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Safety and Efficacy of Oral Deferasirox in Patients With Porphyria Cutanea Tarda

Primary Purpose

Porphyria Cutanea Tarda

Status
Unknown status
Phase
Phase 2
Locations
France
Study Type
Interventional
Intervention
Exjade
Sponsored by
Assistance Publique - Hôpitaux de Paris
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Porphyria Cutanea Tarda focused on measuring PCT sporadic or familial, Skin fragility and bullae lesions, non-transfusion iron overload

Eligibility Criteria

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

Inclusion Criteria:

  • Male and female diagnosed with clinically overt Porphyria Cutanea Tarda, sporadic or familial as per the European Porphyria Network guidelines i.e. increased urinary and plasma porphyrins and faecal isocoproporphyrin detected by fluorescence emission spectroscopy,

    • Skin fragility and bullae lesions,
    • Age ≥ 18 years old,
    • non-transfusion iron overload as depicted by a serum ferritin value ≥ 300 μg/L for men and ≥ 200 μg/L for women, and/or LIC ≥ 2 mg Fe/g dw for both men and women and with transferrin saturation ≥ 45%,
    • Adequate liver function i.e. ALAT/ASAT and Alkaline Phosphatase ? 2.5 times ULN, bilirubin < 1.5 times ULN,
    • Signed informed consent prior to beginning the specific procedures of the protocol,
    • Ability to comply with all study-related procedures, medications, and evaluations,
    • Sexually active women must use an effective method of contraception, or must have undergone clinically documented total hysterectomy and/or oophorectomy, or tubal ligation or be postmenopausal (defined as amenorrhea for at least 12 months). Since hormonal therapy may cause PCT, oral contraceptives will not be started during the course of the study and patients already on oral contraceptives will be advised to speak to their physician about discontinuing them and will not be enrolled in the study.

Exclusion Criteria:

  • Clinical evidence of active Hepatitis B (positive HBsAg with negative HBsAb) and/or hepatitis C (positive HCV antibody and detectable HCV RNA with ALT above the normal range)

    • Patients with on going alcoholic dependency > 60g/day
    • Serum creatinine above the ULN
    • Creatinine clearance < 60 ml/min, estimated according to Cockcroft-Gault formula or MDRD formula for adults
    • Significant proteinuria as indicated by a urine protein: urine creatinine ratio > 0.5 mg/mg in a non-first void urine sample.
    • Diabetes
    • Iron overload due to hereditary hemochromatosis
    • History of blood transfusion during the 6 months prior to study entry,
    • Males with hemoglobin <13 mg/dL, females with hemoglobin <12 mg/dL
    • Active peptic ulcus
    • Treatment with phlebotomy within 2 weeks of screening visit
    • Prior Desferal® treatment within 1 month of the screening visit
    • Patients currently or previously treated with deferiprone or deferasirox
    • Patients with a diagnosis of a clinically relevant cataract or a previous history of clinically relevant ocular toxicity related to iron chelation
    • Patient with clinically significant decrease of hearing
    • Pregnant or lactating women or women of childbearing potential not using adequate contraception (pregnancy test mandatory and negative for patient with childbearing potential)
    • Known hypersensitivity to the active ingredient of deferasirox or any excipients
    • Contraindication to the administration of deferasirox as outlined in the approved prescribing information.
    • Presence of a surgical or medical condition that might significantly alter the absorption, distribution, metabolism or excretion of deferasirox
    • Presence of a non-controlled severe disease affected vital organs as cardiac and/or pulmonary disease
    • Patients with a known diagnosis of cirrhosis (confirmed by biopsy)
    • Patients with active inflammatory diseases that may interfere with the accurate measurement of serum ferritin
    • Patients treated with systemic investigational drug within 4 weeks prior or with topical investigational drug within 7 days prior to the screening visit

Sites / Locations

  • Hopital Louis Mourier, GI unit,Recruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Exjade

Arm Description

Safety and efficacy

Outcomes

Primary Outcome Measures

The primary objective is to assess the safety of deferasirox in treating non-transfusion iron overload in patients with PCT.
Related drug adverse events
Incidence type and severity of drug related adverse events

Secondary Outcome Measures

The change from baseline in serum ferritin after 12 and 24 weeks of treatment,The change from baseline in iron burden after 24 weeks of treatment measured by liver MRI T2,The evolution of clinical symptoms
Chage from baseline in serum ferritin, iron burden, improvement in clincal symptoms, porphyrin levels

Full Information

First Posted
January 26, 2011
Last Updated
January 26, 2011
Sponsor
Assistance Publique - Hôpitaux de Paris
Collaborators
Association pour l'Etude des Fonctions Digestives (AEFD)
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1. Study Identification

Unique Protocol Identification Number
NCT01284946
Brief Title
Safety and Efficacy of Oral Deferasirox in Patients With Porphyria Cutanea Tarda
Official Title
A Phase II, Open Label Clinical Trial Exploring the Safety and the Efficacy of Oral Deferasirox in Patients Newly Diagnosed With Porphyria Cutanea Tarda (PCT) and Non-transfusion Iron Overload
Study Type
Interventional

2. Study Status

Record Verification Date
January 2011
Overall Recruitment Status
Unknown status
Study Start Date
January 2011 (undefined)
Primary Completion Date
December 2012 (Anticipated)
Study Completion Date
December 2012 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
Assistance Publique - Hôpitaux de Paris
Collaborators
Association pour l'Etude des Fonctions Digestives (AEFD)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
While clinical phlebotomy is current standard practice for alleviating non-transfusion iron overload in patients with PCT, it may not be suitable for all patients. For example, some patients are unwilling to be adequately phlebotomized because of inconvenience, as phlebotomy can be cumbersome, especially during the induction treatment phase requiring frequent clinic visits (twice a month, for at least 6 months) or because of venous access difficulties. Other patients are unable to undergo phlebotomy due to medical reasons such as anemia or cardiopulmonary disorders. It is postulated such patients with PCT who have non-transfusion iron overload could benefit from treatment with deferasirox (Exjade®), a once daily oral iron chelator licensed in several countries, including the EU, for treating transfusion iron overload in adult and pediatric patients. Although there is some data on the efficacy and safety of deferasirox in patients with HH, who, like those with PCT, have non-transfusional iron overload, there is a need to evaluate the safety and efficacy of deferasirox treatment of non-transfusion iron overload in patients with PCT.
Detailed Description
The primary objective is to assess the safety of deferasirox in treating non-transfusion iron overload in patients with PCT. The secondary objective is to assess the effectiveness of deferasirox treatment : After 3 and 6 months to: •Lower serum ferritin from abnormal to normal standard ranges specified for males and females in this patient population. After 6 months to : •Lower liver iron content after 24 weeks of treatment measured by liver MRI T2 After 3 and 6 months to : Improve clinical symptoms, i.e. improvement in skin lesions (reduction or no new bullae formation), and skin fragility (photographs will be used). Reduce porphyrin levels.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Porphyria Cutanea Tarda
Keywords
PCT sporadic or familial, Skin fragility and bullae lesions, non-transfusion iron overload

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
45 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Exjade
Arm Type
Experimental
Arm Description
Safety and efficacy
Intervention Type
Drug
Intervention Name(s)
Exjade
Other Intervention Name(s)
DEFERASIROX
Intervention Description
Orodispersible Tablet, 10 mg/Kg/day ± 5 mg/Kg/day during 24 weeks Deferasirox should be taken daily 30 minutes before breakfast
Primary Outcome Measure Information:
Title
The primary objective is to assess the safety of deferasirox in treating non-transfusion iron overload in patients with PCT.
Time Frame
6 months
Title
Related drug adverse events
Description
Incidence type and severity of drug related adverse events
Time Frame
6 months
Secondary Outcome Measure Information:
Title
The change from baseline in serum ferritin after 12 and 24 weeks of treatment,The change from baseline in iron burden after 24 weeks of treatment measured by liver MRI T2,The evolution of clinical symptoms
Time Frame
6 months
Title
Chage from baseline in serum ferritin, iron burden, improvement in clincal symptoms, porphyrin levels
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female diagnosed with clinically overt Porphyria Cutanea Tarda, sporadic or familial as per the European Porphyria Network guidelines i.e. increased urinary and plasma porphyrins and faecal isocoproporphyrin detected by fluorescence emission spectroscopy, Skin fragility and bullae lesions, Age ≥ 18 years old, non-transfusion iron overload as depicted by a serum ferritin value ≥ 300 μg/L for men and ≥ 200 μg/L for women, and/or LIC ≥ 2 mg Fe/g dw for both men and women and with transferrin saturation ≥ 45%, Adequate liver function i.e. ALAT/ASAT and Alkaline Phosphatase ? 2.5 times ULN, bilirubin < 1.5 times ULN, Signed informed consent prior to beginning the specific procedures of the protocol, Ability to comply with all study-related procedures, medications, and evaluations, Sexually active women must use an effective method of contraception, or must have undergone clinically documented total hysterectomy and/or oophorectomy, or tubal ligation or be postmenopausal (defined as amenorrhea for at least 12 months). Since hormonal therapy may cause PCT, oral contraceptives will not be started during the course of the study and patients already on oral contraceptives will be advised to speak to their physician about discontinuing them and will not be enrolled in the study. Exclusion Criteria: Clinical evidence of active Hepatitis B (positive HBsAg with negative HBsAb) and/or hepatitis C (positive HCV antibody and detectable HCV RNA with ALT above the normal range) Patients with on going alcoholic dependency > 60g/day Serum creatinine above the ULN Creatinine clearance < 60 ml/min, estimated according to Cockcroft-Gault formula or MDRD formula for adults Significant proteinuria as indicated by a urine protein: urine creatinine ratio > 0.5 mg/mg in a non-first void urine sample. Diabetes Iron overload due to hereditary hemochromatosis History of blood transfusion during the 6 months prior to study entry, Males with hemoglobin <13 mg/dL, females with hemoglobin <12 mg/dL Active peptic ulcus Treatment with phlebotomy within 2 weeks of screening visit Prior Desferal® treatment within 1 month of the screening visit Patients currently or previously treated with deferiprone or deferasirox Patients with a diagnosis of a clinically relevant cataract or a previous history of clinically relevant ocular toxicity related to iron chelation Patient with clinically significant decrease of hearing Pregnant or lactating women or women of childbearing potential not using adequate contraception (pregnancy test mandatory and negative for patient with childbearing potential) Known hypersensitivity to the active ingredient of deferasirox or any excipients Contraindication to the administration of deferasirox as outlined in the approved prescribing information. Presence of a surgical or medical condition that might significantly alter the absorption, distribution, metabolism or excretion of deferasirox Presence of a non-controlled severe disease affected vital organs as cardiac and/or pulmonary disease Patients with a known diagnosis of cirrhosis (confirmed by biopsy) Patients with active inflammatory diseases that may interfere with the accurate measurement of serum ferritin Patients treated with systemic investigational drug within 4 weeks prior or with topical investigational drug within 7 days prior to the screening visit
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Benoit Coffin, Professor
Phone
33147606061
Email
benoit.coffin@lmr.aphp.fr
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Deybach Jean-Charles, Professor
Organizational Affiliation
Assistance Publique - Hôpitaux de Paris
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hopital Louis Mourier, GI unit,
City
Colombes
State/Province
Ile de France
ZIP/Postal Code
92700
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Benoit Coffin, Professor
Phone
33147606061
Email
benoit.coffin@lmr.aphp.fr
First Name & Middle Initial & Last Name & Degree
Deybach Jean-Charles, Professor

12. IPD Sharing Statement

Citations:
PubMed Identifier
20226990
Citation
Puy H, Gouya L, Deybach JC. Porphyrias. Lancet. 2010 Mar 13;375(9718):924-37. doi: 10.1016/S0140-6736(09)61925-5.
Results Reference
result

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Safety and Efficacy of Oral Deferasirox in Patients With Porphyria Cutanea Tarda

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