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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00773513
Registration number
NCT00773513
Ethics application status
Date submitted
15/10/2008
Date registered
16/10/2008
Date last updated
20/08/2019
Titles & IDs
Public title
A Study to Assess All-Cause Mortality and Cardiovascular Morbidity in Participants With Chronic Kidney Disease (CKD) on Dialysis and Those Not on Renal Replacement Therapy Receiving Methoxy Polyethylene Glycol-Epoetin Beta (Mircera) or Reference Erythropoietin Stimulating Agents (ESAs)
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Scientific title
A Randomized, Controlled, Open-Label, Multi-Centre, Parallel-Group Study To Assess All-Cause Mortality And Cardiovascular Morbidity In Patients With Chronic Kidney Disease On Dialysis And Those Not On Renal Replacement Therapy Under Treatment With MIRCERA® Or Reference ESAs.
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Secondary ID [1]
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2007-005129-31
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Secondary ID [2]
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BH21260
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic Renal Anemia
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Condition category
Condition code
Renal and Urogenital
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Kidney disease
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Renal and Urogenital
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Other renal and urogenital disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Darbepoetin Alfa
Treatment: Drugs - Epoetin Alfa
Treatment: Drugs - Epoetin Beta
Treatment: Drugs - methoxy polyethylene glycol-epoetin beta
Active comparator: Erythropoiesis Stimulating Agents - Participants will receive reference ESA according to approved label. The approved reference ESA compounds in the study will be darbepoetin alfa, epoetin alfa and epoetin beta.
Experimental: Methoxy Polyethylene Glycol-Epoetin Beta - Participants not currently being treated with an ESA will receive methoxy polyethylene glycol-epoetin beta iv or sc once every 2 weeks for correction of renal anemia (target Hb 10-12 g/dL). Once corrected and in participants currently being treated with an ESA, methoxy polyethylene glycol-epoetin beta will be administered once monthly.
Treatment: Drugs: Darbepoetin Alfa
Darbepoetin alfa will be administered as per approved label.
Treatment: Drugs: Epoetin Alfa
Epoetin alfa will be administered as per approved label.
Treatment: Drugs: Epoetin Beta
Epoetin beta will be administered as per approved label.
Treatment: Drugs: methoxy polyethylene glycol-epoetin beta
Participants who are currently not being treated with an ESA will receive methoxy polyethylene glycol-epoetin beta administered at a starting dose of 0.6 mcg/kg body weight once every 2 weeks. Participants who are currently being treated with an ESA will receive methoxy polyethylene glycol-epoetin beta at a dose of 120, 200 or 360 mcg once monthly (based on ESA dose administered in Week -1)
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Time to Composite of All-Cause Mortality and Non-Fatal Cardiovascular Events (Myocardial Infarction, Stroke) Defined as Time Between First Dose of Study Medication and Date of Death or Non-Fatal Cardiovascular Events, Whichever Occurred First
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Assessment method [1]
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Timepoint [1]
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Baseline up to approximately 8.5 years
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Secondary outcome [1]
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Time to All-Cause Mortality
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Assessment method [1]
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Timepoint [1]
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Baseline up to approximately 8.5 years
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Secondary outcome [2]
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Time to Non-Fatal and Fatal Myocardial Infarction
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Assessment method [2]
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Timepoint [2]
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Baseline up to approximately 8.5 years
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Secondary outcome [3]
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Time to Non-Fatal and Fatal Stroke
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Assessment method [3]
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Timepoint [3]
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Baseline up to approximately 8.5 years
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Secondary outcome [4]
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Time to Non-Fatal Cardiovascular Events (Myocardial Infarction or Stroke, Whichever Occurred First)
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Assessment method [4]
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Timepoint [4]
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Baseline up to approximately 8.5 years
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Secondary outcome [5]
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Percentage of Participants With Anti-Erythropoietin Antibody-Mediated Pure Red Cell Aplasia (PRCA)
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Assessment method [5]
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Timepoint [5]
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Baseline up to approximately 8.5 years
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Secondary outcome [6]
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Percentage of Participants With Gastrointestinal Bleeding
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Assessment method [6]
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Timepoint [6]
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Baseline up to approximately 8.5 years
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Secondary outcome [7]
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Percentage of Participants With Thromboembolic Events
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Assessment method [7]
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Timepoint [7]
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Baseline up to approximately 8.5 years
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Eligibility
Key inclusion criteria
* Male or female participants with symptomatic anemia associated with CKD
* Participants with renal anemia who are not treated with an ESA:
* Anemia was defined as hemoglobin (Hb) concentration less than (<) 11.0 grams per deciliter (g/dL) (mean of 2 screening values with at least one day and a maximum of 2 weeks between measurements) with clinical indication for ESA treatment
* Participants with renal anemia who are on maintenance ESA therapy:
* If on dialysis: regular long-term hemodialysis or peritoneal dialysis therapy with the same mode of dialysis for at least 3 months before screening
* Hb concentration between 10 and 12 g/dL (mean of 2 screening values with at least one day and a maximum of 2 weeks between measurements)
* Participants with adequate iron status defined as: serum ferritin above or equal to 100 micrograms per liter or transferrin saturation above or equal to 20 percent
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Contraindications to ESA treatment: uncontrolled hypertension, hypersensitivity to the active substance or any of the excipients, any other contraindication to ESA therapy
* Conditions known to cause inadequate response to ESA treatment or anemia other than symptomatic anemia associated with CKD:
* History of hemoglobinopathy
* Anemia due to hemolysis
* Pure red cell aplasia
* High likelihood of early withdrawal (for example, within 1 year) or interruption of the study
* Pregnancy or breast-feeding
* Women of childbearing potential without effective contraception
* Administration of another investigational drug within 1 month before screening or planned during the study period
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
12/12/2008
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
27/07/2017
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Sample size
Target
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Accrual to date
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Final
2825
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,TAS,VIC,WA
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Recruitment hospital [1]
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Gosford Hospital; Renal - Gosford
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Recruitment hospital [2]
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Renal Research Dr Simon Roger - Gosford
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Cairns Hospital; Renal Services - Cairns
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Recruitment hospital [4]
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Gold Coast Hospital Department of Pharmacology & Therapeutics - Southport
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ROYAL ADELAIDE HOSPITAL; Renal Clinical Trials, CNARTS - Adelaide
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Launceston General Hospital; Diabetes and Renal Research Unit - Launceston
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Monash Medical Centre; Renal Transplant Unit - Clayton
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Royal Perth Hospital; Nephrology - Perth
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2250 - Gosford
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4870 - Cairns
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4215 - Southport
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5000 - Adelaide
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7250 - Launceston
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3186 - Clayton
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Recruitment postcode(s) [7]
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6847 - Perth
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Recruitment outside Australia
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Argentina
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Buenos Aires
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Caba
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West Sussex
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Funding & Sponsors
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Hoffmann-La Roche
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Summary
Brief summary
This 2 arm safety study will compare the outcome with respect to a composite endpoint of all-cause mortality and non-fatal cardiovascular events (myocardial infarction, stroke) in CKD participants either on dialysis or not receiving renal replacement therapy under treatment with methoxy polyethylene glycol-epoetin beta or reference ESAs. Participants will be randomized to receive intravenous (iv) or subcutaneous (sc) methoxy polyethylene glycol-epoetin beta at the following doses: for participants not already receiving ESA treatment, methoxy polyethylene glycol-epoetin beta will be administered at a starting dose of 0.6 micrograms per kilograms every 2 weeks (mcg/kg/2wks) iv or sc; for participants receiving maintenance ESA treatment, iv or sc methoxy polyethylene glycol-epoetin beta will be administered at an initial monthly dose of 120, 200 or 360 micrograms (mcg) depending on the weekly dose of ESA received prior to first methoxy polyethylene glycol-epoetin beta administration. Participants randomized to reference ESA treatment will receive iv or sc ESAs in accordance with their prescribed dosing information.
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Trial website
https://clinicaltrials.gov/study/NCT00773513
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Trial related presentations / publications
Locatelli F, Hannedouche T, Fishbane S, Morgan Z, Oguey D, White WB. Cardiovascular Safety and All-Cause Mortality of Methoxy Polyethylene Glycol-Epoetin Beta and Other Erythropoiesis-Stimulating Agents in Anemia of CKD: A Randomized Noninferiority Trial. Clin J Am Soc Nephrol. 2019 Dec 6;14(12):1701-1710. doi: 10.2215/CJN.01380219. Epub 2019 Aug 16.
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Hoffmann-La Roche
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Attachment
Study protocol
Study Protocol and Statistical Analysis Plan
https://cdn.clinicaltrials.gov/large-docs/13/NCT00773513/Prot_SAP_000.pdf
Statistical analysis plan
Study Protocol and Statistical Analysis Plan
https://cdn.clinicaltrials.gov/large-docs/13/NCT00773513/Prot_SAP_000.pdf
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https://clinicaltrials.gov/study/NCT00773513
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