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CompletedNCT05460234PORTRAYUpdated Jul 15, 2025

RAYALDEE Non Interventional Study (NIS) on Effectiveness in ND-CKD SHPT Patients

An observational study in Chronic Kidney Disease, sponsored by Vifor (International) Inc.. Completed at 16 sites in Germany. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-07-15.

Sponsored by Vifor (International) Inc. · Observational

Study type
Observational
Model
Cohort
Time perspective
Retrospective
Enrollment
110
Ages
18 Years and older
Sex
All
01

Study summary

The overall study objective is to collect real-world data on the safety and effectiveness of ERC to gradually increase 25D to the level required by Stage 3 and 4 CKD patients.

ERC (Rayaldee), a prolonged-release calcifediol (PRC) formulation, is an orally administered prohormone of active Vitamin D (1,25-dihydroxyvitamin D (1,25D)) designed to increase serum total 25D safely and to a high enough magnitude to reliably reduce elevated PTH in patients with non-dialysis chronic kidney disease (ND-CKD). Clinical studies show that ERC is an effective, well tolerated treatment for secondary hyperparathyroidism (SHPT) in ND-CKD patients with Vitamin D insufficiency or deficiency. ERC gradually raises serum 25D levels, resulting in physiologically regulated increases in serum 1,25D and sustained and progressive reductions in PTH levels, while avoiding clinically meaningful increases in serum phosphate and calcium.

To date, experience with the use of ERC results exclusively from patients from the US and mainly from patients who have participated in clinical trials. It is therefore of major interest to observe the value of ERC in daily use outside of the controlled trial settings in the US as well as in Europe. (Protocol v.2.0,06Dec2023).

Read the detailed description

Non-interventional, prospective, multicentre, cohort study. Approximately 100 patients diagnosed with ND-CKD with SHPT being treated with ERC according to the SmPC will be included.

The scheduled total study duration is 2.5 years, with a recruitment phase of approximately 1.5 years. The individual prospective observational period per patient is scheduled to last up to 12 months, or up to 18 months for pre-treated patients. The number of observational time points for an individual patient will be dependent on the individual observational period and is assumed to be approximately every 3 months.

A patient is eligible if ERC treatment initiation can coincide with the date of patient inclusion in the study or can happen up to 6 months before patient inclusion in the study. The observational period of ERC treatment will be retrospective if it occurs before study inclusion and prospective for the period after study inclusion. The decision to initiate treatment remains with the treating physician, in line with their normal standard of care, in accordance with the SMPC.

02

Conditions studied

  • Chronic Kidney Disease

Keywords

  • hyperparathyroidism
  • calcifediol
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Probability sample

Study population

The study will enrol patients from approximately 18 sites in Germany. Male or female adult patients with a diagnosis of ND-CKD and SHPT who are due to be treated with ERC according to their physicians usual standard of care and in accordance with the SMPC are eligible.

Inclusion criteria

  • Signed informed consent

    • Age ≥18 years
    • Indication for ERC treatment in accordance with the currently approved SmPC.
    • Starting ERC treatment or being on ERC treatment for a maximum of 6 months before inclusion in the study.
    • Stable kidney function in the medical judgment of the investigator

Exclusion criteria

Exclusion Criteria:

Parallel participation in an interventional study

  • Enrolment in a prior clinical trial with ERC
04

Study design

Observational model
Cohort
Time perspective
Retrospective
Enrollment
110 participants (actual)
Patient registry
No

Groups and cohorts

  • Single Cohort

    data from medical records up to 3 months prior to ERC treatment start will be retrospectively collected (if available), to provide baseline data and to serve as a basis for evaluating the treatment decision. If relevant baseline data is not available within 3 months preceding treatment start, retrospective documentation can extend to up to 6 months. The observational period of ERC (both retrospective and prospective) is scheduled up to 18 months after treatment start (Protocol v2.0,06Dec2023)

05

What researchers measure

Primary outcomes

  1. Change in 25-hydroxyvitamin D (25D) and iPTH levels

    ng/mL or nmol/L, pg/mL or pmol/L

    Time frame: From up to 6 months prior of ERC treatment start to up to 18 months after treatment

  2. Change in serum calcium level

    mg/mL or nmol/L

    Time frame: From up to 6 months prior of ERC treatment start to up to 18 months after treatment

  3. Change in serum phosphate level

    mg/mL or nmol/L

    Time frame: From up to 6 months prior of ERC treatment start to up to 18 months after treatment

06

Study locations

16 sites
  • Dialysepraxis Spandau - 01012
    Berlin, Germany
  • Tagesklinik - Lehrpraxis der Charité Dialyse - Apherese -01007
    Berlin, Germany
  • Städtisches Klinikum Braunschweig gGmbH -01006
    Braunschweig, Germany
  • Nierenzentrum Eichstätt MVZ GmbH - 01072
    Eichstätt, Germany
  • Universitätsklinik Greifswald Klinik und Poliklinik für Innere Medizin A -01066
    Greifswald, Germany
  • Marien Hospital Herne-Uniklinikum - 01003
    Herne, Germany
  • MVZ Saarpfalz GmbH - 01008
    Homburg, Germany
  • Westpfalz-Klinikum GmbH - 01025
    Kaiserslautern, Germany
  • Nephrologische Gemeinschaftspraxis Baumhackl & Rasche - 01028
    Kulmbach, Germany
  • Klinikum Landshut -01002
    Landshut, Germany
  • Universitätsklinikum Mainz - 01004
    Mainz, Germany
  • Uniklinik Münster, Nephrologische Ambulanz - 01018
    Münster, Germany
  • Universitätsklinikum Münster, Medizinische Klinik D - 01073
    Münster, Germany
  • Nephrologisches Zentrum Rendsburg-Eckernförde - 01056
    Rendsburg, Germany
  • Robert-Bosch-Krankenhaus - 01001
    Stuttgart, Germany
  • Gim - 01013
    Witten, Germany
07

References and documents

Publications

  • Petkovich M, Melnick J, White J, Tabash S, Strugnell S, Bishop CW. Modified-release oral calcifediol corrects vitamin D insufficiency with minimal CYP24A1 upregulation. J Steroid Biochem Mol Biol. 2015 Apr;148:283-9. doi: 10.1016/j.jsbmb.2014.11.022. Epub 2014 Nov 22. PubMed 25446887 ↗
  • Sprague SM, Silva AL, Al-Saghir F, Damle R, Tabash SP, Petkovich M, Messner EJ, White JA, Melnick JZ, Bishop CW. Modified-release calcifediol effectively controls secondary hyperparathyroidism associated with vitamin D insufficiency in chronic kidney disease. Am J Nephrol. 2014;40(6):535-45. doi: 10.1159/000369939. Epub 2015 Jan 7. PubMed 25572630 ↗
  • Sprague SM, Crawford PW, Melnick JZ, Strugnell SA, Ali S, Mangoo-Karim R, Lee S, Petkovich PM, Bishop CW. Use of Extended-Release Calcifediol to Treat Secondary Hyperparathyroidism in Stages 3 and 4 Chronic Kidney Disease. Am J Nephrol. 2016;44(4):316-325. doi: 10.1159/000450766. Epub 2016 Sep 28. PubMed 27676085 ↗
  • Sprague SM, Strugnell SA, Bishop CW. Extended-release calcifediol for secondary hyperparathyroidism in stage 3-4 chronic kidney disease. Expert Rev Endocrinol Metab. 2017 Sep;12(5):289-301. doi: 10.1080/17446651.2017.1347501. Epub 2017 Jul 11. PubMed 30058895 ↗
  • Strugnell SA, Sprague SM, Ashfaq A, Petkovich M, Bishop CW. Rationale for Raising Current Clinical Practice Guideline Target for Serum 25-Hydroxyvitamin D in Chronic Kidney Disease. Am J Nephrol. 2019;49(4):284-293. doi: 10.1159/000499187. Epub 2019 Mar 15. PubMed 30878999 ↗
  • Cozzolino M, Ketteler M. Evaluating extended-release calcifediol as a treatment option for chronic kidney disease-mineral and bone disorder (CKD-MBD). Expert Opin Pharmacother. 2019 Dec;20(17):2081-2093. doi: 10.1080/14656566.2019.1663826. Epub 2019 Nov 1. PubMed 31675257 ↗
  • Ketteler M, Ambuhl P. Where are we now? Emerging opportunities and challenges in the management of secondary hyperparathyroidism in patients with non-dialysis chronic kidney disease. J Nephrol. 2021 Oct;34(5):1405-1418. doi: 10.1007/s40620-021-01082-2. Epub 2021 Jun 25. PubMed 34170509 ↗
  • Cozzolino M, Minghetti P, Navarra P. Extended-release calcifediol in stage 3-4 chronic kidney disease: a new therapy for the treatment of secondary hyperparathyroidism associated with hypovitaminosis D. J Nephrol. 2022 Apr;35(3):863-873. doi: 10.1007/s40620-021-01152-5. Epub 2021 Oct 9. PubMed 34626363 ↗
  • Fadda G, Germain MJ, Broumand V, Nguyen A, McGarvey N, Gitlin M, Bishop CW, Ashfaq A. Real-World Assessment: Clinical Effectiveness and Safety of Extended-Release Calcifediol. Am J Nephrol. 2021;52(10-11):798-807. doi: 10.1159/000518545. Epub 2021 Oct 27. PubMed 34818216 ↗

Individual participant data

Plan to share: Yes — Anonymized individual patient level data will be provided in a secure access environment upon approval of a research proposal and a signed data sharing agreement.

Supporting information: Study protocol, Sap

08

Registry details

Key details

Study ID
NCT05460234
Lead sponsor
Vifor (International) Inc.
Responsible party
Sponsor
First posted
Jul 15, 2022
Start date
Oct 5, 2022
Primary completion
Jan 31, 2024
Completion
Jun 30, 2025
Last update
Jul 15, 2025

Study contacts

Markus Ketteler, Prof.
principal investigator · Robert Bosch Gesellschaft für Medizinische Forschung mbH (RBMF)

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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