A Study of Intermittent Oral Dosing of ASP1517 in Hemodialysis Chronic Kidney Disease Patients With Anemia

Study Overview
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Brief Summary
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The objective of this study is to evaluate the safety and efficacy of ASP1517 compared to darbepoetin alfa in hemodialysis chronic kidney disease patients with anemia.

Official Title
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A Phase 3, Multi-center, Randomized, 2-arm Parallel, Double-blind, Active-comparator (Darbepoetin Alfa) Conversion Study of Intermittent Oral Dosing of ASP1517 in Hemodialysis Chronic Kidney Disease Patients With Anemia

Conditions
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Hemodialysis Chronic Kidney Disease Patients With Anemia

Intervention / Treatment
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* Drug: roxadustat
* Drug: Darbepoetin alfa


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subjects with renal anemia who have been receiving recombinant human erythropoietin (rHuEPO, two times weekly or three times weekly) or darbepoetin alfa (intravenous treatment) within the doses approved in Japan for more than 8 weeks before the screening assessment Mean of the subject's two most recent Hb values before dialysis after the longest dialysis interval during the Screening Period must be ≥10.0 g/dL and ≤12.0 g/dL Either transferrin saturation (TSAT) ≥ 20% or serum ferritin ≥ 100 ng/mL during the screening period Female subject must either: Be of non-childbearing potential: post-menopausal (defined as at least 1 year without any menses) prior to Screening, or documented surgically sterile Or, if of childbearing potential, Agree not to try to become pregnant during the study and for 28 days after the final study drug administration And have a negative pregnancy test at Screening And, if heterosexually active, agree to consistently use two forms of highly effective form of birth control (at least one of which must be a barrier method) starting at Screening and throughout the study period and continued for 28 days after the final study drug administration. Female subject must agree not to breastfeed starting at Screening and throughout the study period, and continued for 28 days after the final study drug administration. Female subject must not donate ova starting at Screening and throughout the study period, and continued for 28 days after the final study drug administration. Male subject and their female spouse/partners who are of childbearing potential must be using two forms of highly effective form of birth control (at least one of which must be a barrier method) starting at Screening and continue throughout the study period, and for 12 weeks after the final study drug administration Male subject must not donate sperm starting at Screening and throughout the study period and, for 12 weeks after the final study drug administration Exclusion Criteria: Concurrent retinal neovascular lesion untreated and macular edema untreated Concurrent autoimmune disease with inflammation that could impact erythropoiesis History of gastric/intestinal resection considered influential on the absorption of drugs in the gastrointestinal tract (excluding resection of gastric or colon polyps) or concurrent gastroparesis Uncontrolled hypertension Concurrent congestive heart failure (NYHA Class III or higher) History of hospitalization for treatment of stroke, myocardial infarction, or pulmonary embolism within 12 weeks before the screening assessment Positive for hepatitis B surface antigen (HBsAg) or anti-hepatitis C virus (HCV) antibody at the screening assessment, or positive for human immunodeficiency virus (HIV) in a past test Concurrent other form of anemia than renal anemia History of pure red cell aplasia Having received treatment with protein anabolic hormone, testosterone enanthate, or mepitiostane within 6 weeks before the screening assessment Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), or total bilirubin that is greater than the criteria, or previous or concurrent another serious liver disease at screening assessment Previous or current malignant tumor (no recurrence for at least 5 years is eligible.) Having undergone blood transfusion and/or a surgical procedure considered to promote anemia (excluding shunt reconstruction surgery for access to the blood) and/or ophthalmological surgery within 4 weeks before the screening assessment Having undergone a kidney transplantation Having a previous history of treatment with ASP1517 History of serious drug allergy including anaphylactic shock Participation in another clinical study or post-marketing clinical study (including that of a medical device) within 12 weeks before informed consent acquisition

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: ASP1517 Group<br>Subjects will take the study drug at two- or three-day intervals. | Drug: roxadustat<br>* Oral<br>* Other names: ASP1517;|
| Experimental: Darbepoetin alfa Group<br>Subjects will take the study drug once a week. | Drug: Darbepoetin alfa<br>* Intravenous<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in the average hemoglobin (Hb) |  | Baseline and Weeks 18 to 24 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Average Hb from Week 18 to Week 24 |  | Week 18 to 24 | 
| Proportion of participants with the target Hb level from Week 18 to Week 24 |  | Week 18 to 24 | 
| Proportion of participants with the target Hb level at each week |  | Up to Week 24 | 
| Change from week 0 in Hb levels to each week |  | Up to Week 24 | 
| Proportion of measurement points with the target Hb level from Week 18 to Week 24 |  | Week 18 to 24 | 
| Rate of rise in Hb levels (g/dL/week) from week 0 to at the earliest date of week 4, time of discontinuation, or time of dose adjustment |  | Up to Week 4 | 
| Average hematocrit level |  | Up to Week 24 | 
| Average reticulocyte level |  | Up to Week 24 | 
| Average iron (Fe) level |  | Up to Week 24 | 
| Average ferritin level |  | Up to Week 24 | 
| Average transferrin level |  | Up to Week 24 | 
| Average total iron binding capacity level |  | Up to Week 24 | 
| Average soluble transferrin receptor level |  | Up to Week 24 | 
| Average transferrin saturation level |  | Up to Week 24 | 
| Average reticulocyte hemoglobin content level |  | Up to Week 24 | 
| Quality of life assessed by SF-36 | SF-36: Medical Outcomes Study 36-Item Short-Form Health Survey | Up to Week 24 | 
| Quality of life assessed by EQ-5D-5L | EQ-5D-5L: EuroQol 5 Dimension 5-Levels | Up to Week 24 | 
| Quality of life assessed by FACT-An | FACT-An: Functional Assessment of Cancer Therapy-Anemia | Up to Week 24 | 
| Number of hospitalizations |  | Up to Week 24 | 
| Duration of hospitalizations |  | Up to Week 24 | 
| Plasma concentration of unchanged ASP1517 |  | Up to Week 24 | 
| Safety assessed by incidence of adverse events |  | Up to Week 24 | 
| Number of participants with abnormal Laboratory values and/or adverse events related to treatment |  | Up to Week 24 | 
| Number of participants with abnormal Vital signs and/or adverse events related to treatment |  | Up to Week 24 | 
| Number of participants with abnormal 12-lead electrocardiogram (ECG) values | Any clinically significant adverse changes on the ECG will be reported as adverse events. | Up to Week 24 | 
| Safety assessed by ophthalmological examination: fundoscopy |  | Up to Week 24 | 
| Safety assessed by ophthalmological examination: Optical coherence tomography |  | Up to Week 24 | 
| Safety assessed by ophthalmological examination: visual acuity |  | Up to Week 24 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ASP1517, Renal anemia, Hemodialysis, Roxadustat