AnaemiaPhase 3NCT03409107
Anemia Studies in Chronic Kidney Disease (CKD): Erythropoiesis Via a Novel Prolyl Hydroxylase Inhibitor (PHI) Daprodustat in Non-Dialysis Subjects Evaluating Hemoglobin (Hgb) and Quality of Life (ASCEND-NHQ)
A Phase 3 study testing Daprodustat (GSK1278863) and Iron therapy in people with Anaemia, run by GlaxoSmithKline at 168 sites in 14 countries.
Trial summary
The purpose of this multi-center study in non-dialysis participants with anemia associated with CKD is to evaluate safety, efficacy and quality of life of daprodustat compared to placebo. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Anaemia
- What is being tested?
- Daprodustat (GSK1278863) and Iron therapy
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 614 participants
- Where
- 168 sitesin 14 countries
- Study dates
- 5 Mar 2018to 7 Oct 2020
- 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 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- >=18 years of age at the time of signing the informed consent.
- Have CKD, confirmed at screening: Kidney Disease Outcomes Quality Initiative (KDOQI) CKD stages 3, 4, or 5 defined by Estimated glomerular filtration rate (eGFR) using the CKD Epidemiology Collaboration (CKD-EPI) formula.
- Participants with Stable HemoCue Hgb from 8.5 to 10.5 at screening visit (Week -4) and from 8.5 to 10.0 g/dL at randomization (Day 1).
- Participants may receive up to one intravenous (IV) iron dose within the 8 weeks prior to screening and NO IV iron use between screening visit and randomization (Day 1).
- If needed, participant may be on stable maintenance oral iron supplementation. There should be <50% change in overall dose and no change in type of iron prescribed in the 4 weeks prior to Day 1 randomization visit.
- Male and female participants are eligible. A female participant is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies: Not a woman of childbearing potential (WOCBP) or WOCBP who agrees to follow the contraceptive guidance during the treatment period and for at least 4 weeks after the last dose of study treatment.
- Capable of giving signed informed consent.
Who cannot join
- Participants who are on dialysis or clinical evidence of impending need to initiate dialysis within 180 days after randomization (Day 1).
- Planned living-related or living-unrelated kidney transplant within 28 weeks after randomization (Day 1).
- Transferrin saturation (TSAT) <15 percent (Screening only).
- Ferritin <50 nanograms per milliliter (ng/mL) (Screening only).
- History of rhEPO or rhEPO analogue use within the 8 weeks prior to screening and rhEPO use between screening and randomization (Day 1).
- History of transfusion within the 8 weeks prior to screening and transfusion between screening and randomization (Day 1).
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- History of bone marrow aplasia or pure red cell aplasia (PRCA).
- Participants with Megaloblastic anemia (untreated pernicious anemia and folate deficiency), thalassemia major, sickle cell disease or myelodysplastic syndrome.
- Evidence of actively bleeding gastric, duodenal, or esophageal ulcer disease or clinically significant gastrointestinal (GI) bleeding <= 8 weeks prior to screening through to randomization (Day 1).
- History of severe allergic or anaphylactic reactions or hypersensitivity to excipients in the investigational product.
- Use of strong inhibitor of CYP2C8 (for example, gemfibrozil) or strong inducers of CYP2C8 (for example, rifampin/rifampicin).
- Ferric citrate use within 4 weeks prior to randomization (Day 1).
- Use of other investigational agent or device prior to screening through to randomization (Day 1).
- Any prior treatment with daprodustat for a treatment duration of >30 days.
- MI or acute coronary syndrome within the 8 weeks prior to screening through to randomization. (Day 1).
- Stroke or transient ischemic attack within the 8 weeks prior to screening through to randomization. (Day 1).
- Chronic Class IV heart failure, as defined by the New York Heart Association (NYHA) functional classification system.
- QT interval corrected by Bazett's formula (QTcB) >500 milliseconds (msec) or QTcB >530 msec in participants with bundle branch block. There is no corrected QT interval (QTc) exclusion for participants with a predominantly paced rhythm.
- Alanine transaminase (ALT) >2x upper limit of normal (ULN) at screening (Week -4).
- Bilirubin >1.5xULN at screening (Week -4).
- Current unstable liver or biliary disease per investigator assessment, generally defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal or gastric varices, persistent jaundice, or cirrhosis.
- History of malignancy within the 2 years prior to screening through to randomization (Day 1), or currently receiving treatment for cancer, or complex kidney cyst (for example, Bosniak Category II F, III or IV) > 3 centimeters (cm).
- Any other condition, clinical or laboratory abnormality, or examination finding that the investigator considers would put the participant at unacceptable risk, which may affect study compliance or prevent understanding of the aims or investigational procedures or possible consequences of the study.
- Current uncontrolled hypertension as determined by the investigator.
Trial locations and contacts
168 sites in 14 countries.
168 sites in 14 countries
United States49 sites
GSK Investigational Site
Adairsville, Georgia, 30103
GSK Investigational Site
Asheville, North Carolina, 28801
GSK Investigational Site
Beaver, Pennsylvania, 15009
GSK Investigational Site
Brookhaven, Mississippi, 39601
GSK Investigational Site
Buckley, Michigan, 49620
GSK Investigational Site
Charlotte, North Carolina, 28262
GSK Investigational Site
Coral Springs, Florida, 33067
GSK Investigational Site
Denver, Colorado, 80230
GSK Investigational Site
DeSoto, Texas, 75115
GSK Investigational Site
Detroit, Michigan, 48202
GSK Investigational Site
Downey, California, 90242
GSK Investigational Site
Duncansville, Pennsylvania, 16635
GSK Investigational Site
Durham, North Carolina, 27704
GSK Investigational Site
El Paso, Texas, 79935
GSK Investigational Site
Fresno, California, 93720
GSK Investigational Site
Hartford, Connecticut, 06112
GSK Investigational Site
Hollywood, Florida, 33024
GSK Investigational Site
Homewood, Alabama, 35209
GSK Investigational Site
Indianapolis, Indiana, 46260
GSK Investigational Site
Kingsport, Tennessee, 37660
GSK Investigational Site
Kissimmee, Florida, 34741
GSK Investigational Site
Lauderdale Lakes, Florida, 33313
GSK Investigational Site
Little Rock, Arkansas, 72204
GSK Investigational Site
Lynwood, California, 90262
GSK Investigational Site
Macon, Georgia, 31201
GSK Investigational Site
Macon, Georgia, 31217
GSK Investigational Site
McAllen, Texas, 78503
GSK Investigational Site
Memphis, Tennessee, 38163
GSK Investigational Site
Middlebury, Connecticut, 06762
GSK Investigational Site
Midwest City, Oklahoma, 73130
GSK Investigational Site
Norfolk, Virginia, 23502
GSK Investigational Site
Northridge, California, 91324
GSK Investigational Site
Northridge, California, 91325
GSK Investigational Site
Oklahoma City, Oklahoma, 73112
GSK Investigational Site
Orangeburg, South Carolina, 29118
GSK Investigational Site
Overland Park, Kansas, 66210
GSK Investigational Site
Pembroke Pines, Florida, 33028
GSK Investigational Site
Riverside, California, 82503
GSK Investigational Site
Rochester, New Hampshire, 03867
GSK Investigational Site
Saint Clair Shores, Michigan, 48081
GSK Investigational Site
Salinas, California, 93901
GSK Investigational Site
Santa Ana, California, 92704
GSK Investigational Site
Scottdale, Pennsylvania, 15683
GSK Investigational Site
Smithfield, Pennsylvania, 15478
GSK Investigational Site
St Louis, Missouri, 63136
GSK Investigational Site
Statesboro, Georgia, 30458
GSK Investigational Site
Tampa, Florida, 33614
GSK Investigational Site
Waxahachie, Texas, 75165
GSK Investigational Site
West Reading, Pennsylvania, 19611
Poland16 sites
GSK Investigational Site
Bialystok, 15-276
GSK Investigational Site
Ciechanów, 06-400
GSK Investigational Site
Krakow, 30510
GSK Investigational Site
Krakow, 31-513
GSK Investigational Site
Krakow, 31-559
GSK Investigational Site
Lodz, 92-213
GSK Investigational Site
Lublin, 20-064
GSK Investigational Site
Oława, 55-200
GSK Investigational Site
Pleszew, 63-300
GSK Investigational Site
Sosnowiec, 41-200
GSK Investigational Site
Świdnik, 21-040
GSK Investigational Site
Szczecin, 70-111
GSK Investigational Site
Tczew, 83-110
GSK Investigational Site
Warsaw, 01-868
GSK Investigational Site
Warsaw, 02-801
GSK Investigational Site
Warsaw, 04-749
Russia16 sites
GSK Investigational Site
Izhevsk, 426061
GSK Investigational Site
Kaliningrad, 236016
GSK Investigational Site
Kemerovo, 650066
GSK Investigational Site
Krasnoyarsk, 660022
GSK Investigational Site
Moscow, 121359
GSK Investigational Site
Nizhny Novgorod, 603126
GSK Investigational Site
Pyatigorsk, 357500
GSK Investigational Site
Pyatigorsk, 357538
GSK Investigational Site
Rostov-on-Don, 344022
GSK Investigational Site
Ryazan, 390037
GSK Investigational Site
Saint Petersburg, 194355
GSK Investigational Site
Saint Petersburg, 197022
GSK Investigational Site
Stavropol, 355017
GSK Investigational Site
Yaroslavl, 150000
GSK Investigational Site
Yaroslavl, 150030
GSK Investigational Site
Yaroslavl, 150062
Canada14 sites
GSK Investigational Site
Brampton, Ontario, L6T 0G1
GSK Investigational Site
Greater Sudbury, Ontario, P3A-1W8
GSK Investigational Site
Guelph, Ontario, N1H 1B1
GSK Investigational Site
Kitchener, Ontario, N2H 5Z8
GSK Investigational Site
Montreal, Quebec, H1M 1B1
GSK Investigational Site
Ottawa, Ontario, K1H 1A2
GSK Investigational Site
Québec, Quebec, G2J 0C4
GSK Investigational Site
Québec, Quebec, G3K 2P8
GSK Investigational Site
Saint-Charles-Borromée, Quebec, J6E 2B4
GSK Investigational Site
Sarnia, Ontario, N7T 4X3
GSK Investigational Site
Toronto, Ontario, M5B 1W8
GSK Investigational Site
Toronto, Ontario, M9N 1N8
GSK Investigational Site
Toronto, Ontario, M9V 4B4
GSK Investigational Site
Victoria, British Columbia, V8V 4A1
Brazil9 sites
GSK Investigational Site
Feira de Santana, Estado de Bahia, 44001-584
GSK Investigational Site
Ribeirão Preto, São Paulo, 14025170
GSK Investigational Site
Salvador, Estado de Bahia, 40415-065
GSK Investigational Site
Santo André - SP, São Paulo, 09080-110
GSK Investigational Site
São Bernardo do Campo, São Paulo, 09715090
GSK Investigational Site
São José do Rio Preto, São Paulo, 15015200
GSK Investigational Site
São José do Rio Preto, São Paulo, 15090-000
GSK Investigational Site
São Paulo, 04038002
GSK Investigational Site
Vitória, Espírito Santo, 29055450
Mexico9 sites
GSK Investigational Site
Boca del Rio, Veracruz, 24290
GSK Investigational Site
Córdoba, Veracruz, 94550
GSK Investigational Site
Guadalajara, Jalisco, 44150
GSK Investigational Site
Guadalajara, 44600
GSK Investigational Site
León, Guanajuato, 37530
GSK Investigational Site
Mérida, Yucatán, 97070
GSK Investigational Site
Mérida, 97000
GSK Investigational Site
Monterrey, Nuevo León, 64060
GSK Investigational Site
Veracruz, 91900
Romania9 sites
GSK Investigational Site
Brasov, 500283
GSK Investigational Site
Bucharest, 022328
GSK Investigational Site
Bucharest, 042122
GSK Investigational Site
Cluj-Napoca, 400139
GSK Investigational Site
Craiova, 200642
GSK Investigational Site
Deva, 330084
GSK Investigational Site
Oradea, 410469
GSK Investigational Site
Târgu Mureş, 540096
GSK Investigational Site
Timișoara, 300723
Argentina8 sites
GSK Investigational Site
Ciudad Autonoma de Buenos Aires, Buenos Aires, C1128AAF
GSK Investigational Site
Ciudad Autonoma de Buenos Aires, Buenos Aires, C1425AGC
GSK Investigational Site
Córdoba, Córdoba Province, 5003
GSK Investigational Site
Mar del Plata, Buenos Aires, 7600
GSK Investigational Site
Mar del Plata, Buenos Aires, B7600FZN
GSK Investigational Site
Rosario, Santa Fe Province, S2000DEJ
GSK Investigational Site
San Nicolás de los Arroyos, Buenos Aires, B2900DMH
GSK Investigational Site
Santa Fe, 3000
France8 sites
GSK Investigational Site
Grenoble, 38043
GSK Investigational Site
Le Mans, 72037
GSK Investigational Site
Marseille, 13385
GSK Investigational Site
Melun, 77000
GSK Investigational Site
Mulhouse, 68070
GSK Investigational Site
Nantes, 44093
GSK Investigational Site
Nice, 06001
GSK Investigational Site
Saint-Priest-en-Jarez, 42270
South Korea8 sites
GSK Investigational Site
Busan, 49201
GSK Investigational Site
Busan, 49241
GSK Investigational Site
Daegu, 42415
GSK Investigational Site
Daegu, 42601
GSK Investigational Site
Gyeonggi-do, 463-712
GSK Investigational Site
Seongnam-si, Gyeonggi-do, 13620
GSK Investigational Site
Seoul, 03312
GSK Investigational Site
Seoul, 08308
Italy7 sites
GSK Investigational Site
Bologna, Emilia-Romagna, 40138
GSK Investigational Site
Catanzaro, Calabria, 88100
GSK Investigational Site
Genoa, Liguria, 16132
GSK Investigational Site
Mestre, Veneto, 30174
GSK Investigational Site
Modena, Emilia-Romagna, 41124
GSK Investigational Site
Naples, Campania, 80131
GSK Investigational Site
Pavia, Lombardy, 27100
United Kingdom7 sites
GSK Investigational Site
Canterbury, Kent, CT1 3NG
GSK Investigational Site
Derby, DE22 3NE
GSK Investigational Site
London, SE5 9RS
GSK Investigational Site
Peterborough, PE3 9GZ
GSK Investigational Site
Plymouth, PL6 8DH
GSK Investigational Site
Shrewsbury, SY3 8XQ
GSK Investigational Site
Swansea, SA6 6NL
Australia5 sites
GSK Investigational Site
Fitzroy, 3065
GSK Investigational Site
Heidelberg, Victoria, 3084
GSK Investigational Site
Murdoch, Western Australia, 6150
GSK Investigational Site
Parkville, Victoria, 3050
GSK Investigational Site
Sydney, New South Wales, 2010
Spain3 sites
GSK Investigational Site
Badalona, 08916
GSK Investigational Site
Madrid, 28040
GSK Investigational Site
Santiago de Compostela, 15890
About this study
Official title: A 28-week, Randomized, Double-blind, Placebo-controlled, Parallel-group, Multi-center, Study in Recombinant Human Erythropoietin (rhEPO) naïve Non-dialysis Participants With Anemia Associated With Chronic Kidney Disease to Evaluate the Efficacy, Safety and Effects on Quality of Life of Daprodustat Compared to Placebo
The purpose of this multi-center study in non-dialysis participants with anemia associated with CKD is to evaluate safety, efficacy and quality of life of daprodustat compared to placebo.
- Conditions
- Anaemia
- Being tested
- Daprodustat (GSK1278863), Placebo, Iron therapy
- Keywords
- Non-Dialysis, Anemia, Chronic kidney disease, Recombinant human erythropoietin naïve, Hemoglobin, Daprodustat
- Medical subject headings
- Anemia, Renal Insufficiency, Chronic
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Daprodustat (GSK1278863)Drug
Daprodustat will be available as 9 millimeter (mm) or 7 mm film-coated tablets. Daprodustat will be administered once daily via oral route and can be taken without regard to food.
PlaceboDrug
Daprodustat matching placebo will be available as 9 mm or 7 mm film coated tablets. Placebo will be administered once daily via oral route and can be taken without regard to food.
Iron therapyDrug
Iron therapy will be administered if ferritin is <50 Nano gram per milliliter and/or TSAT is <15 percent.
| Study group | Role | What they receive |
|---|---|---|
| Daprodustat receivers | Experimental | Participants will receive oral daprodustat once daily Receives: Drug: Daprodustat (GSK1278863); Drug: Iron therapy |
| Placebo receivers | Placebo comparator | Participants will receive oral placebo once daily Receives: Drug: Placebo; Drug: Iron therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mean Change in Hemoglobin From Baseline and Over the Evaluation Period (Mean Over Week 24 and 28)
Blood samples were collected at given time points from participants for hemoglobin measurements. Evaluation period hemoglobin value was defined as the mean of all available post-randomization hemoglobin values (on and off-treatment) during the evaluation period (Week 24 to Week 28 inclusive). For the primary analysis, the missing post-Baseline hemoglobin values were imputed using pre-specified multiple imputations. Change from Baseline was defined as the average of post-randomization values during the evaluation period minus Baseline value. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date. Analysis was performed using the Analysis of Covariance (ANCOVA) model with terms for treatment, Baseline hemoglobin, and region.
Measured: Baseline (Day 1) and Week 24 to Week 28
Secondary outcomes (21)
Percentage of Participants With Hemoglobin Increase of >=1.0 Grams Per Deciliter From Baseline to Evaluation Period
Blood samples were collected at given time points for hemoglobin measurements. Evaluation period hemoglobin value was defined as the mean of all available post-randomization hemoglobin values (on and off-treatment) during the evaluation period (Week 24 to Week 28 inclusive). For the primary analysis, the missing post-Baseline hemoglobin values were imputed using pre-specified multiple imputations. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date. Percentage of participants with hemoglobin increase of >=1.0 grams per deciliter from Baseline to evaluation period was analyzed using Cochran-Mantel-Haenszel (CMH) chi-squared test. The percentage values presented has been rounded off.
Measured: Baseline (Day 1) and Week 24 to Week 28
Change From Baseline in Short Form-36 (SF-36) Questionnaire Vitality Domain Score by Traditional Scoring at Week 28
The SF-36 acute version 2 is a 36-item generic quality of life instrument designed to measure a participant's level of performance in the 8 health domains: Physical Functioning, Role-Physical (role limitations caused by physical problems), Social Functioning, Bodily Pain, Mental Health, Role-Emotional (role limitations caused by emotional problems), Vitality, and General Perception of Health.Each domain is scored from 0 (poorer health) to 100 (better health). Vitality domain score ranges from 0-100; higher score indicates a better health state \& better functioning. Change from Baseline was calculated as Post-Dose Visit Value at Week 28 minus Baseline. For primary analysis, the missing on-treatment Week 28 SF-36 Vitality domain scores were imputed using pre-specified multiple imputations. Baseline value was latest non-missing pre-dose assessment on or before randomization date. Analysis was performed using ANCOVA model with terms for treatment, Baseline score, and region.
Measured: Baseline (Day 1) and Week 28
Percentage of Participants With Hgb Response (Hgb in the 11-12 Grams/Deciliter Range) During Evaluation Period (Week 24 to Week 28 Inclusive)
Mean hemoglobin during the evaluation period was defined as the mean of all evaluable hemoglobin values during the evaluation period (Week 24 to Week 28 inclusive) including any evaluable unscheduled hemoglobin values that were taken during this period. Percentage of participants with Hgb response was defined as participants with mean Hgb within range (11-12 grams per deciliter during the evaluation period (Week 24 to Week 28 inclusive) and it was analyzed using Cochran-Mantel-Haenszel (CMH) chi-squared test. The percentage values presented has been rounded off.
Measured: Week 24 to Week 28
Percentage of Time With Hgb Within the Target Range (11-12 Grams Per Deciliter) During Evaluation Period (Week 24 to Week 28 Inclusive) (Hodges-Lehmann Estimate)
Percentage of days for which participant's Hgb was within the target range of 11-12 grams per deciliter during the evaluation period (Week 24 to Week 28 inclusive), including any unscheduled evaluable Hgb values that were taken during this time period. Percentage of time for which Hgb was within the target range (11-12 grams per deciliter) for a participant was calculated by dividing 'the total number of days that Hgb was within range during Week 24 to 28' by 'the total number of days the participant remained on treatment during Week 24 to 28'.
Measured: Week 24 to Week 28
Percentage of Time With Hgb Within the Target Range (11-12 Grams Per Deciliter) During Evaluation Period (Week 24 to Week 28 Inclusive) (Mann-Whitney Estimate)
Percentage of days for which participant's Hgb was within the target range of 11-12 grams per deciliter during the evaluation period (Week 24 to Week 28 inclusive), including any unscheduled evaluable Hgb values that were taken during this time period. Percentage of time for which Hgb was within the target range (11-12 grams per deciliter) for a participant was calculated by dividing 'the total number of days that Hgb was within range during Week 24 to 28' by 'the total number of days the participant remained on treatment during Week 24 to 28'
Measured: Week 24 to Week 28
Change From Baseline in Post-randomization Hgb at Week 28
Blood samples were collected at given time points for hemoglobin measurements. Change from Baseline in Hgb was analyzed using a mixed model repeated measures (MMRM) approach. Change from Baseline was calculated as Post-dose visit value minus Baseline. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date.
Measured: Baseline (Day 1) and Week 28
Rate of Participants Permanently Stopping Randomized Treatment Due to Meeting Rescue Criteria
The incidence rate of participants permanently stopping randomized treatment due to meeting rescue criteria is presented.
Measured: Up to Week 28
Change From Baseline by Domain and Single Item Scores on the Chronic Kidney Disease -Anemia Questionnaire (CKD-AQ) Symptom Questionnaire
CKD-AQ is 21-item patient reported outcomes measure assessing symptoms \& symptom impact in participants with anemia associated with CKD.CKD-AQ identified 3 domains:1.Tired/Low Energy/Weak scale consisting of ten items;2.Chest Pain/Shortness of Breath scale consisting of four items and 3.Cognitive scale consisting of three items;Single items included: 4.Difficulty Sleeping;5.Difficulty Standing for long periods of time;6.Severity-Shortness of breath while sitting/resting;7.Time with Shortness of breath while not doing activity.Single-item measures were recorded based on 0-100 scoring with 0 is worst possible \& 100 is best possible score.Total domain score is calculated as average of items in each domain \& ranged from 0-100 where 0 is worst possible and 100 is best possible score.Change from Baseline was calculated as post-dose visit value minus Baseline.Baseline was latest non-missing pre-dose assessment on or before randomization date. Adjusted mean \& standard error is presented.
Measured: Baseline (Day 1) and Week 28
Change From Baseline in Patient Global Impression of Severity (PGI-S)
The PGI-S is a 1-item questionnaire designed to assess participant's impression of disease severity on a 5-point disease severity scale (0=absent, 1=mild, 2=moderate, 3=severe, or 4=very severe). A higher score indicated worse outcome. Change from Baseline was calculated as Post-Dose visit value minus Baseline value. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date. Adjusted mean and standard error is presented.
Measured: Baseline (Day 1) and Week 28
Change From Baseline in the SF-36 Physical Functioning Domain
The SF-36 acute version 2 is a 36-item generic quality of life instrument designed to measure a participant's level of performance in the following eight health domains: physical functioning, role-physical (role limitations caused by physical problems), social functioning, bodily pain, mental health, role-emotional (role limitations caused by emotional problems), vitality, and general perception of health. Each domain is scored from 0 (poorer health) to 100 (better health). Physical functioning domain score ranges from 0-100; higher score indicates a better health state and better functioning. Change from Baseline was calculated as post-dose visit value minus Baseline value. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date.
Measured: Baseline (Day 1) and Week 28
Change From Baseline of the SF-36 Individual Items in the Vitality Domain
The SF-36 acute version 2 is a 36-item generic quality of life instrument designed to measure a participant's level of performance in the following eight health domains: physical functioning, role-physical (role limitations caused by physical problems), social functioning, bodily pain, mental health, role-emotional (role limitations caused by emotional problems), vitality, and general perception of health. Individual vitality items include: 1. Did you feel full of life?, 2. Did you have a lot of energy?, 3. Did you feel worn out?, 4. Did you feel tired?. Score of each item in the vitality domain ranges from 0-100; higher score indicates better health state and better functioning. Change from Baseline was calculated as post-dose visit value minus Baseline value. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date.
Measured: Baseline (Day 1) and Week 28
Number of Participants Currently Employed as Per Work Productivity and Activity Impairment Questionnaire: Anemic Symptoms Clinical Practice Version (WPAI-ANS-CPV)
WPAI-ANS-CPV is anemia specific questionnaire designed as self-reported quantitative assessment of social functioning related to work and regular daily activities. It contains 2 concepts-work productivity impairment measured via absenteeism(time missed from work), presenteeism(impairment at work) and regular daily activity impairment. WPAI questions (Q) were:1) currently employed,2) work time missed due to problem, 3) impairment while working due to problem, 4) overall work impairment due to problem, 5) activity impairment due to problem. WPAI generates 4 domain scores:percent (%) of work time missed(absenteeism),% of impairment while working(presenteeism),% of overall work impairment(absenteeism and presenteeism combined),% of activity impairment. Number of participants currently employed as per WPAI-ANS-CPV is presented.
Measured: Week 8, Week 12 and Week 28
Change From Baseline in WPAI-ANS-CPV: Percent Time Missed From Work
WPAI-ANS-CPV is anemia specific questionnaire designed as self-reported quantitative assessment of social functioning related to work and regular daily activities. It contains 2 concepts-work productivity impairment measured via absenteeism (time missed from work), presenteeism (impairment at work) and regular daily activity impairment. WPAI questions (Q) were: 1) currently employed, 2) work time missed due to problem, 3) impairment while working due to problem, 4)overall work impairment due to problem, 5) activity impairment due to problem. Percent work time missed due to problem was a subscale and calculated as: Q2/(Q2+Q4) for those who were currently employed. Subscale score was expressed as an impairment percentage (range: 0-100%) where higher numbers indicate greater impairment and less productivity. Change from Baseline was calculated as post-dose visit value minus Baseline. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date.
Measured: Baseline (Day 1), Week 8, Week 12 and Week 28
Change From Baseline in WPAI-ANS-CPV: Mean Hours Missed From Work in the Past 7 Days
WPAI-ANS-CPV is anemia specific questionnaire designed as self-reported quantitative assessment of social functioning related to work and regular daily activities. It contains 2 concepts-work productivity impairment measured via absenteeism (time missed from work), presenteeism (impairment at work) and regular daily activity impairment. WPAI Qs were: 1) currently employed, 2) work time missed due to problem, 3) impairment while working due to problem, 4) overall work impairment due to problem, 5) activity impairment due to problem. Change from Baseline was calculated as post-dose visit value minus Baseline. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date.
Measured: Baseline (Day 1), Week 8, Week 12 and Week 28
Change From Baseline in WPAI: Percent Impairment at Work
WPAI-ANS-CPV is anemia specific questionnaire designed as self-reported quantitative assessment of social functioning related to work and regular daily activities.It contains 2 concepts-work productivity impairment measured via absenteeism(time missed from work),presenteeism(impairment at work) and regular daily activity impairment.WPAI Qs were:1)currently employed,2)work time missed due to problem,3)impairment while working due to problem,4)overall work impairment due to problem,5)activity impairment due to problem. % Impairment while Working due to Problem was subscale and calculated as: Q5/10 for those who were currently employed and actually worked in past 7 days. Subscale score was expressed as an impairment percentage (range: 0-100%) where higher numbers indicate greater impairment and less productivity. Change from Baseline was calculated as post-dose visit value minus Baseline. Baseline value was the latest non-missing pre-dose assessment on or before randomization date.
Measured: Baseline (Day 1), Week 8, Week 12 and Week 28
Change From Baseline in WPAI: Percent Overall Work Impairment
WPAI-ANS-CPV is anemia specific questionnaire designed as self-reported quantitative assessment of social functioning related to work and regular daily activities. It contains 2 concepts-work productivity impairment measured via absenteeism (time missed from work), presenteeism (impairment at work) and regular daily activity impairment. WPAI Qs were: 1) currently employed, 2) work time missed due to problem, 3) impairment while working due to problem, 4) overall work impairment due to problem, 5) activity impairment due to problem. Percent overall work impairment due to problem was a subscale and calculated as: Q2/(Q2+Q4)+[(1-Q2/(Q2+Q4))×(Q5/10)] for those who were currently employed. Subscale score was expressed as an impairment percentage (range: 0-100%) where higher numbers indicate greater impairment. Change from Baseline was calculated as post-dose visit value minus Baseline. Baseline value was the latest non-missing pre-dose assessment on or before randomization date.
Measured: Baseline (Day 1), Week 8, Week 12 and Week 28
Change From Baseline in WPAI: Percent Regular Daily Activity Impairment
WPAI-ANS-CPV is anemia specific questionnaire designed as self-reported quantitative assessment of social functioning related to work and regular daily activities.It contains 2 concepts-work productivity impairment measured via absenteeism (time missed from work), presenteeism (impairment at work) and regular daily activity impairment. WPAI Qs were: 1) currently employed, 2) work time missed due to problem, 3) impairment while working due to problem, 4) overall work impairment due to problem, 5) activity impairment due to problem. Percent activity impairment due to problem was a subscale and calculated as: Q5/10 for all respondents. Subscale score was expressed as an impairment percentage (range: 0-100%) where higher numbers indicate greater impairment. Change from Baseline was calculated as post-dose visit value minus Baseline. Baseline value was the latest non-missing pre-dose assessment on or before randomization date.
Measured: Baseline (Day 1), Week 8, Week 12 and Week 28
Change From Baseline in EuroQol 5 Dimension 5 Level Health Utility Index (EQ-5D-5L) Utility Score
The EQ-5D-5L is a self-assessment questionnaire, consisting of 5 items covering 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). Each dimension is measured by a 5-point Likert scale (1: no problems, 2: slight problems, 3: moderate problems, 4: severe problems, and 5: extreme problems). The responses for the five dimension together form a five-figure description of health state. Each of these five-figure health states have attached valuation (utility score), expressed as single index on a scale from 0-1, where 1 is full health and 0 is worst health. The higher the score the better the health status. Change from Baseline was calculated as post-dose visit value minus Baseline. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date.
Measured: Baseline (Day 1) and Week 28
Change From Baseline in EuroQol Visual Analogue Scale (EQ-VAS) Score
The EQ VAS records the respondent's self-rated health on a vertical, visual analogue scale where the endpoints are labeled 'the best health you can imagine' and 'the worst health you can imagine' at the time of completion. It is a self-assessment visual analogue scale, ranging from 0=worst imaginable to 100=best. Change from Baseline was calculated as post-dose visit value minus Baseline. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date.
Measured: Baseline (Day 1) and Week 28
Change From Baseline in Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP) at Week 28
SBP, DBP and MAP were measured with participants in a seated position after at least a 5-minute of rest. MAP is the average BP in an individual's arteries during a single cardiac cycle. Change from Baseline was calculated as post-dose visit value minus Baseline. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date.
Measured: Baseline (Day 1) and Week 28
Percentage of Participants With at Least One Blood Pressure (BP) Exacerbation Event
Percentage of participants with at least one BP event is presented. BP exacerbation is defined as: SBP exacerbation: SBP >= 25 mmHg increase from Baseline or SBP >= 180 mmHg; DBP exacerbation: DBP >= 15 mmHg increase from Baseline or DBP >= 110 mmHg. Percentage of participants with at least one BP event is presented. The percentage values presented has been rounded off.
Measured: Up to Week 28
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 Jan 2018
- Study start5 Mar 2018
- Primary completion7 Oct 2020
- Study completion7 Oct 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for AnaemiaStudies of the same condition, open and under way.
- More trials run by GlaxoSmithKlineThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Model description
- Participants will be randomized to receive Daprodustat or placebo in a randomized manner.
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 614 participants (actual)
Sponsor and investigators
- Lead sponsor
- GlaxoSmithKline
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- GSK Clinical Trials, Study director, GlaxoSmithKline
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03409107
- Sponsor's protocol ID
- 205270
- Other IDs
- 2017-002270-39, 2017
- Status last verified
- Mar 2024
- First submitted
- 8 Jan 2018
- Last updated
- 2 Apr 2024
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: Qualified researchers may request access to anonymized individual patient-level data (IPD) and related study documents of the eligible studies via the Data Sharing Portal. Details on GSK's data sharing criteria can be found at: https://www.gsk.com/en-gb/innovation/trials/data-transparency/
Publications
Johansen KL, Cobitz AR, Singh AK, Macdougall IC, Lopes RD, Obrador GT, Kovesdy CP, Israni R, Jha V, Okoro T, Sprys M, Jolly S, Lindsay AC, Bhatt P, Camejo RR, Keeley T, Cizman B, Wheeler DC. The ASCEND-NHQ randomized trial found positive effects of daprodustat on hemoglobin and quality of life in patients with non-dialysis chronic kidney disease. Kidney Int. 2023 Jun;103(6):1180-1192. doi: 10.1016/j.kint.2023.02.019. Epub 2023 Mar 2.
PubMed 36868377Natale P, Palmer SC, Jaure A, Hodson EM, Ruospo M, Cooper TE, Hahn D, Saglimbene VM, Craig JC, Strippoli GF. Hypoxia-inducible factor stabilisers for the anaemia of chronic kidney disease. Cochrane Database Syst Rev. 2022 Aug 25;8(8):CD013751. doi: 10.1002/14651858.CD013751.pub2.
PubMed 36005278
Study at a glance
From the registry record, last updated by the sponsor on 2 Apr 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A 28-week, Randomized, Double-blind, Placebo-controlled, Parallel-group, Multi-center, Study in Recombinant Human Erythropoietin (rhEPO) naïve Non-dialysis Participants With Anemia Associated With Chronic Kidney Disease to Evaluate the Efficacy, Safety and Effects on Quality of Life of Daprodustat Compared to Placebo
- ClinicalTrials.gov ID
- NCT03409107
- Acronym / sponsor ID
- 205270
- Conditions
- Anaemia
- Keywords
- Non-Dialysis, Anemia, Chronic kidney disease, Recombinant human erythropoietin naïve, Hemoglobin, Daprodustat
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 614 participants (actual)
- Lead sponsor
- GlaxoSmithKlineIndustry (pharma, biotech, devices)
- Study start
- 5 Mar 2018 (actual)
- Primary completion
- 7 Oct 2020 (actual)
- Study completion
- 7 Oct 2020 (actual)
- First posted
- 24 Jan 2018 (actual)
- Results
- Posted 3 Nov 2021
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this multi-center study in non-dialysis participants with anemia associated with CKD is to evaluate safety, efficacy and quality of life of daprodustat compared to placebo.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
- Model description
- Participants will be randomized to receive Daprodustat or placebo in a randomized manner.
| Arm | Type | Receives |
|---|---|---|
| Daprodustat receivers | Experimental | Drug: Daprodustat (GSK1278863), Drug: Iron therapyParticipants will receive oral daprodustat once daily |
| Placebo receivers | Placebo comparator | Drug: Placebo, Drug: Iron therapyParticipants will receive oral placebo once daily |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- >=18 years of age at the time of signing the informed consent.
- Have CKD, confirmed at screening: Kidney Disease Outcomes Quality Initiative (KDOQI) CKD stages 3, 4, or 5 defined by Estimated glomerular filtration rate (eGFR) using the CKD Epidemiology Collaboration (CKD-EPI) formula.
- Participants with Stable HemoCue Hgb from 8.5 to 10.5 at screening visit (Week -4) and from 8.5 to 10.0 g/dL at randomization (Day 1).
- Participants may receive up to one intravenous (IV) iron dose within the 8 weeks prior to screening and NO IV iron use between screening visit and randomization (Day 1).
- If needed, participant may be on stable maintenance oral iron supplementation. There should be <50% change in overall dose and no change in type of iron prescribed in the 4 weeks prior to Day 1 randomization visit.
Key exclusion criteria (24 listed)
- Participants who are on dialysis or clinical evidence of impending need to initiate dialysis within 180 days after randomization (Day 1).
- Planned living-related or living-unrelated kidney transplant within 28 weeks after randomization (Day 1).
- Transferrin saturation (TSAT) <15 percent (Screening only).
- Ferritin <50 nanograms per milliliter (ng/mL) (Screening only).
- History of rhEPO or rhEPO analogue use within the 8 weeks prior to screening and rhEPO use between screening and randomization (Day 1).
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Daprodustat (GSK1278863)Daprodustat will be available as 9 millimeter (mm) or 7 mm film-coated tablets. Daprodustat will be administered once daily via oral route and can be taken without regard to food. | Drug | Daprodustat receivers |
| PlaceboDaprodustat matching placebo will be available as 9 mm or 7 mm film coated tablets. Placebo will be administered once daily via oral route and can be taken without regard to food. | Drug | Placebo receivers |
| Iron therapyIron therapy will be administered if ferritin is <50 Nano gram per milliliter and/or TSAT is <15 percent. | Drug | Daprodustat receivers, Placebo receivers |
Primary outcome
Mean Change in Hemoglobin From Baseline and Over the Evaluation Period (Mean Over Week 24 and 28)
Time frame: Baseline (Day 1) and Week 24 to Week 28
Blood samples were collected at given time points from participants for hemoglobin measurements. Evaluation period hemoglobin value was defined as the mean of all available post-randomization hemoglobin values (on and off-treatment) during the evaluation period (Week 24 to Week 28 inclusive). For the primary analysis, the missing post-Baseline hemoglobin values were imputed using pre-specified multiple imputations. Change from Baseline was defined as the average of post-randomization values during the evaluation period minus Baseline value. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date. Analysis was performed using the Analysis of Covariance (ANCOVA) model with terms for treatment, Baseline hemoglobin, and region.
21 secondary outcomes
Percentage of Participants With Hemoglobin Increase of >=1.0 Grams Per Deciliter From Baseline to Evaluation Period
Time frame: Baseline (Day 1) and Week 24 to Week 28
Change From Baseline in Short Form-36 (SF-36) Questionnaire Vitality Domain Score by Traditional Scoring at Week 28
Time frame: Baseline (Day 1) and Week 28
Percentage of Participants With Hgb Response (Hgb in the 11-12 Grams/Deciliter Range) During Evaluation Period (Week 24 to Week 28 Inclusive)
Time frame: Week 24 to Week 28
Percentage of Time With Hgb Within the Target Range (11-12 Grams Per Deciliter) During Evaluation Period (Week 24 to Week 28 Inclusive) (Hodges-Lehmann Estimate)
Time frame: Week 24 to Week 28
Percentage of Time With Hgb Within the Target Range (11-12 Grams Per Deciliter) During Evaluation Period (Week 24 to Week 28 Inclusive) (Mann-Whitney Estimate)
Time frame: Week 24 to Week 28
Change From Baseline in Post-randomization Hgb at Week 28
Time frame: Baseline (Day 1) and Week 28
Rate of Participants Permanently Stopping Randomized Treatment Due to Meeting Rescue Criteria
Time frame: Up to Week 28
Change From Baseline by Domain and Single Item Scores on the Chronic Kidney Disease -Anemia Questionnaire (CKD-AQ) Symptom Questionnaire
Time frame: Baseline (Day 1) and Week 28
Change From Baseline in Patient Global Impression of Severity (PGI-S)
Time frame: Baseline (Day 1) and Week 28
Change From Baseline in the SF-36 Physical Functioning Domain
Time frame: Baseline (Day 1) and Week 28
Change From Baseline of the SF-36 Individual Items in the Vitality Domain
Time frame: Baseline (Day 1) and Week 28
Number of Participants Currently Employed as Per Work Productivity and Activity Impairment Questionnaire: Anemic Symptoms Clinical Practice Version (WPAI-ANS-CPV)
Time frame: Week 8, Week 12 and Week 28
Change From Baseline in WPAI-ANS-CPV: Percent Time Missed From Work
Time frame: Baseline (Day 1), Week 8, Week 12 and Week 28
Change From Baseline in WPAI-ANS-CPV: Mean Hours Missed From Work in the Past 7 Days
Time frame: Baseline (Day 1), Week 8, Week 12 and Week 28
Change From Baseline in WPAI: Percent Impairment at Work
Time frame: Baseline (Day 1), Week 8, Week 12 and Week 28
Change From Baseline in WPAI: Percent Overall Work Impairment
Time frame: Baseline (Day 1), Week 8, Week 12 and Week 28
Change From Baseline in WPAI: Percent Regular Daily Activity Impairment
Time frame: Baseline (Day 1), Week 8, Week 12 and Week 28
Change From Baseline in EuroQol 5 Dimension 5 Level Health Utility Index (EQ-5D-5L) Utility Score
Time frame: Baseline (Day 1) and Week 28
Change From Baseline in EuroQol Visual Analogue Scale (EQ-VAS) Score
Time frame: Baseline (Day 1) and Week 28
Change From Baseline in Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP) at Week 28
Time frame: Baseline (Day 1) and Week 28
Percentage of Participants With at Least One Blood Pressure (BP) Exacerbation Event
Time frame: Up to Week 28
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Apr 2024.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Background: PubMed 36868377Johansen KL, Cobitz AR, Singh AK, Macdougall IC, Lopes RD, Obrador GT, Kovesdy CP, Israni R, Jha V, Okoro T, Sprys M, Jolly S, Lindsay AC, Bhatt P, Camejo RR, Keeley T, Cizman B, Wheeler DC. The ASCEND-NHQ randomized trial found positive effects of daprodustat on hemoglobin and quality of life in patients with non-dialysis chronic kidney disease. Kidney Int. 2023 Jun;103(6):1180-1192. doi: 10.1016/j.kint.2023.02.019. Epub 2023 Mar 2.
- Derived from this study: PubMed 36005278Natale P, Palmer SC, Jaure A, Hodson EM, Ruospo M, Cooper TE, Hahn D, Saglimbene VM, Craig JC, Strippoli GF. Hypoxia-inducible factor stabilisers for the anaemia of chronic kidney disease. Cochrane Database Syst Rev. 2022 Aug 25;8(8):CD013751. doi: 10.1002/14651858.CD013751.pub2.
- Individual participant dataSharing planned: Yes. Qualified researchers may request access to anonymized individual patient-level data (IPD) and related study documents of the eligible studies via the Data Sharing Portal. Details on GSK's data sharing criteria can be found at: https://www.gsk.com/en-gb/innovation/trials/data-transparency/
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
GSK Clinical Trials study director
GlaxoSmithKline
168 sites in 14 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Daprodustat (GSK1278863) and Iron therapy in people with Anaemia, run by GlaxoSmithKline at 168 sites in 14 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 7 inclusion and 24 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 2 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 168 sites in United States, Poland, Russia, Canada, Brazil and 9 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. 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 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 3 Nov 2021). 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?
Mean Change in Hemoglobin From Baseline and Over the Evaluation Period (Mean Over Week 24 and 28) (time frame: Baseline (Day 1) and Week 24 to Week 28). 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 NCT03409107, 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 2 Apr 2024.