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Vadadustat

Phase 3

Anemia | Small molecule | Hematology |Akebia Therapeutics, Inc.|Last Updated: May 22, 2025

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindACTIVE_CONTROLLEDDMCBiomarker
Total Trials8
Total Enrollment8,004
FDA Designations
No designations recorded
Clinical Trials (8)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT04313153Trial Evaluating the Efficacy and Safety of Oral Vadadustat Once Daily (QD) and Three Times Weekly (TIW) for the Maintenance Treatment of Anemia in Hemodialysis Subjects Converting From Erythropoiesis-Stimulating Agents (ESAs)PHASE3 COMPLETED 319May 27, 2020Jun 22, 2022May 22, 202559 United States, Czechia +4
NCT02892149Efficacy and Safety Study to Evaluate Vadadustat for the Maintenance Treatment of Anemia in Participants With Dialysis-dependent Chronic Kidney Disease (DD-CKD)PHASE3 COMPLETED 3,554Aug 1, 2016Mar 30, 2020Jun 28, 2022278 United States, Argentina +16
NCT02865850Efficacy and Safety Study to Evaluate Vadadustat for the Correction or Maintenance Treatment of Anemia in Participants With Incident Dialysis-dependent Chronic Kidney Disease (DD-CKD)PHASE3 COMPLETED 369Jul 1, 2016Mar 30, 2020Jul 18, 2022118 United States, Argentina +9
NCT02680574Efficacy and Safety Study to Evaluate Vadadustat for the Maintenance Treatment of Anemia in Participants With Non-dialysis-dependent Chronic Kidney Disease (NDD-CKD)PHASE3 COMPLETED 1,725Feb 1, 2016Jul 31, 2020Jun 27, 2022503 United States, Argentina +28
NCT02648347Study to Evaluate Vadadustat for the Correction of Anemia in Participants With Non-dialysis-dependent Chronic Kidney DiseasePHASE3 COMPLETED 1,751Dec 1, 2015Jul 31, 2020Jun 27, 2022439 United States, Argentina +18
NCT03799627Study of Vadadustat in Hemodialysis Participants With Anemia Switching From Epoetin AlfaPHASE2 COMPLETED 175Jan 31, 2019Jul 15, 2020Sep 29, 202241 United States
NCT03054350Dose-Finding Study of Vadadustat in Japanese Subjects With Anemia Secondary to Dialysis-Dependent Chronic Kidney Disease (DD-CKD)PHASE2 COMPLETED 60Dec 1, 2016Jan 24, 2018Apr 8, 202118 Japan
NCT03054337Dose-Finding Study of Vadadustat in Japanese Subjects With Anemia Secondary to Non-Dialysis Dependent Chronic Kidney Disease (NDD-CKD)PHASE2 COMPLETED 51Oct 1, 2016Aug 28, 2017Apr 8, 202118 Japan
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Study Endpoints
Primary Endpoints
Change From Baseline in Hb to the Average Over the Primary Evaluation Period (PEP) (Weeks 20 to 26)
Baseline; Weeks 20 to 26

The Baseline Hb was defined as the average of the last 2 central laboratory Hb values taken on or prior to the first dose date. The average for the PEP was calculated as the average of all Hb measurements from the central laboratory within the three visit windows during Weeks 20 through 26, regardless of intercurrent events. Analysis was conducted using an analysis of covariance (ANCOVA) model with multiple imputation for missing data with randomization stratification factors and Baseline Hb as covariates. Change from Baseline was calculated as PEP value minus the Baseline value.

Change From Baseline in Hemoglobin (Hb) to the Average Over the Primary Efficacy Period (Weeks 24 to 36)
Baseline; Weeks 24 to 36

The Baseline average was calculated as the average of the Hb values obtained at the screening visit closest to the date of randomization and the randomization visit. The average for the Primary Efficacy Period was calculated as the average Hb value over Weeks 24 to 36. Analysis was conducted using an analysis of covariance (ANCOVA) model with multiple imputation for missing data with Baseline hemoglobin concentration (\<10.0 versus ≥10.0 g/dL), geographic region (United States \[US\] versus European Union \[EU\] versus Rest of World \[ROW\]), and New York Heart Association congestive heart failure (NYHA CHF) class (Class 0 \[no CHF\] or I versus II or III) as covariates.

Median Time to First Major Adverse Cardiovascular Event (MACE)
Up to 170 weeks

MACE was defined as all-cause mortality, non-fatal myocardial infarction (MI), or non-fatal stroke. The primary safety outcome was positively adjudicated first MACE, which was defined as any death, Endpoint Adjudication Committee (EAC)-confirmed non-fatal MI, or EAC-confirmed non-fatal stroke occurring between the first dose date and each participant's last participation date. INNOVATE MACE results and analysis, by design, was performed on pooled data from studies AKB-6548-CI-0016 (NCT02865850) and AKB-6548-CI-0017 (NCT02892149). Results and statistical analysis from study AKB-6548-CI-0017 has been reported in below table and under section "Statistical Analysis 1". Results and statistical analysis of the pooled data from studies AKB-6548-CI-0016 and AKB-6548-CI-0017 has been reported under section "Statistical Analysis 2" of this outcome measure.

Mean Change in Hemoglobin (Hb) Between Baseline and the Primary Evaluation Period (PEP)
Baseline; Week 10 to Week 12

Change from Baseline in Hb value was calculated as the PEP Hb value minus the Baseline Hb value. The PEP value was the average Hb value from Week 10 to Week 12. The Baseline Hb value was defined as the average of the final two Hb values prior to start of dosing on Day 1.

Number of Participants With Treatment-emergent Adverse Events (TEAEs)
Up to Week 24

An adverse event (AE) was defined as any untoward medical occurrence (including a clinically significant abnormal laboratory finding) that occurred in the protocol-specified AE reporting period. An AE included medical conditions, signs, and symptoms not previously observed in the participant that emerged during the protocol-specified AE reporting period, including signs or symptoms associated with pre-existing underlying conditions that were not present prior to the AE reporting period. TEAEs, defined as AEs that began (or pre-existing AEs that worsened) on or after the first dose through each participant's last participation date, are reported.

Number of Participants With Clinically Significant Changes From Baseline in Laboratory Parameter Values
Up to Week 24

Parameters assessed for laboratory values included hematology (excluding the primary and secondary efficacy endpoint results related to Hb), clinical chemistry, lipid profiles, and glucose. The investigator was responsible for reviewing laboratory results for clinically significant changes.

Number of Participants With Clinically Significant Changes From Baseline in Vital Sign Values
Up to Week 24

Parameters assessed for vital signs included sitting (at rest for a minimum of 5 minutes) heart rate, respiratory rate, body temperature, and blood pressure. The investigator was responsible for reviewing vital sign values for clinically significant changes.

Number of Participants Classified as Hb Outliers
Weeks 13 - 20

The target range for Hb was from 10.0 to 11.0 grams per deciliter (g/dL). Hb outliers included participants with a Hb increase of more than 12.0 g/dL or \<8.0 g/dL and decline in Hb ≥0.5 g/dL from Baseline, and a Hb increase to more than 1.0 g/dL within any 2-week interval during the Study Period.

Mean Change in Hemoglobin (Hb) Levels From Pre-treatment to the End of the Primary Efficacy Period
Pre-treatment; Week 6

The pre-treatment average value for Hb was defined as the average of 3 values obtained prior to treatment, i.e., the qualifying screening value and the Baseline value. Change from Pre-treatment was calculated as the Week 6 value minus the Pre-treatment value.

Secondary Endpoints
Change From Baseline in Hb to the Average Over the Secondary Evaluation Period (SEP) (Weeks 46 to 52)
Baseline; Weeks 46 to 52
Change From Baseline in Hb to the Average Over the Secondary Efficacy Period (Weeks 40 to 52)
Baseline; Weeks 40 to 52
Median Time to First MACE Plus Hospitalization for Heart Failure or Thromboembolic Event Excluding Vascular Access Thrombosis
Up to 170 weeks
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Study Design & Arms
AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Vadadustat once daily (QD)EXPERIMENTAL -
Vadadustat three times weekly (TIW)EXPERIMENTAL -
Darbepoetin alfaACTIVE_COMPARATOR -
VadadustatEXPERIMENTAL -
Vadadustat TIWEXPERIMENTALParticipants randomized to Vadadustat (Main and erythropoiesis-stimulating agent \[ESA\] hyporesponder parallel studies) who complete a once-daily dosing regimen treatment period and meet eligibility criteria for transition to three times weekly (TIW) dosing will switch to TIW dosing
Epoetin AlfaACTIVE_COMPARATOREpoetin Alfa
Vadadustat, Dose 1EXPERIMENTALDaily oral dose
Vadadustat, Dose 2EXPERIMENTALDaily oral dose
Vadadustat, Dose 3EXPERIMENTALDaily oral dose
PlaceboPLACEBO_COMPARATORDaily oral dose
Interventions
NameTypeDescription
VadadustatDRUGoral tablets
Darbepoetin alfaDRUGintravenous or subcutaneous solution
Epoetin AlfaDRUGEpoetin Alfa
Vadadustat TIWDRUGOral Vadadustat
PlaceboDRUGDaily oral dose
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Eligibility Criteria
Age Range18 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites59

Inclusion Criteria: * Receiving chronic, outpatient three times weekly (TIW) in-center hemodialysis for end-stage renal disease for at least 12 weeks prior to Screening * Hemodialysis adequacy as indicated by single-pool Kt/Vurea ≥ 1.2 using the most recent historical measurement within 8 weeks pri...

Countries:United StatesCzechiaHungaryItalyPolandSpainArgentinaAustraliaBrazilBulgariaCanadaFranceGermanyIsraelMexicoPortugalRussiaSerbiaSouth KoreaUkraineUnited KingdomAustriaChileColombiaMalaysiaNew ZealandPuerto RicoRomaniaSlovakiaSouth AfricaTurkey (Türkiye)Japan
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