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Evaluate Safety and Efficacy of Paricalcitol in Reducing Serum Intact Parathyroid Hormone in Chronic Kidney Disease
Evaluate the safety and efficacy of paricalcitol injection with two different dosing regimens (currently approved dosing regimen used in the US package insert versus dosing based on a formula of iPTH/80 that was approved and used in the EU package insert) in Chronic Kidney Disease (CKD) Stage 5 subjects with secondary hyperparathyroidism receiving hemodialysis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1 | Active Comparator | Initial dosing based on a formula of intact parathyroid hormone value/80 (where intact parathyroid hormone value is the baseline value in pg/mL). |
|
| Group 2 | Active Comparator | Dose determined by US paricalcitol injection package insert dosing instructions (starting dose at 0.04 microgram/kg) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| paricalcitol | Drug | Initiation dosing based on 2 approved package inserts , followed by a dose adjusted by limited chemistry test value. See Arm Description for additional details. |
| Measure | Description | Time Frame |
|---|---|---|
| The Achievement of Two Consecutive Greater Than or Equal to 30% Decreases From Baseline Intact Parathyroid Hormone Levels | The number of participants who achieved (Yes) or did not achieve (No) two consecutive decreases of greater than or equal to 30% from baseline in intact parathyroid hormone (iPTH) values | Baseline to 12 Weeks |
| Measure | Description | Time Frame |
|---|---|---|
| The Proportion of Subjects Achieving a Final Intact Parathyroid Hormone Value Between 150 and 300 pg/mL | The number of subjects with (Yes) or without (No) final intact parathyroid hormone (iPTH) values between 150 and 300 pg/mL | Baseline to 12 Weeks |
| The Change From Baseline to the Final Observation in Intact Parathyroid Hormone Value |
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Inclusion Criteria:
Subject is a Chinese male or female greater than or equal to 20 years old.
Subject is diagnosed with Chronic Kidney Disease Stage 5 and must be on maintenance hemodialysis three times a week for at least 2 months prior to the Screening Visit and expected to remain on hemodialysis for the duration of the study.
For entry into the Treatment Phase, the subject must have:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Yue Kang, MD | Abbott (China) | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Site Reference ID/Investigator# 23483 | Beijing | 100034 | China | |||
| Site Reference ID/Investigator# 23485 |
If subjects were receiving vitamin D receptor (VDR) activators, they participated in a Washout Phase for 2 weeks prior to entering into the Screening Phase in order to wash out any VDR activators and their potential hysteresis or carryover effects.
Participants were enrolled in the study at investigative sites in China. Recruitment began in October 2009 and ended in July 2010. The study population consisted of participants with Stage 5 chronic kidney disease who were receiving hemodialysis.
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| ID | Title | Description |
|---|---|---|
| FG000 | Group 1 | Initial dosing based on a formula of intact parathyroid hormone value/80 (where intact parathyroid hormone value is the baseline value in pg/mL). |
| FG001 | Group 2 | Dose determined by US paricalcitol injection package insert dosing instructions (starting dose at 0.04 microgram/kg) |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Group 1 | Initial dosing based on a formula of intact parathyroid hormone value/80 (where intact parathyroid hormone value is the baseline value in pg/mL). |
| BG001 | Group 2 | Dose determined by US paricalcitol injection package insert dosing instructions (starting dose at 0.04 microgram/kg) |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | The Achievement of Two Consecutive Greater Than or Equal to 30% Decreases From Baseline Intact Parathyroid Hormone Levels | The number of participants who achieved (Yes) or did not achieve (No) two consecutive decreases of greater than or equal to 30% from baseline in intact parathyroid hormone (iPTH) values | The analysis was based on the per-protocol population, which consisted of all randomized participants who completed at least 6 weeks of treatment and met the conditions that defined the per-protocol population. | Posted | Number | participants | Baseline to 12 Weeks |
|
From the time of study drug administration until 30 days following discontinuation of study drug administration.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Group 1 | Initial dosing based on a formula of intact parathyroid hormone value/80 (where intact parathyroid hormone value is the baseline value in pg/mL). |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Myocardial ischaemia | Cardiac disorders | MedDRA 13.0 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nephrogenic anaemia | Blood and lymphatic system disorders | MedDRA 13.0 |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Global Medical Services | Abbott | 800-633-9110 |
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| ID | Term |
|---|---|
| D051436 | Renal Insufficiency, Chronic |
| D006962 | Hyperparathyroidism, Secondary |
| ID | Term |
|---|---|
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
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| ID | Term |
|---|---|
| C084656 | paricalcitol |
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|
| Baseline to 12 Weeks |
| The Change From Baseline to the Final Observation in Calcium | Baseline to 12 Weeks |
| The Change From Baseline to the Final Observation in Calcium-phosphorus Product | Baseline to 12 Weeks |
| The Change From Baseline to the Final Observation in the Vital Sign of Systolic Blood Pressure | Baseline to 12 Weeks |
| The Change From Baseline to the Final Observation in the Vital Sign of Diastolic Blood Pressure | Baseline to 12 Weeks |
| The Change From Baseline to the Final Observation in the Vital Sign of Heart Rate | Baseline to 12 Weeks |
| The Proportion of Subjects With 2 Consecutive Calcium Measurements Greater Than 11.0 mg/dL (2.75 mmol/L) | The number of subjects with (Yes) or without (No) two consecutive calcium measurements greater than 11.0 mg/dL (2.75 mmol/L) | Baseline to 12 weeks |
| Beijing |
| 100044 |
| China |
| Site Reference ID/Investigator# 23482 | Beijing | 100730 | China |
| Site Reference ID/Investigator# 23484 | Dalian | 116011 | China |
| Site Reference ID/Investigator# 23486 | Guangzhou | 510080 | China |
| Site Reference ID/Investigator# 23488 | Nanjing | 210029 | China |
| Site Reference ID/Investigator# 37722 | Qingdao | 266003 | China |
| Site Reference ID/Investigator# 23490 | Shanghai | 200001 | China |
| Site Reference ID/Investigator# 25502 | Shanghai | 200001 | China |
| Site Reference ID/Investigator# 23489 | Shanghai | 200025 | China |
| Site Reference ID/Investigator# 23487 | Shanghai | 200092 | China |
| Site Reference ID/Investigator# 35822 | Wenzhou | 325000 | China |
| Missed 3 consecutive doses of study drug |
|
| Hypercalcemia |
|
| BG002 | Total | Total of all reporting groups |
| years |
|
| Age, Customized | Number | Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Group 2 |
Dose determined by US paricalcitol injection package insert dosing instructions (starting dose at 0.04 microgram/kg) |
|
|
| Secondary | The Proportion of Subjects Achieving a Final Intact Parathyroid Hormone Value Between 150 and 300 pg/mL | The number of subjects with (Yes) or without (No) final intact parathyroid hormone (iPTH) values between 150 and 300 pg/mL | The analysis was based on the intent-to-treat (ITT) population, which consisted of all randomized participants who received at least one dose of study drug. | Posted | Number | participants | Baseline to 12 Weeks |
|
|
|
| Secondary | The Change From Baseline to the Final Observation in Intact Parathyroid Hormone Value | The analysis was based on the intent-to-treat (ITT) population, which consisted of all randomized participants who received at least one dose of study drug. | Posted | Mean | Standard Error | pg/mL | Baseline to 12 Weeks |
|
|
|
| Secondary | The Change From Baseline to the Final Observation in Calcium | The analysis was based on the intent-to-treat (ITT) population, which consisted of all randomized participants who received at least one dose of study drug. | Posted | Mean | Standard Error | mg/dL | Baseline to 12 Weeks |
|
|
|
| Secondary | The Change From Baseline to the Final Observation in Calcium-phosphorus Product | The analysis was based on the intent-to-treat (ITT) population, which consisted of all randomized participants who received at least one dose of study drug. | Posted | Mean | Standard Error | mg^2/dL^2 | Baseline to 12 Weeks |
|
|
|
| Secondary | The Change From Baseline to the Final Observation in the Vital Sign of Systolic Blood Pressure | The analysis was based on the intent-to-treat (ITT) population, which consisted of all randomized participants who received at least one dose of study drug. | Posted | Mean | Standard Deviation | mm Hg | Baseline to 12 Weeks |
|
|
|
| Secondary | The Change From Baseline to the Final Observation in the Vital Sign of Diastolic Blood Pressure | The analysis was based on the intent-to-treat (ITT) population, which consisted of all randomized participants who received at least one dose of study drug. | Posted | Mean | Standard Deviation | mm Hg | Baseline to 12 Weeks |
|
|
|
| Secondary | The Change From Baseline to the Final Observation in the Vital Sign of Heart Rate | The analysis was based on the intent-to-treat (ITT) population, which consisted of all randomized participants who received at least one dose of study drug. | Posted | Mean | Standard Deviation | beats per minute | Baseline to 12 Weeks |
|
|
|
| Secondary | The Proportion of Subjects With 2 Consecutive Calcium Measurements Greater Than 11.0 mg/dL (2.75 mmol/L) | The number of subjects with (Yes) or without (No) two consecutive calcium measurements greater than 11.0 mg/dL (2.75 mmol/L) | The analysis was based on the intent-to-treat (ITT) population, which consisted of all randomized participants who received at least one dose of study drug. | Posted | Number | participants | Baseline to 12 weeks |
|
|
|
| 0 |
| 108 |
| 29 |
| 108 |
| EG001 | Group 2 | Dose determined by US paricalcitol injection package insert dosing instructions (starting dose at 0.04 microgram/kg) | 3 | 108 | 19 | 108 |
| Deafness neurosensory | Ear and labyrinth disorders | MedDRA 13.0 |
|
| Cerebral haemorrhage | Nervous system disorders | MedDRA 13.0 |
|
| Palpitations | Cardiac disorders | MedDRA 13.0 |
|
| Eyelid oedema | Eye disorders | MedDRA 13.0 |
|
| Abdominal discomfort | Gastrointestinal disorders | MedDRA 13.0 |
|
| Abdominal rigidity | Gastrointestinal disorders | MedDRA 13.0 |
|
| Diarrhoea | Gastrointestinal disorders | MedDRA 13.0 |
|
| Enteritis | Gastrointestinal disorders | MedDRA 13.0 |
|
| Gingivitis | Gastrointestinal disorders | MedDRA 13.0 |
|
| Haemorrhoidal haemorrhage | Gastrointestinal disorders | MedDRA 13.0 |
|
| Lip oedema | Gastrointestinal disorders | MedDRA 13.0 |
|
| Vomiting | Gastrointestinal disorders | MedDRA 13.0 |
|
| Chest discomfort | General disorders | MedDRA 13.0 |
|
| Chest pain | General disorders | MedDRA 13.0 |
|
| Oedema peripheral | General disorders | MedDRA 13.0 |
|
| Pyrexia | General disorders | MedDRA 13.0 |
|
| Pharyngitis | Infections and infestations | MedDRA 13.0 |
|
| Respiratory tract infection | Infections and infestations | MedDRA 13.0 |
|
| Upper respiratory tract infection | Infections and infestations | MedDRA 13.0 |
|
| Fibula fracture | Injury, poisoning and procedural complications | MedDRA 13.0 |
|
| Procedural hypotension | Injury, poisoning and procedural complications | MedDRA 13.0 |
|
| Alanine aminotransferase increased | Investigations | MedDRA 13.0 |
|
| Aspartate aminotransferase increased | Investigations | MedDRA 13.0 |
|
| Hypercalcaemia | Metabolism and nutrition disorders | MedDRA 13.0 |
|
| Hyperkalaemia | Metabolism and nutrition disorders | MedDRA 13.0 |
|
| Hyperphosphataemia | Metabolism and nutrition disorders | MedDRA 13.0 |
|
| Hypoglycaemia | Metabolism and nutrition disorders | MedDRA 13.0 |
|
| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA 13.0 |
|
| Back pain | Musculoskeletal and connective tissue disorders | MedDRA 13.0 |
|
| Muscle spasms | Musculoskeletal and connective tissue disorders | MedDRA 13.0 |
|
| Myalgia | Musculoskeletal and connective tissue disorders | MedDRA 13.0 |
|
| Tenosynovitis | Musculoskeletal and connective tissue disorders | MedDRA 13.0 |
|
| Cerebral haemorrhage | Nervous system disorders | MedDRA 13.0 |
|
| Dizziness | Nervous system disorders | MedDRA 13.0 |
|
| Headache | Nervous system disorders | MedDRA 13.0 |
|
| Insomnia | Psychiatric disorders | MedDRA 13.0 |
|
| Haematuria | Renal and urinary disorders | MedDRA 13.0 |
|
| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA 13.0 |
|
| Dyspnoea | Respiratory, thoracic and mediastinal disorders | MedDRA 13.0 |
|
| Oropharyngeal pain | Respiratory, thoracic and mediastinal disorders | MedDRA 13.0 |
|
| Upper airway obstruction | Respiratory, thoracic and mediastinal disorders | MedDRA 13.0 |
|
| Drug eruption | Skin and subcutaneous tissue disorders | MedDRA 13.0 |
|
| Pruritus | Skin and subcutaneous tissue disorders | MedDRA 13.0 |
|
| Rash | Skin and subcutaneous tissue disorders | MedDRA 13.0 |
|
| Hypertension | Vascular disorders | MedDRA 13.0 |
|
| Hypotension | Vascular disorders | MedDRA 13.0 |
|
Abbott requests that any investigator or institution that plans on presenting/publishing results disclosure, provide written notification of their request 60 days prior to their presentation/publication. Abbott requests that no presentation/publication will be instituted until 12 months after a study is completed, or after the first presentation/publication whichever occurs first. A delay may be proposed of a presentation/publication if Abbott needs to secure patent or proprietary protection.
| D005261 |
| Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D006961 | Hyperparathyroidism |
| D010279 | Parathyroid Diseases |
| D004700 | Endocrine System Diseases |