Efficacy and Safety Study of Magnesium Iron Hydroxycarbonate for the Reduction of High Blood Phosphate in Hemodialysis Patients

• Change from baseline in mean serum phosphate concentration [ Time Frame: Mean of last two serum phosphate values ] [ Designated as safety issue: No ]
• Change from baseline in serum calcium [ Time Frame: Specified visits throughout the study period ] [ Designated as safety issue: Yes ]
• Change from baseline calcium-phosphate product [ Time Frame: Specified visits throughout the study period ] [ Designated as safety issue: Yes ]
• Change from baseline PTH [ Time Frame: Specified visits throughout the study period ] [ Designated as safety issue: Yes ]
• Change from baseline magnesium [ Time Frame: Specified visits throughout the study period ] [ Designated as safety issue: Yes ]
• Assessment of adverse events [ Time Frame: Throughout the study period ] [ Designated as safety issue: Yes ]
• Assessment of routine safety laboratory parameters [ Time Frame: Specified visits throughout the study period ] [ Designated as safety issue: Yes ]
• Assessment of physical examination [ Time Frame: At screen and follow-up ] [ Designated as safety issue: Yes ]
• Assessment of 12-lead electrocardiogram [ Time Frame: At screen and follow-up ] [ Designated as safety issue: Yes ]
• Assessment of bowel habits [ Time Frame: Specified visits throughout the study period ] [ Designated as safety issue: Yes ]

• Change from baseline in mean serum phosphate concentration
• Change from baseline in serum calcium
• Change from baseline calcium-phosphate product
• Change from baseline PTH
• Change from baseline magnesium
• Assessment of adverse events
• Assessment of routine safety laboratory parameters
• Assessment of physical examination
• Assessment of 12-lead electrocardiogram
• Assessment of bowel habits

Magnesium iron hydroxycarbonate is a phosphate binder that absorbs phosphate from food, reducing the amount that the body can absorb.

The purpose of this study it to look at how effective and safe Magnesium iron hydroxycarbonate is in controlling levels of phosphate in the blood in patients who receive hemodialysis.

High levels of phosphate in the blood are linked with serious effects, due to calcium imbalances (high levels of parathyroid hormone (PTH), bone disease, formation of calcium deposits in the body, and blood-vessel disease).

Current guidelines indicate that blood phosphorus levels should be maintained between 1.13 to 1.78 mmol/L in patients who receive hemodialysis.

This study is designed to investigate magnesium iron hydroxycarbonate's ability to lower and control patients' blood phosphate to the recommended levels and compare the average blood phosphate, calcium, calcium-phosphate product, PTH and magnesium concentrations and overall safety with placebo (or "dummy") tablets.

• Drug: Fermagate
  Film coated tablet 500mg
  Other Name: Magnesium iron hydroxycarbonate
• Drug: Placebo
  Oral administration, film coated tablet, 0mg
  Other Name: Placebo

• Experimental: 1
  Intervention: Drug: Fermagate
• Placebo Comparator: 2
  Intervention: Drug: Placebo

Inclusion Criteria:

• Male or female subjects on active haemodialysis, aged 18 years or over.
• Written informed consent given.
• On a stable haemodialysis regimen (three times per week) for at least 3 months and be unlikely to change their dialysis prescription during the study period.
• On a stable dose of a phosphate binder for at least 1 month prior to screening.
• Willing to abstain from taking any phosphate binder or oral magnesium, aluminum or iron-containing products and preparations, other than the study medication.
• Willing to avoid any intentional changes in diet such as fasting, dieting or overeating.
• Willing to maintain their usual type and dose of Vitamin D supplementation.

Exclusion Criteria:

• Participation in any other clinical trial using an investigational product or device within the previous 4 months.
• A significant history of alcohol, drug or solvent abuse in the opinion of the investigator.
• Any disease or condition, physical or psychological, which in the opinion of the investigator would compromise the safety of the subject or increase the likelihood of the subject being withdrawn.
• Clinically significant laboratory findings (for this subject population) in the opinion of the investigator.
• Any malignancy requiring treatment within 5 years of screening with the exception of basal cell carcinoma and Bowen's disease.
• A history of a motility disorder of the intestines, including, but not limited to, gastroparesis, ileus, pseudo-obstruction, megacolon, or mechanical obstruction.
• A significant illness in the 4 weeks before screening.
• Taking medication prescribed for seizures.
• A history of haemochromatosis.
• A history of high serum ferritin concentration of ≥ 1000ng/ml (excluding transient, treatment-induced ferritin elevation).
• A history of dysphagia or swallowing disorders that might limit the subject's ability to swallow study medication in the opinion of the investigator.
• Female subjects who are lactating or pregnant. Women of childbearing potential (pre-menopausal and not surgically sterilized) unless they are using a reliable contraceptive method, that is, barrier methods, hormones or intrauterine device.
• Current haemoglobin concentration of < 10.00 g/dL.
• Allergy to the IMP or its constituents.