The ASCEND-ND trial: study design and participant characteristics

Nephrol Dial Transplant. 2022 Oct 19;37(11):2157-2170. doi: 10.1093/ndt/gfab318.

Abstract

Background: Anaemia is common in chronic kidney disease (CKD) and assessment of the risks and benefits of new therapies is important.

Methods: The Anaemia Study in CKD: Erythropoiesis via a Novel prolyl hydroxylase inhibitor Daprodustat-Non-Dialysis (ASCEND-ND) trial includes adult patients with CKD Stages 3-5, not using erythropoiesis-stimulating agents (ESAs) with screening haemoglobin (Hb) 8-10 g/dL or receiving ESAs with screening Hb of 8-12 g/dL. Participants were randomized to daprodustat or darbepoetin alfa (1:1) in an open-label trial (steering committee- and sponsor-blinded), with blinded endpoint assessment. The co-primary endpoints are mean change in Hb between baseline and evaluation period (average over Weeks 28-52) and time to first adjudicated major adverse cardiovascular (CV) event. Baseline characteristics were compared with those of participants in similar anaemia trials.

Results: Overall, 3872 patients were randomized from 39 countries (median age 67 years, 56% female, 56% White, 27% Asian and 10% Black). The median baseline Hb was 9.9 g/dL, blood pressure was 135/74 mmHg and estimated glomerular filtration rate was 18 mL/min/1.73 m2. Among randomized patients, 53% were ESA non-users, 57% had diabetes and 37% had a history of CV disease. At baseline, 61% of participants were using renin-angiotensin system blockers, 55% were taking statins and 49% were taking oral iron. Baseline demographics were similar to those in other large non-dialysis anaemia trials.

Conclusion: ASCEND-ND will define the efficacy and safety of daprodustat compared with darbepoetin alfa in the treatment of patients with anaemia associated with CKD not on dialysis.

Trial registration: ClinicalTrials.gov NCT02876835.

Keywords: anaemia; baseline data; chronic kidney disease; daprodustat, darbepoetin alfa.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anemia* / drug therapy
  • Anemia* / etiology
  • Darbepoetin alfa / therapeutic use
  • Erythropoietin* / adverse effects
  • Female
  • Hematinics* / therapeutic use
  • Hemoglobins
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors*
  • Iron
  • Male
  • Prolyl-Hydroxylase Inhibitors*
  • Renal Dialysis
  • Renal Insufficiency, Chronic* / chemically induced
  • Renal Insufficiency, Chronic* / complications

Substances

  • Darbepoetin alfa
  • Erythropoietin
  • Hematinics
  • Hemoglobins
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Iron
  • Prolyl-Hydroxylase Inhibitors

Associated data

  • ClinicalTrials.gov/NCT02876835
  • EudraCT/2016-000542-65