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CompletedNCT00994318FIND-CKDUpdated May 20, 2014Results posted

Ferric Carboxymaltose (FCM) Assessment in Subjects With Iron Deficiency Anaemia and Non-dialysis-dependent Chronic Kidney Disease (NDD-CKD)

A Phase 3 interventional study of FCM (Ferric carboxymaltose) high ferritin target and FCM (Ferric carboxymaltose) low ferritin target in Iron Deficiency Anaemia and Chronic Kidney Disease, sponsored by Vifor Pharma. Completed at 19 sites in 19 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2014-05-20.

Sponsored by Vifor Pharma · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
626
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Phase IIIb study to evaluate the long-term efficacy of ferric carboxymaltose (FCM) (using targeted ferritin levels to determine dosing) or oral iron in non-dialysis-dependent chronic kidney disease (NDD-CKD) subjects with iron deficiency anaemia (IDA).

Read the detailed description

After an initial screening period of up to 4 weeks, eligible subjects were randomised (1:1:2) to 1 of the following 3 treatment arms for a period of 52 weeks.

  1. FCM regimen (maximum single intravenous doses of 1,000 mg of iron) targeting a ferritin level of 400-600 mcg/L.
  2. FCM regimen (maximum single intravenous doses of 200 mg of iron) targeting a ferritin level of 100-200 mcg/L.
  3. Daily oral iron with 200 mg iron/day (100 mg twice daily)
02

Conditions studied

  • Iron Deficiency Anaemia
  • Chronic Kidney Disease

Keywords

  • Ferinject Iron Deficiency Anaemia Chronic Kidney Disease
03

In context

Kidney Diseases

3,840 studies on the registry are indexed under Kidney Diseases; 500 are open to participants now.

This study's enrollment of 626 is above the median of 70 across 2,640 interventional studies indexed under Kidney Diseases.

Browse Kidney Diseases studies →

Lead sponsor

Vifor Pharma is the lead sponsor of 21 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. At least 18 years of age.
  2. NDD-CKD subjects with an estimated glomerular filtration rate (eGFR) ≤60 mL/min/1.73 m2 using modification of diet in renal disease 4 (MDRD-4) calculation.
  3. NDD-CKD subjects with an eGFR loss ≤12 mL/min/1.73 m2/year and a predicted eGFR of ≥15 mL/min/1.73 m2 in 12 months.
  4. Any single Hb between 9 and 11 g/dL within 4 weeks of randomisation. A value taken as part of routine medical care was used.
  5. Any single serum ferritin \<100 mcg/L or \<200 mcg/L with TSAT \<20% within 4 weeks of randomisation. Measurements taken as part of routine medical care were used.
  6. ESA naïve; no exposure to ESA in last 4 months prior to randomisation.
  7. Females of childbearing potential must have had a negative pregnancy test, using any medically acceptable assessment, prior to randomisation.
  8. Before any study specific procedure, the appropriate written informed consent must have been obtained.

Exclusion criteria

Exclusion Criteria:

  1. History of acquired iron overload.
  2. Known hypersensitivity reaction to any component of ferrous sulphate or FCM. Subjects with hypersensitivity to other forms of iron were permitted to participate.
  3. Documented history of discontinuing oral iron products due to significant gastrointestinal (GI) distress.
  4. Screening TSAT >40%.
  5. Known active infection, C-reactive protein >20 mg/L, clinically significant overt bleeding, active malignancy (i.e., clinical evidence of current malignancy or not in stable remission for at least 5 years since completion of last treatment with exception of basal cell or squamous cell carcinoma of the skin, and cervical intraepithelial neoplasia).
  6. History of chronic alcohol abuse (alcohol consumption >40 g/day).
  7. Chronic liver disease and/or screening alanine transaminase or aspartate transaminase above 3 times the upper limit of the normal range.
  8. Active human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome or active hepatitis B or C virus infection.
  9. Anaemia due to reasons other than iron deficiency (e.g., haemoglobinopathy). Subjects with treated Vitamin B12 or folic acid deficiency were permitted.
  10. IV iron and/or blood transfusion in previous 30 days prior to screening (or during the screening period).
  11. Oral iron therapy at doses >100 mg/day dosing must have been discontinued at least 1 week prior to randomisation. If subject had received this therapy for >3 months (at doses >100 mg/day) then subject was not eligible. Ongoing use of multivitamins containing iron was permitted.
  12. Immunosuppressive therapy that may have led to anaemia (e.g., cyclophosphamide, azathioprine, or mycophenolate mofetil). Steroid therapy was permitted.
  13. Currently requiring renal dialysis.
  14. Anticipated dialysis or transplant during the study.
  15. Anticipated need for surgery that may have resulted in significant bleeding (>100 mL).
  16. Currently suffering from chronic heart failure New York Heart Association Class IV.
  17. Poorly controlled hypertension (>160 mmHg systolic pressure or >100 mmHg diastolic pressure).
  18. Acute coronary syndrome or stroke within the 3 months prior to screening.
  19. Currently suffering from concomitant, severe psychiatric disorders or other conditions which, in the opinion of the Investigator, would have made participation unacceptable.
  20. Subject was not using adequate contraceptive precautions.
  21. Subject of childbearing potential was evidently pregnant (e.g., positive human chorionic gonadotropin test) or was breast feeding.
  22. Body weight \<35 kg.
  23. Subject currently was enrolled in or had not yet completed at least 30 days since ending other investigational device or drug studies, or subject was receiving other investigational agent(s).
  24. Subject would not be available for follow-up assessment.
  25. Subject had any kind of disorder that compromised the ability of the subject to give written informed consent and/or to comply with study procedures.
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
626 participants (actual)

Study arms

  • Experimental
    FCM (high ferritin target)

    Ferric carboxymaltose (FCM) (Ferinject / Injectafer) targeting ferritin level of 400 - 600 mcg/L

    Drug: FCM (Ferric carboxymaltose) high ferritin target

  • Experimental
    FCM (low ferritin target)

    Ferric carboxymaltose (FCM) (Ferinject / Injectafer) targeting ferritin level of 100 - 200 mcg/L

    Drug: FCM (Ferric carboxymaltose) low ferritin target

  • Active comparator
    Oral Iron

    Ferrous sulphate 100 mg iron twice daily, continuous

    Drug: Oral Iron (Ferrous sulphate)

Interventions

  • DrugFCM (Ferric carboxymaltose) high ferritin target

    Also known as: Ferinject, Injectafer

  • DrugFCM (Ferric carboxymaltose) low ferritin target

    Also known as: Ferinject, Injectafer

  • DrugOral Iron (Ferrous sulphate)

    Also known as: Ferrous sulphate

06

What researchers measure

Primary outcomes

  1. Kaplan-Meier Survival Analysis for Time to Other Anemia Therapy or Hb Trigger

    Endpoint reported number of participants with/without events and was reached: * First time of initiation of additional or alternative anaemia management, * First time the subject reached the Hb trigger. 3 primary comparisons using a hierarchical step-down procedure on the log-rank test to preserve an alpha level of 0.05, performed in the following order: 1. FCM (high ferritin target) compared with oral iron. 2. FCM (high ferritin target) compared with FCM (low ferritin target). 3. FCM (low ferritin target) compared with oral iron. Sensitivity analyses of the primary endpoint were performed using the following alternative definitions of time to initiation of additional or alternative anaemia management: 1. Without taking into account the Hb trigger. 2. Taking into account the Hb trigger based on local laboratory data, instead of central laboratory data. 3. Taking into account the Hb trigger based on subjects with a complete set of Hb values from the central laboratory.

    Time frame: Up to 1 year after baseline

07

Results

Posted May 7, 2014
Limitations and caveats
Initially 1,016 subjects were planned, but due to slow enrollment only 626 were randomised which was sufficient to make the primary comparison between FCM targeting high ferritin level and oral iron.

Participant flow

Participant flow — Overall Study
MilestoneFCM (High Ferritin Target)FCM (Low Ferritin Target)Oral Iron
Started155154317
Completed133136250
Not completed221867

Outcome measures

PrimaryKaplan-Meier Survival Analysis for Time to Other Anemia Therapy or Hb Trigger

Endpoint reported number of participants with/without events and was reached: * First time of initiation of additional or alternative anaemia management, * First time the subject reached the Hb trigger. 3 primary comparisons using a hierarchical step-down procedure on the log-rank test to preserve an alpha level of 0.05, performed in the following order: 1. FCM (high ferritin target) compared with oral iron. 2. FCM (high ferritin target) compared with FCM (low ferritin target). 3. FCM (low ferritin target) compared with oral iron. Sensitivity analyses of the primary endpoint were performed using the following alternative definitions of time to initiation of additional or alternative anaemia management: 1. Without taking into account the Hb trigger. 2. Taking into account the Hb trigger based on local laboratory data, instead of central laboratory data. 3. Taking into account the Hb trigger based on subjects with a complete set of Hb values from the central laboratory.

Time frame:
Up to 1 year after baseline
Reported as:
Number · participants
Kaplan-Meier Survival Analysis for Time to Other Anemia Therapy or Hb Trigger
participantsFCM (High Ferritin Target)FCM (Low Ferritin Level)Oral Iron
Number of patients with events36 ± 7.6549 ± 9.4798 ± 7.71
Number of patients without events117103210
Statistical analysis
  • FCM (High Ferritin Target) vs Oral Iron · Log Rank · p = 0.026 · Hazard ratio (hr): 0.65 · 95% CI 0.44 to 0.95
  • FCM (High Ferritin Target) vs FCM (Low Ferritin Level) · Log Rank · p = 0.082 · Hazard ratio (hr): 0.68 · 95% CI 0.45 to 1.05
  • FCM (High Ferritin Target) vs Oral Iron · Log Rank · p = 0.020 · Hazard ratio (hr): 0.60 · 95% CI 0.39 to 0.93
  • FCM (High Ferritin Target) vs FCM (Low Ferritin Level) · Log Rank · p = 0.008 · Hazard ratio (hr): 0.62 · 95% CI 0.43 to 0.88
  • FCM (High Ferritin Target) vs Oral Iron · Log Rank · p = 0.12 · Hazard ratio (hr): 0.70 · 95% CI 0.45 to 1.10

Adverse events

Collected over Adverse Event data was collected for 56 weeks after baseline.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
FCM (High Ferritin Target)—39/154 (25.3%)126/154 (81.8%)
FCM (Low Ferritin Target)—36/150 (24%)129/150 (86%)
Oral Iron—59/312 (18.9%)255/312 (81.7%)
Most frequent serious events
Showing 10 of 134
Most frequent serious events
EventFCM (High Ferritin Target)FCM (Low Ferritin Target)Oral Iron
Diabetes MellitusMetabolism and nutrition disorders0/1543/1501/312
Renal Failure ChronicRenal and urinary disorders1/1541/1506/312
HypoglycaemiaMetabolism and nutrition disorders1/1541/1505/312
Chronic Obstructive Pulmonary DiseaseRespiratory, thoracic and mediastinal disorders0/1542/1502/312
AnaemiaBlood and lymphatic system disorders1/1542/1501/312
Acute Myocardial InfarctionCardiac disorders2/1540/1504/312
Cardiac Failure CongestiveCardiac disorders2/1541/1501/312
Acute Coronary SyndromeCardiac disorders2/1540/1501/312
Back PainMusculoskeletal and connective tissue disorders2/1541/1500/312
PneumoniaInfections and infestations0/1541/1504/312
Most frequent other events
Showing 10 of 17
Most frequent other events
EventFCM (High Ferritin Target)FCM (Low Ferritin Target)Oral Iron
DiarrhoeaGastrointestinal disorders15/15411/15045/312
Oedema PeripheralGeneral disorders21/15421/15029/312
HypertensionVascular disorders21/15414/15032/312
ConstipationGastrointestinal disorders2/1545/15037/312
Urinary Tract InfectionInfections and infestations18/15410/15017/312
Back PainMusculoskeletal and connective tissue disorders15/15412/15011/312
NasopharyngitisInfections and infestations13/15410/15016/312
DyspnoeaRespiratory, thoracic and mediastinal disorders7/15411/15011/312
HeadacheNervous system disorders6/15410/1507/312
ArthralgiaMusculoskeletal and connective tissue disorders10/1547/15015/312

Baseline characteristics

Baseline analysis population is the Full Analysis Set (FAS); all subjects randomised to treatment, received at least 1 dose study drug or, per protocol, not treated due to ferritin \<100 mcg/L, and attended at least 1 post-baseline visit with at least 1 non-missing assessment. Overall 626 subjects were randomised, the FAS consists of 613 subjects.

Age, Categorical
Age, Categorical(Participants)FCM (High Ferritin TargetFCM (Low Ferritin Target)Oral IronTotal
<=18 years0000
Between 18 and 65 years414992182
>=65 years112103216431
Age, Continuous
Age, Continuous(years)FCM (High Ferritin TargetFCM (Low Ferritin Target)Oral IronTotal
Mean69.46 ± 12.64368.19 ± 13.26469.31 ± 13.40469.07 ± 13.172
Sex: Female, Male
Sex: Female, Male(Participants)FCM (High Ferritin TargetFCM (Low Ferritin Target)Oral IronTotal
Female9198192381
Male6254116232
Race (NIH/OMB)
Race (NIH/OMB)(Participants)FCM (High Ferritin TargetFCM (Low Ferritin Target)Oral IronTotal
American Indian or Alaska Native0000
Asian23914
Native Hawaiian or Other Pacific Islander0011
Black or African American25714
White149144291584
More than one race0000
Unknown or Not Reported0000
Region of Enrollment
Region of Enrollment(participants)FCM (High Ferritin TargetFCM (Low Ferritin Target)Oral IronTotal
United States43714
Portugal2259
Greece282855111
Turkey771529
Austria2248
United Kingdom17183671
Italy10101939
France1034
Czech Republic16153162
Belgium33410
Poland11112042
Romania2248
Australia15163162
Denmark1124
Germany262549100
Netherlands44816
Norway0145
Sweden0011
Spain441018
08

Study locations

19 sites
  • Trial Management Associates
    Wilmington, North Carolina 28401, United States
  • Gosford Hospital - Renal Research
    Gosford, 2250, Australia
  • Medizinische Universität Innsbruck Univ.-Klinik für Innere Medizin IV
    Innsbruck, 6020, Austria
  • RHMS Baudour - Department of Nephrology and Dialysis
    Baudour, 7331, Belgium
  • Nemocnice s poliklinikou v Novem Jicine, p.o. p.o. Interni oddeleni - nefrologie a dialyza
    Novy Jicin, 74101, Czech Republic
  • Lillebalt Frederica Sygehus Department of Nephrology
    Frederica, 7000, Denmark
  • CHU grenoble - Service de Nephrologie
    Grenoble Cedex, 38043, France
  • Praxis Dr. Kraatz
    Demmin, 17109, Germany
  • General Hospital of Arta - Nephrology Department
    Arta, 47100, Greece
  • Ospedali Riuniti Anzio-Nettuno ASL ROMA H U.O. Nefrologia e Dialisi
    Anzio, 00042, Italy
  • Meander Medisch Centrum - Locatie Amersfoort Lichtenberg
    Amersfoort, 3816 CP, Netherlands
  • St. Olav's Hospital
    Trondheim, 7006, Norway
  • Miedzyleski Szpital Spec. Oddzial I Wewnetrzny I Nefrologii
    Warszawa, 04-749, Poland
  • Hospital Santa Maria - Nefrologia
    Lisboa, 1649-035, Portugal
  • Spitalul Clinic de Nefrologie"Dr Carol Davila"
    Bucuresti, 010731, Romania
  • Hospital Universitario Marqués de Valdecilla - Servicio de Nefrología
    Santander, 39008, Spain
  • Karolinska University Hospital
    Stockholm, 141, Sweden
  • Cukurova University Medical Faculty Balcali Hospital - Department of Nephrology
    Adana, 01330, Turkey
  • King's College Hospital
    London, SE5 9RS, United Kingdom
09

References and documents

Publications

  • Roger SD, Gaillard CA, Bock AH, Carrera F, Eckardt KU, Van Wyck DB, Cronin M, Meier Y, Larroque S, Macdougall IC; FIND-CKD Study Investigators. Safety of intravenous ferric carboxymaltose versus oral iron in patients with nondialysis-dependent CKD: an analysis of the 1-year FIND-CKD trial. Nephrol Dial Transplant. 2017 Sep 1;32(9):1530-1539. doi: 10.1093/ndt/gfw264. PubMed 28339831 ↗
  • Macdougall IC, Bock AH, Carrera F, Eckardt KU, Gaillard C, Van Wyck D, Meier Y, Larroque S, Roger SD; FIND-CKD Study investigators. Renal function in patients with non-dialysis chronic kidney disease receiving intravenous ferric carboxymaltose: an analysis of the randomized FIND-CKD trial. BMC Nephrol. 2017 Jan 17;18(1):24. doi: 10.1186/s12882-017-0444-6. PubMed 28095881 ↗
  • Macdougall IC, Bock AH, Carrera F, Eckardt KU, Gaillard C, Van Wyck D, Roubert B, Nolen JG, Roger SD; FIND-CKD Study Investigators. FIND-CKD: a randomized trial of intravenous ferric carboxymaltose versus oral iron in patients with chronic kidney disease and iron deficiency anaemia. Nephrol Dial Transplant. 2014 Nov;29(11):2075-84. doi: 10.1093/ndt/gfu201. Epub 2014 Jun 2. PubMed 24891437 ↗
10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 20, 2014, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT00994318
Lead sponsor
Vifor Pharma
Collaborators
American Regent, Inc., ICON Clinical Research
Responsible party
Sponsor
First posted
Oct 14, 2009
Start date
Dec 2009
Primary completion
Feb 2013
Completion
Feb 2014
Results posted
May 7, 2014
Last update
May 20, 2014

Study contacts

Iain Macdougall
principal investigator · King's College Hospital NHS Trust

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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