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Ferric Carboxymaltose in Subjects With Functional Iron Deficiency Undergoing Chemotherapy (FID-CHEMO)

Primary Purpose

Iron-Deficiency Anemia

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Ferric carboxymaltose
Sponsored by
Vifor Pharma
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Iron-Deficiency Anemia focused on measuring Anemia, Lymphoproliferative Disorders, Chemotherapy, ferric carboxymaltose, iron

Eligibility Criteria

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

Inclusion Criteria:

  • Subjects (male or female) aged ≥18, suffering from indolent non-Hodgkin's lymphoma, multiple myeloma or chronic lymphocytic leukaemia on any chemotherapy excluding anthracycline containing.
  • Life expectancy at least 6 months.
  • Received at least 12 weeks (or 3 cycles) of treatment in the current course of chemotherapy before start of iron therapy.
  • 8.5 g/dL Hb 10.5 g/dL at time of randomisation.
  • Iron-restricted erythropoiesis as defined:

    • Stainable iron in bone marrow combined with transferrin saturation (TSAT) ≤20% OR
    • where the evaluation of stainable iron in bone marrow is not possible or available:

      • ferritin >30 ng/mL (women) or >40 ng/mL (men) and
      • TSAT ≤20%
  • Signed informed consent (before any study procedure).
  • Females of child-bearing potential must have a negative urine pregnancy test.

Exclusion Criteria:

  • Any anaemia treatment within 4 weeks before inclusion (including red blood cell transfusion, ESA treatment and any oral/parenteral iron supplementation).
  • Subjects weighing <35 kg.
  • Subjects with increase in Hb during the chemotherapy (>1 g/dL rise between initiation of CT and screening laboratory value).
  • Folate deficiency (serum folate <4.5 nmol/L) and/or vitamin B12 deficiency (serum cobalamin <145 pmol/L).
  • Ongoing haemolysis defined as serum haptoglobin <0.2 g/L.
  • Recent significant bleeding/surgery.
  • Monotherapy with immunotherapy agents.
  • Known chronic renal failure, creatinine >125 μmol/L.
  • Anthracycline containing chemotherapy regimens.
  • Clinically relevant active inflammatory disease other than the malignant disease (according to the judgement of the Investigator).
  • Clinically relevant ongoing infectious disease including known human immunodeficiency virus.
  • Serum-ferritin >800 ng/mL.
  • Ongoing significant neurological or psychiatric disorders including psychotic disorders or dementia.
  • Significant cardiovascular disease prior to study inclusion including myocardial infarction within 12 months prior to study inclusion, congestive heart failure New York Heart Association (NYHA) Grade III or IV, or poorly controlled hypertension according to the judgment of the Investigator.
  • Elevation of liver enzymes (aspartate aminotransferase, alanine aminotransferase) over 3 times above the normal range or known acute hepatic disorder.
  • Subject currently is enrolled in or has not yet completed at least 30 days since ending other investigational device or drug study(ies), or subject is receiving other investigational agent(s).
  • Females who are evidently pregnant (e.g., positive HCG test) or are breast feeding.
  • Subject is not using adequate contraceptive precautions. Adequate contraceptive precautions are defined as those which result in a low failure rate (i.e., less than 1% per year) when used consistently and correctly such as implants, injectables, combined oral contraceptives, some intra-uterine devices, sexual abstinence or vasectomised partner. Non-childbearing potential includes being surgically sterilised at least 6 months prior to the study or post menopausal, defined as amenorrhea for at least 12 months.
  • Subject has known sensitivity to any of the products to be administered during dosing.
  • Subject will not be available for follow-up assessment.
  • Subject has any kind of disorder that compromises the ability of the subject to give written informed consent and/or to comply with study procedures.

Sites / Locations

  • Universitätsklinikum Hamburg-Eppendorf
  • Department of Medicine, St Görans Hospital (Capio St Görans Sjukhus)

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

No Intervention

Arm Label

Ferric carboxymaltose

Local standard of care.

Arm Description

Subjects will receive a total dose of 1,000 mg iron as FCM on the day of the next scheduled chemotherapy cycle after randomisation or continuous chemotherapy. In subjects with weight ≤66 kg, the first dose iron will be 500 mg; the second dose (500 mg) will be administered on the visit 4 (week 2).

Subjects will be treated according to the local institutional practice.

Outcomes

Primary Outcome Measures

Change in haemoglobin from baseline to Week 4

Secondary Outcome Measures

The percentage of subjects with blood haemoglobin increase of at least 1 g/dL in the absence of any red cell transfusion or ESA treatment.
Change in haemoglobin from baseline to Week 6
Change in haemoglobin from baseline to Week 8

Full Information

First Posted
March 30, 2010
Last Updated
December 16, 2013
Sponsor
Vifor Pharma
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1. Study Identification

Unique Protocol Identification Number
NCT01101399
Brief Title
Ferric Carboxymaltose in Subjects With Functional Iron Deficiency Undergoing Chemotherapy
Acronym
FID-CHEMO
Official Title
Randomised Controlled Open-label Study to Evaluate Efficacy & Safety of Intravenous Ferric Carboxymaltose Versus no Treatment in Anaemic Subjects With Lymphoid Malignancies & Functional Iron Deficiency Receiving Chemotherapy
Study Type
Interventional

2. Study Status

Record Verification Date
December 2013
Overall Recruitment Status
Completed
Study Start Date
May 2010 (undefined)
Primary Completion Date
November 2012 (Actual)
Study Completion Date
November 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Vifor Pharma

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Anaemia and functional iron deficiency are common conditions in patients with lymphoid malignancies, conditions which reduce significantly the quality of life and increase morbidity and mortality. Traditionally, Erythropoiesis Stimulating Agents (ESAs) have been used, but recently their use has been shown to have a negative impact on overall survival in different oncology populations. Recently published data suggest that intravenous (IV) iron can be effective in anaemia treatment, even without ESAs. This exploratory study is the first clinical project with ferric carboxymaltose (FCM) in patients with lymphoid malignancies: the data generated may be used for further evaluations of the drug in larger populations. In this study, 1,000 mg of IV iron as FCM will be administered on the same day or within 24 hours before or after chemotherapy treatment. The primary objective is to evaluate the efficacy of FCM in the correction of haemoglobin levels in anaemic subjects with lymphoid malignancies, undergoing chemotherapy. Secondary objectives aim to describe the safety and tolerability of FCM, and the effect of FCM treatment on iron status variables in subjects suffering from lymphoid malignancies.
Detailed Description
Multicentre, randomised, controlled, 2-arm open-label prospective pilot study to evaluate efficacy and safety of FCM in the treatment of anaemia in LPD subjects with functional iron deficiency (FID), undergoing chemotherapy. The subjects will be screened for eligibility within 4 weeks prior to inclusion to receive intravenous (IV) infusions of FCM or no FCM infusions (the subjects may be treated according to the local institutional practice if requiring symptomatic management of anaemia). After randomisation, the visits are scheduled weekly until Week 8.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Iron-Deficiency Anemia
Keywords
Anemia, Lymphoproliferative Disorders, Chemotherapy, ferric carboxymaltose, iron

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
19 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ferric carboxymaltose
Arm Type
Active Comparator
Arm Description
Subjects will receive a total dose of 1,000 mg iron as FCM on the day of the next scheduled chemotherapy cycle after randomisation or continuous chemotherapy. In subjects with weight ≤66 kg, the first dose iron will be 500 mg; the second dose (500 mg) will be administered on the visit 4 (week 2).
Arm Title
Local standard of care.
Arm Type
No Intervention
Arm Description
Subjects will be treated according to the local institutional practice.
Intervention Type
Drug
Intervention Name(s)
Ferric carboxymaltose
Other Intervention Name(s)
Ferinject
Intervention Description
Subjects will receive a single dose of 1,000 mg iron as FCM infusion at baseline. Subjects of bw ≤66 kg will receive a single dose of 500 mg iron as FCM infusion at baseline (Week 0) and at Visit 4 (Week 2). Ferric carboxymaltose will be administered on the same day with chemotherapy treatment or within 24 hours before or after the chemotherapy. For subjects with bw ≤66 kg, if no chemotherapy planned for the visit 4 (Week 2), the second FCM dose should be infused independent of chemotherapy.
Primary Outcome Measure Information:
Title
Change in haemoglobin from baseline to Week 4
Time Frame
Weeks 4 post baseline
Secondary Outcome Measure Information:
Title
The percentage of subjects with blood haemoglobin increase of at least 1 g/dL in the absence of any red cell transfusion or ESA treatment.
Time Frame
12 weeks post baseline
Title
Change in haemoglobin from baseline to Week 6
Time Frame
6 weeks after baseline
Title
Change in haemoglobin from baseline to Week 8
Time Frame
8 weeks after baseline

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects (male or female) aged ≥18, suffering from indolent non-Hodgkin's lymphoma, multiple myeloma or chronic lymphocytic leukaemia on any chemotherapy excluding anthracycline containing. Life expectancy at least 6 months. Received at least 12 weeks (or 3 cycles) of treatment in the current course of chemotherapy before start of iron therapy. 8.5 g/dL Hb 10.5 g/dL at time of randomisation. Iron-restricted erythropoiesis as defined: Stainable iron in bone marrow combined with transferrin saturation (TSAT) ≤20% OR where the evaluation of stainable iron in bone marrow is not possible or available: ferritin >30 ng/mL (women) or >40 ng/mL (men) and TSAT ≤20% Signed informed consent (before any study procedure). Females of child-bearing potential must have a negative urine pregnancy test. Exclusion Criteria: Any anaemia treatment within 4 weeks before inclusion (including red blood cell transfusion, ESA treatment and any oral/parenteral iron supplementation). Subjects weighing <35 kg. Subjects with increase in Hb during the chemotherapy (>1 g/dL rise between initiation of CT and screening laboratory value). Folate deficiency (serum folate <4.5 nmol/L) and/or vitamin B12 deficiency (serum cobalamin <145 pmol/L). Ongoing haemolysis defined as serum haptoglobin <0.2 g/L. Recent significant bleeding/surgery. Monotherapy with immunotherapy agents. Known chronic renal failure, creatinine >125 μmol/L. Anthracycline containing chemotherapy regimens. Clinically relevant active inflammatory disease other than the malignant disease (according to the judgement of the Investigator). Clinically relevant ongoing infectious disease including known human immunodeficiency virus. Serum-ferritin >800 ng/mL. Ongoing significant neurological or psychiatric disorders including psychotic disorders or dementia. Significant cardiovascular disease prior to study inclusion including myocardial infarction within 12 months prior to study inclusion, congestive heart failure New York Heart Association (NYHA) Grade III or IV, or poorly controlled hypertension according to the judgment of the Investigator. Elevation of liver enzymes (aspartate aminotransferase, alanine aminotransferase) over 3 times above the normal range or known acute hepatic disorder. Subject currently is enrolled in or has not yet completed at least 30 days since ending other investigational device or drug study(ies), or subject is receiving other investigational agent(s). Females who are evidently pregnant (e.g., positive HCG test) or are breast feeding. Subject is not using adequate contraceptive precautions. Adequate contraceptive precautions are defined as those which result in a low failure rate (i.e., less than 1% per year) when used consistently and correctly such as implants, injectables, combined oral contraceptives, some intra-uterine devices, sexual abstinence or vasectomised partner. Non-childbearing potential includes being surgically sterilised at least 6 months prior to the study or post menopausal, defined as amenorrhea for at least 12 months. Subject has known sensitivity to any of the products to be administered during dosing. Subject will not be available for follow-up assessment. Subject has any kind of disorder that compromises the ability of the subject to give written informed consent and/or to comply with study procedures.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Torbjörn Karlsson, MD, PhD
Organizational Affiliation
Capio St Görans Sjukhus, Stockholm
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Morgan McNamara
Organizational Affiliation
Vifor Pharma, CH-8152 Glattbrugg, Switzerland
Official's Role
Study Director
Facility Information:
Facility Name
Universitätsklinikum Hamburg-Eppendorf
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Facility Name
Department of Medicine, St Görans Hospital (Capio St Görans Sjukhus)
City
Stockholm
ZIP/Postal Code
SE-112 81
Country
Sweden

12. IPD Sharing Statement

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Ferric Carboxymaltose in Subjects With Functional Iron Deficiency Undergoing Chemotherapy

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