual Study Completion Date :
Nov 1, 2013

Arms and Interventions

Arm Intervention/Treatment
Active Comparator: Soluble Ferric Pyrophosphate (SFP) in dialysate

11 micrograms (µg) of iron / deciliter (dL) of dialysate.

Drug: Soluble Ferric Pyrophosphate (SFP)
Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 18 months.

Placebo Comparator: Standard Dialysate

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

Device: Standard dialysate
Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week.

Outcome Measures

Primary Outcome Measures

  1. Change From Baseline Hemoglobin at End-of-Treatment: Least-Squares Mean [Hgb measured weekly; up to 48 weeks from the date of randomization]

    Mean change from baseline Hgb (the average of the three most recent Hgb values preceding randomization) assessments during the last one-sixth of the treatment period for patients who prematurely withdraw from study treatment, but will include a minimum of at least the last two Hgb values. Value is expressed as least-squares mean with standard error.

  2. Change From Baseline Hemoglobin at End-of-Treatment: Mean Baseline and End-of-Treatment Hgb [Hgb measured weekly; up to 48 weeks from the date of randomization]

    Mean change from baseline Hgb (the average of the three most recent Hgb values preceding randomization) assessments during the last one-sixth of the treatment period for patients who prematurely withdraw from study treatment, but will include a minimum of at least the last two Hgb values. Values expressed are mean baseline and end-of-treatment Hgb, along with the mean difference (standard deviation).

Secondary Outcome Measures

  1. Mean Change in Serum Iron From Pre-dialysis to Post-dialysis. [Up to 48 weeks from the date of randomization]

    The mean difference between the pre-dialysis and post-dialysis serum iron was calculated, using all post-baseline values obtained during Stage 2. Subjects could participate in Stage 2 for up to 48 weeks, provided that they did not complete Stage 2 early due to a protocol-mandated change in anemia management or withdraw from the study entirely for other reasons.

  2. Mean Change in TSAT (Transferrin) From Pre-dialysis to Post-dialysis. [Up to 48 weeks from the date of randomization]

    The mean difference between the pre-dialysis and post-dialysis TSAT (transferrin) was calculated, using all post-baseline values obtained during Stage 2. Subjects could participate in Stage 2 for up to 48 weeks, provided that they did not complete Stage 2 early due to a protocol-mandated change in anemia management or withdraw from the study entirely for other reasons.

  3. Mean Change in Unsaturated Iron Binding Capacity (UIBC) From Pre- to Post-dialysis. [Up to 48 weeks from the date of randomization]

    The mean difference between the pre-dialysis and post-dialysis unsaturated iron binding capacity (UIBC) was calculated, using all post-baseline values obtained during Stage 2. Subjects could participate in Stage 2 for up to 48 weeks, provided that they did not complete Stage 2 early due to a protocol-mandated change in anemia management or withdraw from the study entirely for other reasons.

  4. Red Blood Cell or Whole Blood Transfusion: Number of Patients Receiving Transfusion [up to 48 weeks from the date of randomization]

    The number of patients requiring red blood cell or whole blood transfusion while in the randomized treatment stage (Stage 2). Patients remained in Stage 2 until they met protocol-defined criteria for Stage 2 completion or until they had participated in Stage 2 for 48 weeks (whichever came sooner). If a patient was transfused, they were withdrawn from Stage 2.

  5. Red Blood Cell or Whole Blood Transfusion: Number of Units Transfused [up to 48 weeks from the date of randomization]

    The total number of units of red blood cells or whole blood that were received by patients while in the randomized treatment stage (Stage 2). This number is the total number of units received across all randomized patients in each treatment group (it is not the average number of units received per patient). Patients remained in Stage 2 until they met protocol-defined criteria for Stage 2 completion or until they had participated in Stage 2 for 48 weeks (whichever came sooner). If a patient was transfused, they were withdrawn from Stage 2.

  6. Percentage of Change From Baseline to End-of-Treatment (EoT) for: Reticulocyte Hemoglobin Content (CHr), Ferritin, and Pre-Dialysis Serum Iron Panel [Up to 48 weeks from the date of randomization]

    A comparison of the lab values at the end-of-treatment (EoT) to baseline was performed, and the percentage of change from baseline was calculated for the following lab parameters: reticulocyte hemoglobin content (CHr), Ferritin, pre-dialysis unbound iron-binding capacity (UIBC), pre-dialysis serum iron, pre-dialysis transferrin, pre-dialysis total iron-binding capacity TIBC), and transferrin saturation (TSAT).

  7. Change From Baseline to End-of-Treatment (EoT) in Pre-Dialysis Unsaturated Iron-Binding Capacity (UIBC), Serum Iron, and Total Iron-Binding Capacity (TIBC) [Up to 48 weeks from the date of randomization]

    The Mean Change from Stage 2 Baseline to End-of-Treatment (EoT) in Pre-Dialysis Unsaturated Iron-Binding Capacity (UIBC), Pre-Dialysis Serum Iron, and Pre-Dialysis Total Iron-Binding Capacity (TIBC) will be quantified.

  8. Change From Baseline to End-of-Treatment (EoT) in Reticulocyte Hemoglobin Content (CHr) [Up to 48 weeks from the date of randomization]

    The Mean Change from Stage 2 Baseline to End-of-Treatment (EoT) in Reticulocyte Hemoglobin Content (CHr) will be quantified.

  9. Change From Baseline to End-of-Treatment (EoT) in Ferritin [Up to 48 weeks from the date of randomization]

    The Mean Change from Stage 2 Baseline to End-of-Treatment (EoT) in Ferritin will be quantified.

  10. Change From Baseline to End-of-Treatment (EoT) in Pre-Dialysis Transferrin [Up to 48 weeks from the date of randomization]

    The Mean Change from Stage 2 Baseline to End-of-Treatment (EoT) in Pre-Dialysis Transferrin will be quantified.

  11. Change From Baseline to End-of-Treatment (EoT) in Pre-Dialysis Transferrin Saturation (TSAT) [Up to 48 weeks from the date of randomization]

    The Mean Change from Stage 2 Baseline to End-of-Treatment (EoT) in Pre-Dialysis Transferrin Saturation (TSAT) will be quantified.

  12. Variability of Hemoglobin Concentration: Temporal Trend [Hgb measured weekly; up to 48 weeks from the date of randomization]

    The mean temporal trend of hemoglobin concentration value changes, as measured weekly from baseline until the end of participation in Stage 2.

  13. Variability of Hemoglobin Concentration: Residual Standard Deviation [Hgb measured weekly; up to 48 weeks from the date of randomization]

    The mean residual standard deviation of hemoglobin concentration value changes, as measured weekly from baseline until the end of participation in Stage 2.

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Stage 1:
Main Inclusion Criteria:
  • Adult subject ≥ 18 years of age undergoing chronic hemodialysis three or four times per week for chronic kidney disease (CKD) for at least 4 months, and expected to remain on hemodialysis three to four times weekly and be able to complete the duration of the study.

  • Received IV iron therapy between 6 months and 2 weeks prior to enrollment in order to replace iron losses resulting from hemodialysis procedure.

  • Mean Screening Hgb ≥ 9.5 to ≤ 11.5 grams per deciliter (g/dL).

  • Mean Screening Transferrin Saturation (TSAT) ≥ 15% to ≤ 40%.

  • Mean Screening serum ferritin ≥ 200 to ≤ 800 micrograms per liter (µg/L).

  • If being administered epoetin, darbepoetin, or CERA, epoetin dose ≤ 45,000 Units (U)/week, darbepoetin dose ≤ 200 micrograms (µg)/week, or CERA dose ≤ 400 micrograms (µg)/month during the four weeks prior to enrollment.

Main Exclusion Criteria:
  • Patient has living kidney donor identified or living-donor kidney transplant scheduled. (Note: Patients awaiting deceased-donor transplant need not be excluded.)

  • Vascular access for dialysis with femoral catheter or non-tunneled catheter.

  • Received a total of > 800 milligrams (mg) IV iron during the 8 weeks prior to enrollment

  • If being administered an ESA, route of administration change or ESA dose change > 35% (i.e., [max - min dose]/max dose > 0.35) over the 2 weeks prior to screening.

  • Serum albumin < 3.0 grams per deciliter (g/dL) any time over the 8 weeks prior to enrollment.

  • Red Blood Cell (RBC) or whole blood transfusion within 12 weeks prior to enrollment.

Stage 2:
Main Inclusion Criteria:
  • Patient currently enrolled in the Stage 1 run-in period of study.

  • Undergoing chronic hemodialysis three or four times per week for chronic kidney disease (CKD), and expected to remain on hemodialysis three to four times weekly and be able to complete duration of the study.

  • Mean Hgb ≥ 9.5 to ≤ 11.5 g/dL over the three most recent consecutive every-week measurements prior to randomization.

  • Stable Hgb defined as ≤ 1.0 g/dL difference between the maximum and minimum Hgb values over the 3 weeks immediately prior to randomization.

  • Mean TSAT ≥ 15% to ≤ 40% over the two most recent consecutive every-other-week measurements prior to randomization.

  • Mean serum ferritin ≥ 200 to ≤ 800 µg/L over the two most recent consecutive every-other-week measurements prior to randomization.

  • If being administered epoetin, darbepoetin, or CERA, epoetin dose ≤ 45,000 U/week, darbepoetin dose ≤ 200 µg/week, or CERA dose ≤ 400 µg/month during the four weeks prior to randomization.

Main Exclusion Criteria:
  • Patient has living kidney donor identified or living-donor kidney transplant scheduled. (Note: Patients awaiting deceased-donor transplant need not be excluded.)

  • Vascular access for dialysis with femoral catheter or non-tunneled catheter.

  • Received any amount of IV iron during the 4 weeks prior to randomization.

  • If being administered an (Erythropoietin Stimulating Agent) ESA, change in dose over the 6 weeks immediately prior to randomization.

  • Serum albumin < 3.0 g/dL any time over the 8 weeks prior to randomization.

  • RBC or whole blood transfusion during Stage 1.

Stage 3:
Main Inclusion Criteria:
  • Patient randomized in Stage 2 who has completed the full duration of Stage 2 and less than 4 weeks have elapsed since completion of Stage 2, OR

  • Patient in Stage 2 who has been prematurely withdrawn from Stage 2 for protocol-defined Protocol-Mandated Change in Anemia Management and less than 4 weeks have elapsed since withdrawal from Stage 2, OR

  • Patient in Stage 2 who has been prematurely withdrawn from Stage 2 for Hgb >11.5 g/dL over ≥ 1 week confirmed by ≥ 2 consecutive measurements AND an associated increase in Hgb by ≥ 1 g/dL over 4 weeks.

Main Exclusion Criteria:
  • Patient in Stage 2 who has been prematurely withdrawn from Stage 2 for any reason other than as noted in inclusion criteria above.

Contacts and Locations

Locations

Site City State Country Postal Code
1 Bakersfield California United States 93308
2 Investigative Site Chula Vista California United States 91910
3 Cudahy California United States 90201
4 Downey California United States 90240
5 Encino California United States 91316
6 Los Angeles California United States 90022
7 Los Angeles California United States 90033
8 Los Angeles California United States 90057
9 Los Angeles California United States 90404
10 National City California United States 91950
11 Northridge California United States 91324
12 Ontario California United States 91764
13 Panorama City California United States 91402
14 Riverside California United States 92505
15 San Dimas California United States 91773
16 Simi Valley California United States 93065
17 West Covina California United States 91792
18 Yuba City California United States 95991
19 Investigative Site Waterbury Connecticut United States 06708
20 Waterbury Connecticut United States 06708
21 Coral Springs Florida United States 33071
22 Miami Florida United States 33150
23 Investigative Site Augusta Georgia United States 30901
24 Chicago Illinois United States 60617
25 Michigan City Indiana United States 46360
26 Detroit Michigan United States 48202
27 Las Vegas Nevada United States 89102
28 Investigative Site Mineola New York United States 11501
29 Investigative Site Ridgewood New York United States 11385
30 Rosedale New York United States 11422
31 Yonkers New York United States 10704
32 Asheville North Carolina United States 28801
33 Durham North Carolina United States 27704
34 Winston-Salem North Carolina United States 27105
35 Cincinnati Ohio United States 45206
36 Toledo Ohio United States 43613
37 Sumter South Carolina United States 29150
38 Chattanooga Tennessee United States 37404
39 Arlington Texas United States 76011
40 Fort Worth Texas United States 76164
41 Investigative Site Houston Texas United States 77004
42 Houston Texas United States 77081
43 San Antonio Texas United States 78207
44 Fairfax Virginia United States 22030
45 Shorewood Wisconsin United States 53211
46 Caguas Puerto Rico 00725
47 Carolina Puerto Rico 00987

Sponsors and Collaborators

  • Rockwell Medical Technologies, Inc.

Investigators

  • Study Director: Ray Pratt, MD, Rockwell Medical

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Rockwell Medical Technologies, Inc.
ClinicalTrials.gov Identifier:
NCT01320202
Other Study ID Numbers:
  • RMTI-SFP-4
First Posted:
Mar 22, 2011
Last Update Posted:
Apr 26, 2017
Last Verified:
Apr 1, 2017
Keywords provided by Rockwell Medical Technologies, Inc.
Additional relevant MeSH terms:

Study Results

Participant Flow

Recruitment Details
Pre-assignment Detail
Arm/Group Title Soluble Ferric Pyrophosphate (SFP) in Dialysate Standard Dialysate
Arm/Group Description 11 micrograms (µg) of iron / deciliter (dL) of dialysate. Soluble Ferric Pyrophosphate (SFP): Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 48 weeks. 0 micrograms (µg) of iron / deciliter (dL) of dialysate. Standard dialysate: Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week for up to 48 weeks.
Period Title: Overall Study
STARTED 152 153
Comp 48 Wks in St 2 27 27
Comp St 2 Due to ESA/IV Iron Needs 69 82
Enrolled in St 3 98 109
Completed St 3 79 82
COMPLETED 96 109
NOT COMPLETED 56 44

Baseline Characteristics

Arm/Group Title Soluble Ferric Pyrophosphate (SFP) in Dialysate Standard Dialysate Total
Arm/Group Description 11 micrograms (µg) of iron / deciliter (dL) of dialysate. Soluble Ferric Pyrophosphate (SFP): Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 18 months. 0 micrograms (µg) of iron / deciliter (dL) of dialysate. Standard dialysate: Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week for up to 18 months. Total of all reporting groups
Overall Participants 152 153 305
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]
56.6
(12.56)
59.9
(13.01)
58.3
(12.87)
Sex: Female, Male (Count of Participants)
Female
50
32.9%
48
31.4%
98
32.1%
Male
102
67.1%
105
68.6%
207
67.9%
Ethnicity (NIH/OMB) (Count of Participants)
Hispanic or Latino
74
48.7%
65
42.5%
139
45.6%
Not Hispanic or Latino
78
51.3%
88
57.5%
166
54.4%
Unknown or Not Reported
0
0%
0
0%
0
0%
Race (NIH/OMB) (Count of Participants)
American Indian or Alaska Native
6
3.9%
12
7.8%
18
5.9%
Asian
8
5.3%
5
3.3%
13
4.3%
Native Hawaiian or Other Pacific Islander
2
1.3%
0
0%
2
0.7%
Black or African American
50
32.9%
48
31.4%
98
32.1%
White
84
55.3%
84
54.9%
168
55.1%
More than one race
0
0%
0
0%
0
0%
Unknown or Not Reported
2
1.3%
4
2.6%
6
2%
Region of Enrollment (participants) [Number]
United States
145
95.4%
143
93.5%
288
94.4%
Puerto Rico
7
4.6%
10
6.5%
17
5.6%
post-dialysis body weight (kilograms) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [kilograms]
84.08
(23.264)
83.15
(22.166)
83.61
(22.685)
height (centimeters) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [centimeters]
168.48
(10.197)
169.17
(9.350)
168.82
(9.771)

Outcome Measures

1. Primary Outcome
Title Change From Baseline Hemoglobin at End-of-Treatment: Least-Squares Mean
Description Mean change from baseline Hgb (the average of the three most recent Hgb values preceding randomization) assessments during the last one-sixth of the treatment period for patients who prematurely withdraw from study treatment, but will include a minimum of at least the last two Hgb values. Value is expressed as least-squares mean with standard error.
Time Frame Hgb measured weekly; up to 48 weeks from the date of randomization

Outcome Measure Data

Analysis Population Description
modified intent-to-treat populations: all randomized subjects who received at least one dose of study medication and had at least one post-dose hemoglobin measurement obtained.
Arm/Group Title Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate Stage 2 Placebo (Standard Dialysate)
Arm/Group Description 11 micrograms (µg) of iron / deciliter (dL) of dialysate. Soluble Ferric Pyrophosphate (SFP): Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 48 weeks. 0 micrograms (µg) of iron / deciliter (dL) of dialysate. Standard dialysate: Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week for up to 48 weeks.
Measure Participants 148 151
Least Squares Mean (Standard Error) [grams per liter]
0.6
(1.15)
-3.0
(1.14)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate, Stage 2 Placebo (Standard Dialysate)
Comments
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value 0.011
Comments LS Mean (SE) and p-value are from ANCOVA model with baseline Hgb as covariate. Model also includes indicator variable for baseline ESA dose stratum.
Method ANCOVA
Comments
Method of Estimation Estimation Parameter Difference in LS Means between SFP & PBO
Estimated Value 3.6
Confidence Interval (2-Sided) %
to
Parameter Dispersion Type: Standard Error of the Mean
Value: 1.40
Estimation Comments
2. Secondary Outcome
Title Mean Change in Serum Iron From Pre-dialysis to Post-dialysis.
Description The mean difference between the pre-dialysis and post-dialysis serum iron was calculated, using all post-baseline values obtained during Stage 2. Subjects could participate in Stage 2 for up to 48 weeks, provided that they did not complete Stage 2 early due to a protocol-mandated change in anemia management or withdraw from the study entirely for other reasons.
Time Frame Up to 48 weeks from the date of randomization

Outcome Measure Data

Analysis Population Description
modified intent-to-treat population: all randomized subjects who received at least one dose of study drug and had at least one post-dose hemoglobin measured.
Arm/Group Title Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate Stage 2 Placebo (Standard Dialysate)
Arm/Group Description 11 micrograms (µg) of iron / deciliter (dL) of dialysate. Soluble Ferric Pyrophosphate (SFP): Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 48 weeks. 0 micrograms (µg) of iron / deciliter (dL) of dialysate. Standard dialysate: Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week for up to 48 weeks.
Measure Participants 148 151
mean pre-dialysis serum iron
12.1
(4.15)
10.8
(3.04)
mean post-dialysis serum iron
29.6
(8.64)
11.5
(3.91)
serum iron change from pre- to post-dialysis
17.5
(8.70)
0.6
(3.08)
3. Secondary Outcome
Title Mean Change in TSAT (Transferrin) From Pre-dialysis to Post-dialysis.
Description The mean difference between the pre-dialysis and post-dialysis TSAT (transferrin) was calculated, using all post-baseline values obtained during Stage 2. Subjects could participate in Stage 2 for up to 48 weeks, provided that they did not complete Stage 2 early due to a protocol-mandated change in anemia management or withdraw from the study entirely for other reasons.
Time Frame Up to 48 weeks from the date of randomization

Outcome Measure Data

Analysis Population Description
modified intent-to treat: all randomized subjects who had at least one dose of study drug and had at least one post-dose hemoglobin measured.
Arm/Group Title Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate Stage 2 Placebo (Standard Dialysate)
Arm/Group Description 11 micrograms (µg) of iron / deciliter (dL) of dialysate. Soluble Ferric Pyrophosphate (SFP): Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 48 weeks. 0 micrograms (µg) of iron / deciliter (dL) of dialysate. Standard dialysate: Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week for up to 48 weeks.
Measure Participants 148 151
mean pre-dialysis TSAT(transferrin)
24.9
(6.86)
22.4
(5.97)
mean post-dialysis TSAT(transferrin)
57.9
(15.94)
22.2
(7.80)
pre- to post-dialysis change in TSAT
32.7
(15.83)
-0.4
(6.86)
4. Secondary Outcome
Title Mean Change in Unsaturated Iron Binding Capacity (UIBC) From Pre- to Post-dialysis.
Description The mean difference between the pre-dialysis and post-dialysis unsaturated iron binding capacity (UIBC) was calculated, using all post-baseline values obtained during Stage 2. Subjects could participate in Stage 2 for up to 48 weeks, provided that they did not complete Stage 2 early due to a protocol-mandated change in anemia management or withdraw from the study entirely for other reasons.
Time Frame Up to 48 weeks from the date of randomization

Outcome Measure Data

Analysis Population Description
modified intent-to-treat: all randomized subjects who received at least one dose of study drug and had at least one post-dose hemoglobin measured.
Arm/Group Title Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate Stage 2 Placebo (Standard Dialysate)
Arm/Group Description 11 micrograms (µg) of iron / deciliter (dL) of dialysate. Soluble Ferric Pyrophosphate (SFP): Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 48 weeks. 0 micrograms (µg) of iron / deciliter (dL) of dialysate. Standard dialysate: Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week for up to 48 weeks.
Measure Participants 148 151
mean pre-dialysis UIBC
31.49
(6.797)
32.27
(6.580)
mean post-dialysis UIBC
19.48
(7.911)
34.51
(7.208)
pre- to post-dialysis change in UIBC
-11.86
(6.604)
2.38
(3.253)
5. Secondary Outcome
Title Red Blood Cell or Whole Blood Transfusion: Number of Patients Receiving Transfusion
Description The number of patients requiring red blood cell or whole blood transfusion while in the randomized treatment stage (Stage 2). Patients remained in Stage 2 until they met protocol-defined criteria for Stage 2 completion or until they had participated in Stage 2 for 48 weeks (whichever came sooner). If a patient was transfused, they were withdrawn from Stage 2.
Time Frame up to 48 weeks from the date of randomization

Outcome Measure Data

Analysis Population Description
Intent-to-Treat (ITT): all patients randomized are included.
Arm/Group Title Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate Stage 2 Placebo (Standard Dialysate)
Arm/Group Description 11 micrograms (µg) of iron / deciliter (dL) of dialysate. Soluble Ferric Pyrophosphate (SFP): Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 48 weeks in Stage 2. 0 micrograms (µg) of iron / deciliter (dL) of dialysate. Standard dialysate: Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week for up to 48 weeks in Stage 2.
Measure Participants 152 153
Number [participants]
3
2%
11
7.2%
6. Secondary Outcome
Title Red Blood Cell or Whole Blood Transfusion: Number of Units Transfused
Description The total number of units of red blood cells or whole blood that were received by patients while in the randomized treatment stage (Stage 2). This number is the total number of units received across all randomized patients in each treatment group (it is not the average number of units received per patient). Patients remained in Stage 2 until they met protocol-defined criteria for Stage 2 completion or until they had participated in Stage 2 for 48 weeks (whichever came sooner). If a patient was transfused, they were withdrawn from Stage 2.
Time Frame up to 48 weeks from the date of randomization

Outcome Measure Data

Analysis Population Description
Intent-to-Treat (ITT): all patients randomized are included.
Arm/Group Title Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate Stage 2 Placebo (Standard Dialysate)
Arm/Group Description 11 micrograms (µg) of iron / deciliter (dL) of dialysate. Soluble Ferric Pyrophosphate (SFP): Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 48 weeks in Stage 2. 0 micrograms (µg) of iron / deciliter (dL) of dialysate. Standard dialysate: Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week for up to 48 weeks in Stage 2.
Measure Participants 152 153
Number [units of red blood cells or whole blood]
5
19
7. Secondary Outcome
Title Percentage of Change From Baseline to End-of-Treatment (EoT) for: Reticulocyte Hemoglobin Content (CHr), Ferritin, and Pre-Dialysis Serum Iron Panel
Description A comparison of the lab values at the end-of-treatment (EoT) to baseline was performed, and the percentage of change from baseline was calculated for the following lab parameters: reticulocyte hemoglobin content (CHr), Ferritin, pre-dialysis unbound iron-binding capacity (UIBC), pre-dialysis serum iron, pre-dialysis transferrin, pre-dialysis total iron-binding capacity TIBC), and transferrin saturation (TSAT).
Time Frame Up to 48 weeks from the date of randomization

Outcome Measure Data

Analysis Population Description
modified intent-to-treat: all randomized subjects who received at least one dose of study drug and had at least one post-dose hemoglobin measured.
Arm/Group Title Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate Stage 2 Placebo (Standard Dialysate)
Arm/Group Description 11 micrograms (µg) of iron / deciliter (dL) of dialysate. Soluble Ferric Pyrophosphate (SFP): Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 48 weeks in Stage 2. 0 micrograms (µg) of iron / deciliter (dL) of dialysate. Standard dialysate: Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week for up to 48 weeks in Stage 2.
Measure Participants 148 151
CHr: % of change from baseline
-0.64
(3.800)
-2.73
(4.289)
Ferritin: % of change from baseline
-14.8
(27.68)
-28.5
(34.35)
Pre-dialysis UIBC: % of change from baseline
8.36
(53.186)
7.62
(14.818)
Pre-dialysis serum iron: % of change from baseline
4.644
(53.1728)
-4.628
(29.0307)
Pre-dialysis transferrin: % change from baseline
1.718
(8.5133)
2.633
(9.7691)
Pre-dialysis TIBC: % of change from baseline
1.80
(9.255)
2.88
(10.253)
Pre-dialysis TSAT: % of change from baseline
1.8
(44.99)
-7.8
(26.42)
8. Secondary Outcome
Title Change From Baseline to End-of-Treatment (EoT) in Pre-Dialysis Unsaturated Iron-Binding Capacity (UIBC), Serum Iron, and Total Iron-Binding Capacity (TIBC)
Description The Mean Change from Stage 2 Baseline to End-of-Treatment (EoT) in Pre-Dialysis Unsaturated Iron-Binding Capacity (UIBC), Pre-Dialysis Serum Iron, and Pre-Dialysis Total Iron-Binding Capacity (TIBC) will be quantified.
Time Frame Up to 48 weeks from the date of randomization

Outcome Measure Data

Analysis Population Description
modified Intent-to-treat: all randomized subjects who received at least one dose of study drug and had at least one post-dose hemoglobin measured.
Arm/Group Title Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate Stage 2 Placebo (Standard Dialysate)
Arm/Group Description 11 micrograms (µg) of iron / deciliter (dL) of dialysate. Soluble Ferric Pyrophosphate (SFP): Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 48 weeks in Stage 2. 0 micrograms (µg) of iron / deciliter (dL) of dialysate. Standard dialysate: Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week for up to 48 weeks in Stage 2.
Measure Participants 148 151
Baseline UIBC
30.91
(6.784)
30.77
(6.452)
EoT UIBC
32.76
(13.734)
33.03
(7.527)
UIBC: Change from Baseline to EoT
1.93
(13.265)
2.14
(4.447)
Baseline Serum Iron
11.976
(3.9192)
11.443
(3.9198)
EoT Serum Iron
11.911
(4.5412)
10.389
(3.4941)
Serum Iron: Change from Baseline to EoT
-0.196
(4.7462)
-1.051
(3.6562)
Baseline TIBC
42.88
(7.458)
42.22
(7.380)
EoT TIBC
43.59
(8.140)
43.40
(7.964)
TIBC: Change from Baseline to EoT
0.65
(4.051)
1.08
(4.296)
9. Secondary Outcome
Title Change From Baseline to End-of-Treatment (EoT) in Reticulocyte Hemoglobin Content (CHr)
Description The Mean Change from Stage 2 Baseline to End-of-Treatment (EoT) in Reticulocyte Hemoglobin Content (CHr) will be quantified.
Time Frame Up to 48 weeks from the date of randomization

Outcome Measure Data

Analysis Population Description
modified Intent-to-treat: all randomized subjects who received at least one dose of study drug and had at least one post-dose hemoglobin measured.
Arm/Group Title Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate Stage 2 Placebo (Standard Dialysate)
Arm/Group Description 11 micrograms (µg) of iron / deciliter (dL) of dialysate. Soluble Ferric Pyrophosphate (SFP): Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 48 weeks in Stage 2. 0 micrograms (µg) of iron / deciliter (dL) of dialysate. Standard dialysate: Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week for up to 48 weeks in Stage 2.
Measure Participants 148 151
Baseline CHr
32.37
(1.985)
32.57
(1.953)
EoT CHr
32.12
(2.016)
31.64
(2.019)
CHr: Change from Baseline to EoT
-0.23
(1.203)
-0.91
(1.413)
10. Secondary Outcome
Title Change From Baseline to End-of-Treatment (EoT) in Ferritin
Description The Mean Change from Stage 2 Baseline to End-of-Treatment (EoT) in Ferritin will be quantified.
Time Frame Up to 48 weeks from the date of randomization

Outcome Measure Data

Analysis Population Description
modified Intent-to-treat: all randomized subjects who received at least one dose of study drug and had at least one post-dose hemoglobin measured.
Arm/Group Title Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate Stage 2 Placebo (Standard Dialysate)
Arm/Group Description 11 micrograms (µg) of iron / deciliter (dL) of dialysate. Soluble Ferric Pyrophosphate (SFP): Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 48 weeks in Stage 2. 0 micrograms (µg) of iron / deciliter (dL) of dialysate. Standard dialysate: Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week for up to 48 weeks in Stage 2.
Measure Participants 148 151
Baseline Ferritin
509.6
(194.16)
511.3
(209.68)
EoT Ferritin
440.7
(216.41)
366.9
(224.01)
Ferritin: Change from Baseline to EoT
-72.3
(133.40)
-143.1
(188.28)
11. Secondary Outcome
Title Change From Baseline to End-of-Treatment (EoT) in Pre-Dialysis Transferrin
Description The Mean Change from Stage 2 Baseline to End-of-Treatment (EoT) in Pre-Dialysis Transferrin will be quantified.
Time Frame Up to 48 weeks from the date of randomization

Outcome Measure Data

Analysis Population Description
modified Intent-to-treat: all randomized subjects who received at least one dose of study drug and had at least one post-dose hemoglobin measured.
Arm/Group Title Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate Stage 2 Placebo (Standard Dialysate)
Arm/Group Description 11 micrograms (µg) of iron / deciliter (dL) of dialysate. Soluble Ferric Pyrophosphate (SFP): Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 48 weeks in Stage 2. 0 micrograms (µg) of iron / deciliter (dL) of dialysate. Standard dialysate: Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week for up to 48 weeks in Stage 2.
Measure Participants 148 151
Baseline Pre-Dialysis Transferrin
1.928
(0.3427)
1.908
(0.3475)
EoT Pre-Dialysis Transferrin
1.958
(0.3767)
1.957
(0.3731)
Pre-Dialysis Ferritin: Change from Baseline to EoT
0.029
(0.1695)
0.044
(0.1883)
12. Secondary Outcome
Title Change From Baseline to End-of-Treatment (EoT) in Pre-Dialysis Transferrin Saturation (TSAT)
Description The Mean Change from Stage 2 Baseline to End-of-Treatment (EoT) in Pre-Dialysis Transferrin Saturation (TSAT) will be quantified.
Time Frame Up to 48 weeks from the date of randomization

Outcome Measure Data

Analysis Population Description
modified Intent-to-treat: all randomized subjects who received at least one dose of study drug and had at least one post-dose hemoglobin measured.
Arm/Group Title Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate Stage 2 Placebo (Standard Dialysate)
Arm/Group Description 11 micrograms (µg) of iron / deciliter (dL) of dialysate. Soluble Ferric Pyrophosphate (SFP): Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 48 weeks in Stage 2. 0 micrograms (µg) of iron / deciliter (dL) of dialysate. Standard dialysate: Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week for up to 48 weeks in Stage 2.
Measure Participants 148 151
Baseline Pre-Dialysis TSAT
28.1
(8.13)
27.1
(7.79)
EoT Pre-Dialysis TSAT
27.3
(8.52)
24.0
(7.44)
Pre-Dialysis TSAT: Change from Baseline to EoT
-1.1
(9.16)
-3.0
(7.70)
13. Secondary Outcome
Title Variability of Hemoglobin Concentration: Temporal Trend
Description The mean temporal trend of hemoglobin concentration value changes, as measured weekly from baseline until the end of participation in Stage 2.
Time Frame Hgb measured weekly; up to 48 weeks from the date of randomization

Outcome Measure Data

Analysis Population Description
modified intent to treat: all randomized subjects who received at least one dose of study medication and had at least one post-dose hemoglobin measured.
Arm/Group Title Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate Stage 2 Placebo (Standard Dialysate)
Arm/Group Description 11 micrograms (µg) of iron / deciliter (dL) of dialysate. Soluble Ferric Pyrophosphate (SFP): Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 48 weeks. 0 micrograms (µg) of iron / deciliter (dL) of dialysate. Standard dialysate: Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week for up to 48 weeks.
Measure Participants 148 151
Mean (Standard Deviation) [grams per liter per week]
0.060
(0.298)
0.002
(0.235)
14. Secondary Outcome
Title Variability of Hemoglobin Concentration: Residual Standard Deviation
Description The mean residual standard deviation of hemoglobin concentration value changes, as measured weekly from baseline until the end of participation in Stage 2.
Time Frame Hgb measured weekly; up to 48 weeks from the date of randomization

Outcome Measure Data

Analysis Population Description
modified intent to treat: all randomized subjects who received at least one dose of study medication and had at least one post-dose hemoglobin measured.
Arm/Group Title Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate Stage 2 Placebo (Standard Dialysate)
Arm/Group Description 11 micrograms (µg) of iron / deciliter (dL) of dialysate. Soluble Ferric Pyrophosphate (SFP): Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 48 weeks. 0 micrograms (µg) of iron / deciliter (dL) of dialysate. Standard dialysate: Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week for up to 48 weeks.
Measure Participants 148 151
Mean (Standard Deviation) [grams per liter]
4.104
(2.220)
4.588
(1.949)
15. Primary Outcome
Title Change From Baseline Hemoglobin at End-of-Treatment: Mean Baseline and End-of-Treatment Hgb
Description Mean change from baseline Hgb (the average of the three most recent Hgb values preceding randomization) assessments during the last one-sixth of the treatment period for patients who prematurely withdraw from study treatment, but will include a minimum of at least the last two Hgb values. Values expressed are mean baseline and end-of-treatment Hgb, along with the mean difference (standard deviation).
Time Frame Hgb measured weekly; up to 48 weeks from the date of randomization

Outcome Measure Data

Analysis Population Description
modified intent-to-treat: all randomized patients who received at least one dose of study drug and had at least one post-dose hemoglobin measured.
Arm/Group Title Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate Stage 2 Placebo (Standard Dialysate)
Arm/Group Description 11 micrograms (µg) of iron / deciliter (dL) of dialysate. Soluble Ferric Pyrophosphate (SFP): Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week for up to 48 weeks in Stage 2. 0 micrograms (µg) of iron / deciliter (dL) of dialysate. Standard dialysate: Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week for up to 48 weeks in Stage 2.
Measure Participants 148 151
mean baseline hemoglobin
109.6
(5.91)
109.0
(6.36)
mean end-of-treatment hemoglobin
109.1
(12.53)
105.2
(13.65)
mean change in Hemoglobin at end-of-treatment
-0.4
(11.67)
-3.9
(12.52)

Adverse Events

Time Frame In Stage 2, subjects were randomized to placebo or SFP. They were in Stage 2 for up to 48 weeks. Upon completion of Stage 2, subjects could enter the open-label Stage 3 (all received SFP). The maximum total time on study (Stage 2 + Stage 3) was 72 weeks.
Adverse Event Reporting Description The number of subjects included in the safety population = 300, which is 5 patients fewer than the number of patients randomized. This discrepancy is due to the fact that the Safety population includes only those subjects exposed to study drug. Five subjects withdrew from Stage 2 and 2 subjects withdrew from Stage 3 prior to exposure.
Arm/Group Title Stage 2 Placebo (Standard Dialysate) Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate Stage 3 Soluble Ferric Pyrophosphate (SFP) in Dialysate
Arm/Group Description 0 micrograms (µg) of iron / deciliter (dL) of dialysate. Standard dialysate: Patients to receive standard dialysate (no iron) during dialysis 3 or 4 times/week in Stage 2 for up to 48 weeks. 11 micrograms (µg) of iron / deciliter (dL) of dialysate. Soluble Ferric Pyrophosphate (SFP): Patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week in Stage 2 for up to 48 weeks. 11 micrograms (µg) of iron / deciliter (dL) of dialysate. Soluble Ferric Pyrophosphate (SFP): Upon completion of Stage 2, patients to receive 11 micrograms (µg) of iron/ deciliter (dL) of dialysate during dialysis 3 or 4 times/week in Stage 3 for up to 72 weeks of total study participation (Stage 2 + Stage 3).
All Cause Mortality
Stage 2 Placebo (Standard Dialysate) Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate Stage 3 Soluble Ferric Pyrophosphate (SFP) in Dialysate
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total / (NaN) / (NaN) / (NaN)
Serious Adverse Events
Stage 2 Placebo (Standard Dialysate) Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate Stage 3 Soluble Ferric Pyrophosphate (SFP) in Dialysate
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 45/151 (29.8%) 36/149 (24.2%) 81/205 (39.5%)
Blood and lymphatic system disorders
ANAEMIA 1/151 (0.7%) 1 1/149 (0.7%) 1 1/205 (0.5%) 1
ANAEMIA OF CHRONIC DISEASE 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
THROMBOCYTOPENIA 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
Cardiac disorders
ACUTE MYOCARDIAL INFARCTION 3/151 (2%) 3 3/149 (2%) 3 1/205 (0.5%) 1
ANGINA PECTORIS 0/151 (0%) 0 1/149 (0.7%) 1 3/205 (1.5%) 3
ANGINA UNSTABLE 0/151 (0%) 0 1/149 (0.7%) 1 0/205 (0%) 0
ATRIAL FIBRILLATION 1/151 (0.7%) 1 0/149 (0%) 0 3/205 (1.5%) 3
ATRIAL FLUTTER 1/151 (0.7%) 2 0/149 (0%) 0 1/205 (0.5%) 1
ATRIOVENTRICULAR BLOCK FIRST DEGREE 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
ATRIOVENTRICULAR BLOCK SECOND DEGREE 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
CARDIAC ARREST 1/151 (0.7%) 1 2/149 (1.3%) 2 5/205 (2.4%) 5
CARDIAC FAILURE CONGESTIVE 5/151 (3.3%) 8 1/149 (0.7%) 2 4/205 (2%) 8
CARDIOGENIC SHOCK 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
CARDIOMYOPATHY 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
CARDIO-RESPIRATORY ARREST 2/151 (1.3%) 2 0/149 (0%) 0 2/205 (1%) 2
CONGESTIVE CARDIOMYOPATHY 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
CORONARY ARTERY DISEASE 1/151 (0.7%) 1 2/149 (1.3%) 2 3/205 (1.5%) 3
INTRACARDIAC THROMBUS 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
MYOCARDIAL INFARCTION 1/151 (0.7%) 1 0/149 (0%) 0 1/205 (0.5%) 1
SUPRAVENTRICULAR TACHYCARDIA 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
Endocrine disorders
HYPERPARATHYROIDISM SECONDARY 0/151 (0%) 0 0/149 (0%) 0 2/205 (1%) 2
Gastrointestinal disorders
ABDOMINAL PAIN 0/151 (0%) 0 1/149 (0.7%) 1 0/205 (0%) 0
CROHN'S DISEASE 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
DIARRHOEA 2/151 (1.3%) 2 1/149 (0.7%) 1 0/205 (0%) 0
DIVERTICULUM INTESTINAL HAEMORRHAGIC 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
DYSPHAGIA 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
GASTRITIS 1/151 (0.7%) 1 0/149 (0%) 0 2/205 (1%) 2
GASTRITIS EROSIVE 0/151 (0%) 0 1/149 (0.7%) 1 1/205 (0.5%) 1
GASTROINTESTINAL HAEMORRHAGE 1/151 (0.7%) 1 0/149 (0%) 0 1/205 (0.5%) 1
GASTROOESOPHAGEAL REFLUX DISEASE 1/151 (0.7%) 1 0/149 (0%) 0 3/205 (1.5%) 3
LOWER GASTROINTESTINAL HAEMORRHAGE 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
NAUSEA 1/151 (0.7%) 1 0/149 (0%) 0 1/205 (0.5%) 1
OESOPHAGEAL ULCER HAEMORRHAGE 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
PANCREATITIS 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
PANCREATITIS ACUTE 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
PORTAL HYPERTENSIVE GASTROPATHY 0/151 (0%) 0 1/149 (0.7%) 1 0/205 (0%) 0
SMALL INTESTINAL OBSTRUCTION 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
VOMITING 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
General disorders
ADVERSE DRUG REACTION 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
CATHETER SITE HAEMATOMA 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
CHEST PAIN 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
CHILLS 0/151 (0%) 0 1/149 (0.7%) 1 0/205 (0%) 0
DEATH 0/151 (0%) 0 1/149 (0.7%) 1 0/205 (0%) 0
DEVICE DISLOCATION 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
NON-CARDIAC CHEST PAIN 5/151 (3.3%) 5 1/149 (0.7%) 1 3/205 (1.5%) 3
PYREXIA 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
STENT-GRAFT ENDOLEAK 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
SUDDEN DEATH 0/151 (0%) 0 1/149 (0.7%) 1 0/205 (0%) 0
Hepatobiliary disorders
CHOLANGITIS 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
Infections and infestations
ARTERIOVENOUS GRAFT SITE INFECTION 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
BACTERAEMIA 1/151 (0.7%) 1 0/149 (0%) 0 1/205 (0.5%) 1
CELLULITIS 1/151 (0.7%) 1 1/149 (0.7%) 1 2/205 (1%) 2
CLOSTRIDIUM DIFFICILE COLITIS 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
DEVICE RELATED INFECTION 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
DIVERTICULITIS 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
ENDOCARDITIS 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
GANGRENE 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
GASTROENTERITIS 0/151 (0%) 0 0/149 (0%) 0 3/205 (1.5%) 3
GASTROENTERITIS VIRAL 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
INFECTED SKIN ULCER 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
LOBAR PNEUMONIA 0/151 (0%) 0 1/149 (0.7%) 1 0/205 (0%) 0
OSTEOMYELITIS 0/151 (0%) 0 0/149 (0%) 0 2/205 (1%) 2
PNEUMONIA 5/151 (3.3%) 5 4/149 (2.7%) 4 5/205 (2.4%) 10
RENAL CYST INFECTION 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
SEPSIS 0/151 (0%) 0 1/149 (0.7%) 1 4/205 (2%) 4
STAPHYLOCOCCAL BACTERAEMIA 0/151 (0%) 0 0/149 (0%) 0 3/205 (1.5%) 3
UPPER RESPIRATORY TRACT INFECTION 2/151 (1.3%) 2 0/149 (0%) 0 0/205 (0%) 0
URINARY TRACT INFECTION 1/151 (0.7%) 1 1/149 (0.7%) 1 2/205 (1%) 2
UROSEPSIS 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
VIRAL INFECTION 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
Injury, poisoning and procedural complications
ANAEMIA POSTOPERATIVE 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
ARTERIOVENOUS FISTULA ANEURYSM 0/151 (0%) 0 1/149 (0.7%) 1 0/205 (0%) 0
ARTERIOVENOUS FISTULA OCCLUSION 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
ARTERIOVENOUS FISTULA SITE COMPLICATION 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
ARTERIOVENOUS FISTULA SITE HAEMATOMA 0/151 (0%) 0 1/149 (0.7%) 1 0/205 (0%) 0
ARTERIOVENOUS FISTULA SITE HAEMORRHAGE 0/151 (0%) 0 1/149 (0.7%) 1 1/205 (0.5%) 1
ARTERIOVENOUS FISTULA THROMBOSIS 1/151 (0.7%) 1 2/149 (1.3%) 2 4/205 (2%) 4
COMMINUTED FRACTURE 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
FACIAL BONES FRACTURE 1/151 (0.7%) 1 1/149 (0.7%) 1 0/205 (0%) 0
HEAD INJURY 1/151 (0.7%) 1 0/149 (0%) 0 1/205 (0.5%) 1
HIP FRACTURE 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
MUSCLE RUPTURE 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
MUSCLE STRAIN 0/151 (0%) 0 1/149 (0.7%) 1 0/205 (0%) 0
POST PROCEDURAL HAEMATOMA 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
PROCEDURAL HYPERTENSION 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
PROCEDURAL HYPOTENSION 0/151 (0%) 0 0/149 (0%) 0 2/205 (1%) 2
ROAD TRAFFIC ACCIDENT 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
VASCULAR GRAFT THROMBOSIS 1/151 (0.7%) 1 0/149 (0%) 0 4/205 (2%) 6
Metabolism and nutrition disorders
DECREASED APPETITE 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
DEHYDRATION 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
DIABETES MELLITUS INADEQUATE CONTROL 0/151 (0%) 0 1/149 (0.7%) 1 0/205 (0%) 0
DIABETIC FOOT 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
FLUID OVERLOAD 10/151 (6.6%) 12 2/149 (1.3%) 2 5/205 (2.4%) 5
HYPERGLYCAEMIA 2/151 (1.3%) 2 0/149 (0%) 0 0/205 (0%) 0
HYPERKALAEMIA 4/151 (2.6%) 7 0/149 (0%) 0 9/205 (4.4%) 11
HYPOGLYCAEMIA 0/151 (0%) 0 0/149 (0%) 0 2/205 (1%) 2
HYPOVOLAEMIA 0/151 (0%) 0 0/149 (0%) 0 2/205 (1%) 2
Musculoskeletal and connective tissue disorders
BACK PAIN 0/151 (0%) 0 1/149 (0.7%) 1 0/205 (0%) 0
CERVICAL SPINAL STENOSIS 0/151 (0%) 0 1/149 (0.7%) 1 0/205 (0%) 0
CHONDROCALCINOSIS PYROPHOSPHATE 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
MUSCULOSKELETAL CHEST PAIN 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
OSTEOARTHRITIS 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
POLYMYALGIA RHEUMATICA 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
SPONDYLOLISTHESIS 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
CERVIX CARCINOMA STAGE 0 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
COLORECTAL CANCER 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
HAEMANGIOMA OF LIVER 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
OVARIAN LOW MALIGNANT POTENTIAL TUMOUR 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
PROSTATE CANCER 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
RENAL CELL CARCINOMA 2/151 (1.3%) 2 0/149 (0%) 0 0/205 (0%) 0
Nervous system disorders
CEREBROVASCULAR ACCIDENT 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
CONVULSION 0/151 (0%) 0 1/149 (0.7%) 1 0/205 (0%) 0
DIZZINESS 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
ENCEPHALOPATHY 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
HEADACHE 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
HEPATIC ENCEPHALOPATHY 0/151 (0%) 0 1/149 (0.7%) 1 1/205 (0.5%) 1
HYPERTENSIVE ENCEPHALOPATHY 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
LOSS OF CONSCIOUSNESS 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
METABOLIC ENCEPHALOPATHY 0/151 (0%) 0 0/149 (0%) 0 3/205 (1.5%) 3
SYNCOPE 1/151 (0.7%) 1 2/149 (1.3%) 2 3/205 (1.5%) 3
TOXICITY TO VARIOUS AGENTS 0/151 (0%) 0 1/149 (0.7%) 1 0/205 (0%) 0
Psychiatric disorders
ANXIETY 0/151 (0%) 0 1/149 (0.7%) 1 0/205 (0%) 0
MENTAL STATUS CHANGES 1/151 (0.7%) 1 0/149 (0%) 0 1/205 (0.5%) 1
Renal and urinary disorders
RENAL CYST HAEMORRHAGE 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
Reproductive system and breast disorders
ENDOMETRIAL HYPERPLASIA 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
Respiratory, thoracic and mediastinal disorders
ACUTE PULMONARY OEDEMA 1/151 (0.7%) 4 0/149 (0%) 0 0/205 (0%) 0
ACUTE RESPIRATORY FAILURE 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
PLEURAL EFFUSION 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 2
PNEUMONIA ASPIRATION 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
PULMONARY CONGESTION 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
PULMONARY OEDEMA 1/151 (0.7%) 1 0/149 (0%) 0 1/205 (0.5%) 1
RESPIRATORY ARREST 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
RESPIRATORY DISTRESS 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
RESPIRATORY FAILURE 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
Skin and subcutaneous tissue disorders
SKIN ULCER 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
Surgical and medical procedures
CARDIOVERSION 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
Vascular disorders
ACCELERATED HYPERTENSION 0/151 (0%) 0 1/149 (0.7%) 1 0/205 (0%) 0
ARTERIOSCLEROSIS 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 3
DEEP VEIN THROMBOSIS 2/151 (1.3%) 2 0/149 (0%) 0 0/205 (0%) 0
HYPERTENSION 1/151 (0.7%) 1 0/149 (0%) 0 5/205 (2.4%) 5
HYPERTENSIVE CRISIS 0/151 (0%) 0 1/149 (0.7%) 1 4/205 (2%) 4
HYPERTENSIVE EMERGENCY 1/151 (0.7%) 1 0/149 (0%) 0 0/205 (0%) 0
HYPOTENSION 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
ORTHOSTATIC HYPOTENSION 0/151 (0%) 0 1/149 (0.7%) 1 0/205 (0%) 0
PERIPHERAL ARTERIAL OCCLUSIVE DISEASE 0/151 (0%) 0 1/149 (0.7%) 2 0/205 (0%) 0
PERIPHERAL VASCULAR DISORDER 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
SHOCK 0/151 (0%) 0 0/149 (0%) 0 1/205 (0.5%) 1
Other (Not Including Serious) Adverse Events
Stage 2 Placebo (Standard Dialysate) Stage 2 Soluble Ferric Pyrophosphate (SFP) in Dialysate Stage 3 Soluble Ferric Pyrophosphate (SFP) in Dialysate
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 100/151 (66.2%) 96/149 (64.4%) 148/205 (72.2%)
Blood and lymphatic system disorders
ANAEMIA 7/151 (4.6%) 10 3/149 (2%) 4 11/205 (5.4%) 11
Cardiac disorders
ANGINA PECTORIS 1/151 (0.7%) 1 2/149 (1.3%) 2 7/205 (3.4%) 7
Gastrointestinal disorders
ABDOMINAL PAIN UPPER 6/151 (4%) 6 3/149 (2%) 3 7/205 (3.4%) 7
CONSTIPATION 2/151 (1.3%) 2 1/149 (0.7%) 1 11/205 (5.4%) 12
DIARRHOEA 15/151 (9.9%) 17 13/149 (8.7%) 14 30/205 (14.6%) 45
NAUSEA 14/151 (9.3%) 25 11/149 (7.4%) 13 20/205 (9.8%) 31
VOMITING 12/151 (7.9%) 16 5/149 (3.4%) 6 16/205 (7.8%) 18
General disorders
ASTHENIA 7/151 (4.6%) 7 7/149 (4.7%) 7 9/205 (4.4%) 9
FATIGUE 2/151 (1.3%) 2 7/149 (4.7%) 7 2/205 (1%) 2
MALAISE 1/151 (0.7%) 1 2/149 (1.3%) 2 9/205 (4.4%) 10
NON-CARDIAC CHEST PAIN 0/151 (0%) 0 1/149 (0.7%) 1 9/205 (4.4%) 9
OEDEMA PERIPHERAL 6/151 (4%) 7 8/149 (5.4%) 12 14/205 (6.8%) 27
PAIN 4/151 (2.6%) 4 2/149 (1.3%) 2 10/205 (4.9%) 11
PYREXIA 4/151 (2.6%) 4 7/149 (4.7%) 12 10/205 (4.9%) 11
THROMBOSIS IN DEVICE 5/151 (3.3%) 6 3/149 (2%) 3 6/205 (2.9%) 15
Infections and infestations
NASOPHARYNGITIS 6/151 (4%) 9 2/149 (1.3%) 2 9/205 (4.4%) 9
UPPER RESPIRATORY TRACT INFECTION 5/151 (3.3%) 6 4/149 (2.7%) 4 5/205 (2.4%) 6
URINARY TRACT INFECTION 2/151 (1.3%) 2 7/149 (4.7%) 8 3/205 (1.5%) 5
Injury, poisoning and procedural complications
ARTERIOVENOUS FISTULA SITE COMPLICATION 19/151 (12.6%) 23 17/149 (11.4%) 30 25/205 (12.2%) 58
ARTERIOVENOUS FISTULA SITE HAEMORRHAGE 3/151 (2%) 3 4/149 (2.7%) 8 7/205 (3.4%) 14
ARTERIOVENOUS FISTULA THROMBOSIS 3/151 (2%) 3 2/149 (1.3%) 2 7/205 (3.4%) 10
HAEMODIALYSIS-INDUCED SYMPTOM 5/151 (3.3%) 9 7/149 (4.7%) 11 39/205 (19%) 199
PROCEDURAL DIZZINESS 1/151 (0.7%) 2 1/149 (0.7%) 4 7/205 (3.4%) 9
PROCEDURAL HYPOTENSION 41/151 (27.2%) 216 43/149 (28.9%) 174 68/205 (33.2%) 494
VASCULAR GRAFT COMPLICATION 1/151 (0.7%) 1 4/149 (2.7%) 8 13/205 (6.3%) 25
Metabolism and nutrition disorders
DECREASED APPETITE 4/151 (2.6%) 5 0/149 (0%) 0 8/205 (3.9%) 8
FLUID OVERLOAD 2/151 (1.3%) 5 5/149 (3.4%) 7 8/205 (3.9%) 15
HYPERKALAEMIA 4/151 (2.6%) 4 4/149 (2.7%) 6 7/205 (3.4%) 7
VITAMIN D DEFICIENCY 2/151 (1.3%) 2 0/149 (0%) 0 9/205 (4.4%) 34
Musculoskeletal and connective tissue disorders
ARTHRALGIA 3/151 (2%) 3 6/149 (4%) 9 15/205 (7.3%) 17
BACK PAIN 4/151 (2.6%) 4 5/149 (3.4%) 6 13/205 (6.3%) 16
MUSCLE SPASMS 11/151 (7.3%) 20 7/149 (4.7%) 15 10/205 (4.9%) 33
MUSCULOSKELETAL PAIN 2/151 (1.3%) 2 2/149 (1.3%) 4 13/205 (6.3%) 16
PAIN IN EXTREMITY 7/151 (4.6%) 7 13/149 (8.7%) 18 13/205 (6.3%) 13
Nervous system disorders
DIZZINESS 14/151 (9.3%) 16 13/149 (8.7%) 17 26/205 (12.7%) 52
HEADACHE 8/151 (5.3%) 9 14/149 (9.4%) 16 38/205 (18.5%) 53
HYPOAESTHESIA 0/151 (0%) 0 5/149 (3.4%) 7 5/205 (2.4%) 5
Psychiatric disorders
INSOMNIA 3/151 (2%) 3 0/149 (0%) 0 7/205 (3.4%) 7
Respiratory, thoracic and mediastinal disorders
COUGH 10/151 (6.6%) 11 11/149 (7.4%) 14 21/205 (10.2%) 27
DYSPNOEA 7/151 (4.6%) 9 6/149 (4%) 8 22/205 (10.7%) 34
Vascular disorders
HYPERTENSION 2/151 (1.3%) 2 3/149 (2%) 3 8/205 (3.9%) 9

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

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

The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is less than or equal to 60 days. The sponsor cannot require changes to the communication and cannot extend the embargo.

Results Point of Contact

Name/Title Senior Director, Clinical Research & Operations
Organization Rockwell Medical
Phone 248-960-9009
Email rd@rockwellmed.com
Responsible Party:
Rockwell Medical Technologies, Inc.
ClinicalTrials.gov Identifier:
NCT01320202
Other Study ID Numbers:
  • RMTI-SFP-4
First Posted:
Mar 22, 2011
Last Update Posted:
Apr 26, 2017
Last Verified:
Apr 1, 2017