Dialysis patients regularly suffer from anemia which may be caused by various contributing factors, alone or in combination, including blood loss, low erythropoietin and iron sequestration. In most patients, the anemia is responsive to treatment with erythropoietin or other erythropoiesis stimulating agents (ESA) alone or in combination with intravenous (i.v.) iron. In about 10% of patients however, the anaemia does not respond appropriately to this standard treatment and high to very high doses of ESA and i.v. iron are used to maintain acceptable hemoglobin concentrations. In these patients, hepcidin was identified as a causative factor leading to anemia of chronic disease with functional iron deficiency and ESA-hyporesponsiveness. The Spiegelmer lexaptepid pegol (NOX-H94) offers a hepcidin-specific approach to the treatment of anemia of chronic disease. The safety and the activity of lexaptepid pegol are supported by data from healthy subjects and patients with multiple myeloma or lymphoma. The present study in dialysis patients with functional iron deficiency and ESA-hyporesponsiveness is conducted to demonstrate the safety of lexaptepid pegol in this population, to investigate its pharmacokinetic (PK) and pharmacodynamic (PD) profiles and its efficacy in increasing haemoglobin (Hb) in dialysis patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
33
anti-hepcidin L-RNA-aptamer (Spiegelmer)
Dialysis Unit
Düsseldorf, Germany
University Hospital
Halle, Germany
Hospital
Leipzig, Germany
Dialysis Unit
Villingen-Schwenningen, Germany
Hospital
Siena, Italy
Hospital
Swansea, Wales, United Kingdom
Hospital
Leicester, United Kingdom
Hospital
London, United Kingdom
King's College London
London, United Kingdom
Lister Hospital
Stevenage, United Kingdom
Number of adverse events
Time frame: up to 8 weeks
Pharmacokinetics
Peak concentrations, systemic exposure, elimination
Time frame: Weeks 1, 2, 3, 4, 5, 6, 8
Pharmacodynamics
Change in serum iron concentrations
Time frame: 0 to 48 hours
Efficacy
Change in hemoglobin
Time frame: Weeks 1, 2, 3, 4, 5, 6, 8
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