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RED-HF™ Trial - Reduction of Events With Darbepoetin Alfa in Heart Failure Trial

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Amgen
ClinicalTrials.gov Identifier:
NCT00358215
First received: July 27, 2006
Last updated: July 14, 2014
Last verified: July 2014
Results First Received: October 23, 2013  
Study Type: Interventional
Study Design: Allocation: Randomized;   Intervention Model: Parallel Assignment;   Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor);   Primary Purpose: Treatment
Conditions: Heart Failure
Anemia
Cardiovascular Disease
Ventricular Dysfunction
Congestive Heart Failure
Interventions: Drug: Darbepoetin alfa
Drug: Placebo

  Participant Flow
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Recruitment Details
Key information relevant to the recruitment process for the overall study, such as dates of the recruitment period and locations
First patient enrolled 13 June 2006; Last patient enrolled 4 May 2012

Pre-Assignment Details
Significant events and approaches for the overall study following participant enrollment, but prior to group assignment
No text entered.

Reporting Groups
  Description
Placebo Participants received dose and administration schedule (every 2 weeks or once a month) changes that simulated the changes for participants receiving darbepoetin alfa.
Darbepoetin Alfa Starting dose of 0.75 µg/kg subcutaneously every 2 weeks until hemoglobin concentrations reach 13.0 g/dL on 2 consecutive visits, then monthly dosing, titrated to achieve hemoglobin target of 13.0 g/dL, not to exceed 14.5 g/dL.

Participant Flow:   Overall Study
    Placebo   Darbepoetin Alfa
STARTED   1142   1136 
Received Investigational Product   1140   1133 
COMPLETED   463 [1]   484 [1] 
NOT COMPLETED   679   652 
Ineligibility determined                4                3 
Adverse Event                83                65 
Withdrawal by Subject                111                102 
Participant request                65                64 
Physician Decision                47                39 
Lost to Follow-up                16                22 
Death                265                281 
Protocol Violation                64                59 
Pregnancy                1                0 
Other                21                14 
Did not receive investigational product                2                3 
[1] Participants who completed investigational product



  Baseline Characteristics
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Population Description
Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
No text entered.

Reporting Groups
  Description
Placebo Participants received dose and administration schedule (every 2 weeks or once a month) changes that simulated the changes for participants receiving darbepoetin alfa.
Darbepoetin Alfa Starting dose of 0.75 µg/kg subcutaneously every 2 weeks until hemoglobin concentrations reach 13.0 g/dL on 2 consecutive visits, then monthly dosing, titrated to achieve hemoglobin target of 13.0 g/dL, not to exceed 14.5 g/dL.
Total Total of all reporting groups

Baseline Measures
   Placebo   Darbepoetin Alfa   Total 
Overall Participants Analyzed 
[Units: Participants]
 1142   1136   2278 
Age 
[Units: Years]
Mean (Standard Deviation)
 69.6  (11.3)   70.0  (11.6)   69.8  (11.4) 
Gender 
[Units: Participants]
     
Female   486   458   944 
Male   656   678   1334 
Race/Ethnicity, Customized 
[Units: Participants]
     
White or Caucasian   768   781   1549 
Black or African American   113   89   202 
Hispanic or Latino   84   98   182 
Asian   162   162   324 
Japanese   0   1   1 
American Indian or Alaska Native   2   2   4 
Native Hawaiian or Other Pacific Islander   1   0   1 
Other   12   3   15 
Region 
[Units: Participants]
     
North America   323   321   644 
Latin America and Asia   286   285   571 
Western Europe, Israel, South Africa, Australia   306   303   609 
Eastern Europe and Russia   227   227   454 
Device Usage [1] 
[Units: Participants]
     
CRT with or without ICD   143   143   286 
ICD without CRT   124   122   246 
None   875   871   1746 
[1] Usage of implantable cardioverter defibrillator / cardiac resynchronization therapy (ICD/CRT)
Kansas City Cardiomyopathy Questionnaire: Overall Summary Score [1] 
[Units: Units on a scale]
Mean (Standard Deviation)
 56.5  (22.5)   55.8  (22.6)   56.2  (22.5) 
[1] The KCCQ is a patient-reported measure for patients with heart failure. It consists of 23 items, is comprised of 7 clinically relevant scales (Symptom Frequency, Burden and Stability, Physical and Social Limitation, Quality of Life, and Self-Efficacy), and yields 3 summary scores (Clinical Summary, Total Symptom, and Overall Summary Scores). Scores range between 0 and 100, with higher scores indicating better health status (eg, better functioning, quality of life, fewer symptoms). Number of participants with available data = 1106 and 1104 for each treatment group respectively, total = 2210.
Study Specific Characteristic [Kansas City Cardiomyopathy Questionnaire: Symptom Frequency Scale [1] 
[Units: Units on a scale]
Mean (Standard Deviation)
 63.3  (25.2)   63.1  (25.6)   63.2  (25.4) 
[1] The KCCQ is a patient-reported measure for patients with heart failure. It consists of 23 items, is comprised of 7 clinically relevant scales (Symptom Frequency, Burden and Stability, Physical and Social Limitation, Quality of Life, and Self-Efficacy), and yields 3 summary scores (Clinical Summary, Total Symptom, and Overall Summary Scores). Scores range between 0 and 100, with higher scores indicating better health status (eg, better functioning, quality of life, fewer symptoms). Number of participants with available data = 1106 and 1104 for each treatment group respectively, total = 2210.


  Outcome Measures
  Show All Outcome Measures

1.  Primary:   Time to All Cause Death or First Hospitalization for Worsening Heart Failure   [ Time Frame: From randomization to the end of study; maximum time on study was 73 months ]

2.  Secondary:   Time to Death From Any Cause   [ Time Frame: From randomization to the end of study; maximum time on study was 73 months ]
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Measure Type Secondary
Measure Title Time to Death From Any Cause
Measure Description Time from randomization to death due to any cause, estimated by the Kaplan-Meier method. Participants not experiencing a qualifying event during the study were censored at their last contact time or the study termination date, whichever occurred first.
Time Frame From randomization to the end of study; maximum time on study was 73 months  

Population Description
Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
Intent-to-treat

Reporting Groups
  Description
Placebo Participants received dose and administration schedule (every 2 weeks or once a month) changes that simulated the changes for participants receiving darbepoetin alfa.
Darbepoetin Alfa Starting dose of 0.75 µg/kg subcutaneously every 2 weeks until hemoglobin concentrations reach 13.0 g/dL on 2 consecutive visits, then monthly dosing, titrated to achieve hemoglobin target of 13.0 g/dL, not to exceed 14.5 g/dL.

Measured Values
   Placebo   Darbepoetin Alfa 
Participants Analyzed 
[Units: Participants]
 1142   1136 
Time to Death From Any Cause 
[Units: Days]
Median (Inter-Quartile Range)
 1637.0 
 (766.0 to 2229.0) 
 1629.0 
 (682.0 to 2117.0) 


Statistical Analysis 1 for Time to Death From Any Cause
Groups [1] All groups
Statistical Test Type [2] Superiority or Other
Statistical Method [3] Stratified Log Rank
P Value [4] 0.512
Hazard Ratio (HR) [5] 1.04
95% Confidence Interval 0.92 to 1.19
[1] Additional details about the analysis, such as null hypothesis and power calculation:
  No text entered.
[2] Details of power calculation, definition of non-inferiority margin, and other key parameters:
  No text entered.
[3] Other relevant method information, such as adjustments or degrees of freedom:
  No text entered.
[4] Additional information, such as whether or not the p-value is adjusted for multiple comparisons and the a priori threshold for statistical significance:
  Stratification factors are: region and type of device (cardiac resynchronization therapy (CRT) with or without implantable cardioverter defibrillator (ICD), ICD without CRT, or none).
[5] Other relevant estimation information:
  The hazard ratio and 95% confidence intervals are from the Cox proportional hazards model adjusted by the stratification factors.



3.  Secondary:   Time to Cardiovascular Death or First Hospital Admission for Worsening Heart Failure   [ Time Frame: From randomization to the end of study; maximum time on study was 73 months ]

4.  Secondary:   Change From Baseline to Month 6 in Kansas City Cardiomyopathy Questionnaire (KCCQ) Overall Summary Score   [ Time Frame: Baseline and Month 6 ]

5.  Secondary:   Change From Baseline to Month 6 in KCCQ Symptom Frequency Score   [ Time Frame: Baseline and Month 6 ]


  Serious Adverse Events


  Other Adverse Events


  Limitations and Caveats
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Limitations of the study, such as early termination leading to small numbers of participants analyzed and technical problems with measurement leading to unreliable or uninterpretable data
No text entered.


  More Information
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Certain Agreements:  
Principal Investigators are NOT employed by the organization sponsoring the study.
There IS an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
The agreement is:
unchecked The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is less than or equal to 60 days. The sponsor cannot require changes to the communication and cannot extend the embargo.
unchecked The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is more than 60 days but less than or equal to 180 days. The sponsor cannot require changes to the communication and cannot extend the embargo.


Results Point of Contact:  
Name/Title: Study Director
Organization: Amgen Inc.
phone: 866-572-6436


Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Responsible Party: Amgen
ClinicalTrials.gov Identifier: NCT00358215     History of Changes
Other Study ID Numbers: 20050222
RED-HF™ Trial
Study First Received: July 27, 2006
Results First Received: October 23, 2013
Last Updated: July 14, 2014