BCD-131 is pegylated darbepoetin beta. This clinical study BCD-131-3 is a randomized, open-label, phase III study of the efficacy and safety of BCD-131 and Mircera used for the treatment of anemia in end-stage chronic kidney disease (CKD) patients on dialysis.
This clinical study is based on the hypothesis that BCD-131 is non-inferior to Mircera when used for the treatment of anemia in dialysis patients with end-stage CKD after 32 weeks of therapy. The study is intended to include subjects with stage 5 CKD, receiving dialysis for at least 90 days before signing the ICF (for patients on hemodialysis - a least 3 times per week and at least 12 hours per week of standard hemodialysis), with established dialysis efficacy, with anemia of renal origin, without other causes for anemia (anemia of chronic disease, vitamin B12 deficiency, folic acid deficiency, iron deficiency, etc.). This is a study of efficacy of BCD-131 as a maintenance therapy, therefore the population includes patients who have been receiving stable doses of erythropoietins (epoetin alfa, epoetin beta or darbepoetin alfa) for at least 3 months prior to signing the informed consent form (ICF) and throughout the screening period and with target hemoglobin level (100-120 g/L) maintained for at least 2 weeks before the ICF signing and at the screening. The study includes the following periods: * Screening period (28 days), * Main period (32 weeks), consisting of dose titration (weeks 0-12) and maintenance therapy (weeks 13-32) - for the primary efficacy analysis * Extension period (weeks 33-52) - for long-term safety and efficacy assessment * Follow-up period (weeks 53-56)
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
228
BCD-131 (pegdarbepoetin beta), subcutaneous injection; regimen: once every 4 weeks; therapy duration: 52 weeks
Mircera (methoxypolyethylene glycol-epoetin beta), subcutaneous injection; regimen: once every 4 weeks; therapy duration: 52 weeks
Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology
Minsk, Belarus
RECRUITINGB. Braun Avitum Russland Clinics Ltd.
Saint Petersburg, Russia
RECRUITINGProportion of subjects (%) with the target hemoglobin level (100-120 g/L inclusive)
Time frame: During the assessment period at Weeks 28-32
Proportion of subjects (%) with the target hemoglobin level (100-120 g/L inclusive) during the last month of therapy
Time frame: Weeks 48-52
Proportion of subjects (%) with a mean hemoglobin level at the time of assessment within the range of ±10 g/L from baseline
Time frame: Weeks 28-32
Proportion of subjects (%) with a mean hemoglobin level at the time of assessment within the range of ±10 g/L from baseline
Time frame: Weeks 48-52
Proportion of subjects (%) who required dose adjustment of the test drug/reference drug during the maintenance therapy stage of the main study period
In the main study period, a dose adjustment is expected during the first 12 weeks of therapy (titration phase), and a maintenance therapy stage is expected during the subsequent weeks of the main study period.
Time frame: Weeks 12-32
Proportion of subjects (%) who required dose adjustment of the test drug/reference drug during the extension study period
Time frame: Weeks 33-52
Proportion of subjects (%) who required blood transfusion during the main study period
Time frame: Weeks 0-32
Proportion of subjects (%) who required blood transfusion during the entire study
Time frame: Weeks 0-52
The mean hemoglobin level during the main study period
Time frame: Weeks 0-32
The mean hemoglobin level during the entire study
Time frame: Weeks 0-52
Proportion of subjects (%) with hemoglobin values greater than 130 g/L and with values greater than 140 g/L during the main study period
Time frame: Weeks 0-32
Proportion of subjects (%) with hemoglobin values greater than 130 g/L and with values greater than 140 g/L during the entire study
Time frame: Weeks 0-52
Proportion of subjects with reported AEs/SAEs, which, according to the investigator, are related to the study drugs
Time frame: Weeks 0-56
Proportion of subjects in each group who developed CTCAE v. 5.0 grade 3-4 AEs, which, in the investigator's opinion, are related to the use of the study drugs
Time frame: Weeks 0-56
Proportion of subjects in each group who prematurely withdrew due to AEs/SAEs
Time frame: Weeks 0-56
Frequency of arterial and venous thrombotic complications (cerebrovascular accident, vascular access thrombosis, etc.)
Time frame: Weeks 0-56
Frequency of non-fatal myocardial infarction, death from cardiovascular diseases, death from any cause
Time frame: Weeks 0-56
The Proportion of BAb- and NAb-positive Patients
Blood sampling for immunogenicity assessment (binding antibodies \[BAbs\] or neutralizing antibodies \[NAbs\]) will be performed before the first injection (Week 0) and then at Weeks 12, 24, 36, and 52
Time frame: Weeks 0, 12, 24, 36, and 52
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