Last reviewed · How we verify

NCT03799627: FO2RWARD-2

Study of Vadadustat in Hemodialysis Participants With Anemia Switching From Epoetin Alfa

Completed Phase 2 Results posted Last updated 29 September 2022
What this trial tests

Phase 2 trial testing Vadadustat in Anemia in 175 participants. Completed in 15 July 2020.

Timeline
31 January 2019
Primary endpoint
5 June 2020
15 July 2020

Quick facts

Lead sponsorAkebia Therapeutics
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingnone
Primary purposetreatment
Enrollment175
Start date31 January 2019
Primary completion5 June 2020
Estimated completion15 July 2020
Sites41 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Akebia Therapeutics — full company profile →

Who can join

Adults 18 to 99, any sex, with Anemia or Dialysis-dependent Chronic Kidney Disease. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Mean Change in Hemoglobin (Hb) Between Baseline and the Primary Evaluation Period (PEP) Primary · Baseline; Week 10 to Week 12

Change from Baseline in Hb value was calculated as the PEP Hb value minus the Baseline Hb value. The PEP value was the average Hb value from Week 10 to Week 12. The Baseline Hb value was defined as the average of the final two Hb values prior to start of dosing on Day 1.

Baseline
GroupValue95% CI
Low Dose of Epoetin Alfa: Vadadustat 300 mg10.223± 0.5805
Low Dose of Epoetin Alfa: Vadadustat 450 mg10.059± 0.6769
Low Dose of Epoetin Alfa: Epoetin Alfa10.165± 0.6806
High Dose of Epoetin Alfa: Vadadustat 300 mg9.778± 0.6832
High Dose of Epoetin Alfa: Vadadustat 450 mg10.288± 0.5445
High Dose of Epoetin Alfa: Vadadustat 600 mg10.095± 0.7150
High Dose of Epoetin Alfa: Epoetin Alfa9.950± 0.7950
ESA Hyporesponder: Vadadustat 600 mg9.530± 0.2864
ESA Hyporesponder: Epoetin Alfa9.620± 0.6925
Change from Baseline at PEP
GroupValue95% CI
Low Dose of Epoetin Alfa: Vadadustat 300 mg-0.371± 0.8920
Low Dose of Epoetin Alfa: Vadadustat 450 mg0.072± 1.1353
Low Dose of Epoetin Alfa: Epoetin Alfa0.160± 0.7519
High Dose of Epoetin Alfa: Vadadustat 300 mg-0.911± 1.3515
High Dose of Epoetin Alfa: Vadadustat 450 mg-0.284± 1.0383
High Dose of Epoetin Alfa: Vadadustat 600 mg-0.418± 1.2752
High Dose of Epoetin Alfa: Epoetin Alfa0.268± 1.0087
ESA Hyporesponder: Vadadustat 600 mg-0.671± 0.7643
ESA Hyporesponder: Epoetin Alfa-0.290± 1.7730
Number of Participants With Treatment-emergent Adverse Events (TEAEs) Primary · Up to Week 24

An adverse event (AE) was defined as any untoward medical occurrence (including a clinically significant abnormal laboratory finding) that occurred in the protocol-specified AE reporting period. An AE included medical conditions, signs, and symptoms not previously observed in the participant that emerged during the protocol-specified AE reporting period, including signs or symptoms associated with pre-existing underlying conditions that were not present prior to the AE reporting period. TEAEs, defined as AEs that began (or pre-existing AEs that worsened) on or after the first dose through each

GroupValue95% CI
Low Dose of Epoetin Alfa: Vadadustat 300 mg18
Low Dose of Epoetin Alfa: Vadadustat 450 mg27
Low Dose of Epoetin Alfa: Epoetin Alfa13
High Dose of Epoetin Alfa: Vadadustat 300 mg12
High Dose of Epoetin Alfa: Vadadustat 450 mg14
High Dose of Epoetin Alfa: Vadadustat 600 mg13
High Dose of Epoetin Alfa: Epoetin Alfa9
ESA Hyporesponder: Vadadustat 600 mg5
ESA Hyporesponder: Epoetin Alfa3
Number of Participants With Clinically Significant Changes From Baseline in Laboratory Parameter Values Primary · Up to Week 24

Parameters assessed for laboratory values included hematology (excluding the primary and secondary efficacy endpoint results related to Hb), clinical chemistry, lipid profiles, and glucose. The investigator was responsible for reviewing laboratory results for clinically significant changes.

GroupValue95% CI
Low Dose of Epoetin Alfa: Vadadustat 300 mg0
Low Dose of Epoetin Alfa: Vadadustat 450 mg0
Low Dose of Epoetin Alfa: Epoetin Alfa0
High Dose of Epoetin Alfa: Vadadustat 300 mg0
High Dose of Epoetin Alfa: Vadadustat 450 mg0
High Dose of Epoetin Alfa: Vadadustat 600 mg0
High Dose of Epoetin Alfa: Epoetin Alfa0
ESA Hyporesponder: Vadadustat 600 mg0
ESA Hyporesponder: Epoetin Alfa0
Number of Participants With Clinically Significant Changes From Baseline in Vital Sign Values Primary · Up to Week 24

Parameters assessed for vital signs included sitting (at rest for a minimum of 5 minutes) heart rate, respiratory rate, body temperature, and blood pressure. The investigator was responsible for reviewing vital sign values for clinically significant changes.

GroupValue95% CI
Low Dose of Epoetin Alfa: Vadadustat 300 mg0
Low Dose of Epoetin Alfa: Vadadustat 450 mg0
Low Dose of Epoetin Alfa: Epoetin Alfa0
High Dose of Epoetin Alfa: Vadadustat 300 mg0
High Dose of Epoetin Alfa: Vadadustat 450 mg0
High Dose of Epoetin Alfa: Vadadustat 600 mg0
High Dose of Epoetin Alfa: Epoetin Alfa0
ESA Hyporesponder: Vadadustat 600 mg0
ESA Hyporesponder: Epoetin Alfa0
Number of Participants Classified as Hb Outliers Primary · Weeks 13 - 20

The target range for Hb was from 10.0 to 11.0 grams per deciliter (g/dL). Hb outliers included participants with a Hb increase of more than 12.0 g/dL or \<8.0 g/dL and decline in Hb ≥0.5 g/dL from Baseline, and a Hb increase to more than 1.0 g/dL within any 2-week interval during the Study Period.

Hb >12.0 g/dL
GroupValue95% CI
Low Dose of Epoetin Alfa: Vadadustat 300 mg2
Low Dose of Epoetin Alfa: Vadadustat 450 mg2
Low Dose of Epoetin Alfa: Epoetin Alfa3
High Dose of Epoetin Alfa: Vadadustat 300 mg0
High Dose of Epoetin Alfa: Vadadustat 450 mg1
High Dose of Epoetin Alfa: Vadadustat 600 mg0
High Dose of Epoetin Alfa: Epoetin Alfa1
ESA Hyporesponder: Vadadustat 600 mg0
ESA Hyporesponder: Epoetin Alfa0
Hb >13.0 g/dL
GroupValue95% CI
Low Dose of Epoetin Alfa: Vadadustat 300 mg1
Low Dose of Epoetin Alfa: Vadadustat 450 mg0
Low Dose of Epoetin Alfa: Epoetin Alfa1
High Dose of Epoetin Alfa: Vadadustat 300 mg0
High Dose of Epoetin Alfa: Vadadustat 450 mg0
High Dose of Epoetin Alfa: Vadadustat 600 mg0
High Dose of Epoetin Alfa: Epoetin Alfa0
ESA Hyporesponder: Vadadustat 600 mg0
ESA Hyporesponder: Epoetin Alfa0
Hb >14.0 g/dL
GroupValue95% CI
Low Dose of Epoetin Alfa: Vadadustat 300 mg1
Low Dose of Epoetin Alfa: Vadadustat 450 mg0
Low Dose of Epoetin Alfa: Epoetin Alfa1
High Dose of Epoetin Alfa: Vadadustat 300 mg0
High Dose of Epoetin Alfa: Vadadustat 450 mg0
High Dose of Epoetin Alfa: Vadadustat 600 mg0
High Dose of Epoetin Alfa: Epoetin Alfa0
ESA Hyporesponder: Vadadustat 600 mg0
ESA Hyporesponder: Epoetin Alfa0
Hb <8.0 g/dL and decline in Hb ≥0.5 g/dL from Baseline
GroupValue95% CI
Low Dose of Epoetin Alfa: Vadadustat 300 mg2
Low Dose of Epoetin Alfa: Vadadustat 450 mg2
Low Dose of Epoetin Alfa: Epoetin Alfa0
High Dose of Epoetin Alfa: Vadadustat 300 mg1
High Dose of Epoetin Alfa: Vadadustat 450 mg1
High Dose of Epoetin Alfa: Vadadustat 600 mg3
High Dose of Epoetin Alfa: Epoetin Alfa1
ESA Hyporesponder: Vadadustat 600 mg1
ESA Hyporesponder: Epoetin Alfa1
Hb increase >1.0 g/dL within any 2-week interval
GroupValue95% CI
Low Dose of Epoetin Alfa: Vadadustat 300 mg4
Low Dose of Epoetin Alfa: Vadadustat 450 mg8
Low Dose of Epoetin Alfa: Epoetin Alfa4
High Dose of Epoetin Alfa: Vadadustat 300 mg4
High Dose of Epoetin Alfa: Vadadustat 450 mg2
High Dose of Epoetin Alfa: Vadadustat 600 mg3
High Dose of Epoetin Alfa: Epoetin Alfa6
ESA Hyporesponder: Vadadustat 600 mg0
ESA Hyporesponder: Epoetin Alfa2
Number of Participants With Hb Values Within the Target Range at the PEP Secondary · Week 10 to Week 12

The target range for Hb was from 10.0 to 11.0 g/dL, inclusive. The PEP was comprised of Week 10 to Week 12.

GroupValue95% CI
Low Dose of Epoetin Alfa: Vadadustat 300 mg12
Low Dose of Epoetin Alfa: Vadadustat 450 mg13
Low Dose of Epoetin Alfa: Epoetin Alfa15
High Dose of Epoetin Alfa: Vadadustat 300 mg1
High Dose of Epoetin Alfa: Vadadustat 450 mg4
High Dose of Epoetin Alfa: Vadadustat 600 mg4
High Dose of Epoetin Alfa: Epoetin Alfa6
ESA Hyporesponder: Vadadustat 600 mg0
ESA Hyporesponder: Epoetin Alfa0
Mean Change in Hb From the PEP to the Secondary Evaluation Period (SEP) in Participants Who Transitioned to Three Times Per Week (TIW) Vadadustat Dosing After Week 12 Secondary · Week 10 to Week 12; Week 18 to Week 20

Change from PEP was calculated as the SEP value minus the PEP value. The PEP value was the average Hb value from Week 10 to Week 12. The SEP value was the average Hb value from Week 18 to Week 20. For the Main Study, analysis is presented per dose level according to the starting dose in TIW regimen, as well as being presented as a combined arm for "Vadadustat Total (TIW dosing regimen)". For the ESA Hyporesponder Parallel Study, a starting dose classification for TIW dosing regimen was not applicable due to no participants switching from Vadadustat QD to TIW dosing.

GroupValue95% CI
Vadadustat 300 mg (Starting Dose in TIW Dosing Regimen)-0.050± NA
Vadadustat 450 mg (Starting Dose in TIW Dosing Regimen)-1.021± 1.0961
Vadadustat 600 mg (Starting Dose in TIW Dosing Regimen)-0.360± 0.4894
Vadadustat 750 mg (Starting Dose in TIW Dosing Regimen)-0.103± 1.9225
Vadadustat Total (TIW Dosing Regimen)-0.422± 1.1708
Mean Change in Hb Between Baseline and the SEP Secondary · Baseline; Week 18 to Week 20

Change from Baseline was calculated as the SEP value minus the Baseline value. The Baseline Hb value was defined as the average of the final two Hb values prior to start of dosing on Day 1. The SEP value was the average Hb value from Week 18 to Week 20.

GroupValue95% CI
Low Dose of Epoetin Alfa: Vadadustat 300 mg-0.197± 1.1597
Low Dose of Epoetin Alfa: Vadadustat 450 mg-0.186± 0.8703
Low Dose of Epoetin Alfa: Epoetin Alfa0.070± 0.9545
High Dose of Epoetin Alfa: Vadadustat 300 mg0.114± 1.0242
High Dose of Epoetin Alfa: Vadadustat 450 mg-0.421± 0.8370
High Dose of Epoetin Alfa: Vadadustat 600 mg-0.545± 0.9771
High Dose of Epoetin Alfa: Epoetin Alfa0.343± 0.8897
ESA Hyporesponder: Vadadustat 600 mg-0.283± 0.7371
ESA Hyporesponder: Epoetin Alfa-0.400± 1.0157
Number of Participants With Hb Values Within the Target Range at the SEP Secondary · Week 18 to Week 20

The target range for Hb was from 10.0 to 11.0 g/dL. The SEP was comprised of Week 18 to Week 20.

GroupValue95% CI
Low Dose of Epoetin Alfa: Vadadustat 300 mg6
Low Dose of Epoetin Alfa: Vadadustat 450 mg7
Low Dose of Epoetin Alfa: Epoetin Alfa9
High Dose of Epoetin Alfa: Vadadustat 300 mg2
High Dose of Epoetin Alfa: Vadadustat 450 mg3
High Dose of Epoetin Alfa: Vadadustat 600 mg2
High Dose of Epoetin Alfa: Epoetin Alfa6
ESA Hyporesponder: Vadadustat 600 mg1
ESA Hyporesponder: Epoetin Alfa1
Number of Participants With Hb Values Within the Target Range at the SEP in Participants Who Transitioned to TIW Vadadustat Dosing Secondary · Week 18 to Week 20

The target range for Hb was from 10.0 to 11.0 g/dL. The SEP was comprised of Week 18 to Week 20. For the Main Study, analysis is presented per dose level according to the starting dose in TIW regimen, as well as being presented as a combined arm for "Vadadustat Total (TIW dosing regimen)". For the ESA Hyporesponder Parallel Study, a starting dose classification for TIW dosing regimen was not applicable due to no participants switching from Vadadustat QD to TIW dosing.

GroupValue95% CI
Vadadustat 300 mg (Starting Dose in TIW Dosing Regimen)0
Vadadustat 450 mg (Starting Dose in TIW Dosing Regimen)2
Vadadustat 600 mg (Starting Dose in TIW Dosing Regimen)2
Vadadustat 750 mg (Starting Dose in TIW Dosing Regimen)3
Vadadustat Total (TIW Dosing Regimen)7
Number of Participants With a Mean Increase in Hb From Baseline to the PEP ≥0.5 g/dL or With Hb Values Within the Target Range at the PEP Secondary · Week 10 to Week 12

The target range for Hb was from 10.0 to 11.0 g/dL. The PEP was comprised of Week 10 to Week 12.

GroupValue95% CI
Low Dose of Epoetin Alfa: Vadadustat 300 mg14
Low Dose of Epoetin Alfa: Vadadustat 450 mg19
Low Dose of Epoetin Alfa: Epoetin Alfa18
High Dose of Epoetin Alfa: Vadadustat 300 mg1
High Dose of Epoetin Alfa: Vadadustat 450 mg6
High Dose of Epoetin Alfa: Vadadustat 600 mg6
High Dose of Epoetin Alfa: Epoetin Alfa8
ESA Hyporesponder: Vadadustat 600 mg0
ESA Hyporesponder: Epoetin Alfa1
Number of Participants With a Mean Increase in Hb From Baseline to the SEP ≥0.5 g/dL or With Hb Values Within the Target Range at the SEP Secondary · Week 18 to Week 20

The target range for Hb was from 10.0 to 11.0 grams per g/dL. The SEP was comprised of Week 18 to Week 20.

GroupValue95% CI
Stratum 1 (Epoetin Alfa ≤90 U/kg/Week): Vadadustat 300 mg10
Stratum 1 (Epoetin Alfa ≤90 U/kg/Week): Vadadustat 450 mg11
Stratum 1 (Epoetin Alfa ≤90 U/kg/Week): Epoetin Alfa14
High Dose of Epoetin Alfa: Vadadustat 300 mg3
High Dose of Epoetin Alfa: Vadadustat 450 mg5
High Dose of Epoetin Alfa: Vadadustat 600 mg2
High Dose of Epoetin Alfa: Epoetin Alfa8
ESA Hyporesponder (Epoetin Alfa ≥300 U/kg/Week): Vadadustat 600 mg1
ESA Hyporesponder (Epoetin Alfa ≥300 U/kg/Week): Epoetin Alfa2

Adverse events — posted to ClinicalTrials.gov

Time frame: Up to Week 24 (from first dose of study drug to last dose + 4 weeks of follow-up). Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Low Dose of Epoetin Alfa: Vadadustat 300 mg
Serious: 9/34 (26%)
Deaths: 0/34
Low Dose of Epoetin Alfa: Vadadustat 450 mg
Serious: 7/35 (20%)
Deaths: 0/35
Low Dose of Epoetin Alfa: Epoetin Alfa
Serious: 5/23 (22%)
Deaths: 0/23
High Dose of Epoetin Alfa: Vadadustat 300 mg
Serious: 8/18 (44%)
Deaths: 1/18
High Dose of Epoetin Alfa: Vadadustat 450 mg
Serious: 6/21 (29%)
Deaths: 1/21
High Dose of Epoetin Alfa: Vadadustat 600 mg
Serious: 10/21 (48%)
Deaths: 1/21
High Dose of Epoetin Alfa: Epoetin Alfa
Serious: 5/13 (38%)
Deaths: 1/13
ESA Hyporesponder: Vadadustat 600 mg
Serious: 4/5 (80%)
Deaths: 0/5
ESA Hyporesponder: Epoetin Alfa
Serious: 3/5 (60%)
Deaths: 0/5

Serious adverse events (71 terms)

ReactionSystemLow Dose of Epoetin Alfa: …Low Dose of Epoetin Alfa: …Low Dose of Epoetin Alfa: …High Dose of Epoetin Alfa:…High Dose of Epoetin Alfa:…High Dose of Epoetin Alfa:…High Dose of Epoetin Alfa:…ESA Hyporesponder: Vadadus…ESA Hyporesponder: Epoetin…
Acute myocardial infarctionCardiac disorders
SepsisInfections and infestations
Fluid overloadMetabolism and nutrition disorders
AnaemiaBlood and lymphatic system disorders
Nephrogenic anaemiaBlood and lymphatic system disorders
ThrombocytopeniaBlood and lymphatic system disorders
Acute coronary syndromeCardiac disorders
Acute left ventricular failureCardiac disorders
Atrial flutterCardiac disorders
Cardiac arrestCardiac disorders
Cardiac failureCardiac disorders
TachycardiaCardiac disorders
DiarrhoeaGastrointestinal disorders
Gastrointestinal haemorrhageGastrointestinal disorders
Gastrooesophageal reflux diseaseGastrointestinal disorders
Incarcerated inguinal herniaGastrointestinal disorders
Incarcerated umbilical herniaGastrointestinal disorders
NauseaGastrointestinal disorders
PancreatitisGastrointestinal disorders
VomitingGastrointestinal disorders
Catheter site thrombosisGeneral disorders
DeathGeneral disorders
FatigueGeneral disorders
Non-cardiac chest painGeneral disorders
Cholecystitis acuteHepatobiliary disorders
Other adverse events (84 terms — click to expand)

ReactionSystemLow Dose of Epoetin Alfa: …Low Dose of Epoetin Alfa: …Low Dose of Epoetin Alfa: …High Dose of Epoetin Alfa:…High Dose of Epoetin Alfa:…High Dose of Epoetin Alfa:…High Dose of Epoetin Alfa:…ESA Hyporesponder: Vadadus…ESA Hyporesponder: Epoetin…
DiarrhoeaGastrointestinal disorders
PainGeneral disorders
NasopharyngitisInfections and infestations
PneumoniaInfections and infestations
Muscle spasmsMusculoskeletal and connective tissue disorders
HeadacheNervous system disorders
HypertensionVascular disorders
Abdominal discomfortGastrointestinal disorders
NauseaGastrointestinal disorders
VomitingGastrointestinal disorders
AstheniaGeneral disorders
InfluenzaInfections and infestations
Arteriovenous fistula thrombosisInjury, poisoning and procedural complications
FallInjury, poisoning and procedural complications
HyperkalaemiaMetabolism and nutrition disorders
Pain in extremityMusculoskeletal and connective tissue disorders
CoughRespiratory, thoracic and mediastinal disorders
PruritusSkin and subcutaneous tissue disorders
AnaemiaBlood and lymphatic system disorders
Nephrogenic anaemiaBlood and lymphatic system disorders
ThrombocytopeniaBlood and lymphatic system disorders
Arteriosclerosis coronary arteryCardiac disorders
Bundle branch block rightCardiac disorders
Diastolic dysfunctionCardiac disorders
Left atrial enlargementCardiac disorders
Mitral valve incompetenceCardiac disorders
Right atrial enlargementCardiac disorders
Sinus tachycardiaCardiac disorders
Supraventricular tachycardiaCardiac disorders
Systolic dysfunctionCardiac disorders
TinnitusEar and labyrinth disorders
CataractEye disorders
Abdominal painGastrointestinal disorders
HaematemesisGastrointestinal disorders
ToothacheGastrointestinal disorders
FatigueGeneral disorders
PyrexiaGeneral disorders
Ulcer haemorrhageGeneral disorders
AcarodermatitisInfections and infestations
CellulitisInfections and infestations

Most-reported serious reactions: Acute myocardial infarction, Sepsis, Fluid overload, Anaemia, Nephrogenic anaemia, Thrombocytopenia, Acute coronary syndrome, Acute left ventricular failure.

Data from ClinicalTrials.gov NCT03799627 adverse events section.

Sponsor's own description

This is a Phase 2 open-label efficacy, safety, and pharmacokinetic/pharmacodynamic (PK/PD) study to evaluate oral Vadadustat for the treatment of anemia in hemodialysis participants converting from Epoetin Alfa therapy.

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

  1. Hypoxia-inducible factor-prolyl hydroxylase inhibitors in the treatment of anemia of chronic kidney disease.
    Haase VH. · · 2021 · cited 115× · PMID 33777492 · DOI 10.1016/j.kisu.2020.12.002

Verify or expand the search:

Other trials of Vadadustat

Trials testing the same drug.

Other recruiting trials for Anemia

Currently open trials in the same condition.

Other Akebia Therapeutics trials

Trials by the same sponsor.

Verify against primary sources

Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT03799627.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing