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A Study Assessing the Efficacy and Safety of Deferasirox in Patients With Transfusion-dependent Iron Overload

Primary Purpose

Transfusion-dependent Iron Overload

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Deferasirox
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Transfusion-dependent Iron Overload focused on measuring Thalassemia, Myelodysplastic Syndrome, MDS, Sickle cell, Diamond-Blackfan anemia, Transfusion, Anemia, Fanconi, Chelation, Deferasirox

Eligibility Criteria

2 Years - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Patients presenting with transfusion-dependent anemias (independent of underlying condition) with transfusional iron overload as shown by a serum ferritin level of ≥ 1000 ng/ml Patients of either gender and aged ≥ 2 years Female patients who have reached menarche and who are sexually active must use an effective method of contraception, or must have undergone clinically documented total hysterectomy and/or ovariectomy, or tubal ligation. Additional Inclusion Criteria for Adult Patients: Written informed consent by the patient Additional Inclusion Criteria for Pediatric Patients: The definition of the term "pediatric" will be in accordance with local legislation. Parents or legal guardians will be fully informed by the investigator as to the requirements of the study. The pediatric patients themselves will be informed according to their capabilities in a language and terms that they are able to understand. Written informed consent will be obtained from their parents or legal guardians on the patient's behalf in accordance with the national legislation. If capable, all patients should also personally sign their written informed assent. Exclusion Criteria: Non-transfusional hemosiderosis Patients with clinical evidence supporting the need for intensive chelation, based on the investigator's judgment Patients with mean levels of alanine aminotransferase (ALT) > 300 U/l Patients with uncontrolled systemic hypertension Patients with serum creatinine above the upper limit of normal (ULN) Significant proteinuria as indicated by a urinary protein/creatinine ratio > 0.5 (mg/mg) in second-voiding urine samples taken at both visits 1 and 2. A third sample is to be taken from patients in whom one ratio is > 0.5 (mg/mg) and one is ≤ 0.5 (mg/mg) and patients in whom the urinary protein/creatinine ratio is > 0.5 (mg/mg) in two of the three determinations are also to be excluded. History of nephrotic syndrome Patients with 3rd atrioventricular (A-V) block, clinically relevant Q-T interval prolongation as well as patients requiring treatment with digoxin and similar compounds or drugs which may induce prolongation of the Q-T interval Patients with a previous history of clinically relevant ocular toxicity related to iron chelation Systemic diseases (cardiovascular, renal, hepatic, etc.) which would prevent the patient from undergoing study treatment Patients with psychiatric or addictive disorders which prevent them from giving their informed consent or undergoing study treatment Pregnant or breast feeding patients Patients treated with systemic investigational drugs within the past 4 weeks or topical investigational drugs within the past 7 days Any other surgical or medical condition which might significantly alter the absorption, distribution, metabolism or excretion of any drug. The investigator should be guided by evidence of any of the following: history of inflammatory bowel syndrome, gastritis, ulcers, gastrointestinal or rectal bleeding; history of major gastrointestinal tract surgery such as gastrectomy, gastroenterostomy, or bowel resection; history of pancreatic injury or pancreatitis; indications of impaired pancreatic function/injury as indicated by abnormal lipase or amylase; history or presence of impaired renal function as indicated by creatinine or blood urea nitrogen (BUN) values equal or above ULN; history of urinary obstruction or difficulty in voiding. History of non-compliance to medical regimens and patients who are considered potentially unreliable and/or not cooperative History of drug or alcohol abuse within the 12 months prior to dosing or evidence of such abuse as indicated by the laboratory assays conducted during the run-in period Patients with positive test to HIV Life expectancy of < 1 year Exclusion Criteria for Pediatric Patients: Patient body weight which prevents the use of the smallest tablet strength (i.e. 125 mg) for proper dosing Other protocol-defined inclusion/exclusion criteria may apply.

Sites / Locations

  • Novartis Investigative Site
  • Novartis Investigative Site
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Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

ICL670 (Deferasirox)

Arm Description

Outcomes

Primary Outcome Measures

To evaluate if fixed starting doses of ICL670, based on transfusion history and subsequent dose titration can provide clinically acceptable chelation as measured by serum ferritin

Secondary Outcome Measures

To evaluate the safety and tolerability profile of in patients treated for up to 52 weeks
Evaluate efficacy, tolerabilty and safety in the subgroup of patients with baseline LIC < 7 mg Fe/g dw
Evaluate the relationship between serum ferritin and potential surrogate markers

Full Information

First Posted
September 13, 2005
Last Updated
February 8, 2020
Sponsor
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT00171821
Brief Title
A Study Assessing the Efficacy and Safety of Deferasirox in Patients With Transfusion-dependent Iron Overload
Official Title
A One Year, Open-label, Single-arm, Multi-center Trial Evaluating the Efficacy and Safety of Oral ICL670 (20 mg/kg/Day) in Patients Diagnosed With Transfusion-dependent Iron Overload
Study Type
Interventional

2. Study Status

Record Verification Date
June 2013
Overall Recruitment Status
Completed
Study Start Date
April 2005 (undefined)
Primary Completion Date
May 2009 (Actual)
Study Completion Date
July 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novartis Pharmaceuticals

4. Oversight

5. Study Description

Brief Summary
This study uses a single arm, multi-center, open-label trial design. The study will assess the efficacy and safety of 52 weeks of treatment with deferasirox (ICL670) in patients with evidence of transfusion induced iron overload.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Transfusion-dependent Iron Overload
Keywords
Thalassemia, Myelodysplastic Syndrome, MDS, Sickle cell, Diamond-Blackfan anemia, Transfusion, Anemia, Fanconi, Chelation, Deferasirox

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
1784 (Actual)

8. Arms, Groups, and Interventions

Arm Title
ICL670 (Deferasirox)
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Deferasirox
Other Intervention Name(s)
ICL670
Primary Outcome Measure Information:
Title
To evaluate if fixed starting doses of ICL670, based on transfusion history and subsequent dose titration can provide clinically acceptable chelation as measured by serum ferritin
Time Frame
at baseline and at 52 weeks
Secondary Outcome Measure Information:
Title
To evaluate the safety and tolerability profile of in patients treated for up to 52 weeks
Time Frame
Monthly
Title
Evaluate efficacy, tolerabilty and safety in the subgroup of patients with baseline LIC < 7 mg Fe/g dw
Time Frame
Monthly
Title
Evaluate the relationship between serum ferritin and potential surrogate markers
Time Frame
Monthly

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients presenting with transfusion-dependent anemias (independent of underlying condition) with transfusional iron overload as shown by a serum ferritin level of ≥ 1000 ng/ml Patients of either gender and aged ≥ 2 years Female patients who have reached menarche and who are sexually active must use an effective method of contraception, or must have undergone clinically documented total hysterectomy and/or ovariectomy, or tubal ligation. Additional Inclusion Criteria for Adult Patients: Written informed consent by the patient Additional Inclusion Criteria for Pediatric Patients: The definition of the term "pediatric" will be in accordance with local legislation. Parents or legal guardians will be fully informed by the investigator as to the requirements of the study. The pediatric patients themselves will be informed according to their capabilities in a language and terms that they are able to understand. Written informed consent will be obtained from their parents or legal guardians on the patient's behalf in accordance with the national legislation. If capable, all patients should also personally sign their written informed assent. Exclusion Criteria: Non-transfusional hemosiderosis Patients with clinical evidence supporting the need for intensive chelation, based on the investigator's judgment Patients with mean levels of alanine aminotransferase (ALT) > 300 U/l Patients with uncontrolled systemic hypertension Patients with serum creatinine above the upper limit of normal (ULN) Significant proteinuria as indicated by a urinary protein/creatinine ratio > 0.5 (mg/mg) in second-voiding urine samples taken at both visits 1 and 2. A third sample is to be taken from patients in whom one ratio is > 0.5 (mg/mg) and one is ≤ 0.5 (mg/mg) and patients in whom the urinary protein/creatinine ratio is > 0.5 (mg/mg) in two of the three determinations are also to be excluded. History of nephrotic syndrome Patients with 3rd atrioventricular (A-V) block, clinically relevant Q-T interval prolongation as well as patients requiring treatment with digoxin and similar compounds or drugs which may induce prolongation of the Q-T interval Patients with a previous history of clinically relevant ocular toxicity related to iron chelation Systemic diseases (cardiovascular, renal, hepatic, etc.) which would prevent the patient from undergoing study treatment Patients with psychiatric or addictive disorders which prevent them from giving their informed consent or undergoing study treatment Pregnant or breast feeding patients Patients treated with systemic investigational drugs within the past 4 weeks or topical investigational drugs within the past 7 days Any other surgical or medical condition which might significantly alter the absorption, distribution, metabolism or excretion of any drug. The investigator should be guided by evidence of any of the following: history of inflammatory bowel syndrome, gastritis, ulcers, gastrointestinal or rectal bleeding; history of major gastrointestinal tract surgery such as gastrectomy, gastroenterostomy, or bowel resection; history of pancreatic injury or pancreatitis; indications of impaired pancreatic function/injury as indicated by abnormal lipase or amylase; history or presence of impaired renal function as indicated by creatinine or blood urea nitrogen (BUN) values equal or above ULN; history of urinary obstruction or difficulty in voiding. History of non-compliance to medical regimens and patients who are considered potentially unreliable and/or not cooperative History of drug or alcohol abuse within the 12 months prior to dosing or evidence of such abuse as indicated by the laboratory assays conducted during the run-in period Patients with positive test to HIV Life expectancy of < 1 year Exclusion Criteria for Pediatric Patients: Patient body weight which prevents the use of the smallest tablet strength (i.e. 125 mg) for proper dosing Other protocol-defined inclusion/exclusion criteria may apply.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Novartis Pharmaceuticals
Organizational Affiliation
Novartis Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Novartis Investigative Site
City
Adelaide
Country
Australia
Facility Name
Novartis Investigative Site
City
Camperdown
Country
Australia
Facility Name
Novartis Investigative Site
City
Clayton
Country
Australia
Facility Name
Novartis Investigative Site
City
Melbourne
Country
Australia
Facility Name
Novartis Investigative Site
City
Perth
Country
Australia
Facility Name
Novartis Investigative Site
City
South Brisbane
Country
Australia
Facility Name
Novartis Investigative Site
City
Westmead
Country
Australia
Facility Name
Novartis Investigative Site
City
Graz
Country
Austria
Facility Name
Novartis Investigative Site
City
Linz
Country
Austria
Facility Name
Novartis Investigative Site
City
Wien
Country
Austria
Facility Name
Novartis Investigative Site
City
Brussels
Country
Belgium
Facility Name
Novartis Investigative Site
City
Gent
Country
Belgium
Facility Name
Novartis Investigative Site
City
Godinne
Country
Belgium
Facility Name
Novartis Investigative Site
City
La Louviere
Country
Belgium
Facility Name
Novartis Investigative Site
City
Leuven
Country
Belgium
Facility Name
Novartis Investigative Site
City
GuangZhou
Country
China
Facility Name
Novartis Investigative Site
City
Nanjing
Country
China
Facility Name
Novartis Investigative Site
City
Shanghai
Country
China
Facility Name
Novartis Investigative Site
City
Arhus
Country
Denmark
Facility Name
Novartis Investigative Site
City
Copenhagen
Country
Denmark
Facility Name
Novartis Investigative Site
City
Herlev
Country
Denmark
Facility Name
Novartis Investigative Site
City
Hillerod
Country
Denmark
Facility Name
Novartis Investigative Site
City
Cairo
Country
Egypt
Facility Name
Novartis Investigative Site
City
Angers
Country
France
Facility Name
Novartis Investigative Site
City
Avignon
Country
France
Facility Name
Novartis Investigative Site
City
Bobigny
Country
France
Facility Name
Novartis Investigative Site
City
Creteil
Country
France
Facility Name
Novartis Investigative Site
City
Lille Cedex
Country
France
Facility Name
Novartis Investigative Site
City
Lyon
Country
France
Facility Name
Novartis Investigative Site
City
Nice
Country
France
Facility Name
Novartis Investigative Site
City
Paris Cedex 14
Country
France
Facility Name
Novartis Investigative Site
City
Paris
Country
France
Facility Name
Novartis Investigative Site
City
Pessac Cedex
Country
France
Facility Name
Novartis Investigative Site
City
Rennes
Country
France
Facility Name
Novartis Investigative Site
City
Toulouse Cedex
Country
France
Facility Name
Novartis Investigative Site
City
Vandoeuvre Les Nancy
Country
France
Facility Name
Novartis Investigative Site
City
Augsburg
Country
Germany
Facility Name
Novartis Investigative Site
City
Braunschweig
Country
Germany
Facility Name
Novartis Investigative Site
City
Dresden
Country
Germany
Facility Name
Novartis Investigative Site
City
Dusseldorf
Country
Germany
Facility Name
Novartis Investigative Site
City
Frankfurt/Main
Country
Germany
Facility Name
Novartis Investigative Site
City
Frankfurt
Country
Germany
Facility Name
Novartis Investigative Site
City
Frieburg
Country
Germany
Facility Name
Novartis Investigative Site
City
Gottingen
Country
Germany
Facility Name
Novartis Investigative Site
City
Greifswald
Country
Germany
Facility Name
Novartis Investigative Site
City
Hannover
Country
Germany
Facility Name
Novartis Investigative Site
City
Mainz
Country
Germany
Facility Name
Novartis Investigative Site
City
Muenchen
Country
Germany
Facility Name
Novartis Investigative Site
City
Ulm
Country
Germany
Facility Name
Novartis Investigative Site
City
Athens
Country
Greece
Facility Name
Novartis Investigative Site
City
Larissa
Country
Greece
Facility Name
Novartis Investigative Site
City
Patras
Country
Greece
Facility Name
Novartis Investigative Site
City
Thessaloniki
Country
Greece
Facility Name
Novartis Investigative Site
City
Hong Kong
Country
Hong Kong
Facility Name
Novartis Investigative Site
City
Afula
Country
Israel
Facility Name
Novartis Investigative Site
City
Jerusalem
Country
Israel
Facility Name
Novartis Investigative Site
City
Petach-Tikva
Country
Israel
Facility Name
Novartis Investigative Site
City
Bologna
Country
Italy
Facility Name
Novartis Investigative Site
City
Brindisi
Country
Italy
Facility Name
Novartis Investigative Site
City
Cagliari
Country
Italy
Facility Name
Novartis Investigative Site
City
Cona
Country
Italy
Facility Name
Novartis Investigative Site
City
Genova
Country
Italy
Facility Name
Novartis Investigative Site
City
Milano
Country
Italy
Facility Name
Novartis Investigative Site
City
Napoli
Country
Italy
Facility Name
Novartis Investigative Site
City
Orbassano
Country
Italy
Facility Name
Novartis Investigative Site
City
Palermo
Country
Italy
Facility Name
Novartis Investigative Site
City
Pavia
Country
Italy
Facility Name
Novartis Investigative Site
City
Pisa
Country
Italy
Facility Name
Novartis Investigative Site
City
Reggio Calabria
Country
Italy
Facility Name
Novartis Investigative Site
City
Roma
Country
Italy
Facility Name
Novartis Investigative Site
City
Sassari
Country
Italy
Facility Name
Novartis Investigative Site
City
Seoul
Country
Korea, Republic of
Facility Name
Novartis Investigative Site
City
Hazmiyeh
Country
Lebanon
Facility Name
Novartis Investigative Site
City
Kota Bahru
Country
Malaysia
Facility Name
Novartis Investigative Site
City
Kuala Lumpur
Country
Malaysia
Facility Name
Novartis Investigative Site
City
Nijmegen
Country
Netherlands
Facility Name
Novartis Investigative Site
City
Johannesburg
Country
South Africa
Facility Name
Novartis Investigative Site
City
Parktown
Country
South Africa
Facility Name
Novartis Investigative Site
City
Baracaldo
Country
Spain
Facility Name
Novartis Investigative Site
City
Barcelona
Country
Spain
Facility Name
Novartis Investigative Site
City
Madrid
Country
Spain
Facility Name
Novartis Investigative Site
City
Sevilla
Country
Spain
Facility Name
Novartis Investigative Site
City
Valencia
Country
Spain
Facility Name
Novartis Investigative Site
City
Geneve
Country
Switzerland
Facility Name
Novartis Investigative Site
City
Zurich
Country
Switzerland
Facility Name
Novartis Investigative Site
City
Taichung
Country
Taiwan
Facility Name
Novartis Investigative Site
City
Taipei
Country
Taiwan
Facility Name
Novartis Investigative Site
City
Bangkok
Country
Thailand
Facility Name
Novartis Investigative Site
City
Chaingmai
Country
Thailand
Facility Name
Novartis Investigative Site
City
Adana
Country
Turkey
Facility Name
Novartis Investigative Site
City
Ankara
Country
Turkey
Facility Name
Novartis Investigative Site
City
Istanbul
Country
Turkey
Facility Name
Novartis Investigative Site
City
Izmir
Country
Turkey
Facility Name
Novartis Investigative Site
City
Leeds
Country
United Kingdom
Facility Name
Novartis Investigative Site
City
Leicester
Country
United Kingdom
Facility Name
Novartis Investigative Site
City
London
Country
United Kingdom
Facility Name
Novartis Investigative Site
City
Manchester
Country
United Kingdom
Facility Name
Novartis Investigative Site
City
Sheffield
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
25691036
Citation
Porter JB, El-Alfy M, Viprakasit V, Giraudier S, Chan LL, Lai Y, El-Ali A, Han J, Cappellini MD. Utility of labile plasma iron and transferrin saturation in addition to serum ferritin as iron overload markers in different underlying anemias before and after deferasirox treatment. Eur J Haematol. 2016 Jan;96(1):19-26. doi: 10.1111/ejh.12540. Epub 2015 Jun 23.
Results Reference
derived
PubMed Identifier
23585526
Citation
Lee JW, Yoon SS, Shen ZX, Ganser A, Hsu HC, El-Ali A, Habr D, Martin N, Porter JB. Hematologic responses in patients with aplastic anemia treated with deferasirox: a post hoc analysis from the EPIC study. Haematologica. 2013 Jul;98(7):1045-8. doi: 10.3324/haematol.2012.077669. Epub 2013 Apr 12.
Results Reference
derived
PubMed Identifier
21071497
Citation
Pennell DJ, Porter JB, Cappellini MD, Chan LL, El-Beshlawy A, Aydinok Y, Ibrahim H, Li CK, Viprakasit V, Elalfy MS, Kattamis A, Smith G, Habr D, Domokos G, Roubert B, Taher A. Continued improvement in myocardial T2* over two years of deferasirox therapy in beta-thalassemia major patients with cardiac iron overload. Haematologica. 2011 Jan;96(1):48-54. doi: 10.3324/haematol.2010.031468. Epub 2010 Nov 11.
Results Reference
derived
PubMed Identifier
20566896
Citation
Lee JW, Yoon SS, Shen ZX, Ganser A, Hsu HC, Habr D, Domokos G, Roubert B, Porter JB; EPIC study investigators. Iron chelation therapy with deferasirox in patients with aplastic anemia: a subgroup analysis of 116 patients from the EPIC trial. Blood. 2010 Oct 7;116(14):2448-54. doi: 10.1182/blood-2010-01-261289. Epub 2010 Jun 21.
Results Reference
derived
PubMed Identifier
19996412
Citation
Pennell DJ, Porter JB, Cappellini MD, El-Beshlawy A, Chan LL, Aydinok Y, Elalfy MS, Sutcharitchan P, Li CK, Ibrahim H, Viprakasit V, Kattamis A, Smith G, Habr D, Domokos G, Roubert B, Taher A. Efficacy of deferasirox in reducing and preventing cardiac iron overload in beta-thalassemia. Blood. 2010 Mar 25;115(12):2364-71. doi: 10.1182/blood-2009-04-217455. Epub 2009 Dec 8.
Results Reference
derived
PubMed Identifier
19951979
Citation
Cappellini MD, Porter J, El-Beshlawy A, Li CK, Seymour JF, Elalfy M, Gattermann N, Giraudier S, Lee JW, Chan LL, Lin KH, Rose C, Taher A, Thein SL, Viprakasit V, Habr D, Domokos G, Roubert B, Kattamis A; EPIC Study Investigators. Tailoring iron chelation by iron intake and serum ferritin: the prospective EPIC study of deferasirox in 1744 patients with transfusion-dependent anemias. Haematologica. 2010 Apr;95(4):557-66. doi: 10.3324/haematol.2009.014696. Epub 2009 Nov 30.
Results Reference
derived

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A Study Assessing the Efficacy and Safety of Deferasirox in Patients With Transfusion-dependent Iron Overload

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