Pediatric Chronic Kidney Disease Safety and Efficacy

This study has been terminated.
(Study was suspended in agreement between sponsor and FDA due to concerns about the study design after a fatality had occurred in the presence of hypocalcemia.)
Sponsor:
Information provided by (Responsible Party):
Amgen
ClinicalTrials.gov Identifier:
NCT01277510
First received: January 13, 2011
Last updated: February 11, 2015
Last verified: February 2015
  Purpose

The purpose of this study is to assess the safety and efficacy of adding cinacalcet to the current treatment of secondary hyperparathyroidism in children currently receiving dialysis compared to a treatment regimen that does not include cinacalcet.


Condition Intervention Phase
Chronic Kidney Disease
Hyperparathyroidism
Hyperparathyroidism, Secondary
Kidney Disease
Secondary Hyperparathyroidism
Drug: cinacalcet capsule
Drug: placebo
Drug: Standard of Care
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized, Double-blind, Placebo Controlled Study to Assess the Efficacy and Safety of Cinacalcet HCl in Pediatric Subjects With Chronic Kidney Disease and Secondary Hyperparathyroidism Receiving Dialysis

Resource links provided by NLM:


Further study details as provided by Amgen:

Primary Outcome Measures:
  • To demonstrate the efficacy of cinacalcet for reducing the plasma intact parathyroid hormone level (iPTH) by ≥ 30% [ Time Frame: From baseline to end of Efficacy Assessment Period, assessed up to 30 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • To demonstrate the efficacy of cinacalcet for lowering the plasma iPTH level to ≤ 300 pg/mL (31.8 pmol/L) [ Time Frame: From baseline to end of Efficacy Assessment Period, assessed up to 30 weeks ] [ Designated as safety issue: No ]
  • To demonstrate the impact of cinacalcet on corrected total serum calcium level [ Time Frame: From baseline to end of Efficacy Assessment Period, assessed up to 30 weeks ] [ Designated as safety issue: No ]
  • To demonstrate the impact of cinacalcet on serum phosphorus level [ Time Frame: From baseline to end of Efficacy Assessment Period, assessed up to 30 weeks ] [ Designated as safety issue: No ]
  • To demonstrate the impact of cinacalcet on the calcium x phosphorus product (Ca x P) [ Time Frame: From baseline to end of Efficacy Assessment Period, assessed up to 30 weeks ] [ Designated as safety issue: No ]
  • Evaluate number of participants with adverse events, and frequency of episodes of hypocalcemia [ Time Frame: Throughout entire treatment period, up to 60 weeks ] [ Designated as safety issue: Yes ]
  • Measure change in height to assess overall growth velocity [ Time Frame: From baseline to end of Efficacy Assessment at Week 30, and from Week 30 to end of entire treatment at Week 60 ] [ Designated as safety issue: No ]
  • To measure the percent change in ionized calcium [ Time Frame: From baseline to the end of Efficacy Assessment Period up to 30 weeks ] [ Designated as safety issue: No ]

Enrollment: 43
Study Start Date: June 2011
Study Completion Date: April 2014
Primary Completion Date: April 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Placebo Comparator: Placebo
Participants received standard of care and placebo once daily for 30 weeks during the double-blind phase. During the open-label phase, participants received cinacalcet with standard of care for an additional 30 weeks. The starting dose of cinacalcet was ≤ 0.20 mg/kg based on dry weight, and could be titrated up according to plasma iPTH and serum calcium levels every 4 weeks up to Week 54 to a maximum dose of 4.2 mg/kg.
Drug: placebo
Placebo tablets and capsules for sprinkling identical to active treatment.
Drug: Standard of Care
All participants, regardless of treatment assignment, will receive standard of care with vitamin D sterols (calcitriol and its analogs), as prescribed by the treating physician.
Experimental: Cinacalcet
Participants received standard of care and cinacalcet once daily for 30 weeks during the double-blind phase. The starting dose of cinacalcet was ≤ 0.20 mg/kg based on dry weight, and could be titrated up according to plasma iPTH and serum calcium levels every 4 weeks until Week 24 to a maximum dose of 4.2 mg/kg. During the open-label phase participants continued to receive cinacalcet with standard of care for an additional 30 weeks.
Drug: cinacalcet capsule
Cinacalcet was prepared for oral administration as both capsules for sprinkling and film coated tablets for swallowing.
Other Name: Sensipar, Mimpara
Drug: Standard of Care
All participants, regardless of treatment assignment, will receive standard of care with vitamin D sterols (calcitriol and its analogs), as prescribed by the treating physician.

Detailed Description:

Secondary hyperparathyroidism (SHPT) is a condition that can develop early in patients with chronic kidney disease (CKD), usually gets worse over time, and is known to cause problems for patients on dialysis. Children on dialysis can have a wide range of bone and growth issues, and common treatments have a chance of making these things worse by increasing serum calcium and serum phosphorus. Cinacalcet has been shown to be effective in controlling parathyroid hormone (PTH), calcium and phosphorus in adults. The purpose of this study is to show that including cinacalcet in the treatment of SHPT will lower the levels of intact parathyroid hormone (iPTH) in a larger number of pediatric patients with CKD who are receiving dialysis, compared to a treatment regimen that does not include cinacalcet.

  Eligibility

Ages Eligible for Study:   6 Years to 17 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age 6 to less than 18 years at screening
  • Diagnosed with CKD and SHPT receiving hemodialysis or peritoneal dialysis for ≥ 2 months before randomization
  • Dry weight ≥ 12.5 kg at screening
  • iPTH obtained from the central laboratory must be > 300 pg/mL (31.8 pmol/L)
  • Serum calcium (corrected) obtained from the central laboratory must be ≥ 8.8 mg/dL (2.2 mmol/L)
  • Serum phosphorus obtained from the central laboratory ≥ 4.0 mg/dL (1.3 mmol/L) for children 6 to less than 12 years old, or ≥ 3.5 mg/dL (1.1 mmol/L) for children 12 to less than 18 years old
  • Subjects already receiving vitamin D sterols (either calcitriol or a synthetic analog), a stable dose within the last 2 months prior to randomization
  • Subjects taking growth hormone, a stable dose defined as no change > than 20% in the last 2 months prior to randomization
  • Subjects on anti-convulsant medication must be on a stable dose for 3 months, and have a therapeutic blood level of the anti-convulsant at the time of randomization
  • Subjects must be on a dialysate calcium concentration of ≥ 2.5 mEq/L (1.25 mmol/L) for at least 2 months prior to randomization

Exclusion Criteria:

  • Underwent parathyroidectomy in the last 6 months
  • Anticipated parathyroidectomy within 6 months after randomization
  • Received therapy with cinacalcet (sensipar/mimpara) within the last month
  • A new onset of seizure or worsening of a pre-existing seizure disorder within the last 3 months
  • Scheduled date for kidney transplant from a known living donor that makes completion of the study unlikely
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01277510

  Show 51 Study Locations
Sponsors and Collaborators
Amgen
Investigators
Study Director: MD Amgen
  More Information

Additional Information:
No publications provided

Responsible Party: Amgen
ClinicalTrials.gov Identifier: NCT01277510     History of Changes
Other Study ID Numbers: 20070208
Study First Received: January 13, 2011
Last Updated: February 11, 2015
Health Authority: European Union: EMEA
United States: Food and Drug Administration
Belgium: Federal Agency for Medicines and Health Products, FAMHP
Hungary: National Institute of Pharmacy
Poland: Office for Registration of Medicinal Products, Medical Devices and Biocidal Products
Russia: Federal Service for Surveillance in the field of Healthcare and Social Development (a body of the Ministry of Health)
Spain: Agencia Española de Medicamentos y Productos Sanitarios
Mexico: Comisión Federal para la Protección contra Riesgos Sanitarios (COFEPRIS)
Peru: Instituto Nacional de Salud (INS)
Brasil: ANVISA - Agência Nacional de Vigilância Sanitária ("National Agency of Sanitary Surveillance")
Argentina: ANMAT - Administración Nacional de Medicamentos, Alimentos y Tecnologia Médica ("National Drug Administration, Food and Medical Tecnology")

Keywords provided by Amgen:
dialysis
sensipar
mimpara
hemodialysis
peritoneal dialysis
renal
parathyroid hormone
pediatric

Additional relevant MeSH terms:
Hyperparathyroidism
Hyperparathyroidism, Secondary
Kidney Diseases
Neoplasm Metastasis
Renal Insufficiency, Chronic
Endocrine System Diseases
Neoplasms
Neoplastic Processes
Parathyroid Diseases
Pathologic Processes
Renal Insufficiency
Urologic Diseases

ClinicalTrials.gov processed this record on April 19, 2015