Etelcalcetide: Etelcalcetide has been shown to be safe and efficacious in treating adult CKD patients with SHPT by simultaneously controlling iPTH, Ca, and phosphorus and has recently been approved for use in adult patients with SHPT treated with hemodialysis in both the United States and Europe
Standard of Care: Standard of care, which can include therapy with vitamin D sterols, Ca supplementation, and/or phosphate binders
Study summary
This is a phase 3 trial of etelcalcetide in pediatric participants with secondary hyperparathyroidism (SHPT) and chronic kidney disease (CKD) on hemodialysis.
Eligibility
Sex
ALL
Min age
0 Years
Max age
18 Years
Healthy volunteers
No
Inclusion criteria
* Age of 28 days \< 18 years.
* Dry weight ≥ 7 kg during screening.
* Diagnosed with CKD and SHPT undergoing hemodialysis at the time of screening.
* Diagnosis of SHPT with the mean of the 2 consecutive central laboratory iPTH values ≥ 300 pg/mL (32 pmol/L) during screening, on separate days and within 2 weeks of enrolment.
* Serum corrected calcium (cCa) value ≥ 9.0 mg/dL (2.25 mmol/L) for participants ≥ 2 years of age and older and serum cCa value ≥ 9.6 mg/dL (2.4 mmol/L) for participants 28 days to \< 2 years of age obtained from the central laboratory during screening.
* Dialysate Ca level ≥ 2.5 mEq/L during screening for at least 4 weeks prior to screening and throughout the duration of the trial.
* No more than a maximum prescribed dose change of 50% for active vitamin D sterols/phosphate binders/Ca supplements within the 2 weeks prior to screening assessments and remain stable.
* SHPT not due to vitamin D deficiency, per investigator assessment.
Exclusion Criteria Disease Related
* History of congenital long QT syndrome, second or third degree heart block, ventricular tachyarrhythmia's or other conditions associated with prolonged QT interval.
* Anticipated or scheduled parathyroidectomy during the trial period.
* Anticipated or scheduled kidney transplant during the trial period.
* Participant has received a parathyroidectomy within 6 months prior to randomization.
Other Medical Conditions
• History of other malignancy, except non-melanoma skin cancers, cervical or breast ductal carcinoma in situ within the last 5 years.
Prior/Concomitant Therapy
* Use of concomitant medications that may prolong the corrected QT interval (eg, ondansetron, albuterol, sotalol, amiodarone, erythromycin, or clarithromycin). Refer to CredibleMeds.org for guidance. Certain medications may be allowed based on review by the medical monitor and require additional electrocardiogram (ECG) monitoring and potential electrolyte monitoring.
* Receipt of cinacalcet therapy within 30 days prior to screening assessments and through randomization.
* Receipt of etelcalcetide within 6 months prior to screening assessments and through randomization.
* All herbal medicines (eg, St. John's wort), vitamins, and supplements consumed by the participant within the 30 days prior to randomization, and continuing use if applicable, will be reviewed by the Principal Investigator and the Amgen Medical Monitor. Written documentation of the review and Amgen acknowledgment is required for participant participation.
* Use of any over-the-counter or prescription medications within the 14 days or 5 half-lives (whichever is longer) prior to randomization that are not established therapies for participants with renal disease or other conditions secondary to renal disease will be reviewed by the Principal Investigator and the Amgen Medical Monitor. Written documentation of the review and Amgen acknowledgment is required for participant participation. Paracetamol for analgesia will be allowed.
Prior/Concurrent Clinical Trial Experience • Currently receiving treatment in another investigational device or drug trial, or less than 30 days or 5 half-lives (whichever is longer) since ending treatment on another investigational device or drug trial(s). Other investigational procedures while participating in this trial are excluded.
Diagnostic Assessments During Screening
* Participant has significant abnormalities on the most recent central laboratory test during the screening period prior to enrollment per the Investigator including but not limited to the following: a. Serum transaminase (alanine aminotransferase \[ALT\] or serum glutamic pyruvic transaminase \[SGPT\], aspartate aminotransferase \[AST\] or serum glutamic oxaloacetic transaminase \[SGOT\]) \> 2.0 times the upper limit of normal (ULN).
* Corrected QT interval (QTc) \> 500 ms, using Bazett's formula.
* QTc ≥ 450 to ≤ 500 ms, using Bazett's formula, unless written permission to enroll is provided by the investigator after consultation with a pediatric cardiologist.
* Participant has a clinically significant ECG abnormality during screening that, in the opinion of the investigator, could pose a risk to participant safety or interfere with the trial evaluation.
Within the 60 days prior to enrollment
• New onset or worsening of a pre-existing seizure disorder.
Other Exclusions
* Participants aged 28 days to 6 months of age who were born prematurely at \< 36 weeks gestational age.
* Female participant is pregnant or breastfeeding or planning to become pregnant or breastfeed during treatment and for an additional 3 months after the last dose of etelcalcetide. (Females of childbearing potential should only be included in the trial after a confirmed menstrual period and a negative highly sensitive serum pregnancy test within 7 days prior to the first dose of investigational product).
* Female participants of childbearing potential unwilling to use 1 highly-effective or acceptable method of contraception during treatment and for an additional 3 months after the last dose of investigational product.
* Participant has known sensitivity to etelcalcetide or excipients to be administered during dosing.
* Participant likely to not be available to complete all protocol-required trial visits or procedures, and/or to comply with all required trial procedures (eg, to the best of the participant and investigator's knowledge).
* History or evidence of any other clinically significant disorder, condition, or disease (with the exception of those outlined above) that, in the opinion of the investigator or Amgen physician, if consulted, would pose a risk to participant safety or interfere with the trial evaluation, procedures, or completion.
* Participant has previously entered this trial.
Primary outcome measure(s)
Percentage of Participants Achieving a ≥ 30% Reduction from Baseline in Mean iPTH During the Efficacy Assessment Period (EAP) — Baseline and Weeks 20-27 Achievement of at least a 30% reduction from baseline in mean iPTH during the EAP (defined as weeks 20 through 27).
Percentage Change from Baseline in Mean iPTH During the EAP — Baseline and Weeks 20-27 Percent Change from Baseline in Mean iPTH During EAP (defined as weeks 20 through 27).
Trial sites (43)
Facility
City
Region
Status
Childrens Hospital of Los Angeles
Los Angeles
California
Recruiting
Childrens Hospital Colorado
Aurora
Colorado
Terminated
Childrens Mercy Hospital
Kansas City
Missouri
Recruiting
Mount Sinai Kidney Center - B1 Renal Treatment
New York
New York
Completed
Cincinnati Childrens Hospital Medical Center
Cincinnati
Ohio
Completed
Cleveland Clinic Foundation
Cleveland
Ohio
Recruiting
The Childrens Hospital at Oklahoma University Medical Center
Oklahoma City
Oklahoma
Completed
Childrens Hospital of Philadelphia
Philadelphia
Pennsylvania
Recruiting
Childrens Medical Center Dallas
Dallas
Texas
Terminated
Primary Childrens Hospital Outpatient Services
Salt Lake City
Utah
Recruiting
Fresenius Escobar
Belen de Escobar
Buenos Aires
Terminated
Hospital Italiano
Cuidad Autonoma de Buenos Aires
Buenos Aires
Recruiting
Centro Infantil Del Rinon
San Miguel de Tucumán
Tucumán Province
Recruiting
Manipal Hospital
Bangalore
Karnataka
Active Not Recruiting
KLES Dr Prabhakar Kore Hospital and Medical Research Centre
Belagavi
Karnataka
Active Not Recruiting
Fortis Flt Lt Rajan Dhall Hospital
New Delhi
National Capital Territory of Delhi
Active Not Recruiting
All India Institute of Medical Sciences
New Delhi
National Capital Territory of Delhi
Active Not Recruiting
Sir Ganga Ram Hospital
New Delhi
National Capital Territory of Delhi
Active Not Recruiting
NRS Medical College and Hospital
Kolkata
West Bengal
Active Not Recruiting
Hospital Raja Perempuan Zainab II
Kota Bharu
Kelantan
Terminated
Hospital Wanita Dan Kanak-Kanak Kuala Lumpur
Kuala Lumpur
Kuala Lumpur
Terminated
Hospital TuanKu Jaafar
Seremban
Negeri Sembilan
Terminated
SBHI Pediatrics city clinical hospital of Saint Vladimir
Moscow
Russia
Terminated
SBHI Children's City Multidisciplinary Clinical Specialized Center of High Medical Technologies
Saint Petersburg
Russia
Completed
State Budgetary Healthcare Institution Samara Regional Clinical Hospital na V D Seredavin
Samara
Russia
Terminated
National University Hospital
Singapore
Singapore
Recruiting
Asan Medical Center
Seoul
South Korea
Terminated
Seoul National University Hospital
Seoul
South Korea
Terminated
Pusan National University Yangsan Hospital
Yangsan-si, Gyeongsangnam-do
South Korea
Terminated
Kaohsiung Veterans General Hospital
Kaohsiung City
Taiwan
Terminated
National Cheng Kung University Hospital
Tainan
Taiwan
Terminated
National Taiwan University Hospital
Taipei
Taiwan
Recruiting
Linkou Chang Gung Memorial Hospital
Taoyuan
Taiwan
Recruiting
Hacettepe Universitesi Tip Fakultesi Hastanesi
Ankara
Turkey (Türkiye)
Recruiting
Baskent Universitesi Ankara Hastanesi
Ankara
Turkey (Türkiye)
Recruiting
Gazi Universitesi Saglik Arastirma ve Uygulama Merkezi Gazi Hastanesi
Ankara
Turkey (Türkiye)
Recruiting
Ankara Bilkent Sehir Hastanesi
Ankara
Turkey (Türkiye)
Recruiting
Firat Universitesi Tip Fakultesi Hastanesi
Elâzığ
Turkey (Türkiye)
Recruiting
Istanbul Universitesi Cerrahpasa Tip Fakultesi
Istanbul
Turkey (Türkiye)
Recruiting
Marmara Universitesi Tip Fakultesi Hastanesi
Istanbul
Turkey (Türkiye)
Recruiting
+ 3 more sites — see the full list on the official registry below.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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