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AKB-6548, reference formulation given in the

Phase 2

Anemia | Small molecule | Hematology |Akebia Therapeutics, Inc.|Last Updated: Jul 21, 2022

Target and mechanism

Molecular targetHIF
Target classHypoxia-inducible Factor
ModalitySmall molecule

Also known as AKB-6548, reference formulation given in the fasted state, AKB-6548, AKB-6548 (therapeutic dose)

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLED
Total Trials4
Total Enrollment407

FDA Designations

No designations recorded

Clinical trial landscape

AKB-6548, reference formulation given in the · 8 trials · 6 indications

Phase 2 4Phase 1 4
NCT0226019316-Week Repeat Oral Dose Study of AKB-6548 for Anemia in Participants With End Stage Renal Disease (ESRD) Requiring Chronic HemodialysisAnemia
COMPLETED94 Analytics
NCT0190648920-Week Repeat Oral Dose Study of AKB-6548 in Participants With Chronic Kidney Disease and AnemiaAnemia
COMPLETED210 Analytics
NCT0138109442-Day Repeat Oral Dose Study of AKB-6548 in Participants With Chronic Kidney Disease and AnemiaAnemia
COMPLETED93 Analytics
NCT01235936Safety and Efficacy Study for AKB-6548 in Participants With Chronic Kidney Disease and AnemiaAnemia
COMPLETED10 Analytics
PHASE2COMPLETED
16-Week Repeat Oral Dose Study of AKB-6548 for Anemia in Participants With End Stage Renal Disease (ESRD) Requiring Chronic Hemodialysis
AnemiaUnlock trial analytics
PHASE2COMPLETED
20-Week Repeat Oral Dose Study of AKB-6548 in Participants With Chronic Kidney Disease and Anemia
AnemiaUnlock trial analytics
PHASE2COMPLETED
42-Day Repeat Oral Dose Study of AKB-6548 in Participants With Chronic Kidney Disease and Anemia
AnemiaUnlock trial analytics
PHASE2COMPLETED
Safety and Efficacy Study for AKB-6548 in Participants With Chronic Kidney Disease and Anemia
AnemiaUnlock trial analytics

Study Endpoints

Primary Endpoints

Change From Pre-dose Average in Hemoglobin (Hgb) Level to The Mid-study Average
Pre-dose (Screening, Second Screening, and Baseline), Week 7, and Week 8

Change from pre-dose average was calculated by the mid-study average minus the pre-dose average. The pre-dose average was defined as the average of the 3 Hgb values that were obtained before dosing at the first screening visit, the second screening visit, and the Baseline visit; the mid-study average was defined as the average of the 2 Hgb values that were obtained at the Week 7 and Week 8 visits.

Change From Pre-dose Average in Hgb Level to The End-of-study Average
Pre-dose, Week 15, and Week 16

Change from pre-dose average was calculated by the end-of-study average minus the pre-dose average. The pre-dose average was defined as the average of the 3 Hgb values that were obtained before dosing at the first screening visit, the second screening visit, and the Baseline visit; the end-of-study average was defined as the average of the 2 Hgb values that were obtained at the Week 15 and Week 16 visits.

Change From Mid-study Average in Hgb Level to The End-of-study Average
Week 7, Week 8, Week 15, and Week 16

Change from mid-study average was calculated by the end-of-study average minus the mid-study average. The mid-study average was defined as the average of the 2 Hgb values that were obtained at the Week 7 and Week 8 visits; the end-of-study average was defined as the average of the 2 Hgb values that were obtained at the Week 15 and Week 16 visits.

Percentage of Participants Achieving a Successful Hemoglobin Response
Weeks 19 and 20

Hemoglobin (Hgb) response was defined as participants with mean Hgb ≥11.0 grams per deciliter (g/dL) (average of Weeks 19 and 20) or increase in Hgb by ≥ 1.2 g/dL (average of Weeks 19 and 20) over pre-dose average (average of the two Hgb values obtained prior to dosing) without receiving Erythropoiesis-Stimulating Agents (ESA) or transfusion.

Absolute Change From Baseline in Hemoglobin (Hgb) to End of Treatment (Week 6)
Baseline, Week 6

Absolute change from Baseline was calculated as the Week 6 (end of treatment) value minus the Baseline value. Baseline Hgb was defined as the average of the last two measurements obtained prior to dosing. If there was only one measurement prior to dosing, this measurement served as Baseline. A positive change from Baseline indicated that hemoglobin concentration increased.

Mean Change From Baseline in Hemoglobin (Hgb) on Day 29
Baseline; Day 29

Blood samples were collected to assess Hgb. Baseline Hgb was defined as the average of the 2 samples obtained prior to dosing (Pre-Baseline and Baseline). A positive change from baseline indicates that hemoglobin concentration increased.

PK parameters (Cmax)
pre-dose to 48 hours post-dose

maximum observed plasma concentration (Cmax) for celecoxib

PK parameters (time to reach Cmax )
pre-dose to 48 hours post-dose

time to reach Cmax for celecoxib

PK parameters (t½)
from pre-dose to 48 hours post-dose

terminal elimination half-life (t½) for celecoxib

PK parameters (AUC0-t)
pre-dose to 48 hours post-dose

concentration (AUC0-t) for celecoxib

PK parameters (area under the plasma concentration-time curve from 0 to last quantifiable)
pre-dose to 48 hours post-dose

area under the plasma concentration-time curve from 0 to last quantifiable

PK parameters (AUC0-inf)
from pre-dose to 48 hours post-dose

AUC from time 0 to infinity (AUC0-inf) for celecoxib

PK parameters (CL/F)
pre-dose to 48 hours post-dose

apparent oral clearance (CL/F) for celecoxib

PK parameters (Vz/F)
pre-dose to 48 hours post-dose

apparent volume of distribution during the terminal phase (Vz/F) for celecoxib

Bioavailability endpoints: Area under the plasma concentration-time curve from 0 to last quantifiable concentration (AUC 0-t) of AKB-6548
Multiple timepoint evaluations from pre-dose to 24 hours post-dose
Bioavailability endpoints: Area under the concentration time curve from time 0 to infinity (AUC 0-inf) of AKB-6548
Multiple timepoint evaluations from pre-dose to 24 hours post-dose
Bioavailability endpoints: Maximum observed plasma concentration (Cmax) of AKB-6548
Multiple timepoint evaluations from pre-dose to 24 hours post-dose
Food Effect Endpoint: AKB-6548 AUC 0-t for the fed versus fasted administration of AKB-6548 tablets
Multiple timepoint evaluations from pre-dose to 24 hours post-dose
Food Effect Endpoint: AKB-6548 AUC 0-inf for the fed versus fasted administration of AKB-6548 tablets
Multiple timepoint evaluations from pre-dose to 24 hours post-dose
Food Effect Endpoint: AKB-6548 Cmax for the fed versus fasted administration of AKB-6548 tablets
Multiple timepoint evaluations from pre-dose to 24 hours post-dose
PK parameters of AKB-6548: Maximum plasma concentration (Cmax)
Multiple timepoint evaluations from pre-dose to 24 hours post-dose
PK parameters of AKB-6548: Area under the curve from time 0 until the last quantifiable concentration (AUC [last])
Multiple timepoint evaluations from pre-dose to 24 hours post-dose
PK parameters of AKB-6548: Area under the concentration-time curve from 0 to infinity (AUCinf)
Multiple timepoint evaluations from pre-dose to 24 hours post-dose
Placebo-corrected change-from-baseline QTcF (ΔΔQTcF) following AKB-6548 administration.
multiple timepoint evaluations from pre-dose to 24 hours post-dose

Secondary Endpoints

Change From Baseline in Hgb
Baseline, Week 4, Week 8, Week 12, and Week 16
Change From Baseline in Hematocrit
Baseline, Week 4, Week 8, Week 12, and Week 16
Change From Baseline in Red Blood Cell (RBC) Count
Baseline, Week 4, Week 8, Week 12, and Week 16
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Study Design & Arms

AllocationNON_RANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
AKB-6548, starting dose 1EXPERIMENTAL -
AKB-6548, starting dose 2EXPERIMENTAL -
AKB-6548, starting dose 3EXPERIMENTAL -
AKB-6548EXPERIMENTAL -
PlaceboPLACEBO_COMPARATOR -
AKB-6548 240 mgEXPERIMENTAL -
AKB-6548 370 mgEXPERIMENTAL -
AKB-6548 500 mgEXPERIMENTAL -
AKB-6548 630 mgEXPERIMENTAL -
CelecoxibACTIVE_COMPARATORCelecoxib
AKB-6548 and CelecoxibEXPERIMENTALAKB-6548; celecoxib
Treatment AEXPERIMENTALAKB-6548
Treatment BEXPERIMENTALAKB-6548
Treatment CEXPERIMENTALAKB-6548
AKB-6548 plus Ferrous SulfateEXPERIMENTALAKB-6548 plus ferrous sulfate
AKB-6548 (therapeutic dose)EXPERIMENTAL -
AKB-6548 (supratherapeutic dose)EXPERIMENTAL -
MoxifloxacinACTIVE_COMPARATOR -

Interventions

NameTypeDescription
AKB-6548DRUGStarting dose 1. Oral dose administered once daily for 16 weeks. Dose adjustment based on hemoglobin level as defined in the protocol.
PlaceboDRUGOral Placebo administered once daily for 20 weeks. Dose adjustment based on hemoglobin level as defined in the protocol.
CelecoxibDRUG -
AKB-6548 tablet, reference formulation given in the fasted stateDRUG -
AKB-6548 tablet, test formulation given in the fasted state.DRUG -
AKB-6548 tablet, test formulation given in the fed stateDRUG -
Ferrous SulfateDRUG -
AKB-6548 (therapeutic dose)DRUGSingle oral dose of AKB-6548 at a therapeutic dose level
AKB-6548 (supratherapeutic dose)DRUGSingle oral dose of AKB-6548 at a supratherapeutic dose level
MoxifloxacinDRUGSingle oral dose of 400 mg moxifloxacin
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Eligibility Criteria

Age Range18 Years to 79 Years
SexALL
Healthy VolunteersNo
Study Sites16

Key Inclusion Criteria: * 18 to 79 years inclusive * Chronic Kidney Disease (CKD) Stage 5 on chronic hemodialysis for at least 3 months * Anemia secondary to CKD treated with erythropoiesis stimulating agent and intravenous iron Key Exclusion Criteria: * Body mass index \>44.0 kilograms per meter...

Countries:United States
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Frequently asked questions about AKB-6548, reference formulation given in the

What is AKB-6548?

AKB-6548 is an investigational small molecule developed by Akebia Therapeutics, Inc. (ticker AKBA) for anemia. It has been studied in healthy volunteers and in participants with end stage renal disease requiring chronic hemodialysis. The program includes four completed clinical trials with a combined enrollment of 407 participants.

What does AKB-6548 target?

AKB-6548 targets hypoxia-inducible factor, or HIF. HIF is a transcription factor that regulates the body's response to low oxygen, including erythropoiesis. By acting on the HIF pathway, AKB-6548 is designed to stimulate red blood cell production, which is the rationale for studying it in anemia.

Who makes AKB-6548?

AKB-6548 is developed by Akebia Therapeutics, Inc., which trades under the ticker AKBA. Akebia is the sponsor of the clinical program studying the drug in anemia and in healthy volunteer settings.

What phase is AKB-6548 in?

AKB-6548 is in Phase 2 development. The Phase 2 study was a 16-week repeat oral dose trial in participants with anemia and end stage renal disease requiring chronic hemodialysis. The remaining three trials were Phase 1 studies in healthy volunteers. All four trials are completed.

What clinical trials is AKB-6548 in?

AKB-6548 has been studied in four completed trials: NCT02260193, a Phase 2 anemia study in end stage renal disease; NCT02412449, a Phase 1 relative bioavailability and food effect study; NCT02502500, a Phase 1 drug interaction study with celecoxib; and NCT02327546, a Phase 1 study of ferrous sulfate effects on pharmacokinetics.