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AnemiaPhase 3NCT00436748

Study to Assess Darbepoetin Alfa Dosing for the Correction of Anemia in Pediatric Patients With Chronic Kidney Disease

A Phase 3 study testing Darbepoetin Alfa in people with Anemia and Chronic Kidney Disease, run by Amgen at 67 sites in 10 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The primary objectives of this study are the following: 1. To test if the proportion of participants achieving a hemoglobin value greater than or equal to 10.0 g/dL at any time point after the first dose during the study is greater than 0.8 when administered de novo darbepoetin alfa once a week (QW) for treatment of… Read more about this study

Who is it for?
Ages 1 year to 18 years
Conditions the study is for
Anemia, Chronic Kidney Disease, Kidney Disease
What is being tested?
Darbepoetin Alfa
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
116 participants
Where
67 sitesin 10 countries
Study dates
16 Sep 2008to 3 Mar 2014
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 1 year to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Current diagnosis of Chronic Kidney Disease, either receiving or not receiving dialysis
  • Anemic, with two consecutive screening hemoglobin values drawn at least 7 days apart < 11.0 g/dL
  • Transferrin saturation (Tsat) greater than or equal to 20%

Who cannot join

  • Any erythropoiesis stimulating agent (ESA) use within 12 weeks prior to randomization
  • other hematologic disorders
  • upper or lower gastrointenstinal bleeding within 6 months prior to randomization
  • uncontrolled hypertension
  • prior history (within 12 weeks prior to randomization) of acute myocardial ischemia, hospitalization for congestive heart failure, myocardial infarction, stroke or transient ischemic attack
  • prior history (within 6 months prior to randomization) of thromboembolism

Trial locations and contacts

67 sites in 10 countries.

67 sites in 10 countries

United States42 sites
  • Research Site

    Akron, Ohio, 44308

  • Research Site

    Albuquerque, New Mexico, 87131

  • Research Site

    Baltimore, Maryland, 21287

  • Research Site

    Birmingham, Alabama, 35233

  • Research Site

    Boise, Idaho, 83712

  • Research Site

    Boston, Massachusetts, 02115

  • Research Site

    Buffalo, New York, 14222

  • Research Site

    Charlotte, North Carolina, 28203

  • Research Site

    Charlottesville, Virginia, 22908

  • Research Site

    Chicago, Illinois, 60612

  • Research Site

    Cincinnati, Ohio, 45229

  • Research Site

    Cleveland, Ohio, 44106

  • Research Site

    Cleveland, Ohio, 44195

  • Research Site

    Columbus, Ohio, 43205

  • Research Site

    Dallas, Texas, 75390

  • Research Site

    Gainesville, Florida, 32610

  • Research Site

    Houston, Texas, 77030

  • Research Site

    Iowa City, Iowa, 52242

  • Research Site

    Kansas City, Missouri, 64108

  • Research Site

    Livingston, New Jersey, 07039

  • Research Site

    Los Angeles, California, 90027

  • Research Site

    Los Angeles, California, 90095

  • Research Site

    Louisville, Kentucky, 40202

  • Research Site

    Miami, Florida, 33136

  • Research Site

    New Brunswick, New Jersey, 08901

  • Research Site

    New Hyde Park, New York, 11040

  • Research Site

    New Orleans, Louisiana, 70118

  • Research Site

    New York, New York, 10029

  • Research Site

    Norfolk, Virginia, 23507

  • Research Site

    Orlando, Florida, 32806

  • Research Site

    Philadelphia, Pennsylvania, 19104

  • Research Site

    Portland, Oregon, 97227

  • Research Site

    Portland, Oregon, 97239

  • Research Site

    Richmond, Virginia, 23219

  • Research Site

    San Antonio, Texas, 78229

  • Research Site

    San Diego, California, 92123

  • Research Site

    San Francisco, California, 94143

  • Research Site

    Seattle, Washington, 98105

  • Research Site

    Stanford, California, 94305-5208

  • Research Site

    The Bronx, New York, 10467

  • Research Site

    Valhalla, New York, 10595

  • Research Site

    Washington D.C., District of Columbia, 20010

Other trials in United States

Russia6 sites
  • Research Site

    Krasnodar, 350033

  • Research Site

    Moscow, 107014

  • Research Site

    Moscow, 117997

  • Research Site

    Orenburg, 460004

  • Research Site

    Saint Petersburg, 198205

  • Research Site

    Samara, 443095

Other trials in Russia

Mexico4 sites
  • Research Site

    Aguascalientes, 20230

  • Research Site

    Chihuahua City, 31000

  • Research Site

    Mexico City, Mexico City, 06720

  • Research Site

    Puebla City, 72190

Other trials in Mexico

Belgium3 sites
  • Research Site

    Edegem, 2650

  • Research Site

    Ghent, 9000

  • Research Site

    Leuven, 3000

Other trials in Belgium

Poland3 sites
  • Research Site

    Gdansk, 80-952

  • Research Site

    Lodz, 93-338

  • Research Site

    Szczecin, 70-410

Other trials in Poland

Slovakia3 sites
  • Research Site

    Banská Bystrica, 974 09

  • Research Site

    Bratislava, 833 40

  • Research Site

    Košice, 040 11

Other trials in Slovakia

United Kingdom3 sites
  • Research Site

    Birmingham, B4 6NH

  • Research Site

    Leeds, LS1 3EX

  • Research Site

    London, SE1 7EH

Other trials in United Kingdom

Latvia1 site
  • Research Site

    Jūrmala, 2015

Other trials in Latvia

Lithuania1 site
  • Research Site

    Vilnius, 08406

Other trials in Lithuania

Puerto Rico1 site
  • Research Site

    San Juan, 00935

Other trials in Puerto Rico

About this study

Official title: A Multi-Center, Double-Blind, Randomized Study Evaluating De Novo Weekly and Once Every Two Week Darbepoetin Alfa Dosing for the Correction of Anemia in Pediatric Subjects With Chronic Kidney Disease Receiving and Not Receiving Dialysis

The primary objectives of this study are the following:

  1. To test if the proportion of participants achieving a hemoglobin value greater than or equal to 10.0 g/dL at any time point after the first dose during the study is greater than 0.8 when administered de novo darbepoetin alfa once a week (QW) for treatment of anemia in pediatric patients with chronic kidney disease receiving and not receiving dialysis, and
  2. To test if the proportion of participants achieving a hemoglobin value greater than or equal to 10.0 g/dL at any time point after the first dose during the study is greater than 0.8 when administered de novo darbepoetin alfa every 2 weeks (Q2W) for treatment of anemia in pediatric patients with chronic kidney disease receiving and not receiving dialysis.
Being tested
Darbepoetin Alfa, Placebo
Keywords
Chronic Kidney Disease, Dialysis, Anemia, Nephrology, Pediatric, Hemodialysis, Peritoneal Dialysis, Chronic Renal Insufficiency
Medical subject headings
Anemia, Renal Insufficiency, Chronic, Kidney Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Darbepoetin AlfaDrug

    Also called Aranesp®

    Administered by subcutaneous or intravenous injection

  • PlaceboDrug

    Matching placebo solution for subcutaneous or intravenous injection to maintain the blind in the Q2W arm.

Study groups in NCT00436748
Study groupRoleWhat they receive
Darbepoetin Alfa QWExperimentalParticipants received darbepoetin alfa once a week (QW) for 24 weeks. The initial dose was 0.45 μg/kg; thereafter, active doses were administered to achieve and then maintain hemoglobin levels within a target range of 10.0 to 12.0 g/dL. Participants not on dialysis or who were receiving peritoneal dialysis were administered darbepoetin alfa subcutaneously; participants receiving hemodialysis were administered darbepoetin alfa intravenously.
Receives: Drug: Darbepoetin Alfa
Darbepoetin Alfa Q2WExperimentalParticipants received darbepoetin alfa every 2 weeks (Q2W) and a placebo every other 2 weeks to maintain the blind for 24 weeks. The initial dose was 0.75 μg/kg; thereafter, active doses were administered to achieve and then maintain hemoglobin levels within a target range of 10.0 to 12.0 g/dL. Participants not on dialysis or who were receiving peritoneal dialysis were administered darbepoetin alfa subcutaneously; participants receiving hemodialysis were administered darbepoetin alfa intravenously.
Receives: Drug: Darbepoetin Alfa; Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Proportion of Participants Achieving Hemoglobin ≥ 10.0 g/dL

    The proportion of participants achieving hemoglobin ≥ 10.0 g/dL (the correction proportion) was calculated as the number of participants achieving a hemoglobin ≥ 10.0 g/dL at any time point during the study when administered de novo darbepoetin alfa without receiving any red blood cell transfusion after randomization and within 90 days before the achievement, divided by the number of participants in the efficacy analysis set.

    Measured: 24 weeks

Secondary outcomes (14)
  1. Time to First Hemoglobin Value ≥ 10.0 g/dL

    The time from study Day 1 to the day a participant first achieved hemoglobin ≥ 10.0 g/dL for participants who achieved hemoglobin ≥ 10.0 g/dL.

    Measured: 24 weeks

  2. Hemoglobin Concentration Over Time

    Measured: Baseline and Weeks 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 and 25.

  3. Weight-adjusted Darbepoetin Alfa Dose at Time of Achieving First Hemoglobin ≥ 10.0 g/dL

    The darbepoetin alfa dose at the time a participant achieved a first hemoglobin level ≥ 10.0 g/dL, divided by the participant's weight measured at the closest study week prior to the dosing, post dialysis.

    Measured: 24 weeks

  4. Darbepoetin Alfa Weight-Adjusted Dose Over Time

    Arithmetic means are provided; Withheld doses are counted as 0 μg.

    Measured: Day 1 (initial dose) and Weeks 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 and 25.

  5. Change From Baseline at Week 13 and Week 25 in Parent-reported Pediatric Quality of Life Inventory (PedsQL) Scores

    The PedsQL is a health-related quality of life (HRQOL) questionnaire that can be used to measure quality of life in children ≥ 2 years old. The 23-item PedsQL 4.0 includes physical functioning (8 items), emotional functioning (5 items), social functioning (5 items), and school functioning (5 items). Separate questionnaires for ages 2 to 4 (toddler), 5-7, 8-12, and 13-18 years are used for parent proxy-reporting, which assesses parents' perceptions of their child's HRQOL. The instructions ask how much of a problem each item has been during the past 1 month; each item is answered on a 5-point scale: 0 = never a problem; 1 = almost never a problem; 2 = sometimes a problem; 3 = often a problem; 4 = almost always a problem. Scores from the 4 subscales, the total score, and the psychosocial composite score were generated using standard algorithms. Each item's score in the questionnaire was converted to a 0 to 100 scale (with higher scores indicating better HRQOL).

    Measured: Baseline, Week 13 and Week 25 (or end of study visit if earlier than Week 25)

  6. Change From Baseline at Week 13 and Week 25 in Child Self-reported Pediatric Quality of Life Inventory (PedsQL) Scores

    The PedsQL child self-reported questionnaire was used in children > 5 years old. The 23-item PedsQL 4.0 includes physical functioning (8 items), emotional functioning (5 items), social functioning (5 items), and school functioning (5 items). Separate questionnaires for ages 5-7, 8-12, and 13-18 years was used for child self-reporting. The instructions asked how much of a problem each item has been during the past 1 month; each item is answered on a 5-point scale for ages 8 to 18 (0 = never a problem; 1 = almost never a problem; 2 = sometimes a problem; 3 = often a problem; 4 = almost always a problem), or simplified to a 3-point scale for ages 5 to 7 (0 = not at all a problem; 2 = sometimes a problem; 4 = a lot of a problem). Scores from the 4 subscales, the total score, and the psychosocial composite score were generated using standard algorithms. Each item's score in the questionnaire was converted to a 0 to 100 scale (with higher scores indicating better HRQOL).

    Measured: Baseline, Week 13 and Week 25 (or end of study visit if earlier than Week 25)

  7. Number of Participants With Treatment-emergent Adverse Events

    A serious adverse event (SAE) is defined as an adverse event that meets at least one of the following serious criteria: • is fatal, • is life threatening, • requires in-patient hospitalization or prolongation of existing hospitalization, • results in persistent or significant disability/incapacity, • is a congenital anomaly/birth defect, and/or • other significant medical hazard. The investigator assessed whether the adverse event was related to the investigational product (IP). Events of interest included hypertension, ischemic heart disease, cardiac failure, cerebrovascular disorders, convulsions, embolic and thrombotic events, embolic and thrombotic events: venous, embolic and thrombotic events: arterial, embolic and thrombotic events: vessel type unspecified and mixed arterial and venous, dialysis vascular access thrombosis, antibody-mediated pure red cell aplasia, hypersensitivity, lack of efficacy-effect, and malignancies.

    Measured: 25 weeks

  8. Hemoglobin Serial Rate of Change (ROC) Over Time

    Calculated using the serial method as the change in hemoglobin from the previous non-missing hemoglobin level divided by number of days in between, and then multiplied by 7.

    Measured: Weeks 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 and 25.

  9. Number of Participants With Hemoglobin > 12.0, > 13.0, and > 14.0 g/dL During the Study

    Measured: 25 weeks

  10. Maximum Increase in Hemoglobin Over Any 2 Week Period

    The maximum increase between any 2 non-missing hemoglobin measurements over any 2-week period from Day 1.

    Measured: 25 weeks

  11. Change From Baseline in Systolic Blood Pressure Over Time

    Measured: Baseline and Weeks 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 and 25.

  12. Change From Baseline in Diastolic Blood Pressure Over Time

    Measured: Baseline and Weeks 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 and 25.

  13. Number of Participants Who Developed Anti-erythropoiesis Antibodies

    Participants who were negative for anti-erythropoiesis antibodies at Baseline (pre-dose) and who developed anti-erythropoiesis antibodies during the study. Serum samples were tested using Amgen's Surface Plasmon Resonance Immunoassay (SPRIA) method.

    Measured: 25 weeks

  14. Darbepoetin Alfa Serum Concentrations for Participants Less Than 6 Years of Age

    Serum concentrations of darbepoetin alfa were measured by an enzyme-linked immunosorbent assay (ELISA).

    Measured: Weeks 1, 2, and 3 before the investigational product dose and 2 days after the first investigational product dose

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Feb 2007 (estimated)
  2. Study start16 Sep 2008
  3. Primary completion3 Mar 2014
  4. Study completion3 Mar 2014

Why it stopped: FDA and EMA agreed that the information that had been submitted to date was acceptable to meet the requirements of the post-marketing commitment.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
116 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00436748
Sponsor's protocol ID
20050256
Status last verified
Nov 2022
First submitted
15 Feb 2007
Last updated
29 Nov 2022
Data monitoring committee
No

Publications

  • Warady BA, Barcia J, Benador N, Jankauskiene A, Olson K, Podracka L, Shavkin A, Srivaths P, Wong CJ, Petersen J. De novo weekly and biweekly darbepoetin alfa dosing in pediatric patients with chronic kidney disease. Pediatr Nephrol. 2018 Jan;33(1):125-137. doi: 10.1007/s00467-017-3758-5. Epub 2017 Aug 17.

    PubMed 28815341
  • Chung EY, Palmer SC, Saglimbene VM, Craig JC, Tonelli M, Strippoli GF. Erythropoiesis-stimulating agents for anaemia in adults with chronic kidney disease: a network meta-analysis. Cochrane Database Syst Rev. 2023 Feb 13;2(2):CD010590. doi: 10.1002/14651858.CD010590.pub3.

    PubMed 36791280

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Darbepoetin Alfa in people with Anemia and Chronic Kidney Disease, run by Amgen at 67 sites in 10 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 29 Nov 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 67 sites in United States, Russia, Mexico, Belgium, Poland and 5 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 31 Mar 2015). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Proportion of Participants Achieving Hemoglobin ≥ 10.0 g/dL (time frame: 24 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00436748, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Nov 2022.

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