Clinical trial NCT05265325: A Study of AND017 to Treat Anemia in Chronic Kidney Disease Patients on Dialysis
Official title: A Phase 2, Multicenter, Open-label, Randomized, Active-Controlled Study of Efficacy and Safety of AND017 in the Treatment of Anemia in Patients With Chronic Kidney Disease on Dialysis
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Renal Anemia
Lead sponsor: Kind Pharmaceuticals LLC
Sponsor class: INDUSTRY
First posted: 2022-03-03
Enrollment: 175
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This is a phase II study to evaluate the safety and efficacy of AND017 in renal anemia patients on dialysis

Detailed description: This is a Phase II study to assess the safety and efficacy of AND017 in patients with CKD who are anemic and on dialysis.

Eligibility criteria: Key Inclusion Criteria:

1. Body weight from 45 to 140 kg inclusive
2. Receiving stable HD (including combination methods such as hemodiafiltration or hemofiltration), HHD, or PD for ESKD for a minimum of 16 weeks prior to randomization and determined by the Investigator to be compliant with dialysis treatment prescription.
3. Patient must have been on IV or SC of an approved ESA under the prescription for at least 6 weeks, and ≤25% change in dose between the two most recent doses, prior to randomization.
4. The mean of two hemoglobin values during screening (at least 7 days apart) must be 9.0-11.0 g/dL with a difference of ≤1.3 g/dL between the two values
5. TSAT ≥ 20% or ferritin ≥ 100 ng/mL at screening
6. Folate ≥ 3.0 ng/mL and vitamin B12 ≥ lower limit of normal (LLN) at screening
7. AST and ALT \< 3×ULN at screening.
8. No evidence of other causes of anemia caused by a pathologic process in the hematopoietic system, including intra- or extravascular hemolysis, or myelodysplasia.

Key Exclusion Criteria:

1. Concurrent retinal neovascular lesions requiring treatment including proliferative diabetic retinopathy, exudative age-related macular degeneration, retinal vein occlusion, macular edema, etc.
2. Anemia determined by the Investigator to be caused by concurrent autoimmune disease with inflammatory symptoms (such as systemic erythematosus, ankylosing spondylitis, rheumatoid arthritis, psoriatic arthritis, Sjögren's syndrome, celiac disease, etc.).
3. 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 symptomatic gastroparesis despite on treatment.
4. Clinically significant bleeding (eg, requiring transfusion or drop in Hb of ≥ 2 g/dL) within 4 weeks of first dose; bleeding diathesis or risk of bleeding that has not been medically or surgically corrected at least 4 weeks prior to first dose of study drug.
5. Uncontrolled hypertension defined as patients with hypertension having more than one of three diastolic blood pressure values \>95 mmHg and each test at least 5 min apart during the screening assessment.
6. Concurrent congestive heart failure (New York Heart Association \[NYHA\] Class III or higher).
7. History of stroke, transient ischemic attack (TIA), myocardial infarction, thromboembolic event (deep vein thrombosis, DVT), pulmonary embolism, or lung infarction within 24 weeks before the screening assessment.
8. Positive for hepatitis B surface antigen or anti-hepatitis C virus antibody at the screening assessment, or positive for human immunodeficiency virus in a past test.
9. Not complying with COVID-19 prevention and control requirements per local policy.
10. Concurrent primary form of anemia other than renal anemia (hemolytic anemia, thalassemia, sickle cell anemia, history of pure red cell aplasia, history of myelodysplastic syndrome or multiple myeloma, iron deficiency, etc.). Any question of the primary cause of anemia should be discussed with the Medical Monitor before the patient signs informed consent.
11. Known hemosiderosis, hemochromatosis or hyper-coagulable condition
12. Known to be hypersensitive or intolerant to ESA.
13. Having received treatment with androgenic anabolic steroids, testosterone enanthate, or mepitiostane within 5 weeks prior to the first dose.
14. Any treatment with a hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI) within 5 weeks prior to the first dose.
15. TBIL\>1.5 ULN, or AST\>3 ULN, or ALT\>3 ULN, or ALP\>3 ULN, or previous or concurrent serious liver disease (acute or active chronic hepatitis, cirrhosis, etc.) thought to be caused by any other HIF-PHI.
16. Previous or current malignant tumor (patients with no recurrence for at least 5 years are eligible. Exemption: basal cell and squamous cell carcinoma not under active stage).
17. Patients with a history of significant liver disease or active liver disease.
18. Patients that have major surgery planned during the study period.
19. Patients that have undergone blood transfusion or with evidence of major blood loss within 8 weeks before the screening assessment. Investigators should discuss this with the Medical Monitor for cases where there is doubt about whether to exclude or not.
20. Patients unable to discontinue IV iron during the screening period.
21. Patients with an organ transplant on immunosuppression, or with a scheduled kidney or any other organ transplant within the duration of the study, or without kidney.
22. Serum albumin \< 2.5 g/dL at screening.
23. Patients with other chronic medical condition that may limit life expectancy in the opinion of the Investigator.
24. History of a seizure disorder or any occurrence of seizures in the past.

Primary outcomes:
measure: Incidence of adverse events
timeFrame: Up to 20 weeks
measure: Mean change from baseline in Hb at Week 6
timeFrame: Up to 5 weeks after dosing
Secondary outcomes:
measure: Proportion of responders, during the entire study period.
timeFrame: up to Week 20
measure: Mean proportion of visits at which patients maintain Hb within the target range from baseline during the fixed-dose period and titration period
timeFrame: up to Week 20
measure: Proportion of patients with a mean Hb between 10.0-11.0 g/dL inclusive during Week 14-20
timeFrame: at Week 14, 15, 16, 17, 18, 19, and 20
measure: Change in Hb from baseline to the mean Hb levels over Week 14-20
timeFrame: Baseline and at Week 14, 15, 16, 17, 18, 19, and 20
measure: Mean Hb levels and mean change from baseline in Hb level at each visit
timeFrame: up to Week 20
measure: Cumulative response rate over the entire study period
timeFrame: up to Week 20
Other outcomes:
measure: EPO levels and change from baseline at each visit
timeFrame: up to Week 20
measure: Hepcidin levels and change from baseline at each visit
timeFrame: up to Week 20
measure: Iron study levels and change from baseline at each visit
timeFrame: up to Week 20
Locations:
city: Pine Bluff
country: United States
facility: US Renal Care - Pine Bluff
state: Arkansas
city: Riverside
country: United States
facility: North America Research Institute
state: California
city: Lone Tree
country: United States
facility: Rocky Mountain Kidney Care
state: Colorado
city: Dalton
country: United States
facility: Nephrology and Hypertension Specialists
state: Georgia
city: Gallup
country: United States
facility: High Desert Nephrology Associates
state: New Mexico
city: Cheektowaga
country: United States
facility: Nephrology Associates of Western New York
state: New York
city: Toledo
country: United States
facility: Nephrology Consultants of Northwest Ohio - Toledo
state: Ohio
city: San Antonio
country: United States
facility: South Texas Renal Care Group - San Saba
state: Texas
city: San Antonio
country: United States
facility: Clinical Advancement Center PLLC
state: Texas
city: San Antonio
country: United States
facility: South Texas Renal Care Group
state: Texas
city: Chongqing
country: China
facility: The Second Affiliated Hospital of Chongqing Medical University
state: Chongqing
city: Xiamen
country: China
facility: The First Affiliated Hospital of Xiamen University
state: Fujian
city: Xiamen
country: China
facility: Xiamen Branch, Zhongshan hospital affilicated to Fudan University
state: Fujian
city: Xiamen
country: China
facility: Xiamen Fifth Hospital
state: Fujian
city: Luoyang
country: China
facility: The First Affiliated Hospital of Henan University of Science and Technology
state: Henan
city: Wuhan
country: China
facility: Renmin Hospital of Wuhan University
state: Hunan
city: Changzhou
country: China
facility: The First People's Hospital of Changzhou
state: Jiangsu
city: Nanjing
country: China
facility: Second Affiliated Hospital of Nanjing Medical University
state: Jiangsu
city: Suzhou
country: China
facility: Second Affiliated Hospital of Soochow University
state: Jiangsu
city: Dalian
country: China
facility: The Affiliated Zhongshan Hospital of Dalian University
state: Liaoning
city: Shanghai
country: China
facility: Zhongshan Hospital affiliated to Fudan University
state: Shanghai
city: Shanghai
country: China
facility: Jinshan Hospital Affiliated to Fudan University
state: Shanghai
city: Xi'an
country: China
facility: First Affiliated Hospital of Xi'an Jiaotong University
state: Shanxi
city: Chengdu
country: China
facility: Sichuan Provincial People's Hospital
state: Sichuan
city: Zigong
country: China
facility: Zigong First People's Hospital
state: Sichuan
Study officials:
affiliation: Kind Pharmaceuticals LLC
name: Yusha Zhu, MD, PhD
role: STUDY_DIRECTOR
References: