Clinical Trial: Post Approval Study of Lixelle for the Treament of Dialysis-Related Amyloidosis

Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional

Official Title: Treatment of Dialysis-Related Amyloidosis Using Lixelle® β2-microglobulin Apheresis Column

Brief Summary:

Dialysis-related amyloidosis (DRA) is a serious complication of long-term hemodialysis (HD). Its pathogenic mechanism involves accumulation of β2-microglobulin (β2M) in the blood. β2M is produced by most cells in the body and is metabolized in the kidney in healthy individuals. However, in HD patients with renal dysfunction, β2M which is not removed entirely by HD accumulates excessively in the blood. Then it forms amyloid fibrils that are deposited in bones, joints, and soft tissues. The fibrils are further modified by advanced glycation end products (AGE), inducing local macrophage infiltration and production of cytokines leading to chronic inflammation and activation of osteoclasts. Consequently, severe complications with various symptoms are developed, which are collectively referred to as DRA.

Lixelle® is a whole-blood β2M apheresis column developed to adsorb and eliminate β2M selectively from the blood of DRA patients. The treatment is performed with Lixelle® connected upstream of the dialyzer in series on a HD circuit in every session. The Lixelle® column contains porous cellulose beads with covalently linked hexadecyl alkyl chain ligands, which selectively adsorb β2M, via a molecular sieving effect because of its porous structure and hydrophobic interaction with ligands. Lixelle® has been used to relieve symptoms and prevent the progression of DRA in Japan since 1996, when health insurance coverage and reimbursement for the treatment were approved by Japanese Ministry of Health, Labor, and Welfare. Improvement of the activities of daily living (ADL) and remission of arthralgia by Lixelle® treatment has been shown in several clinical studies.


Detailed Summary:
Sponsor: Kaneka Pharma America LLC

Current Primary Outcome: the rate of SAE [ Time Frame: through 2 years of Lixelle® treatment during the study period ]

Original Primary Outcome: Same as current

Current Secondary Outcome:

  • β2M reduction rate in Lixelle® treatment (2 year) [ Time Frame: comparison between baseline and 2 years (104 weeks) after Lixelle® treatment ]
  • comparison of β2M reduction rate between Lixelle® treatment and natural history [ Time Frame: comparison between baseline and 2 years (104 weeks) after Lixelle® treatment ]


Original Secondary Outcome: Same as current

Information By: Kaneka Pharma America LLC

Dates:
Date Received: October 30, 2016
Date Started: October 2015
Date Completion: March 2019
Last Updated: October 30, 2016
Last Verified: October 2016