| NCT ID | Title | Phase | Status | Enrollment | Velocity | Design | Start | Completion | Last Updated | Sites | Countries |
|---|---|---|---|---|---|---|---|---|---|---|---|
| NCT04313153 | Trial 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 | 319 | — | — | May 27, 2020 | Jun 22, 2022 | May 22, 2025 | 59 | United States, Czechia +4 |
| NCT02892149 | Efficacy and Safety Study to Evaluate Vadadustat for the Maintenance Treatment of Anemia in Participants With Dialysis-dependent Chronic Kidney Disease (DD-CKD) | PHASE3 | COMPLETED | 3,554 | — | — | Aug 1, 2016 | Mar 30, 2020 | Jun 28, 2022 | 278 | United States, Argentina +16 |
| NCT02865850 | Efficacy 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 | 369 | — | — | Jul 1, 2016 | Mar 30, 2020 | Jul 18, 2022 | 118 | United States, Argentina +9 |
| NCT02680574 | Efficacy 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 | 1,725 | — | — | Feb 1, 2016 | Jul 31, 2020 | Jun 27, 2022 | 503 | United States, Argentina +28 |
| NCT02648347 | Study to Evaluate Vadadustat for the Correction of Anemia in Participants With Non-dialysis-dependent Chronic Kidney Disease | PHASE3 | COMPLETED | 1,751 | — | — | Dec 1, 2015 | Jul 31, 2020 | Jun 27, 2022 | 439 | United States, Argentina +18 |
| NCT03799627 | Study of Vadadustat in Hemodialysis Participants With Anemia Switching From Epoetin Alfa | PHASE2 | COMPLETED | 175 | — | — | Jan 31, 2019 | Jul 15, 2020 | Sep 29, 2022 | 41 | United States |
| NCT03054350 | Dose-Finding Study of Vadadustat in Japanese Subjects With Anemia Secondary to Dialysis-Dependent Chronic Kidney Disease (DD-CKD) | PHASE2 | COMPLETED | 60 | — | — | Dec 1, 2016 | Jan 24, 2018 | Apr 8, 2021 | 18 | Japan |
| NCT03054337 | Dose-Finding Study of Vadadustat in Japanese Subjects With Anemia Secondary to Non-Dialysis Dependent Chronic Kidney Disease (NDD-CKD) | PHASE2 | COMPLETED | 51 | — | — | Oct 1, 2016 | Aug 28, 2017 | Apr 8, 2021 | 18 | Japan |
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.
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.
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.
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.
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.
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.
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.
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.
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.
| Arm | Type | Description |
|---|---|---|
| Vadadustat once daily (QD) | EXPERIMENTAL | - |
| Vadadustat three times weekly (TIW) | EXPERIMENTAL | - |
| Darbepoetin alfa | ACTIVE_COMPARATOR | - |
| Vadadustat | EXPERIMENTAL | - |
| Vadadustat TIW | EXPERIMENTAL | Participants 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 Alfa | ACTIVE_COMPARATOR | Epoetin Alfa |
| Vadadustat, Dose 1 | EXPERIMENTAL | Daily oral dose |
| Vadadustat, Dose 2 | EXPERIMENTAL | Daily oral dose |
| Vadadustat, Dose 3 | EXPERIMENTAL | Daily oral dose |
| Placebo | PLACEBO_COMPARATOR | Daily oral dose |
| Name | Type | Description |
|---|---|---|
| Vadadustat | DRUG | oral tablets |
| Darbepoetin alfa | DRUG | intravenous or subcutaneous solution |
| Epoetin Alfa | DRUG | Epoetin Alfa |
| Vadadustat TIW | DRUG | Oral Vadadustat |
| Placebo | DRUG | Daily oral dose |
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...