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Anemia Studies in Chronic Kidney Disease (CKD): Erythropoiesis Via a Novel Prolyl Hydroxylase Inhibitor (PHI) Daprodustat in Non-Dialysis Subjects Evaluating Hemoglobin (Hgb) and Quality of Life (ASCEND-NHQ)

NCT03409107 — Phase 3, Completed, 614 participants, GlaxoSmithKline

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A 28-week, Randomized, Double-blind, Placebo-controlled, Parallel-group, Multi-center, Study in Recombinant Human Erythropoietin (rhEPO) naïve Non-dialysis Participants With Anemia Associated With Chronic Kidney Disease to Evaluate the Efficacy, Safety and Effects on Quality of Life of Daprodustat Compared to Placebo

RegistryNCT03409107
StatusCompleted
PhasePhase 3
Study typeInterventional; randomized, parallel, masking: double, treatment
Enrollment614 (Actual)
SponsorGlaxoSmithKline (Industry)
ConditionsAnaemia
InterventionsDaprodustat (GSK1278863), Placebo, Iron therapy (Drug)
Datesstart 2018-03-05, primary completion 2020-10-07, completion 2020-10-07, first posted 2018-01-24, last updated 2024-04-02
Locations168 sites in United States, Argentina, Australia, Brazil, Canada, France, Italy, Mexico and 6 more countries

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-Summary

The purpose of this multi-center study in non-dialysis participants with anemia associated with CKD is to evaluate safety, efficacy and quality of life of daprodustat compared to placebo.

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+Arms and interventions

ArmTypeInterventionsDescription
Daprodustat receiversExperimentalDrug: Daprodustat (GSK1278863); Drug: Iron therapyParticipants will receive oral daprodustat once daily
Placebo receiversPlacebo comparatorDrug: Placebo; Drug: Iron therapyParticipants will receive oral placebo once daily
  • Daprodustat (GSK1278863) (Drug): Daprodustat will be available as 9 millimeter (mm) or 7 mm film-coated tablets. Daprodustat will be administered once daily via oral route and can be taken without regard to food.
  • Placebo (Drug): Daprodustat matching placebo will be available as 9 mm or 7 mm film coated tablets. Placebo will be administered once daily via oral route and can be taken without regard to food.
  • Iron therapy (Drug): Iron therapy will be administered if ferritin is <50 Nano gram per milliliter and/or TSAT is <15 percent.

+Outcome measures

Primary outcomes

  • Mean Change in Hemoglobin From Baseline and Over the Evaluation Period (Mean Over Week 24 and 28) [Baseline (Day 1) and Week 24 to Week 28]: Blood samples were collected at given time points from participants for hemoglobin measurements. Evaluation period hemoglobin value was defined as the mean of all available post-randomization hemoglobin values (on and off-treatment) during the evaluation period (Week 24 to Week 28 inclusive). For the primary analysis, the missing post-Baseline hemoglobin values were imputed using pre-specified multiple imputations. Change from Baseline was defined as the average of post-randomization values during the evaluation period minus Baseline value. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date. Analysis was performed using the Analysis of Covariance (ANCOVA) model with terms for treatment, Baseline hemoglobin, and region.

Secondary outcomes

  • Percentage of Participants With Hemoglobin Increase of >=1.0 Grams Per Deciliter From Baseline to Evaluation Period [Baseline (Day 1) and Week 24 to Week 28]: Blood samples were collected at given time points for hemoglobin measurements. Evaluation period hemoglobin value was defined as the mean of all available post-randomization hemoglobin values (on and off-treatment) during the evaluation period (Week 24 to Week 28 inclusive). For the primary analysis, the missing post-Baseline hemoglobin values were imputed using pre-specified multiple imputations. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date. Percentage of participants with hemoglobin increase of >=1.0 grams per deciliter from Baseline to evaluation period was analyzed using Cochran-Mantel-Haenszel (CMH) chi-squared test. The percentage values presented has been rounded off.
  • Change From Baseline in Short Form-36 (SF-36) Questionnaire Vitality Domain Score by Traditional Scoring at Week 28 [Baseline (Day 1) and Week 28]: The SF-36 acute version 2 is a 36-item generic quality of life instrument designed to measure a participant's level of performance in the 8 health domains: Physical Functioning, Role-Physical (role limitations caused by physical problems), Social Functioning, Bodily Pain, Mental Health, Role-Emotional (role limitations caused by emotional problems), Vitality, and General Perception of Health.Each domain is scored from 0 (poorer health) to 100 (better health). Vitality domain score ranges from 0-100; higher score indicates a better health state \& better functioning. Change from Baseline was calculated as Post-Dose Visit Value at Week 28 minus Baseline. For primary analysis, the missing on-treatment Week 28 SF-36 Vitality domain scores were imputed using pre-specified multiple imputations. Baseline value was latest non-missing pre-dose assessment on or before randomization date. Analysis was performed using ANCOVA model with terms for treatment, Baseline score, and region.
  • Percentage of Participants With Hgb Response (Hgb in the 11-12 Grams/Deciliter Range) During Evaluation Period (Week 24 to Week 28 Inclusive) [Week 24 to Week 28]: Mean hemoglobin during the evaluation period was defined as the mean of all evaluable hemoglobin values during the evaluation period (Week 24 to Week 28 inclusive) including any evaluable unscheduled hemoglobin values that were taken during this period. Percentage of participants with Hgb response was defined as participants with mean Hgb within range (11-12 grams per deciliter during the evaluation period (Week 24 to Week 28 inclusive) and it was analyzed using Cochran-Mantel-Haenszel (CMH) chi-squared test. The percentage values presented has been rounded off.
  • Percentage of Time With Hgb Within the Target Range (11-12 Grams Per Deciliter) During Evaluation Period (Week 24 to Week 28 Inclusive) (Hodges-Lehmann Estimate) [Week 24 to Week 28]: Percentage of days for which participant's Hgb was within the target range of 11-12 grams per deciliter during the evaluation period (Week 24 to Week 28 inclusive), including any unscheduled evaluable Hgb values that were taken during this time period. Percentage of time for which Hgb was within the target range (11-12 grams per deciliter) for a participant was calculated by dividing 'the total number of days that Hgb was within range during Week 24 to 28' by 'the total number of days the participant remained on treatment during Week 24 to 28'.
  • Percentage of Time With Hgb Within the Target Range (11-12 Grams Per Deciliter) During Evaluation Period (Week 24 to Week 28 Inclusive) (Mann-Whitney Estimate) [Week 24 to Week 28]: Percentage of days for which participant's Hgb was within the target range of 11-12 grams per deciliter during the evaluation period (Week 24 to Week 28 inclusive), including any unscheduled evaluable Hgb values that were taken during this time period. Percentage of time for which Hgb was within the target range (11-12 grams per deciliter) for a participant was calculated by dividing 'the total number of days that Hgb was within range during Week 24 to 28' by 'the total number of days the participant remained on treatment during Week 24 to 28'
  • Change From Baseline in Post-randomization Hgb at Week 28 [Baseline (Day 1) and Week 28]: Blood samples were collected at given time points for hemoglobin measurements. Change from Baseline in Hgb was analyzed using a mixed model repeated measures (MMRM) approach. Change from Baseline was calculated as Post-dose visit value minus Baseline. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date.
  • Rate of Participants Permanently Stopping Randomized Treatment Due to Meeting Rescue Criteria [Up to Week 28]: The incidence rate of participants permanently stopping randomized treatment due to meeting rescue criteria is presented.
  • Change From Baseline by Domain and Single Item Scores on the Chronic Kidney Disease -Anemia Questionnaire (CKD-AQ) Symptom Questionnaire [Baseline (Day 1) and Week 28]: CKD-AQ is 21-item patient reported outcomes measure assessing symptoms \& symptom impact in participants with anemia associated with CKD.CKD-AQ identified 3 domains:1.Tired/Low Energy/Weak scale consisting of ten items;2.Chest Pain/Shortness of Breath scale consisting of four items and 3.Cognitive scale consisting of three items;Single items included: 4.Difficulty Sleeping;5.Difficulty Standing for long periods of time;6.Severity-Shortness of breath while sitting/resting;7.Time with Shortness of breath while not doing activity.Single-item measures were recorded based on 0-100 scoring with 0 is worst possible \& 100 is best possible score.Total domain score is calculated as average of items in each domain \& ranged from 0-100 where 0 is worst possible and 100 is best possible score.Change from Baseline was calculated as post-dose visit value minus Baseline.Baseline was latest non-missing pre-dose assessment on or before randomization date. Adjusted mean \& standard error is presented.
  • Change From Baseline in Patient Global Impression of Severity (PGI-S) [Baseline (Day 1) and Week 28]: The PGI-S is a 1-item questionnaire designed to assess participant's impression of disease severity on a 5-point disease severity scale (0=absent, 1=mild, 2=moderate, 3=severe, or 4=very severe). A higher score indicated worse outcome. Change from Baseline was calculated as Post-Dose visit value minus Baseline value. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date. Adjusted mean and standard error is presented.
  • Change From Baseline in the SF-36 Physical Functioning Domain [Baseline (Day 1) and Week 28]: The SF-36 acute version 2 is a 36-item generic quality of life instrument designed to measure a participant's level of performance in the following eight health domains: physical functioning, role-physical (role limitations caused by physical problems), social functioning, bodily pain, mental health, role-emotional (role limitations caused by emotional problems), vitality, and general perception of health. Each domain is scored from 0 (poorer health) to 100 (better health). Physical functioning domain score ranges from 0-100; higher score indicates a better health state and better functioning. Change from Baseline was calculated as post-dose visit value minus Baseline value. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date.
  • Change From Baseline of the SF-36 Individual Items in the Vitality Domain [Baseline (Day 1) and Week 28]: The SF-36 acute version 2 is a 36-item generic quality of life instrument designed to measure a participant's level of performance in the following eight health domains: physical functioning, role-physical (role limitations caused by physical problems), social functioning, bodily pain, mental health, role-emotional (role limitations caused by emotional problems), vitality, and general perception of health. Individual vitality items include: 1. Did you feel full of life?, 2. Did you have a lot of energy?, 3. Did you feel worn out?, 4. Did you feel tired?. Score of each item in the vitality domain ranges from 0-100; higher score indicates better health state and better functioning. Change from Baseline was calculated as post-dose visit value minus Baseline value. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date.
  • Number of Participants Currently Employed as Per Work Productivity and Activity Impairment Questionnaire: Anemic Symptoms Clinical Practice Version (WPAI-ANS-CPV) [Week 8, Week 12 and Week 28]: WPAI-ANS-CPV is anemia specific questionnaire designed as self-reported quantitative assessment of social functioning related to work and regular daily activities. It contains 2 concepts-work productivity impairment measured via absenteeism(time missed from work), presenteeism(impairment at work) and regular daily activity impairment. WPAI questions (Q) were:1) currently employed,2) work time missed due to problem, 3) impairment while working due to problem, 4) overall work impairment due to problem, 5) activity impairment due to problem. WPAI generates 4 domain scores:percent (%) of work time missed(absenteeism),% of impairment while working(presenteeism),% of overall work impairment(absenteeism and presenteeism combined),% of activity impairment. Number of participants currently employed as per WPAI-ANS-CPV is presented.
  • Change From Baseline in WPAI-ANS-CPV: Percent Time Missed From Work [Baseline (Day 1), Week 8, Week 12 and Week 28]: WPAI-ANS-CPV is anemia specific questionnaire designed as self-reported quantitative assessment of social functioning related to work and regular daily activities. It contains 2 concepts-work productivity impairment measured via absenteeism (time missed from work), presenteeism (impairment at work) and regular daily activity impairment. WPAI questions (Q) were: 1) currently employed, 2) work time missed due to problem, 3) impairment while working due to problem, 4)overall work impairment due to problem, 5) activity impairment due to problem. Percent work time missed due to problem was a subscale and calculated as: Q2/(Q2+Q4) for those who were currently employed. Subscale score was expressed as an impairment percentage (range: 0-100%) where higher numbers indicate greater impairment and less productivity. Change from Baseline was calculated as post-dose visit value minus Baseline. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date.
  • Change From Baseline in WPAI-ANS-CPV: Mean Hours Missed From Work in the Past 7 Days [Baseline (Day 1), Week 8, Week 12 and Week 28]: WPAI-ANS-CPV is anemia specific questionnaire designed as self-reported quantitative assessment of social functioning related to work and regular daily activities. It contains 2 concepts-work productivity impairment measured via absenteeism (time missed from work), presenteeism (impairment at work) and regular daily activity impairment. WPAI Qs were: 1) currently employed, 2) work time missed due to problem, 3) impairment while working due to problem, 4) overall work impairment due to problem, 5) activity impairment due to problem. Change from Baseline was calculated as post-dose visit value minus Baseline. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date.
  • Change From Baseline in WPAI: Percent Impairment at Work [Baseline (Day 1), Week 8, Week 12 and Week 28]: WPAI-ANS-CPV is anemia specific questionnaire designed as self-reported quantitative assessment of social functioning related to work and regular daily activities.It contains 2 concepts-work productivity impairment measured via absenteeism(time missed from work),presenteeism(impairment at work) and regular daily activity impairment.WPAI Qs were:1)currently employed,2)work time missed due to problem,3)impairment while working due to problem,4)overall work impairment due to problem,5)activity impairment due to problem. % Impairment while Working due to Problem was subscale and calculated as: Q5/10 for those who were currently employed and actually worked in past 7 days. Subscale score was expressed as an impairment percentage (range: 0-100%) where higher numbers indicate greater impairment and less productivity. Change from Baseline was calculated as post-dose visit value minus Baseline. Baseline value was the latest non-missing pre-dose assessment on or before randomization date.
  • Change From Baseline in WPAI: Percent Overall Work Impairment [Baseline (Day 1), Week 8, Week 12 and Week 28]: WPAI-ANS-CPV is anemia specific questionnaire designed as self-reported quantitative assessment of social functioning related to work and regular daily activities. It contains 2 concepts-work productivity impairment measured via absenteeism (time missed from work), presenteeism (impairment at work) and regular daily activity impairment. WPAI Qs were: 1) currently employed, 2) work time missed due to problem, 3) impairment while working due to problem, 4) overall work impairment due to problem, 5) activity impairment due to problem. Percent overall work impairment due to problem was a subscale and calculated as: Q2/(Q2+Q4)+\[(1-Q2/(Q2+Q4))×(Q5/10)\] for those who were currently employed. Subscale score was expressed as an impairment percentage (range: 0-100%) where higher numbers indicate greater impairment. Change from Baseline was calculated as post-dose visit value minus Baseline. Baseline value was the latest non-missing pre-dose assessment on or before randomization date.
  • Change From Baseline in WPAI: Percent Regular Daily Activity Impairment [Baseline (Day 1), Week 8, Week 12 and Week 28]: WPAI-ANS-CPV is anemia specific questionnaire designed as self-reported quantitative assessment of social functioning related to work and regular daily activities.It contains 2 concepts-work productivity impairment measured via absenteeism (time missed from work), presenteeism (impairment at work) and regular daily activity impairment. WPAI Qs were: 1) currently employed, 2) work time missed due to problem, 3) impairment while working due to problem, 4) overall work impairment due to problem, 5) activity impairment due to problem. Percent activity impairment due to problem was a subscale and calculated as: Q5/10 for all respondents. Subscale score was expressed as an impairment percentage (range: 0-100%) where higher numbers indicate greater impairment. Change from Baseline was calculated as post-dose visit value minus Baseline. Baseline value was the latest non-missing pre-dose assessment on or before randomization date.
  • Change From Baseline in EuroQol 5 Dimension 5 Level Health Utility Index (EQ-5D-5L) Utility Score [Baseline (Day 1) and Week 28]: The EQ-5D-5L is a self-assessment questionnaire, consisting of 5 items covering 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). Each dimension is measured by a 5-point Likert scale (1: no problems, 2: slight problems, 3: moderate problems, 4: severe problems, and 5: extreme problems). The responses for the five dimension together form a five-figure description of health state. Each of these five-figure health states have attached valuation (utility score), expressed as single index on a scale from 0-1, where 1 is full health and 0 is worst health. The higher the score the better the health status. Change from Baseline was calculated as post-dose visit value minus Baseline. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date.
  • Change From Baseline in EuroQol Visual Analogue Scale (EQ-VAS) Score [Baseline (Day 1) and Week 28]: The EQ VAS records the respondent's self-rated health on a vertical, visual analogue scale where the endpoints are labeled 'the best health you can imagine' and 'the worst health you can imagine' at the time of completion. It is a self-assessment visual analogue scale, ranging from 0=worst imaginable to 100=best. Change from Baseline was calculated as post-dose visit value minus Baseline. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date.
  • Change From Baseline in Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP) at Week 28 [Baseline (Day 1) and Week 28]: SBP, DBP and MAP were measured with participants in a seated position after at least a 5-minute of rest. MAP is the average BP in an individual's arteries during a single cardiac cycle. Change from Baseline was calculated as post-dose visit value minus Baseline. Baseline value was the latest non-missing pre-dose assessment on or before the randomization date.
  • Percentage of Participants With at Least One Blood Pressure (BP) Exacerbation Event [Up to Week 28]: Percentage of participants with at least one BP event is presented. BP exacerbation is defined as: SBP exacerbation: SBP >= 25 mmHg increase from Baseline or SBP >= 180 mmHg; DBP exacerbation: DBP >= 15 mmHg increase from Baseline or DBP >= 110 mmHg. Percentage of participants with at least one BP event is presented. The percentage values presented has been rounded off.

+Eligibility

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* >=18 years of age at the time of signing the informed consent.
* Have CKD, confirmed at screening: Kidney Disease Outcomes Quality Initiative (KDOQI) CKD stages 3, 4, or 5 defined by Estimated glomerular filtration rate (eGFR) using the CKD Epidemiology Collaboration (CKD-EPI) formula.
* Participants with Stable HemoCue Hgb from 8.5 to 10.5 at screening visit (Week -4) and from 8.5 to 10.0 g/dL at randomization (Day 1).
* Participants may receive up to one intravenous (IV) iron dose within the 8 weeks prior to screening and NO IV iron use between screening visit and randomization (Day 1).
* If needed, participant may be on stable maintenance oral iron supplementation. There should be <50% change in overall dose and no change in type of iron prescribed in the 4 weeks prior to Day 1 randomization visit.
* Male and female participants are eligible. A female participant is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies: Not a woman of childbearing potential (WOCBP) or WOCBP who agrees to follow the contraceptive guidance during the treatment period and for at least 4 weeks after the last dose of study treatment.
* Capable of giving signed informed consent.

Exclusion Criteria:

* Participants who are on dialysis or clinical evidence of impending need to initiate dialysis within 180 days after randomization (Day 1).
* Planned living-related or living-unrelated kidney transplant within 28 weeks after randomization (Day 1).
* Transferrin saturation (TSAT) <15 percent (Screening only).
* Ferritin <50 nanograms per milliliter (ng/mL) (Screening only).
* History of rhEPO or rhEPO analogue use within the 8 weeks prior to screening and rhEPO use between screening and randomization (Day 1).
* History of transfusion within the 8 weeks prior to screening and transfusion between screening and randomization (Day 1).
* History of bone marrow aplasia or pure red cell aplasia (PRCA).
* Participants with Megaloblastic anemia (untreated pernicious anemia and folate deficiency), thalassemia major, sickle cell disease or myelodysplastic syndrome.
* Evidence of actively bleeding gastric, duodenal, or esophageal ulcer disease or clinically significant gastrointestinal (GI) bleeding <= 8 weeks prior to screening through to randomization (Day 1).
* History of severe allergic or anaphylactic reactions or hypersensitivity to excipients in the investigational product.
* Use of strong inhibitor of CYP2C8 (for example, gemfibrozil) or strong inducers of CYP2C8 (for example, rifampin/rifampicin).
* Ferric citrate use within 4 weeks prior to randomization (Day 1).
* Use of other investigational agent or device prior to screening through to randomization (Day 1).
* Any prior treatment with daprodustat for a treatment duration of >30 days.
* MI or acute coronary syndrome within the 8 weeks prior to screening through to randomization. (Day 1).
* Stroke or transient ischemic attack within the 8 weeks prior to screening through to randomization. (Day 1).
* Chronic Class IV heart failure, as defined by the New York Heart Association (NYHA) functional classification system.
* QT interval corrected by Bazett's formula (QTcB) >500 milliseconds (msec) or QTcB >530 msec in participants with bundle branch block. There is no corrected QT interval (QTc) exclusion for participants with a predominantly paced rhythm.
* Alanine transaminase (ALT) >2x upper limit of normal (ULN) at screening (Week -4).
* Bilirubin >1.5xULN at screening (Week -4).
* Current unstable liver or biliary disease per investigator assessment, generally defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal or gastric varices, persistent jaundice, or cirrhosis.
* History of malignancy within the 2 years prior to screening through to randomization (Day 1), or currently receiving treatment for cancer, or complex kidney cyst (for example, Bosniak Category II F, III or IV) > 3 centimeters (cm).
* Any other condition, clinical or laboratory abnormality, or examination finding that the investigator considers would put the participant at unacceptable risk, which may affect study compliance or prevent understanding of the aims or investigational procedures or possible consequences of the study.
* Current uncontrolled hypertension as determined by the investigator.

+Posted results

Participant flow

MilestonePlaceboDaprodustat
Started307307
Completed290300
Not completed177

Outcome results

  • Mean Change in Hemoglobin From Baseline and Over the Evaluation Period (Mean Over Week 24 and 28) (Primary), Least squares mean, Grams per deciliter: Placebo 0.19 +/- 0.062; Daprodustat 1.58 +/- 0.061 (p <0.0001)
  • Percentage of Participants With Hemoglobin Increase of >=1.0 Grams Per Deciliter From Baseline to Evaluation Period (Secondary), Number, Percentage of participants: Placebo 18; Daprodustat 77 (p <0.0001)
  • Change From Baseline in Short Form-36 (SF-36) Questionnaire Vitality Domain Score by Traditional Scoring at Week 28 (Secondary), Least squares mean, Scores on a scale: Placebo 1.93 +/- 1.161; Daprodustat 7.29 +/- 1.121 (p 0.0005)
  • Percentage of Participants With Hgb Response (Hgb in the 11-12 Grams/Deciliter Range) During Evaluation Period (Week 24 to Week 28 Inclusive) (Secondary), Number, Percentage of participants: Placebo 8; Daprodustat 52 (p <0.0001)
  • Percentage of Time With Hgb Within the Target Range (11-12 Grams Per Deciliter) During Evaluation Period (Week 24 to Week 28 Inclusive) (Hodges-Lehmann Estimate) (Secondary), Median, Percentage of days: Placebo 0.00 (0.0 to 100.0); Daprodustat 53.59 (0.0 to 100.0)
  • Percentage of Time With Hgb Within the Target Range (11-12 Grams Per Deciliter) During Evaluation Period (Week 24 to Week 28 Inclusive) (Mann-Whitney Estimate) (Secondary), Median, Percentage of days: Placebo 0.00 (0.0 to 100.0); Daprodustat 53.59 (0.0 to 100.0) (p <0.0001)
  • Change From Baseline in Post-randomization Hgb at Week 28 (Secondary), Least squares mean, Grams per deciliter: Placebo 0.20 +/- 0.070; Daprodustat 1.56 +/- 0.069 (p <0.0001)
  • Rate of Participants Permanently Stopping Randomized Treatment Due to Meeting Rescue Criteria (Secondary), Number, Events per 100 person year: Placebo 18.88 (12.33 to 27.66); Daprodustat 1.33 (0.16 to 4.82) (p 0.0002)
  • Change From Baseline by Domain and Single Item Scores on the Chronic Kidney Disease -Anemia Questionnaire (CKD-AQ) Symptom Questionnaire (Secondary), Mean, Scores on a scale: Placebo 2.81 +/- 1.132; Daprodustat 8.72 +/- 1.086 (p <0.0001)
  • Change From Baseline in Patient Global Impression of Severity (PGI-S) (Secondary), Least squares mean, Scores on a scale: Placebo -0.04 +/- 0.055; Daprodustat -0.18 +/- 0.052 (p 0.0391)
  • Change From Baseline in the SF-36 Physical Functioning Domain (Secondary), Least squares mean, Scores on a scale: Placebo 1.23 +/- 1.354; Daprodustat 3.80 +/- 1.298 (p 0.0858)
  • Change From Baseline of the SF-36 Individual Items in the Vitality Domain (Secondary), Least squares mean, Scores on a scale: Placebo -0.02 +/- 0.070; Daprodustat 0.16 +/- 0.067 (p 0.0357)
  • Number of Participants Currently Employed as Per Work Productivity and Activity Impairment Questionnaire: Anemic Symptoms Clinical Practice Version (WPAI-ANS-CPV) (Secondary), Count of participants, Participants: Placebo 195; Daprodustat 204
  • Change From Baseline in WPAI-ANS-CPV: Percent Time Missed From Work (Secondary), Mean, Percentage of time: Placebo -2.4 +/- 28.40; Daprodustat -6.1 +/- 24.92
  • Change From Baseline in WPAI-ANS-CPV: Mean Hours Missed From Work in the Past 7 Days (Secondary), Mean, Percentage of hours: Placebo 0.1 +/- 18.46; Daprodustat -1.8 +/- 11.88
  • Change From Baseline in WPAI: Percent Impairment at Work (Secondary), Mean, Percentage of impairment: Placebo -5.1 +/- 18.42; Daprodustat -11.3 +/- 24.06
  • Change From Baseline in WPAI: Percent Overall Work Impairment (Secondary), Mean, Percentage of impairment: Placebo -4.3 +/- 24.04; Daprodustat -12.0 +/- 25.90
  • Change From Baseline in WPAI: Percent Regular Daily Activity Impairment (Secondary), Mean, Percentage of impairment: Placebo -4.6 +/- 23.67; Daprodustat -7.7 +/- 24.53
  • Change From Baseline in EuroQol 5 Dimension 5 Level Health Utility Index (EQ-5D-5L) Utility Score (Secondary), Least squares mean, Scores on a scale: Placebo 0.01 +/- 0.015; Daprodustat 0.03 +/- 0.014 (p 0.1098)
  • Change From Baseline in EuroQol Visual Analogue Scale (EQ-VAS) Score (Secondary), Least squares mean, Scores on a scale: Placebo 0.80 +/- 1.427; Daprodustat 5.30 +/- 1.373 (p 0.0120)
  • 2 more outcome measures not shown.

Adverse events

Time frame: All cause mortality, serious adverse events (SAEs) and non-serious AEs were collected up to follow-up (Week 32).

ArmDeathsSerious adverse eventsOther adverse events
Placebo16/306 (5.2%)68/306 (22.2%)44/306 (14.4%)
Daprodustat10/308 (3.2%)62/308 (20.1%)49/308 (15.9%)

Serious adverse events by term

TermOrgan systemPlaceboDaprodustat
Acute kidney injuryRenal and urinary disorders5/3065/308
Renal failureRenal and urinary disorders6/3062/308
End stage renal diseaseRenal and urinary disorders2/3062/308
Renal impairmentRenal and urinary disorders2/3061/308
AzotaemiaRenal and urinary disorders1/3061/308
Urinary retentionRenal and urinary disorders2/3060/308
Chronic kidney diseaseRenal and urinary disorders1/3060/308
IgA nephropathyRenal and urinary disorders0/3061/308
NephrolithiasisRenal and urinary disorders0/3061/308
Nephropathy toxicRenal and urinary disorders0/3061/308
Nephrotic syndromeRenal and urinary disorders1/3060/308
Renal haematomaRenal and urinary disorders1/3060/308
Cardiac failure congestiveCardiac disorders2/3063/308
Cardiac failure acuteCardiac disorders4/3060/308
Acute coronary syndromeCardiac disorders2/3061/308
Atrial fibrillationCardiac disorders0/3063/308
BradycardiaCardiac disorders2/3060/308
Left ventricular failureCardiac disorders0/3062/308
Acute myocardial infarctionCardiac disorders1/3060/308
Angina pectorisCardiac disorders0/3061/308
Angina unstableCardiac disorders0/3061/308
ArrhythmiaCardiac disorders0/3061/308
Atrial flutterCardiac disorders0/3061/308
Atrial thrombosisCardiac disorders0/3061/308
Cardiac failure chronicCardiac disorders1/3060/308
Coronary artery diseaseCardiac disorders0/3061/308
Mitral valve incompetenceCardiac disorders1/3060/308
Myocardial infarctionCardiac disorders1/3060/308
Myocardial ischaemiaCardiac disorders0/3061/308
Right ventricular failureCardiac disorders0/3061/308
Cardiac failureCardiac disorders1/3064/308
Tricuspid valve incompetenceCardiac disorders0/3061/308
SepsisInfections and infestations2/3062/308
CellulitisInfections and infestations2/3061/308
Urinary tract infectionInfections and infestations4/3062/308
PneumoniaInfections and infestations1/3062/308
Septic shockInfections and infestations2/3060/308
UrosepsisInfections and infestations0/3062/308
COVID-19Infections and infestations0/3061/308
Diabetic foot infectionInfections and infestations0/3061/308
Ear infectionInfections and infestations1/3060/308
EndophthalmitisInfections and infestations1/3060/308
Escherichia urinary tract infectionInfections and infestations0/3061/308
GastroenteritisInfections and infestations1/3060/308
Lower respiratory tract infectionInfections and infestations0/3061/308
Otitis externaInfections and infestations1/3060/308
Perirectal abscessInfections and infestations0/3061/308
Pneumonia bacterialInfections and infestations0/3061/308
PyelonephritisInfections and infestations0/3061/308
Upper respiratory tract infectionInfections and infestations1/3060/308
Gastrointestinal haemorrhageGastrointestinal disorders2/3061/308
VomitingGastrointestinal disorders1/3062/308
ConstipationGastrointestinal disorders2/3060/308
Upper gastrointestinal haemorrhageGastrointestinal disorders1/3061/308
Abdominal pain upperGastrointestinal disorders0/3061/308
AscitesGastrointestinal disorders1/3060/308
ColitisGastrointestinal disorders1/3060/308
Diabetic gastropathyGastrointestinal disorders1/3060/308
DiarrhoeaGastrointestinal disorders0/3061/308
Large intestine polypGastrointestinal disorders1/3060/308

60 more terms not shown.

Other adverse events by term

TermOrgan systemPlaceboDaprodustat
DiarrhoeaGastrointestinal disorders17/30624/308
HypertensionVascular disorders14/30621/308
Oedema peripheralGeneral disorders21/30612/308

+Locations (168)

FacilityCityCountryStatus
GSK Investigational SiteHomewood, AlabamaUnited States
GSK Investigational SiteLittle Rock, ArkansasUnited States
GSK Investigational SiteDowney, CaliforniaUnited States
GSK Investigational SiteFresno, CaliforniaUnited States
GSK Investigational SiteLynwood, CaliforniaUnited States
GSK Investigational SiteNorthridge, CaliforniaUnited States
GSK Investigational SiteNorthridge, CaliforniaUnited States
GSK Investigational SiteRiverside, CaliforniaUnited States
GSK Investigational SiteSalinas, CaliforniaUnited States
GSK Investigational SiteSanta Ana, CaliforniaUnited States
GSK Investigational SiteDenver, ColoradoUnited States
GSK Investigational SiteHartford, ConnecticutUnited States
GSK Investigational SiteMiddlebury, ConnecticutUnited States
GSK Investigational SiteCoral Springs, FloridaUnited States
GSK Investigational SiteHollywood, FloridaUnited States
GSK Investigational SiteKissimmee, FloridaUnited States
GSK Investigational SiteLauderdale Lakes, FloridaUnited States
GSK Investigational SitePembroke Pines, FloridaUnited States
GSK Investigational SiteTampa, FloridaUnited States
GSK Investigational SiteAdairsville, GeorgiaUnited States
GSK Investigational SiteMacon, GeorgiaUnited States
GSK Investigational SiteMacon, GeorgiaUnited States
GSK Investigational SiteStatesboro, GeorgiaUnited States
GSK Investigational SiteIndianapolis, IndianaUnited States
GSK Investigational SiteOverland Park, KansasUnited States
GSK Investigational SiteBuckley, MichiganUnited States
GSK Investigational SiteDetroit, MichiganUnited States
GSK Investigational SiteSaint Clair Shores, MichiganUnited States
GSK Investigational SiteBrookhaven, MississippiUnited States
GSK Investigational SiteSt Louis, MissouriUnited States
GSK Investigational SiteRochester, New HampshireUnited States
GSK Investigational SiteAsheville, North CarolinaUnited States
GSK Investigational SiteCharlotte, North CarolinaUnited States
GSK Investigational SiteDurham, North CarolinaUnited States
GSK Investigational SiteMidwest City, OklahomaUnited States
GSK Investigational SiteOklahoma City, OklahomaUnited States
GSK Investigational SiteBeaver, PennsylvaniaUnited States
GSK Investigational SiteDuncansville, PennsylvaniaUnited States
GSK Investigational SiteScottdale, PennsylvaniaUnited States
GSK Investigational SiteSmithfield, PennsylvaniaUnited States
GSK Investigational SiteWest Reading, PennsylvaniaUnited States
GSK Investigational SiteOrangeburg, South CarolinaUnited States
GSK Investigational SiteKingsport, TennesseeUnited States
GSK Investigational SiteMemphis, TennesseeUnited States
GSK Investigational SiteDeSoto, TexasUnited States
GSK Investigational SiteEl Paso, TexasUnited States
GSK Investigational SiteMcAllen, TexasUnited States
GSK Investigational SiteWaxahachie, TexasUnited States
GSK Investigational SiteNorfolk, VirginiaUnited States
GSK Investigational SiteCiudad Autonoma de Buenos Aires, Buenos AiresArgentina
GSK Investigational SiteCiudad Autonoma de Buenos Aires, Buenos AiresArgentina
GSK Investigational SiteMar del Plata, Buenos AiresArgentina
GSK Investigational SiteMar del Plata, Buenos AiresArgentina
GSK Investigational SiteSan Nicolás de los Arroyos, Buenos AiresArgentina
GSK Investigational SiteCórdoba, Córdoba ProvinceArgentina
GSK Investigational SiteRosario, Santa Fe ProvinceArgentina
GSK Investigational SiteSanta FeArgentina
GSK Investigational SiteSydney, New South WalesAustralia
GSK Investigational SiteHeidelberg, VictoriaAustralia
GSK Investigational SiteParkville, VictoriaAustralia
GSK Investigational SiteMurdoch, Western AustraliaAustralia
GSK Investigational SiteFitzroyAustralia
GSK Investigational SiteVitória, Espírito SantoBrazil
GSK Investigational SiteFeira de Santana, Estado de BahiaBrazil
GSK Investigational SiteSalvador, Estado de BahiaBrazil
GSK Investigational SiteRibeirão Preto, São PauloBrazil
GSK Investigational SiteSanto André - SP, São PauloBrazil
GSK Investigational SiteSão Bernardo do Campo, São PauloBrazil
GSK Investigational SiteSão José do Rio Preto, São PauloBrazil
GSK Investigational SiteSão José do Rio Preto, São PauloBrazil
GSK Investigational SiteSão PauloBrazil
GSK Investigational SiteVictoria, British ColumbiaCanada
GSK Investigational SiteBrampton, OntarioCanada
GSK Investigational SiteGreater Sudbury, OntarioCanada
GSK Investigational SiteGuelph, OntarioCanada
GSK Investigational SiteKitchener, OntarioCanada
GSK Investigational SiteOttawa, OntarioCanada
GSK Investigational SiteSarnia, OntarioCanada
GSK Investigational SiteToronto, OntarioCanada
GSK Investigational SiteToronto, OntarioCanada
GSK Investigational SiteToronto, OntarioCanada
GSK Investigational SiteMontreal, QuebecCanada
GSK Investigational SiteQuébec, QuebecCanada
GSK Investigational SiteQuébec, QuebecCanada
GSK Investigational SiteSaint-Charles-Borromée, QuebecCanada
GSK Investigational SiteGrenobleFrance
GSK Investigational SiteLe MansFrance
GSK Investigational SiteMarseilleFrance
GSK Investigational SiteMelunFrance
GSK Investigational SiteMulhouseFrance
GSK Investigational SiteNantesFrance
GSK Investigational SiteNiceFrance
GSK Investigational SiteSaint-Priest-en-JarezFrance
GSK Investigational SiteCatanzaro, CalabriaItaly
GSK Investigational SiteNaples, CampaniaItaly
GSK Investigational SiteBologna, Emilia-RomagnaItaly
GSK Investigational SiteModena, Emilia-RomagnaItaly
GSK Investigational SiteGenoa, LiguriaItaly
GSK Investigational SitePavia, LombardyItaly
GSK Investigational SiteMestre, VenetoItaly

68 more sites not listed.

+Publications

  • Johansen KL, Cobitz AR, Singh AK, Macdougall IC, Lopes RD, Obrador GT, Kovesdy CP, Israni R, Jha V, Okoro T, Sprys M, Jolly S, Lindsay AC, Bhatt P, Camejo RR, Keeley T, Cizman B, Wheeler DC. The ASCEND-NHQ randomized trial found positive effects of daprodustat on hemoglobin and quality of life in patients with non-dialysis chronic kidney disease. Kidney Int. 2023 Jun;103(6):1180-1192. doi: 10.1016/j.kint.2023.02.019. Epub 2023 Mar 2. PMID 36868377
  • Results publication: Natale P, Palmer SC, Jaure A, Hodson EM, Ruospo M, Cooper TE, Hahn D, Saglimbene VM, Craig JC, Strippoli GF. Hypoxia-inducible factor stabilisers for the anaemia of chronic kidney disease. Cochrane Database Syst Rev. 2022 Aug 25;8(8):CD013751. doi: 10.1002/14651858.CD013751.pub2. PMID 36005278

+Study documents

+Investigators

  • GSK Clinical Trials, Study director, GlaxoSmithKline

+Funding

NIH grants: 2017

My Notes