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Secondary HyperparathyroidismPhase 1NCT03283098

A Phase 1 Study to Evaluate PK, Safety and Tolerability of AMG 416

A Phase 1 study testing Etelcalcetide in people with Secondary Hyperparathyroidism, run by Amgen at 5 sites in China.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This was a multiple-dose, double-blind, randomized, placebo-controlled study. Chinese subjects residing in Mainland China with chronic kidney disease (CKD) receiving hemodialysis were randomized in a 3:1 ratio to receive 5 mg intravenous (IV) of etelcalcetide or placebo 3 times a week (TIW) for approximately 4 weeks… Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Secondary Hyperparathyroidism
What is being tested?
Etelcalcetide
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
33 participants
Where
5 sitesChina
Study dates
1 Mar 2018to 4 Feb 2019
Phase
Phase 1
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 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Subject has provided informed consent prior to initiation of any study-specific activities/procedures
  • Resident in Mainland China and of Chinese ancestry
  • Male or female subject ≥ 18 and ≤ 70 years of age at the time of screening, with end stage renal disease receiving hemodialysis
  • Subject must be receiving hemodialysis 3 times weekly for at least 3 months through a functioning permanent dialysis access prior to Day -2 and have adequate hemodialysis with a delivered Kt/V ≥ 1.2 or urea reduction ratio (URR) ≥ 65% within 4 weeks to screening. The subject's routine hemodialysis session must be of 3-4.5 hours in duration, inclusive
  • Subject has stable dialysis prescription and this prescription is not anticipated to significantly change during the course of the study

Who cannot join

  • Corrected calcium (calculated) level is < 2.07 mmol/L (8.3 mg/dL), and/or intact PTH level is outside the range of 31.8 - 127.3 pmol/L (300 - 1200 pg/mL)
  • Female subjects who are pregnant, lactating/breastfeeding, or who plan to conceive, or breastfeed while on study through 3 months after receiving the dose of study drug
  • Female subject of reproductive potential not willing to use a(n) acceptable method(s) of effective birth control during treatment with AMG 416, and for an additional 3 months after the end of treatment with AMG 416. Female subjects who have had a hysterectomy, bilateral salpingectomy, bilateral oophorectomy, bilateral tubal ligation, or who are postmenopausal are not required to use contraception. Postmenopausal is defined as:
  • Age > 55 years with cessation of menses for 12 months or more
  • Age < 55 but no spontaneous menses for at least 2 years
  • Age < 55 years and spontaneous menses within the past 1 years, but currently amenorrheic, AND with postmenopausal gonadrotropin levels (luteinizing hormone and follicle-stimulating hormone levels > 40 IU/L) or postmenopausal estradiol levels (<5.3 pmol/L or 5 ng/dL) or according to the definition of "postmenopausal range" for the laboratory involved
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  • Underwent a bilateral oophorectomy
  • Females of reproductive potential with a positive pregnancy test, unless medical follow-up confirms the subject is not pregnant
  • Previous administration of AMG 416
  • Subject has received cinacalcet within the 30 days prior to informed consent (treatment with cinacalcet is prohibited during the study)
  • Subject has lost 500 mL or more of blood or plasma within 8 weeks of study drug administration or during the study period
  • Anticipated or scheduled to have major surgical procedures during the study period such as kidney transplant or parathyroidectomy
  • History of malignancy within 5 years before Day -2 (except non melanoma skin cancers, or cervical carcinoma in situ)
  • Subject's 12-lead electrocardiogram (ECG) at screening suggests unstable arrhythmia or other cardiac abnormality that could place the subject at increased risk, based upon the Investigator's opinion
  • Subject has current or history of cardiovascular conditions such as uncontrolled hypertension, symptomatic ventricular dysrhythmias, Torsades de Pointes, angina pectoris congestive heart failure (New York Heart Association Classification III or IV), myocardial infarction, coronary angioplasty, or coronary arterial bypass grafting within the past 6 months prior to screening

Trial locations and contacts

5 sites in 1 country.

5 sites in 1 country

China5 sites
  • Research Site

    Beijing, Beijing Municipality, 100044

  • Research Site

    Nanjing, Jiangsu, 210029

  • Research Site

    Shanghai, Shanghai Municipality, 200032

  • Research Site

    Shanghai, Shanghai Municipality, 200040

  • Research Site

    Shanghai, Shanghai Municipality, 200127

Other trials in China

About this study

Official title: A Phase 1, Multiple Dose, Randomized, Double-blind, Placebo-controlled Study to Evaluate Pharmacokinetics, Safety and Tolerability of AMG 416 Administered Intravenously to Chinese Subjects With Chronic Kidney Disease on Hemodialysis

This was a multiple-dose, double-blind, randomized, placebo-controlled study. Chinese subjects residing in Mainland China with chronic kidney disease (CKD) receiving hemodialysis were randomized in a 3:1 ratio to receive 5 mg intravenous (IV) of etelcalcetide or placebo 3 times a week (TIW) for approximately 4 weeks, with a subsequent follow up period of approximately 4 weeks.

Doses were given at the end of each scheduled hemodialysis session on study days 1 through day 27 and subject participation was complete after day 55 end-of-study (EOS) procedures were performed. Doses were administered TIW for 4 weeks, for a total of 12 doses.

Being tested
Etelcalcetide, Placebo
Keywords
Secondary hyperparathyroidism, Chronic kidney disease CKD, Intact parathyroid hormone iPTH, Hemodialysis
Medical subject headings
Hyperparathyroidism, Secondary, Renal Insufficiency, Chronic

What participants receive

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

  • EtelcalcetideDrug

    Also called AMG 416

    Etelcalcetide was supplied as a sterile, preservative-free, aqueous solution in a single-use 3 mL glass vial.

  • PlaceboDrug

    Placebo supplied to match active intervention.

Study groups in NCT03283098
Study groupRoleWhat they receive
PlaceboPlacebo comparatorIntravenous (IV) administration of placebo three times a week (TIW) for 4 weeks for a total of 12 doses. Participants were followed for an additional 4 weeks.
Receives: Drug: Placebo
EtelcalcetideExperimental5 mg intravenous (IV) dose of etelcalcetide three times a week (TIW) for 4 weeks for a total of 12 doses. Participants were followed for an additional 4 weeks.
Receives: Drug: Etelcalcetide

What is being measured

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

  1. Pharmacokinetic (PK) Parameter: Time to Maximum Drug Concentration (Tmax) of Plasma Etelcalcetide on Days 1 and 27

    Tmax is the time to maximum drug concentration of plasma etelcalcetide after dosing on Days 1 and 27.

    Measured: Days 1 and 27; PK blood sampling predialysis, and at 10, 30, 60, 90 min postdose, as well as on Day 2 and 28 between 18 and 30 hours after study drug administration

  2. PK: Maximum Observed Drug Concentration (Cmax) of Plasma Etelcalcetide on Days 1 and 27

    Cmax was defined as the maximum observed plasma drug concentration measured between the time of drug administration to the beginning of the next dialysis session.

    Measured: Days 1 and 27; PK blood sampling predialysis, and at 10, 30, 60, 90 min postdose, as well as on Day 2 and 28 between 18 and 30 hours after study drug administration

  3. Pharmacokinetic (PK) Parameter: Area Under the Curve From Time Zero to the Beginning of the Subsequent Hemodialysis Treatment (AUClast) of Plasma Etelcalcetide on Days 1 and 27

    AUClast was specifically defined in this study as the area under the concentration time curve measured from the time of drug administration to the beginning of the next dialysis session, following the first and last dose.

    Measured: Days 1 and 27; PK blood sampling predialysis, and up to 44-50 hour postdose.at 10, 30, 60, 90 min postdose: Day 2 and 28 between 18 and 30 hours after study drug administration; Day 3 (predialysis) + Day 29

  4. Pharmacokinetic (PK) Parameter: Accumulation Ratio Comparing Days 1 and 27

    Accumulation ratio, calculated as AUClast day 27/AUClast day 1.

    Measured: Days 1 and 27; PK blood sampling predialysis, and up to 44-50 hour postdose.at 10, 30, 60, 90 min postdose: Day 2 and 28 between 18 and 30 hours after study drug administration; Day 3 (predialysis) + Day 29

Secondary outcomes (12)
  1. Participants With Treatment-Emergent Adverse Events (TEAEs)

    The severity of each adverse event was assessed using the NCI-CTCAE Version 4.0 according to the following:

    • Grade 1 - Mild: Asymptomatic or mild symptoms; intervention not indicated
    • Grade 2 - Moderate: Minimal, local or noninvasive intervention indicated; limiting age-appropriate instrumental activities of daily living (ADL)
    • Grade 3 - Severe: Medically significant but not life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care ADL
    • Grade 4 - Life-threatening
    • Grade 5 - Fatal.

    A serious AE is an AE that met one or more of the following criteria:

    • Death
    • Life-threatening
    • Required inpatient hospitalization or prolongation of an existing hospitalization
    • Resulted in persistent or significant disability/incapacity
    • A congenital anomaly/birth defect
    • Important medical events that required medical or surgical intervention to prevent one of the outcomes above.

    Measured: Day 1 up to Day 55 (end of study)

  2. Participants With Treatment-Emergent Adverse Events (TEAEs) of Interest

    Terms were coded with Medical Dictionary for Regulatory Activities (MedDRA) version 21.1. Narrow search criteria used for both standardized MedDRA queries (SMQ) and events of interest (EOI). One preferred term (PT) could match multiple EOIs. Infusion Reaction EOI counts included only those events which had onset day coinciding with study medication infusion and resolved on the same day or the day after onset.

    Measured: Day 1 up to Day 55 (end of study)

  3. Participants With Clinically-Significant Changes in Electrocardiograms (ECGs) From Baseline to End of Study

    Count of participants who exhibited a clinically significant change in the results of their 12-lead electrocardiograms (ECG) when comparing baseline to end of study ECGs.

    Measured: Baseline is Day -2; End of Study is Day 55

  4. Change From Baseline to End of Study in Weight

    Change from baseline in weight measured at visit.

    Measured: Day 1 up to Day 55

  5. Change From Baseline to End of Study in Systolic and Diastolic Blood Pressures

    Participants remained seated for at least 10 minutes prior to measurement of predialysis heart rate and blood pressure.

    Measured: Baseline Day 1 prior to dialysis; End of Study is Day 55

  6. Baseline and Change From Baseline to End of Study in Heart Rate

    Participants remained seated for at least 10 minutes prior to measurement of predialysis heart rate and blood pressure.

    Measured: Baseline Day 1 prior to dialysis; End of Study is Day 55

  7. Change From Baseline to End of Study in Calcium

    Calcium was tested at a central laboratory.

    Measured: Baseline is Day 1 prior to dialysis; End of Study is Day 55

  8. Change From Baseline to End of Study in Corrected Calcium (cCa)

    Total serum calcium was corrected if the serum albumin was < 4 g/dL or 40 g/L, otherwise cCa equals total serum calcium.

    The correction formula was:

    Corrected calcium (mg/dL) = Total calcium (mg/dL) + (4 - albumin [g/dL]) * 0.8

    Measured: Baseline is the average of Day -2 and Day 1 prior to dialysis; End of Study is Day 55

  9. Participants With Low Corrected Calcium (cCA) By Category

    The lowest cCA value for each participant is reported.

    Total serum calcium was corrected if the serum albumin was < 4 g/dL or 40 g/L, otherwise cCa equals total serum calcium.

    The correction formula was:

    Corrected calcium (mg/dL) = Total calcium (mg/dL) + (4 - albumin [g/dL]) * 0.8

    Measured: Timeframes: Days 8, 15, 22, 27, 29, 34, 41, 55

  10. Baseline and Change From Baseline to End of Study in Serum Albumin

    Serum albumin was tested at a central laboratory.

    Measured: Baseline is the average of Day -2 and Day 1 prior to dialysis; End of Study is Day 55

  11. Change From Baseline to End of Study in Serum Phosphorus

    Serum phosphorus was tested at a central laboratory.

    Measured: Baseline is Day 1 prior to dialysis; End of Study is Day 55

  12. Participants With Anti-etelcalcetide Antibody at Baseline and Postbaseline

    Participants with positive titers for antibodies to etelcalcetide could be asked to return to the clinical research unit to provide additional serum samples.

    Measured: Baseline: Day 1 prior to dialysis. Postbaseline: Days 29 and 55 prior to dialysis

Timeline

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

  1. First posted14 Sep 2017
  2. Study start1 Mar 2018
  3. Primary completion4 Feb 2019
  4. Study completion4 Feb 2019

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 1
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
This is a multiple dose, double-blind, randomized, placebo-controlled clinical study conducted in Chinese subjects residing in Mainland China with chronic kidney disease receiving hemodialysis. The treatment duration will be approximately 4 weeks with a post treatment followup of 4 weeks. A dose will be given at each scheduled hemodialysis session (Dose administered three times a week for 4 weeks, for a total of 12 doses).
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
33 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03283098
Sponsor's protocol ID
20140197
Status last verified
Jan 2020
First submitted
31 Aug 2017
Last updated
10 Feb 2020
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: De-identified individual patient data for variables necessary to address the specific research question in an approved data sharing request.

Publications

  • Xing C, Chen J, Zuo L, Fang Y, Ding X, Ni Z, Kong C, Shi G, Lu H, Hellawell J, Cheng S, Sohn W. A Phase I, Multiple-Dose, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate Pharmacokinetics, Safety, and Tolerability of Etelcalcetide Administered Intravenously to Chinese Patients With Chronic Kidney Disease Undergoing Hemodialysis. Clin Ther. 2021 Nov;43(11):2013-2023. doi: 10.1016/j.clinthera.2021.09.019. Epub 2021 Nov 11.

    PubMed 34774334

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Etelcalcetide in people with Secondary Hyperparathyroidism, run by Amgen at 5 sites in China.

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 5 inclusion and 15 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: finished, as of the sponsor's last update on 10 Feb 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in China. 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. Some participants in this study may receive a placebo. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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 10 Feb 2020). 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?

Pharmacokinetic (PK) Parameter: Time to Maximum Drug Concentration (Tmax) of Plasma Etelcalcetide on Days 1 and 27 (time frame: Days 1 and 27; PK blood sampling predialysis, and at 10, 30, 60, 90 min postdose, as well as on Day 2 and 28 between 18 and 30 hours after study drug administration). The study lists 4 primary outcomes in all. 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 NCT03283098, which also lists 1 linked publication.

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 10 Feb 2020.

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