TARGTEPO Treatment for Anemia in Chronic Kidney Disease (CKD) Patients and End-Stage Renal Disease (ESRD)

• ClinicalTrials.gov Identifier: NCT02117427
• Recruitment Status: Completed
• First Posted: April 21, 2014
• Results First Posted: October 30, 2018
• Last Update Posted: October 30, 2018
• Sponsor: Aevi Genomic Medicine, LLC, a Cerecor company
• Collaborator: Medgenics Medical Israel Ltd.
• Information provided by (Responsible Party): Aevi Genomic Medicine, LLC, a Cerecor company

Study Description

Brief Summary:

The objectives of this study are to assess safety and to evaluate the biologic activity of TARGTEPO treatment.

Condition or disease	Intervention/treatment	Phase
Chronic Kidney Disease; End Stage Renal Disease	Biological: MDGN201 TARGTEPO	Phase 1; Phase 2

Detailed Description:

This is a Phase I-II, open-label study. Each patient will receive targeted dose of EPO delivered via TARGTEPO. The targeted doses will be determined according to 3 cohorts as follows: Group A (18-25 IU/Kg/day), Group B (35-45 IU/Kg/day), Group C (55-65 IU/Kg/day). The objective is to evaluate safety and biologic activity of TARGTEPO treatment when maintaining Hb levels within the target range of 9-12 g/dl. Biological activity assessments will include duration of TARGTEPO secretion as measured by serum EPO levels above baseline

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 11 participants
• Allocation: Non-Randomized
• Intervention Model: Parallel Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: Safety and Efficacy of Sustained Erythropoietin Therapy of Anemia in Chronic Kidney Disease (CKD) Patients and End-Stage Renal Disease (ESRD) Dialysis Patients Using MDGN201 TARGTEPO
• Actual Study Start Date: May 27, 2014
• Actual Primary Completion Date: June 30, 2016
• Actual Study Completion Date: March 20, 2017

Arms and Interventions

Arm	Intervention/treatment
Experimental: Group A; MDGN201 TARGTEPO secreting EPO (18-25 IU/Kg/day)	Biological: MDGN201 TARGTEPO; Erythropoietin secreted by TARGTEPO transduced with MDGN201
Experimental: Group B; MDGN201 TARGTEPO secreting EPO (35-45 IU/Kg/day)	Biological: MDGN201 TARGTEPO; Erythropoietin secreted by TARGTEPO transduced with MDGN201
Experimental: Group C; MDGN201 TARGTEPO secreting EPO (55-65 IU/Kg/day)	Biological: MDGN201 TARGTEPO; Erythropoietin secreted by TARGTEPO transduced with MDGN201

Outcome Measures

Primary Outcome Measures :

1. Total EPO Secretion [ Time Frame: up to 52 weeks ]
2. Percent (%) of Hb Measurements After Implantation Within 9-11 g/dL [ Time Frame: 52 weeks ]
3. Percent (%) of Hb Measurements After Implantation Within 9-12 g/dL [ Time Frame: 52 weeks ]
   Due to the small sample size and the dispersion of total EPO secretion, the efficacy analyses were performed on all of the patients as a single cohort of intended dose between 25 and 45 U/Kg/d.

Eligibility Criteria

• Ages Eligible for Study: 18 Years to 80 Years (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

1. For ESRD patients: Subject diagnosed with Anemia due to Chronic Renal Failure CKD stage 5 on hemodialysis treatment for at least 6 months. Average Hb during last month between 9 to 12g/dL.
2. Kt/V >1
3. INR not higher than 1.2
4. Serum albumin >3.5
5. Subjects with adequate iron stores (transferrin saturation > 20.0% and/or ferritin >100 ng/ml).

Exclusion Criteria:

1. Uncontrolled hypertension (defined as diastolic blood pressure > 110 mmHg or systolic blood pressure > 180 mmHg during screening).
2. Subjects who receive oral anti-coagulation treatment (e.g. warfarin)
3. Subjects who receive Acetyl Salicylic Acid (ASA) above 325 mg/day or patients who receive ASA treatment between 100mg/d and 325 mg/d who cannot discontinue it for 1 week prior to each EPODURE procedure
4. Patients currently receiving injections of long-acting Erythropoiesis Stimulating Agents (ESA) (e.g. Aranesp, Mircera), a patient on long acting ESA can be switched to a short acting preparation (e.g Eprex) and enroll in the study after meeting the inclusion criteria and not meeting any other exclusion criteria.
5. Congestive heart failure (New York Heart Association functional class III or IV).
6. Grand mal seizures within 2 years of the screening visit.
7. Clinical evidence of severe hyperparathyroidism as defined by PTH levels of > 10 times the upper normal limits.
8. Major surgery within 12 weeks of the screening visit.
9. Systemic hematologic diseases (e.g., sickle cell anemia, thalassemia, myelodysplastic syndromes, hematologic malignancy, myeloma, hemolytic anemia).
10. Current systemic infection, active inflammatory disease, or malignancy under active treatment.
11. Subjects known to have tested positive at any time in the past for antibodies to erythropoietic proteins.
12. Subject has history of malignancy within the past 2 years prior to the screening visit, with the exception of basal cell carcinoma.
13. Subjects with other concurrent severe and/or uncontrolled medical condition which could compromise participation in the study (i.e. active infection, uncontrolled diabetes, uncontrolled hypertension, congestive heart failure, unstable angina, ventricular arrhythmias, active ischemic heart disease, myocardial infarction within six months, uncompensated cirrhosis, active upper GI tract ulceration).
14. Subject is currently enrolled in, or has not yet completed a period of at least 30 days or five half-lives of the investigational drug whichever is longer, since ending other investigational device or drug trial(s) prior to Screening phase.
15. Psychiatric, addictive, or any other disorder that compromises ability to provide informed consent for participation in this study.
16. Female subjects of child-bearing potential and males that do not agree to use acceptable methods of contraception during the study.
17. Pregnant and lactating female subjects.
18. Chronic alcoholic or drug abuse subjects.
19. Steroid or other immunosuppressive treatment (other than topical or inhaled steroids).
20. Subjects unwilling or unable to comply with the study procedures.
21. EPO Naïve subjects.
22. Known sensitivity to Gentamycin and Amphotericin
23. History of chronic or active Hepatitis B and/or C infection or positive serology at screening and known positive HIV or positive serology at screening.
24. Subject had blood transfusion within 84 days prior to Screening visit.
25. Subject has a date for renal transplantation.
26. Subject has a temporary or permanent hemodialysis catheter, unless: Subject has a permanent hemodialysis catheter over 6 months without signs/events of line sepsis.
27. Refer to the USPI - Depo-Medrol - Methylprednisolone Acetate - Injectable (Appendix A) for any concomitant drug taken by the patient which its interaction with Depo-Medrol will warrant exclusion from this protocol.

Contacts and Locations

Locations

Israel

Barzili Medical Center

Ashkelon, Israel

Meir Medical Center

Kfar Saba, Israel

Medical Center of the Galilee

Nahariya, Israel

Tel Aviv Sourasky Medical Center

Tel Aviv, Israel

Assaf Harofeh Medical Center

Zrifin, Israel

Sponsors and Collaborators

Aevi Genomic Medicine, LLC, a Cerecor company

Medgenics Medical Israel Ltd.

Investigators

• Study Director: Shany Blum, MD PhD; Aevi Genomic Medicine, LLC, a Cerecor company

More Information

Additional Information:

Related Info 

• Responsible Party: Aevi Genomic Medicine, LLC, a Cerecor company
• ClinicalTrials.gov Identifier: NCT02117427
• Other Study ID Numbers: MG-EP-RF-02
• First Posted: April 21, 2014
• Results First Posted: October 30, 2018
• Last Update Posted: October 30, 2018
• Last Verified: February 2018

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: Undecided

Additional relevant MeSH terms:

Kidney Diseases; Renal Insufficiency, Chronic; Kidney Failure, Chronic; Urologic Diseases; Renal Insufficiency