A Phase 3b Study of Erythropoietin Drugs Using a Specified Dosing Algorithm in Patients With Chronic Kidney Disease on Hemodialysis



Status:Completed
Conditions:Renal Impairment / Chronic Kidney Disease
Therapuetic Areas:Nephrology / Urology
Healthy:No
Age Range:18 - Any
Updated:6/15/2018
Start Date:July 13, 2015
End Date:July 16, 2016

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The Pieda Study: A Phase 3b Investigation Of Erythropoietin Drugs Using A Specified Dosing Algorithm: A Randomized Open Label Dosing Study In Adult Chronic Kidney Disease Subjects On Hemodialysis

A phase 3b study for subjects receiving Epogen to compare a dosing algorithm between Hospira
Epoetin and Standard of Care Epogen.

Primary Objective: To evaluate switching from Epogen to Epoetin Hospira for maintenance of
hemoglobin levels in anemic chronic kidney disease (CKD) subjects on hemodialysis using a
specified algorithm for the dosing of erythropoietin stimulating agents (ESA).

Secondary Objective: To evaluate switching from Epogen to Epoetin Hospira on the dosing of
ESA in anemic CKD subjects on hemodialysis using a specified algorithm for the dosing of ESA.

Exploratory Objectives: To generate hypotheses regarding maintenance of hemoglobin levels,
dosing of ESA, intravenous (IV) iron dosing requirements, transferrin saturation (TSAT)
levels and ferritin levels associated with the switch from Epogen to Epoetin Hospira in
anemic CKD subjects on hemodialysis using specified algorithms for the dosing of ESA and for
the dosing of IV iron, that are standard of care.

Inclusion Criteria

Subjects eligible to be entered into the study will meet all of the following criteria:

1. Adult female or male subjects; age ≥ 18 years.

2. End stage renal disease subjects treated in-center with the modality of hemodialysis
for ≥ 120 days.

3. Diagnosed with anemia.

4. Administered routine Epogen therapy for at least 16 weeks by an IV route for treatment
of anemia using an Epogen version of an FMCNA dosing algorithm for ESA, and did not
miss more than 3 prescribed doses of Epogen within 12 weeks prior to randomization.

5. Currently using the IV Epogen version of the ESA dosing algorithm cMAB 5 (inclusive of
versions 5.0, 5.1, …) for anemia management.

6. Receiving hemodialysis at a clinic using the FMCNA dosing algorithm for IV iron that
is the FMCNA standard of care treatment for iron replacement.

Exclusion Criteria

Subjects that meet any of the following criteria will be ineligible to be entered into the
interventional cohort:

1. Subjects unable to provide a signed and dated informed consent for this clinical
research study.

2. As determined by the Investigator, female subjects of child bearing potential who do
not agree to use a highly effective method of contraception.

3. Any condition as determined by the investigator that would place a subject at an
increased risk, or preclude subject's full compliance with the study procedures and
visits.

4. Female subjects who are known to be or found to be, pregnant or lactating.

5. Subjects that are not a candidate for ESA therapies per the label warnings listed in
the package insert for Epogen and/or contraindications to Epoetin Hospira listed in
the Investigators' Brochure; or have had a known positive test for anti-rhEPO
antibodies.

6. Treatment with any investigational drug within 30 days prior to randomization and
throughout this clinical trial.

7. Diagnosed with any concurrent condition that could lead to greater-than-normal loss of
blood, including but not limited to:

- Menorrhagia, peptic ulcer disease, gastrointestinal bleeding, blood dyscrasia,
hemoglobinopathy

- Use of anticoagulation therapy, including warfarin with a target international
normalized ratio (INR) of 2 or greater Anti-platelet therapy (e.g. aspirin or
clopidogrel) is permitted, as is heparin given during hemodialysis. Low-dose
warfarin is permitted and defined as the presence of at least two INR values less
than or equal to 1.5 during the 120 days prior to enrollment and no values
exceeding 1.5 at any time after 120 days prior to enrollment.

Subjects started on warfarin with a known INR goal of 2.0 or greater are to receive no
further treatment with the study drugs, but follow up visits can continue.

Subjects on warfarin who meet criteria to enter the study are terminated if an INR >
2.0 is discovered or if no INR is available for 60 days.

8. History of transfusion of any blood product in the past 3 months, or 2 or more
transfusions in the past 1 year; or donated or lost > 475 mL blood volume (including
plasmapheresis) in the past 3 months.

9. Subjects currently receiving a long acting ESA, or who have received a long acting ESA
in the 16 weeks prior to study randomization
We found this trial at
42
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11031 Via Frontera
Rancho Bernardo, California 92127
2563
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Rancho Bernardo, CA
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Austin, Texas 78751
1691
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Austin, TX
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12221 Renfert Way
Austin, Texas 78758
1684
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784 Howard Avenue
Biloxi, Mississippi 39530
1284
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Boise, Idaho 83702
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Caldwell, Idaho 83605
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1680
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Carolina,
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Charlotte, North Carolina 28204
719
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Charlotte, North Carolina 28204
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Chula Vista, California 91910
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Crossville, Tennessee 38555
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Durham, North Carolina 27703
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Durham, North Carolina 27704
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Franklin, Tennessee 37067
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4405 East Aloha Drive
Gulfport, Mississippi 39503
1306
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Gulfport, MS
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Gulfport, Mississippi 39501
1292
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Houston, Texas 77083
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Houston, Texas 77099
1601
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2901 East Kilgore Road
Kalamazoo, Michigan 49001
736
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Kalamazoo, Michigan 49007
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6739 Seeco Drive
Kalamazoo, Michigan 49009
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Knoxville, Tennessee 37923
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Knoxville, Tennessee 37934
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Lansdale, Pennsylvania 19446
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Matthews, North Carolina 28105
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McAllen, Texas 78503
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Meridian, Idaho 83642
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Nampa, Idaho 83686
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Nashville, Tennessee 37205
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265
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Philadelphia, PA
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2561
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Poway, CA
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Rosenberg, Texas 77471
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2572
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San Diego, CA
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San Diego, California 92139
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Tampa, Florida 33609
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Tampa, Florida 33614
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Warwick, Rhode Island 02886
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Weslaco, Texas 78596
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