search
Back to results

Multi-center Trial of Ferric Derisomaltose in Children 0 to <18 Years of Age With Iron Deficiency Anemia

Primary Purpose

Iron Deficiency, Anaemia in Children

Status
Recruiting
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Ferric Derisomaltose
Sponsored by
Pharmacosmos A/S
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Iron Deficiency, Anaemia in Children

Eligibility Criteria

undefined - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Subjects <18 years
  • Informed consent and child assent, as age-appropriate, obtained before any trial- related activities and willingness to participate. LAR of the subject must sign and date the ICF (according to local requirements). The child must sign and date the CAF or provide oral assent, if required according to local requirements
  • IDA caused by different etiologies such as gastrointestinal disease, NDD-CKD, or other conditions leading to IDA
  • Hb concentration less than the 5th percentile for age and sex-specific reference range (Appendix B)
  • Subjects with NDD-CKD (a) or who are intolerant or unresponsive to oral iron (b):

    a) Subjects with NDD-CKD:

  • TSAT ≤35 % or s-ferritin <100 ng/mL
  • Estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2
  • If on ESA, receiving stable ESA regimen defined as dose adjustments no more than

    ± 20 % for ≥8 weeks prior to screening

    b) Subjects with documented history of intolerance or unresponsiveness to oral iron therapy for at least one month prior to trial enrolment.

  • TSAT ≤20 % or s-ferritin <100 ng/mL

Exclusion Criteria:

  • Anemia caused by factors other than IDA according to Investigator's judgment
  • S-ferritin >600 ng/mL
  • Hb ≤5.0 g/dL
  • Iron overload or disturbances in utilization of iron (e.g. hemochromatosis and hemosiderosis)
  • ALAT and/or ASAT >2 times upper limit of normal (e.g. decompensated liver cirrhosis or active hepatitis)
  • Pregnant or nursing female subjects. In order to avoid pregnancy, female subjects of childbearing potential have to use adequate contraception (e.g. intrauterine devices, hormonal contraceptives, or double barrier method) or be abstinent during the whole trial period and 7 days after the last dosing. Childbearing potential refers to all female subjects ≥12 years old or <12 years old who have started menstruating
  • Previous serious hypersensitivity reactions to any IV iron compounds including ferric derisomaltose
  • Received an investigational drug within 30 days prior to screening
  • Treatment with IV iron within 10 days prior to screening
  • Treatment with blood transfusion, radiotherapy, chemotherapy or other drugs that suppress the bone marrow, and drugs which have anemia as side effect within 30 days prior to screening
  • Planned elective surgery (or planned surgery during the trial period) where significant blood loss is expected within the last 30 days prior to screening
  • Any non-viral infection (non-viral infection that has been fully treated before the baseline visit is accepted)
  • Any other laboratory abnormality, medical condition, or psychiatric disorders which, in the opinion of the Investigator, will put the subject's disease management at risk or may result in the subject being unable to comply with the trial requirements

Sites / Locations

  • Pharmacosmos Investigational SiteRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Ferric Derisomaltose

Arm Description

All subjects (a total of 200) will be treated with Ferric Derisomaltose. 12 subjects (half of the 24 subjects participating in the PK-part of the trial) will be treated with 10mg/kg while the remaining subjects will be treated with 20 mg/kg. .

Outcomes

Primary Outcome Measures

Incidence of subjects with a Hb increase of ≥1 g/dL (NDD-CKD) or 2 g/dL (intolerant or unresponsive to oral iron). Measurement by bloodsample.
Hb (g/dL), measurement by bloodsample analysis

Secondary Outcome Measures

Time to increase Hb ≥1 g/dL (NDD-CKD) or 2 g/dL (intolerant or unresponsive to oral iron). Measurement by bloodsample.
Hb (g/dL), measurement by bloodsample analysis
Incidence of subjects who achieve a serum (s-) ferritin of ≥100 ng/mL. Measurement by bloodsample.
s-ferritin (ng/mL), measurement by bloodsample analysis
Incidence of subjects who achieve a TSAT of ≥35 % (NDD-CKD) or ≥20 % (intolerant or unresponsive to oral iron). Measurement by bloodsample.
TSAT (%), measurement by bloodsample analysis
Total iron PK parameters: AUC0-∞
Total iron (µg/dL), measurement by bloodsample analysis
Total iron PK parameters: AUC0-t
Total iron (µg/dL), measurement by bloodsample analysis
Total iron PK parameters: Cmax
Total iron (µg/dL), measurement by bloodsample analysis
Total iron PK parameters: Tmax
Total iron (µg/dL), measurement by bloodsample analysis
Total iron PK parameters: Ke
Total iron (µg/dL), measurement by bloodsample analysis
Total iron PK parameters: T½
Total iron (µg/dL), measurement by bloodsample analysis
Total iron PK parameters: CL
Total iron (µg/dL), measurement by bloodsample analysis
Total iron PK parameters: Vd
Total iron (µg/dL), measurement by bloodsample analysis
Type and incidence of AEs
Any AE
Serious or severe hypersensitivity reaction
Any serious or severe hypersensitivity reaction

Full Information

First Posted
November 16, 2021
Last Updated
October 18, 2023
Sponsor
Pharmacosmos A/S
search

1. Study Identification

Unique Protocol Identification Number
NCT05179226
Brief Title
Multi-center Trial of Ferric Derisomaltose in Children 0 to <18 Years of Age With Iron Deficiency Anemia
Official Title
A Phase III, Prospective, Open-label, Multi-center Trial of Ferric Derisomaltose in Children 0 to <18 Years of Age With Iron Deficiency Anemia Due to NDD-CKD or With Iron Deficiency Anemia Who Are Intolerant or Unresponsive to Oral Iron
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
November 28, 2022 (Actual)
Primary Completion Date
April 30, 2024 (Anticipated)
Study Completion Date
June 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pharmacosmos A/S

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Several clinical trials have been reported for ferric derisomaltose where it has been shown to be well tolerated and to improve markers of IDA. All clinical trials with ferric derisomaltose have been performed in adults, however, IDA is not specific to the adult population. In fact, children are likely to develop IDA due to their rapid growth. The aim in this trial is to evaluate the efficacy and safety of intravenous (IV) ferric derisomaltose in children 0 to <18 years of age with IDA due to NDD-CKD or with IDA who are intolerant or unresponsive to oral iron . The subjects will receive ferric derisomaltose/iron isomaltoside 1000 (Monoferric®/Monofer®), at single doses of 10 mg/kg or 20 mg/kg with a maximal dose of 1000 mg. 24 subjects will be part of a PK assessment, meaning that more blood samples will be drawn within the first week after treatment. The blood samples will be used for analysis of the amount of total iron in the blood from treatment is given to day 7. For the individual subject, duration of the trial will be approximately 10 weeks (including a 14-day screening period) and each subject will attend 6-9 visits. Subjects who will be included in the PK assessments will attend 8 (subjects age 6 to <12 years old and 0 to <6 years old) or 9 (subjects age 12 to <18 years old) visits, while the other subjects will attend 6 visits.
Detailed Description
This is a combined clinical pharmacology and phase III study. The study is a prospective, open-label, multi-center study. Children 0 to <18 years of age with iron deficiency anemia (IDA) with a) non-dialysis dependent chronic kidney disease (NDD-CKD) or b) who are intolerant or unresponsive to oral iron will be enrolled. The subjects will receive ferric derisomaltose/iron isomaltoside 1000 (Monoferric®) at single doses of 10 mg/kg or 20 mg/kg with a maximal dose of 1000 mg. A total of 200 subjects will be enrolled. Of these will 24 be part of the PK assessment. PK-subjects will be included in cohorts of 4 with the oldest age group as the first and with ferric derisomaltose 10 mg/kg to be increased to 20 mg/kg for the next cohort. Thus 12 subjects will be treated with 10mg/kg and the remaining 188 subjects with 20mg/kg.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Iron Deficiency, Anaemia in Children

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Model Description
The study includes a PK-part. 24 subjects will be part of a PK assessment and have total- iron PK-parameters measured 7 or 8 times between baseline visit and week 1.
Masking
None (Open Label)
Allocation
N/A
Enrollment
200 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Ferric Derisomaltose
Arm Type
Experimental
Arm Description
All subjects (a total of 200) will be treated with Ferric Derisomaltose. 12 subjects (half of the 24 subjects participating in the PK-part of the trial) will be treated with 10mg/kg while the remaining subjects will be treated with 20 mg/kg. .
Intervention Type
Drug
Intervention Name(s)
Ferric Derisomaltose
Other Intervention Name(s)
Monofer®, Monoferric®
Intervention Description
All subjects will be treated with Ferric derisomaltose 20 mg/kg at baseline visit except for 12 subjects included in the PK-group, who will be treated with 10 mg/kg
Primary Outcome Measure Information:
Title
Incidence of subjects with a Hb increase of ≥1 g/dL (NDD-CKD) or 2 g/dL (intolerant or unresponsive to oral iron). Measurement by bloodsample.
Description
Hb (g/dL), measurement by bloodsample analysis
Time Frame
From baseline at any time from week 1 to week 8
Secondary Outcome Measure Information:
Title
Time to increase Hb ≥1 g/dL (NDD-CKD) or 2 g/dL (intolerant or unresponsive to oral iron). Measurement by bloodsample.
Description
Hb (g/dL), measurement by bloodsample analysis
Time Frame
From baseline at any time from week 1 to week 8
Title
Incidence of subjects who achieve a serum (s-) ferritin of ≥100 ng/mL. Measurement by bloodsample.
Description
s-ferritin (ng/mL), measurement by bloodsample analysis
Time Frame
At weeks 1, 2, 4, and 8
Title
Incidence of subjects who achieve a TSAT of ≥35 % (NDD-CKD) or ≥20 % (intolerant or unresponsive to oral iron). Measurement by bloodsample.
Description
TSAT (%), measurement by bloodsample analysis
Time Frame
At weeks 1, 2, 4, and 8
Title
Total iron PK parameters: AUC0-∞
Description
Total iron (µg/dL), measurement by bloodsample analysis
Time Frame
From baseline to day 7
Title
Total iron PK parameters: AUC0-t
Description
Total iron (µg/dL), measurement by bloodsample analysis
Time Frame
From baseline to day 7
Title
Total iron PK parameters: Cmax
Description
Total iron (µg/dL), measurement by bloodsample analysis
Time Frame
From baseline to day 7
Title
Total iron PK parameters: Tmax
Description
Total iron (µg/dL), measurement by bloodsample analysis
Time Frame
From baseline to day 7
Title
Total iron PK parameters: Ke
Description
Total iron (µg/dL), measurement by bloodsample analysis
Time Frame
From baseline to day 7
Title
Total iron PK parameters: T½
Description
Total iron (µg/dL), measurement by bloodsample analysis
Time Frame
From baseline to day 7
Title
Total iron PK parameters: CL
Description
Total iron (µg/dL), measurement by bloodsample analysis
Time Frame
From baseline to day 7
Title
Total iron PK parameters: Vd
Description
Total iron (µg/dL), measurement by bloodsample analysis
Time Frame
From baseline to day 7
Title
Type and incidence of AEs
Description
Any AE
Time Frame
From baseline to week 8
Title
Serious or severe hypersensitivity reaction
Description
Any serious or severe hypersensitivity reaction
Time Frame
From treatment (Baseline) to 24 hours

10. Eligibility

Sex
All
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects <18 years Informed consent and child assent, as age-appropriate, obtained before any trial- related activities and willingness to participate. LAR of the subject must sign and date the ICF (according to local requirements). The child must sign and date the CAF or provide oral assent, if required according to local requirements IDA caused by different etiologies such as gastrointestinal disease, NDD-CKD, or other conditions leading to IDA Hb concentration less than the 5th percentile for age and sex-specific reference range (Appendix B) Subjects with NDD-CKD (a) or who are intolerant or unresponsive to oral iron (b): a) Subjects with NDD-CKD: TSAT ≤35 % or s-ferritin <100 ng/mL Estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 If on ESA, receiving stable ESA regimen defined as dose adjustments no more than ± 20 % for ≥8 weeks prior to screening b) Subjects with documented history of intolerance or unresponsiveness to oral iron therapy for at least one month prior to trial enrolment. TSAT ≤20 % or s-ferritin <100 ng/mL Exclusion Criteria: Anemia caused by factors other than IDA according to Investigator's judgment S-ferritin >600 ng/mL Hb ≤5.0 g/dL Iron overload or disturbances in utilization of iron (e.g. hemochromatosis and hemosiderosis) ALAT and/or ASAT >2 times upper limit of normal (e.g. decompensated liver cirrhosis or active hepatitis) Pregnant or nursing female subjects. In order to avoid pregnancy, female subjects of childbearing potential have to use adequate contraception (e.g. intrauterine devices, hormonal contraceptives, or double barrier method) or be abstinent during the whole trial period and 7 days after the last dosing. Childbearing potential refers to all female subjects ≥12 years old or <12 years old who have started menstruating Previous serious hypersensitivity reactions to any IV iron compounds including ferric derisomaltose Received an investigational drug within 30 days prior to screening Treatment with IV iron within 10 days prior to screening Treatment with blood transfusion, radiotherapy, chemotherapy or other drugs that suppress the bone marrow, and drugs which have anemia as side effect within 30 days prior to screening Planned elective surgery (or planned surgery during the trial period) where significant blood loss is expected within the last 30 days prior to screening Any non-viral infection (non-viral infection that has been fully treated before the baseline visit is accepted) Any other laboratory abnormality, medical condition, or psychiatric disorders which, in the opinion of the Investigator, will put the subject's disease management at risk or may result in the subject being unable to comply with the trial requirements
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Pharmacosmos A/S Clinical and Non-clinical Research
Phone
+4559485959
Email
info@pharmacosmos.com
Facility Information:
Facility Name
Pharmacosmos Investigational Site
City
Miami
State/Province
Florida
ZIP/Postal Code
33142
Country
United States
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Multi-center Trial of Ferric Derisomaltose in Children 0 to <18 Years of Age With Iron Deficiency Anemia

We'll reach out to this number within 24 hrs