This study aims to characterize the relationship between dose of GSK1278863 and hemoglobin (Hgb) response in hemodialysis-dependent (HDD) subjects with anemia associated with chronic kidney disease (CKD). It is anticipated that the data generated will enable selection of the starting dose(s) and optimize dose adjustment regimen(s) for Phase 3 clinical trials. This study will consist of a screening phase of 3-9 weeks, a 4-week treatment phase and a follow-up visit approximately 4 weeks after completing treatment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
97
GSK1278863 will be supplied as film coated tablets for oral administration containing 1 mg, 2 mg, or 5 mg of GSK1278863.
Film coated tablets of GSK1278863 matching placebo for oral administration.
GSK Investigational Site
Aichi, Japan
GSK Investigational Site
Aichi, Japan
GSK Investigational Site
Aichi, Japan
GSK Investigational Site
Aichi, Japan
GSK Investigational Site
Aichi, Japan
GSK Investigational Site
Aichi, Japan
GSK Investigational Site
Chiba, Japan
GSK Investigational Site
Fukuoka, Japan
GSK Investigational Site
Ibaraki, Japan
GSK Investigational Site
Ibaraki, Japan
...and 11 more locations
Change From Baseline (CFB) in Hemaglobin (Hgb) at Week 4
Baseline was defined as the value on Day 1. CFB was calculated by subtracting the baseline value from the post-dose value at Week 4. To model the dose-response relationship a four-parameter Emax model was used. E0 is the expected Hgb change from Baseline for a participant receiving placebo and experiencing the average Hgb Baseline observed in the study. Emax is the expected Hgb change from Baseline for a participant receiving the highest dose above which no further increase in response can be achieved. ED50 is the dose that attains the intermediate response. Gamma is the slope parameter. Minimal Effective Dose (MED) is defined as the smallest dose that achieves a placebo-corrected change of 0.5 g/dL over Week 4. Target dose (TD) is defined as the dose that achieves a placebo-corrected 1.0 g/dL change over Week 4. Maximum Acceptable Dose (MAD) is defined as the dose that achieves a placebo-corrected 2.0 g/dL change over Week 4.
Time frame: Baseline (Day 1) and Week 4
CFB in Hgb Upto Week 8
Hgb assessments were performed at Baseline, Week 1, Week 2, Week 3, W eek4/Early withdrawal and Week 8 (follow-up) based on central laboratory (Quest diagnosis). Baseline was defined as the value on Day 1. CFB was calculated by subtracting the Baseline value from the post-dose value at Week 4.
Time frame: Baseline (Day 1) Upto Week 8
Number of Participants Who Achieved Hgb Response at Week 4
Hgb response was defined as achieving an increase of at least 0.5 g/dL, 1.0 g/dL, 1.5 g/dL, and 2.0 g/dL in Hgb. The number of participants with Hgb response: Hgb increase \<-1.0, Hgb increase -1.0 -\< -0.5, Hgb increase -0.5 -\< 0.5, Hgb increase 0.5 -\< 1.0 and Hgb increase \>=1.0 have been presented.
Time frame: Week 4
Percentage of Participants Who Achieved Hgb Response at Week 4
Hgb response was defined as achieving an increase of at least 0.5 g/dL, 1.0 g/dL, 1.5 g/dL, and 2.0 g/dL in Hgb. The percentage of participants with Hgb response: Hgb increase \<-1.0, Hgb increase -1.0 -\< -0.5, Hgb increase -0.5 -\< 0.5, Hgb increase 0.5 -\< 1.0 and Hgb increase \>=1.0 have been presented.
Time frame: Week 4
Number of Participants Who Reached Pre-defined Hgb Stopping Criteria
Hgb stopping criteria was defined as: (1) Hgb \<7.5 g/dL (2) 7.5 \<= Hgb \<1 3.0 g/dL and \>2 g/dL Hgb change over 2W (3) Hgb \>=13.0 g/dL. The number of participants who reached pre-defined Hgb stopping criteria have been presented.
Time frame: Upto Week 4
Maximum Observed CFB in Erythropoietin (EPO) Upto Week 4
Blood samples for EPO were collected on Day 1 (pre-dose), Week 2 (collected approx 6-12 hours post-dose on arrival and after 1, 2 and 3 hours) and Week 4 (pre-dose and 3 hours post-dose). Maximum observed value meant maximum value between Week 1 and Week 4. Baseline was defined as the value on Day 1. Maximum observed CFB was calculated by subtracting the Baseline value from the maximum observed value between Week 1 and Week 4.
Time frame: Baseline (Day 1) Upto Week 4
Maximum Observed Percent CFB in Peak Vascular Endothelial Growth Factor (VEGF) Upto Week 4
Blood samples for VEGF were collected on Day 1 (pre-dose), Week 2 (collected approximately 6-12 hours post-dose on arrival and after 1, 2 and 3 hours) and Week 4 (pre-dose and 3 hours post-dose). Maximum observed value meant maximum value between Week 1 and Week 4. Baseline was defined as the value on Day 1. Maximum observed percent CFB was calculated as 100 multiplied by the maximum observed exponential mean change on a log scale minus 1.
Time frame: Baseline (Day 1) Upto Week 4
Percent CFB in Hepcidine Upto Week 4
Blood samples for hepcidine were collected on Day 1 (pre-dose), Week 2 (collected approximately 6-12 hours post-dose) and Week 4 (pre-dose). Baseline was defined as the value on Day 1. Percent CFB was calculated as 100 multiplied by the exponential mean change on a log scale minus 1.
Time frame: Baseline (Day 1) Upto Week 4
CFB in Ferritin at Week 4
Ferritin was used as marker of iron metabolism and utilization. Baseline was defined as the value on Day 1. CFB was calculated by subtracting the Baseline value from the post dose value at Week 4.
Time frame: Baseline (Day 1) and Week 4
CFB in Total Iron Binding Capacity [TIBC], Unbound Iron Binding Capacity [UIBC] and Iron at Week 4
TIBC, UIBC and Iron were used as marker of iron metabolism and utilization. Baseline was defined as the value on Day 1. CFB was calculated by subtracting the Baseline value from the post-dose value at Week 4.
Time frame: Baseline (Day 1) and Week 4
CFB in Transferrin at Week 4
Transferrin was used as marker of iron metabolism and utilization. Baseline was defined as the value on Day 1. CFB was calculated by subtracting the Baseline value from the post-dose value at Week 4.
Time frame: Baseline (Day 1) and Week 4
Percent CFB in Transferrin Saturation (TS) at Week 4
TS was used as marker of iron metabolism and utilization. Baseline was defined as the value on Day 1. Percent CFB was calculated as 100 multiplied by the exponential mean change on a log scale minus 1.
Time frame: Baseline (Day 1) and Week 4
Plasma Pharmacokinetic Concentration of GSK1278863 and Metabolites (M) at Week 4
Blood samples for plasma pharmacokinetic analysis were collected at Week 4 (pre-dose, 1, 2, 3 hours post-dose). Individual plasma GSK1278863 and M-GSK2391220, GSK2487818, GSK2506102, GSK2531398, GSK2531401, GSK2531403 concentrations have been presented.
Time frame: Week 4
Number of Participants With Adverse Events (AE) and Serious Adverse Events (SAE) on Therapy
An AE is defined as any untoward medical occurrence in clinical investigation participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a medicinal product. A SAE is defined as any AE which results in death; is life-threatening; requires participant hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity; is a congenital anomaly/birth defect; constitutes an important medical event.
Time frame: Upto Week 4
Number of Participants With Chemistry and Hematology Data of Potential Clinical Importance (PCI) Upto Week 4
The PCI range was as follows: alkaline phosphates \>= 3 times upper limit of normal range \[ULRR\]), potassium (\>0.5 millimoles/liter below the LLRR or \>1.0 millimoles/liter above the ULRR), phosphate (\>0.323 millimoles/liter above ULRR or below lower limit reference range \[LLRR\]), glucose (\<3.9 or \>22 millimoles/liter), magnesium (\<LLRR or \> 0.3 milimoles/liter above ULRR), lymphocytes \<0.5x LLRR, neutrophils (\<0.5 times LLRR), platelets (80 or \>500 times giga/liter), platelets (80 or \>500 times giga/liter) and leukocytes \>1 x giga/liter below the LLRR or \>5 x GI/L above the ULRR. The participants who had PCI values higher and lower than the reference range have been presented.
Time frame: Upto Week 4
Number of Participants With Vital Signs Parameters Systolic and Diastolic Blood Pressure (SBP,DBP) of PCI Upto Week 4
Vital signs SBP and DBP were recorded pre-dialysis and post-dialysis. Measurements were taken from the participant while in a seated position or semi-supine in the dialysis chair. PCI range for SBP was \< 85 or \> 170 and for DBP was \< 45 or \> 100 millimeters of mercury. Participant's with values high and low from the PCI range have been presented.
Time frame: Upto Week 4
Number of Participants With Vital Sign Parameter Heart Rate (HR) of PCI Upto Week 4
Vital sign HR was recorded pre-dialysis and post-dialysis. Measurements were taken from the participant while in a seated position or semi-supine in the dialysis chair. PCI range for HR was \< 40 or \> 110 beats per minute. Participant's with values higher than the PCI range have been presented.
Time frame: Upto Week 4
Number of Participants With Abnormal Electrocardiogram (ECG) Findings Upto Week 4
Full 12-lead ECGs included heart rate, PR, QRS, QT and QTc intervals. Measurements were taken from the participant while in a supine position. ECGs were performed consistently either before or after dialysis throughout the study. ECG abnormalities characterized as abnormal-not clinically significant (A-NCS) and abnormal-clinically significant (A-CS) upto W4 have been presented.
Time frame: Upto Week 4
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