Pharmacokinetic/Pharmacodynamic Parameters of NNG-DEPO (Stimus) With Aranesp® (Amgen) in Treatment of Anemia in CKD Patients on Dialysis

This is a double-blind, randomized, active-control study with 2-study arms-darbepoetin alfa biosimilar and Aranesp, noninferiority trial design in dialysis patients. Dialysis patients will be randomized into 1:1 ratio to receive either Darbepoetin alfa or Aranesp 0.75 µg/kg by subcutaneous injection every other week for 24 weeks.Pharmacokinetic/pharmacodynamic parameters for evaluation are assessed as per study endpoints at defined time points on all patients.During the treatment, dose adjustments will be made as necessary to achieve a hemoglobin response, defined as maintaining Hb in target range 10 - 12 g/dL.

Inclusion CriteriaThe patients signed the informe consent form and adhere to study visit schedule.Male or female patients aged from 18 to 65 years.Patients on hemodialysis or peritoneal dialysis for at least 3 months and have Hb baseline <10 g/dL during the screening period.Have transferrin saturation ≥ 20%, serum ferritin ≥ 200 ng/mL, vitamin B12 and folate within the normal range.Have expected survival of at least 6 months from time of enrollment (by investigator's assessment).Women childbearing age must agree to use medically acceptable methods of contraception during the study and for 6 months after the last study treatment.The patient does not have any serious medical conditions that may affect to study treatment compliance.Exclusion CriteriaUncontrolled hypertension over 2 weeks prior to and within the screening period (BP ≥ 160/90 mmHg).Patients treated with Darbepoetin alfa or r-HuEPO within 4 weeks prior to enrollment.Patients with Uncontrolled diabetes mellitus with HbA1C ≥ 10%.Congestive Heart Failure of grade 3 or 4 as New York Heart Association classification.History of unstable angina or myocardial infarction within 6 months.History of Grand mal seizures in last 2 years.Present with severe hyperparathyroidism (iPTH >1500 pg/mL for Dialysis).History of major surgery within 12 weeks prior to screening.Systemic hematologic disorders including sickle cell anemia, myelodysplastic syndromes, hematological malignancy, myeloma and hemolytic anemia.Systemic infections, active inflammatory diseases and malignancies.Active liver disease or hepatic with liver enzymes AST and ALT raised > 2-times of laboratory normal values, child B or child C cirrhosis.Are being treated with androgen therapy within the 8 weeks prior to the screening period.Pregnant or suspected pregnant women, breast-feeding women.Patients scheduled for any transplant procedure within 6 months of screening or with a previous history of kidney transplantation.Patients who are hypersensitive to any of substances of investigational product.Patients using drugs that can affect the concentration of Hb in the blood (except blood-forming drugs such as iron, folic acid).Patients with seropositivity to HIV, HBV or anti-HCV.Patients having acute tuberculosis or any acute bacterial infection within 1 month prior to the screening.Patient has occult blood in stool or any other known source of internal bleeding and confirmed gastrointestinal bleeding by endoscopy.Patients with blood transfusion due to acute bleeding within 12 weeks prior to screening period.Patients with a history of immunosuppressive therapy within 1 month.The patient is suffering from advanced cancer.Patients having participated in any other clinical trial within 1 month prior to the screening period.The patient had any medical condition that the investigator assessed as affecting the study.