Phase 2a Pilot Study of NBMI Treatment in Patients With Beta Thalassemia Major, Requiring Iron Chelation (EMERA007)
Primary Purpose
Beta Thalassemia Major
Status
Completed
Phase
Phase 2
Locations
Albania
Study Type
Interventional
Intervention
Emeramide
Sponsored by
About this trial
This is an interventional treatment trial for Beta Thalassemia Major
Eligibility Criteria
Inclusion Criteria:
- Patient has clinically confirmed documented diagnosis of Beta Thalassemia Major, according to the current clinical criteria, and are on blood transfusions.
- Patient has been on a stable maintaince therapy with deferasirox for at least during last 3 months.
- Patients current chelation therapy is considered inadequate, meaning that there is evidence from clinical monitoring that chronic iron overload is present (e.g. serum ferritin >1,000 µg/l), for at least during the last 3 months.
- The ferritin level has been stable with max 10% difference between max-to-low, and the iron chelator treatment dose has been unchanged during the last 3 months
- Patient is aged 18 years or older at screening.
- Female patients are only eligible for the study if they are either surgically sterile or at least 2 years postmenopausal, or have a negative result of serum hCG test at screening and if willing to use acceptable, effective methods of contraception during the trial and for three month after the end of trial participation as defined inpoint 7.7. of this the protocol.
- Male patients must either be surgically sterile or he and his female spouse/partner who is of childbearing potential must be willing to use highly effective methods of contraception consisting of 2 forms of birth control (1 of which must be a barrier method) starting at screening and continuing throughout the study.
- Patient is fluent in the local language and provides written informed consent.
Exclusion Criteria:
- Known history or presence of clinically significant other, hematologic, endocrine, oncologic, pulmonary, immunologic, genitourinary, psychiatric, or cardiovascular disease or any other condition which, in the opinion of the Investigator, would jeopardize the safety of the subject or impact the validity of the study results.
- Known or suspected allergy hypersensitivity or idiosyncratic reaction to NBMI or any other drug substances with similar activity.
- History of drug or alcohol addiction requiring treatment.
- History of malabsorption within the last year or presence of clinically significant gastrointestinal disease or surgery that may affect drug bioavailability, including but not limited to cholecystectomy.
- Presence of hepatic or renal dysfunction. (SGOT and SGPT and bilirubin > X3 (3 fold) UNL. creatinine > 1.5mg/dl).
- Female patient who is pregnant (serum hCG level consistent with pregnancy diagnosis); or breastfeeding.
- Participation in a clinical trial that involved administration of an investigational medicinal product within 90 days prior to drug administration, or recent participation in a clinical investigation that, in the opinion of the Investigator, would jeopardize subject safety or the integrity of the study results.
- Have clinically significant abnormal laboratory values (e.g. liver enzymes).
- Have clinically significant findings from a physical examination (e.g. fever).
- Patient has Inflammatory disorders, liver disease such as hepatitis, malignancy or other condition that could influence ferritine levels and therefore validity of study results.
Sites / Locations
- University Hospital Center "Mother Theresa" Tirana
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Experimental: Treatment
Arm Description
28 days treatment with NBMI 600 mg/day
Outcomes
Primary Outcome Measures
Incidence of Treatment-Emergent Adverse Events
The safety assessment is based on the number, type and severity of adverse events. The incidence of adverse events will be summarized by organ class, severity and duration.
Secondary Outcome Measures
Change in serum ferritin levels
Change in serum ferritin levels measured in µg/l (V2 level compared to V4 level and V5 level compared to V2 level)
Change in iron load in the liver and heart
Change in iron load in the liver and heart as measured by magnetic resonance imaging (MRI) techniques for assessing tissue iron T* (V2 level compared to V4 level and V5 level compared to V2 level)
Percentage of NBMI-treated patients who will develop a response
Percentage of NBMI-treated patients who will develop a response to NBMI (response will be defined as lack of increase of ferritin levels ) as compared between V2 level and V4 level
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04092205
Brief Title
Phase 2a Pilot Study of NBMI Treatment in Patients With Beta Thalassemia Major, Requiring Iron Chelation
Acronym
EMERA007
Official Title
EMERA007 - An Open Label, Active-treatment Controlled, Phase 2a Pilot Study to Explore Safety and Efficacy of NBMI Treatment in Patients With Beta Thalassemia Major, Requiring Iron Chelation
Study Type
Interventional
2. Study Status
Record Verification Date
August 2021
Overall Recruitment Status
Completed
Study Start Date
November 21, 2019 (Actual)
Primary Completion Date
July 30, 2020 (Actual)
Study Completion Date
August 30, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
EmeraMed
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
A pilot study to explore safety and efficacy of NBMI treatment in patients with Beta Thalassemia Major requiring iron chelation
Investigational product: NBMI (N1,N3-bis(2-mercaptoethyl) isophthalamide), INN: Emeramide
Indication: Beta Thalassemia Major
Detailed Description
Patients with iron overload, not controlled with current therapy will be enrolled to the study. After initial treatment with standard chelation therapy (deferasirox), patients will receive 600 mg daily dose of emeramide (NBMI) for 28 days. After that follow up period on standard treatment with deferasirox shall follow.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Beta Thalassemia Major
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
An open label, active-treatment controlled once daily oral administration for 28 days and 28 days follow up
Masking
None (Open Label)
Allocation
N/A
Enrollment
13 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Experimental: Treatment
Arm Type
Experimental
Arm Description
28 days treatment with NBMI 600 mg/day
Intervention Type
Drug
Intervention Name(s)
Emeramide
Other Intervention Name(s)
NBMI, Irminix
Intervention Description
Lipophilic, membrane passing Metal chelator and anti oxidant
Primary Outcome Measure Information:
Title
Incidence of Treatment-Emergent Adverse Events
Description
The safety assessment is based on the number, type and severity of adverse events. The incidence of adverse events will be summarized by organ class, severity and duration.
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Change in serum ferritin levels
Description
Change in serum ferritin levels measured in µg/l (V2 level compared to V4 level and V5 level compared to V2 level)
Time Frame
28 days
Title
Change in iron load in the liver and heart
Description
Change in iron load in the liver and heart as measured by magnetic resonance imaging (MRI) techniques for assessing tissue iron T* (V2 level compared to V4 level and V5 level compared to V2 level)
Time Frame
28 days
Title
Percentage of NBMI-treated patients who will develop a response
Description
Percentage of NBMI-treated patients who will develop a response to NBMI (response will be defined as lack of increase of ferritin levels ) as compared between V2 level and V4 level
Time Frame
28 days
Other Pre-specified Outcome Measures:
Title
Kidney markers (serum creatinine levels, glomerular filtration calculation)
Description
Change from baseline after both treatments. Serum creatinine levels will be measured in μmol/l, glomerular filtration in ml/min.
Time Frame
28 days
Title
Pharmacokinetic parameters
Description
Pharmacokinetic parameters derived from plasma concentrations of NBMI (Time of maximum analyte concentration - Tmax, Maximum drug concentration - Cmax,The terminal elimination rate constant - λz, Apparent terminal elimination half-life - t1/2, The area under the plasma concentration - AUC0-t, Area under the concentration-time curve - AUC0-∞, Area under the concentration-time curve - AUC%Extrap)
Time Frame
Visit 4, 5, 6, 7
Title
Malondialdehyde levels
Description
Indicator of oxidative stress measured in μmol/l.
Time Frame
Visit 2, 4
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patient has clinically confirmed documented diagnosis of Beta Thalassemia Major, according to the current clinical criteria, and are on blood transfusions.
Patient has been on a stable maintaince therapy with deferasirox for at least during last 3 months.
Patients current chelation therapy is considered inadequate, meaning that there is evidence from clinical monitoring that chronic iron overload is present (e.g. serum ferritin >1,000 µg/l), for at least during the last 3 months.
The ferritin level has been stable with max 10% difference between max-to-low, and the iron chelator treatment dose has been unchanged during the last 3 months
Patient is aged 18 years or older at screening.
Female patients are only eligible for the study if they are either surgically sterile or at least 2 years postmenopausal, or have a negative result of serum hCG test at screening and if willing to use acceptable, effective methods of contraception during the trial and for three month after the end of trial participation as defined inpoint 7.7. of this the protocol.
Male patients must either be surgically sterile or he and his female spouse/partner who is of childbearing potential must be willing to use highly effective methods of contraception consisting of 2 forms of birth control (1 of which must be a barrier method) starting at screening and continuing throughout the study.
Patient is fluent in the local language and provides written informed consent.
Exclusion Criteria:
Known history or presence of clinically significant other, hematologic, endocrine, oncologic, pulmonary, immunologic, genitourinary, psychiatric, or cardiovascular disease or any other condition which, in the opinion of the Investigator, would jeopardize the safety of the subject or impact the validity of the study results.
Known or suspected allergy hypersensitivity or idiosyncratic reaction to NBMI or any other drug substances with similar activity.
History of drug or alcohol addiction requiring treatment.
History of malabsorption within the last year or presence of clinically significant gastrointestinal disease or surgery that may affect drug bioavailability, including but not limited to cholecystectomy.
Presence of hepatic or renal dysfunction. (SGOT and SGPT and bilirubin > X3 (3 fold) UNL. creatinine > 1.5mg/dl).
Female patient who is pregnant (serum hCG level consistent with pregnancy diagnosis); or breastfeeding.
Participation in a clinical trial that involved administration of an investigational medicinal product within 90 days prior to drug administration, or recent participation in a clinical investigation that, in the opinion of the Investigator, would jeopardize subject safety or the integrity of the study results.
Have clinically significant abnormal laboratory values (e.g. liver enzymes).
Have clinically significant findings from a physical examination (e.g. fever).
Patient has Inflammatory disorders, liver disease such as hepatitis, malignancy or other condition that could influence ferritine levels and therefore validity of study results.
Facility Information:
Facility Name
University Hospital Center "Mother Theresa" Tirana
City
Tirana
ZIP/Postal Code
1006
Country
Albania
12. IPD Sharing Statement
Plan to Share IPD
No
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Phase 2a Pilot Study of NBMI Treatment in Patients With Beta Thalassemia Major, Requiring Iron Chelation
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