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CompletedNCT02858726Updated Jul 29, 2020Results posted

Study to Evaluate IV CR845 in Hemodialysis Patients With Moderate-to-Severe Pruritus

A Phase 2/3 interventional study of CR845 0.5 mcg/kg and CR845 1 mcg/kg in Uremic Pruritus, sponsored by Cara Therapeutics, Inc.. Completed at 29 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-07-29.

Sponsored by Cara Therapeutics, Inc. · Phase 2/3, Interventional, and Treatment

Phase
Phase 2/3
Study type
Interventional
Enrollment
226
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

2 Part Study: Part A will assess 3 different dosing levels of IV CR845 versus placebo in patient on hemodialysis who have moderate-to-severe itching due to uremic pruritus. Patients will receive either CR845 or placebo after each dialysis session for eight weeks. The safety and efficacy of CR845 will be monitored throughout the study. A sub-group of patients will also have pharmacokinetic assessments completed. Part B of the study will assess one dose of IVCR845 versus placebo for 12 weeks in patients on hemodialysis who have moderate-to-severe itching. The dose of CR845 used in Part B will be based on safety and efficacy found in Part A.

Read the detailed description

This is a two-part study. Patients participating in Part A will be consented and trained on the completion of questionnaires about the severity of itching and overall health. Patients will be required to complete questionnaires during their visits to the dialysis center and also while at home on other days. Results of the screening questionnaires will assess eligibility for the study. Additional laboratory tests and measurements for safety will also be completed during the screening period. Patients meeting all criteria for entry into Part A of the study will be randomized to receive either one of three different doses of CR845 or a placebo. Patients will receive the study drug for eight weeks IV after each hemodialysis treatment (i.e. 3 times per week). Assessments for intensity of itch and safety will also be completed during the 8 week treatment period. When patients have completed treatment, a Follow-up visit will be completed 7 days later.

Patients participating in Part B will be consented and trained on the completion of questionnaires about itching and overall health. Patients will be required to complete questionnaires during their visits to the dialysis center and also while at home on other days. Laboratory tests and measurements for safety will also be completed during the screening period to determine study eligibility. Patients meeting all criteria for entry into Part B of the study will be randomized to receive either CR845 or a placebo. The dose of CR845 used will have been determined based on the safety and efficacy from Part A. Patients will be dosed with either CR845 or placebo for twelve weeks after each hemodialysis treatment (i.e. 3 times per week). Assessments for intensity of itch and safety will be completed during the treatment period also. When patients have completed treatment, a Follow-up visit will be completed 7 days later.

02

Conditions studied

  • Uremic Pruritus

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Keywords

  • Hemodialysis
  • CR845
  • Kappa opioid
  • Anti-itch
  • difelikefalin
03

In context

Pruritus

354 studies on the registry are indexed under Pruritus; 74 are open to participants now.

This study's enrollment of 226 is above the median of 60 across 294 interventional studies indexed under Pruritus.

Browse Pruritus studies →

Lead sponsor

Cara Therapeutics, Inc. is the lead sponsor of 24 studies on the registry; none are open to participants now.

Of its 15 completed or terminated interventional studies of FDA-regulated products, 5 (33%) have results posted.

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. Willing and able to provide written informed consent prior to participating in this study;
  2. Able to communicate clearly with the Investigator and staff, able to read, complete questionnaires, and understand the study procedures;
  3. Males or females 18 years of age or older;
  4. ESRD patients who have been on hemodialysis 3 times per week for at least 3 months prior to the start of Screening;
  5. Women of child-bearing potential must have a negative serum pregnancy test and agree to practice an acceptable form of birth control for the duration of the study
  6. Male patients that are not biologically or surgically sterile must agree to practice an acceptable from of birth control for the duration of the study
  7. Weigh between 88.2 lb (40.0 kg) and 297.6 lb (135.0 kg).
  8. Patient must self-report pruritus in the month prior to screening.
  9. If patient is receiving treatment for itch, this treatment must be stable prior to screening and during treatment period.
  10. At least 2 single-pool Kt/V measurements ≥ 1.2, or at least 2 urea reduction ratio measurements ≥ 65%, or 1 single-pool Kt/V measurement ≥ 1.2 and 1 urea reduction ratio measurement ≥ 65% on different dialysis days during the 3 months period prior to Screening;
  11. Patient who self-categorize as moderate-to-severe itch.

Exclusion criteria

Exclusion Criteria:

  1. Known to be non-compliant with dialysis treatment (i.e., has missed more than 2 dialysis sessions in the past 2 months because of non-compliance);
  2. Anticipated to receive a kidney transplant during the study;
  3. Known history of allergic reaction to opiates, such as hives
  4. Known or suspected history of alcohol, narcotic, or other drug abuse or dependence within 12 months prior to Screening;
  5. Patient has any clinically relevant acute or chronic medical or neuropsychiatric condition which, in the opinion of the Investigator, would pose undue risk to the patient, would impede completion of the study procedures, or would compromise the validity of the study measurements;
  6. Serum alanine aminotransferase or aspartate aminotransferase greater than 2.5 times the reference upper limit of normal (ULN), or total bilirubin greater than 2 times ULN at Screening;
  7. Received another investigational drug within 30 days prior to the start of Screening or has planned to participate in another clinical trial while enrolled in this study;
  8. Has pruritus probably or definitely attributed to a cause other than ESRD or its complications (e.g., patients with concomitant pruritic dermatological disease or cholestatic liver disease would be excluded). (Note: Patients whose pruritus is attributed to ESRD complications such as hyperparathyroidism, hyperphosphatemia, anemia, or the dialysis procedure or prescription may be enrolled);
  9. Has localized itch restricted to the palms of the hands;
  10. Has pruritus only during the dialysis session (by patient report);
  11. Anticipated to receive opioid antagonists (e.g., naloxone, naltrexone), or opioid mixed agonist-antagonist (e.g., buprenorphine, nalbuphine) from the start of Screening through the end of the Treatment Period;
  12. Used Salvia divinorum or Salvinorin A within 30 days prior to the start of Screening or is anticipated to use it during the study;
  13. Received ultraviolet B treatment within 30 days prior to the start of Screening or anticipated to receive such treatment during the study;
  14. Participated in a previous clinical trial with CR845.
05

Study design

Phase
Phase 2 / Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
226 participants (actual)

Study arms

  • Experimental
    CR845 0.5mcg/kg

    Part A of study: IV CR845 0.5 mcg/kg administered after each dialysis session (3 times/week)

    Drug: CR845 0.5 mcg/kg

  • Experimental
    CR845 1 mcg/kg

    Part A of study: IV CR845 1 mcg/kg administered after each dialysis session (3 times/week)

    Drug: CR845 1 mcg/kg

  • Experimental
    CR845 1.5mcg/kg

    Part A of study: IV CR845 1.5 mcg/kg administered after each dialysis session (3 times/week)

    Drug: CR845 1.5mcg/kg

  • Placebo comparator
    Placebo

    Part A of study: IV Placebo administered after each dialysis session (3 times/week)

    Drug: Placebo

Interventions

  • DrugCR845 0.5 mcg/kg

    IV medication delivered three times/week

    Also known as: CR845

  • DrugCR845 1 mcg/kg

    IV medication delivered three times/week

    Also known as: CR845

  • DrugCR845 1.5mcg/kg

    IV medication delivered three times/week

    Also known as: CR845

  • DrugPlacebo

    IV medication delivered three times/week

06

What researchers measure

Primary outcomes

  1. Change From Baseline in the Weekly Mean of the Daily 24-hour Worst Itching Intensity NRS Score During Week 8

    Intensity of itch was measured using a numerical rating scale (NRS) used to indicate the intensity of the worst itching over the past 24 hours using a 0 to 10 numeric rating scale, where "0" represents "no itching" and "10" represents "worst itching imaginable". Higher scores meant worse itch intensity.

    Time frame: Baseline, Week 8

Secondary outcomes

  1. Improvement in Itch-related Quality of Life as Assessed by the Change From Baseline in Total Skindex-10 Scale Score at the End of Week 8

    The Skindex-10 Scale is a multidimensional questionnaire which assesses itch-related quality of life over the past week. The questions cover 3 domains: disease, mood/emotional distress, and social functioning domain. A lower total score represents better quality of life. The minimum score is 0 and the maximum score is 60 (or total score can range from 0 to 60) with a higher score meaning a worse quality of life.

    Time frame: Baseline, Week 8

07

Results

Posted Jul 29, 2020

Participant flow

Participant flow — Overall Study
MilestoneCR845 0.5mcg/kgCR845 1 mcg/kgCR845 1.5mcg/kgPlacebo
Started44424445
Completed39353342
Not completed57113
Withdrew: Adverse event4491
Withdrew: Physician decision0010
Withdrew: Protocol violation0001
Withdrew: Study terminated by sponsor0001
Withdrew: Withdrawal by subject1210
Withdrew: Noncompliance0100

Outcome measures

PrimaryChange From Baseline in the Weekly Mean of the Daily 24-hour Worst Itching Intensity NRS Score During Week 8

Intensity of itch was measured using a numerical rating scale (NRS) used to indicate the intensity of the worst itching over the past 24 hours using a 0 to 10 numeric rating scale, where "0" represents "no itching" and "10" represents "worst itching imaginable". Higher scores meant worse itch intensity.

Time frame:
Baseline, Week 8
Reported as:
Least squares mean · score on a scale
Change From Baseline in the Weekly Mean of the Daily 24-hour Worst Itching Intensity NRS Score During Week 8
score on a scaleCR845 0.5mcg/kgCR845 1 mcg/kgCR845 1.5mcg/kgPlacebo
Change From Baseline in the Weekly Mean of the Daily 24-hour Worst Itching Intensity NRS Score During Week 8-3.8 ± 0.4-2.8 ± 0.4-3.2 ± 0.4-1.9 ± 0.4
Statistical analysis
  • CR845 0.5mcg/kg vs Placebo · Mixed Models Analysis · p = <0.001 · Mean difference (final values): -1.8 · 95% CI -2.8 to -0.8MMRM with effects for treatment, visit, treatment by visit interaction, and covariates for prior anti-itch medication usage and baseline score.
  • CR845 1 mcg/kg vs Placebo · Mixed Models Analysis · p = 0.107 · Mean difference (final values): -0.8 · 95% CI -1.9 to 0.2MMRM with effects for treatment, visit, treatment by visit interaction, and covariates for prior anti-itch medication usage and baseline score.
  • CR845 1.5mcg/kg vs Placebo · Mixed Models Analysis · p = 0.019 · Median difference (final values): -1.2 · 95% CI -2.3 to -0.2MMRM with effects for treatment, visit, treatment by visit interaction, and covariates for prior anti-itch medication usage and baseline score.
SecondaryImprovement in Itch-related Quality of Life as Assessed by the Change From Baseline in Total Skindex-10 Scale Score at the End of Week 8

The Skindex-10 Scale is a multidimensional questionnaire which assesses itch-related quality of life over the past week. The questions cover 3 domains: disease, mood/emotional distress, and social functioning domain. A lower total score represents better quality of life. The minimum score is 0 and the maximum score is 60 (or total score can range from 0 to 60) with a higher score meaning a worse quality of life.

Time frame:
Baseline, Week 8
Reported as:
Least squares mean · score on a scale
Improvement in Itch-related Quality of Life as Assessed by the Change From Baseline in Total Skindex-10 Scale Score at the End of Week 8
score on a scaleCR845 0.5mcg/kgCR845 1 mcg/kgCR845 1.5mcg/kgPlacebo
Improvement in Itch-related Quality of Life as Assessed by the Change From Baseline in Total Skindex-10 Scale Score at the End of Week 8-18.7 ± 2.0-15.5 ± 2.2-15.1 ± 2.3-8.2 ± 2.0
Statistical analysis
  • CR845 0.5mcg/kg vs Placebo · Mixed Models Analysis · p = <0.001 · Mean difference (final values): -10.4 · 95% CI -16.0 to -4.8MMRM with effects for treatment, visit, treatment by visit interaction, and covariates for prior anti-itch medication usage and baseline score.
  • CR845 1 mcg/kg vs Placebo · Mixed Models Analysis · p = 0.016 · Mean difference (final values): -7.2 · 95% CI -13.1 to -1.4MMRM with effects for treatment, visit, treatment by visit interaction, and covariates for prior anti-itch medication usage and baseline score.
  • CR845 1.5mcg/kg vs Placebo · Mixed Models Analysis · p = 0.026 · Mean difference (final values): -6.8 · 95% CI -12.8 to -0.8MMRM with effects for treatment, visit, treatment by visit interaction, and covariates for prior anti-itch medication usage and baseline score.

Adverse events

Collected over The period of adverse event reporting started after the signing of the ICF through the study follow-up visit or early termination visit (or 7 days after the last dose if no early termination visit was conducted).. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
CR845 0.5mcg/kg1/44 (2.3%)10/44 (22.7%)22/44 (50%)
CR845 1 mcg/kg0/41 (0%)6/41 (14.6%)16/41 (39%)
CR845 1.5mcg/kg2/44 (4.5%)11/44 (25%)18/44 (40.9%)
Placebo1/45 (2.2%)4/45 (8.9%)3/45 (6.7%)
Most frequent serious events
Showing 10 of 47
Most frequent serious events
EventCR845 0.5mcg/kgCR845 1 mcg/kgCR845 1.5mcg/kgPlacebo
Abdominal PainGastrointestinal disorders3/440/410/440/45
Mental status changesPsychiatric disorders0/440/413/440/45
SeizureNervous system disorders0/440/412/440/45
Chest painGeneral disorders1/440/411/442/45
NauseaGastrointestinal disorders0/441/410/440/45
VomitingGastrointestinal disorders0/441/410/440/45
DiarrhoeaGastrointestinal disorders0/441/411/440/45
Cerebrovascular accidentNervous system disorders0/441/410/440/45
DizzinessNervous system disorders0/441/410/440/45
ColitisGastrointestinal disorders0/441/410/440/45
Most frequent other events
Showing 10 of 13
Most frequent other events
EventCR845 0.5mcg/kgCR845 1 mcg/kgCR845 1.5mcg/kgPlacebo
DiarrhoeaGastrointestinal disorders7/443/414/440/45
DizzinessNervous system disorders6/443/412/442/45
HeadacheNervous system disorders0/445/410/441/45
NauseaGastrointestinal disorders5/441/413/440/45
SomnolenceNervous system disorders2/442/415/441/45
FallInjury, poisoning and procedural complications3/442/412/440/45
HyperglycaemiaMetabolism and nutrition disorders3/441/411/440/45
ParaesthesiaNervous system disorders1/442/413/440/45
FatigueGeneral disorders1/441/413/440/45
HyperkalaemiaMetabolism and nutrition disorders3/441/411/440/45

Baseline characteristics

Age, Continuous
Age, Continuous(years)CR845 0.5mcg/kgCR845 1 mcg/kgCR845 1.5mcg/kgPlaceboTotal
Mean57.9 (29 to 80)58.2 (26 to 84)54.1 (29 to 74)59.0 (27 to 84)57.3 (26 to 84)
Sex: Female, Male
Sex: Female, Male(Participants)CR845 0.5mcg/kgCR845 1 mcg/kgCR845 1.5mcg/kgPlaceboTotal
Female1818161769
Male26232828105
Race (NIH/OMB)
Race (NIH/OMB)(Participants)CR845 0.5mcg/kgCR845 1 mcg/kgCR845 1.5mcg/kgPlaceboTotal
American Indian or Alaska Native10124
Asian20114
Native Hawaiian or Other Pacific Islander00101
Black or African American24223125102
White1719101662
More than one race00000
Unknown or Not Reported00011
08

Study locations

29 sites
  • Cara Therapeutics Investigator Site
    Phoenix, Arizona 85035, United States
  • Cara Therapeutics Study Site
    Pine Bluff, Arkansas 71603, United States
  • Cara Therapeutics Investigator Site
    Long Beach, California 90806, United States
  • Cara Therapeutics Study Site
    Northridge, California 91324, United States
  • Cara Therapeutics Study Site
    Whittier, California 90603, United States
  • Cara Therapeutics Study Site
    Denver, Colorado 80218, United States
  • Cara Therapeutics Study Site
    Hollywood, Florida 33024, United States
  • Cara Therapeutics Study Site
    Tampa, Florida 33614, United States
  • Cara Therapeutics Study Site
    Winter Park, Florida 32789, United States
  • Cara Therapeutics Study Site
    Augusta, Georgia 30909, United States
  • Cara Therapeutics Study Site
    Meridian, Idaho 83642, United States
  • Cara Therapetics Study Site
    Creve Coeur, Missouri 63141, United States
  • Cara Therapeutics Study Site
    Kansas City, Missouri 64111, United States
  • Cara Therapeutics Study Site
    Kansas City, Missouri 64131, United States
  • Cara Therapeutics Study Site
    Omaha, Nebraska 68124, United States
  • Cara Therapetics Investigator Site
    Albuquerque, New Mexico 87109, United States
  • Cara Therapeutics Study Site
    Gallup, New Mexico 87301, United States
  • Cara Therapeutics Study Site
    College Point, New York 11385, United States
  • Cara Therapeutics Investigator Site
    Mineola, New York 11501, United States
  • Cara Therapeutics Investigator Site
    Wilmington, North Carolina 28401, United States
  • Cara Therapeutics Study Site
    Winston-Salem, North Carolina 27103, United States
  • Cara Therapeutics Study Site
    Bethlehem, Pennsylvania 18017, United States
  • Cara Therapeutics Investigator Site
    Philadelphia, Pennsylvania 19140, United States
  • Cara Therapeutics Study Site
    Chattanooga, Tennessee 37408, United States
  • Cara Therapetics Study Site
    Knoxville, Tennessee 37920, United States
  • Cara Therapeutics Study Site
    San Antonio, Texas 78221, United States
  • Cara Therapeutics Study Site
    San Antonio, Texas 78229, United States
  • Cara Therapeutics Study Site
    San Antonio, Texas 78251, United States
  • Cara Therapeutics Study Site
    Milwaukee, Wisconsin 53226, United States
09

References and documents

Publications

  • Hercz D, Jiang SH, Webster AC. Interventions for itch in people with advanced chronic kidney disease. Cochrane Database Syst Rev. 2020 Dec 7;12(12):CD011393. doi: 10.1002/14651858.CD011393.pub2. PubMed 33283264 ↗

Study documents

  • Study protocol · May 19, 2016
  • Statistical analysis plan · Feb 22, 2017

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Undecided

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 29, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT02858726
Lead sponsor
Cara Therapeutics, Inc.
Responsible party
Sponsor
First posted
Aug 8, 2016
Start date
Jun 2016
Primary completion
Mar 14, 2017
Completion
Mar 14, 2017
Results posted
Jul 29, 2020
Last update
Jul 29, 2020

Study contacts

Frederique Menzaghi, PhD
study director · Cara Therapeutics

Oversight

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

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