ORal IrON Supplementation With Ferric Maltol in Patients With Pulmonary Hypertension (ORION-PH-1) (ORION-PH-1)
Primary Purpose
Hypertension, Pulmonary, Anemia, Iron Deficiency
Status
Terminated
Phase
Phase 3
Locations
Germany
Study Type
Interventional
Intervention
Ferric maltol 30 mg (Feraccru®)
Sponsored by
About this trial
This is an interventional treatment trial for Hypertension, Pulmonary focused on measuring Pulmonary Hypertension, Iron Deficiency
Eligibility Criteria
Inclusion Criteria:
- Signed written informed consent prior to any study-related procedure and willingness to comply with treatment and follow-up procedures
- Male and female patients ≥18 years at day of inclusion
- Patients capable of understanding the investigational nature, potential risks and benefits of the clinical trial
- Patients with a diagnosis of PH confirmed by a (historical) right heart catheterization showing a mean pulmonary artery pressure ≥25 mmHg at rest and stable PH medication for at least 3 months.
- 6 min walk distance >50 m
- Mild-to-moderate iron-deficiency anemia as defined by a hemoglobin concentration ≥7 g/dl and <12 g/dl in females or ≥8 g/dl and <13 g/dl in males, and serum ferritin <100 µg/l, or 100-300 µg/l and transferrin saturation <20% at screening
- Prevention of pregnancy:
Women without childbearing potential defined as follows:
- at least 6 weeks after surgical sterilization by bilateral tubal ligation or bilateral oophorectomy or
- hysterectomy or uterine agenesis or
- ≥ 50 years and in postmenopausal state ≥ 1 year or
- < 50 years and in postmenopausal state ≥ 1 year with serum FSH > 40 IU/l and serum oestrogen < 30 ng/l or a negative oestrogen test or
Women of childbearing potential with a negative ß-HCG pregnancy test at screening who agree to meet one of the following criteria from the time of screening, during the study and for a period of four weeks following the last administration of study medication:
- correct use of contraception methods. The following are acceptable: hormonal contraceptives (combined oral contraceptives and oestrogen-free pills with desogestrel, implants, transdermal patches, hormonal vaginal devices or injections with prolonged release), intrauterine device (IUS) or a barrier method, e.g. condom or occlusive cap (diaphragm or cervical/vault caps) with spermicide (foam, gel, film, cream or suppository)
- true abstinence (periodic abstinence and withdrawal are not acceptable methods of contraception)
- sexual relationship only with female partners and/or sterile male partners
Exclusion Criteria:
- Active hematological disorders other than iron-deficiency anemia
- Other medical condition that according to the investigator's assessment is causing or contributing to anemia
- Active malignancy
- Active infectious disease
- Active bleeding
- Severe renal insufficiency (glomerular filtration rate <30 ml/min)
- Severe liver injury as indicated by serum aminotransferases >3 x upper limit of normal or bilirubin levels >50 µmol/l
- Ongoing oral or intravenous iron supplementation
- Hemoglobin <7 g/dl in females or <8 g/dl in males at screening
- Concomitant erythropoietin medication
- Pregnancy or lactation period
- Subject has received any investigational medication or any investigational device within 30 days prior to the first dose of study medication or is actively participating in any investigational drug/devices trial, or is scheduled to receive an investigational drug/device during the course of the study.
- Known or suspected hypersensitivity to any of the active substances or any excipients of the investigational medicinal product
- Known haemochromatosis or other iron overload syndromes
- Patients who have been receiving repeated (>1) blood transfusions during the past 6 months
Sites / Locations
- Hannover Medical School
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Ferric maltol 30 mg (Feraccru®)
Arm Description
Treatment with Feraccru® 30 mg hard capsules (Ferric maltol 30 mg). One capsule twice daily, morning and evening, on an empty stomach for 12 weeks
Outcomes
Primary Outcome Measures
Change in hemoglobin level from baseline to week 12
measurement of hemoglobin in blood
Secondary Outcome Measures
Change in hemoglobin from baseline to week 6
measurement of hemoglobin in blood
Change in serum ferritin levels from baseline to week 6 and 12
measurement of serum ferritin levels
Change in transferrin saturation from baseline to week 6 and 12
measurement of transferrin saturation
Change in 6 min walking distance from baseline to week 12
measurement of functional exercise capacity
Change in serum NT-proBNP from baseline to weeks 6 and 12
measurement of serum NT-proBNP
Change in echocardiographic markers of right ventricular function from baseline to week 12 (1)
measurement of right atrial area
Change in echocardiographic markers of right ventricular function from baseline to week 12 (2)
measurement of right ventricular diameter
Change in echocardiographic markers of right ventricular function from baseline to week 12 (3)
measurement of fractional area change
Change in echocardiographic markers of right ventricular function from baseline to week 12 (4)
measurement of tricuspid annular plane systolic excursion
Change in World Health Organization Functional Class (WHO FC) from baseline to week 6 and week 12
measurement of different parameter according to an evaluated process
Full Information
NCT ID
NCT03371173
First Posted
October 16, 2017
Last Updated
April 17, 2020
Sponsor
Hannover Medical School
Collaborators
Shields, Shields and Associates
1. Study Identification
Unique Protocol Identification Number
NCT03371173
Brief Title
ORal IrON Supplementation With Ferric Maltol in Patients With Pulmonary Hypertension (ORION-PH-1)
Acronym
ORION-PH-1
Official Title
A Pilot Study to Explore Preliminary Safety, Tolerability and Efficacy of ORal IrON Supplementation With Ferric Maltol in Treating Iron Deficiency in Patients With Pulmonary Hypertension and Iron Deficiency Anemia
Study Type
Interventional
2. Study Status
Record Verification Date
June 2019
Overall Recruitment Status
Terminated
Why Stopped
low recruitment rate; difficulties to achieve planned number of participants within reasonable time frame
Study Start Date
March 27, 2018 (Actual)
Primary Completion Date
March 19, 2020 (Actual)
Study Completion Date
March 19, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hannover Medical School
Collaborators
Shields, Shields and Associates
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This is an explorative, open-label, uncontrolled, single center study to explore the preliminary safety, tolerability and efficacy of oral ferric maltol in treating iron deficiency in patients with pulmonary hypertension and iron deficiency anemia.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypertension, Pulmonary, Anemia, Iron Deficiency
Keywords
Pulmonary Hypertension, Iron Deficiency
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Model Description
Explorative, open-label, uncontrolled monocenter study
Masking
None (Open Label)
Allocation
N/A
Enrollment
22 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Ferric maltol 30 mg (Feraccru®)
Arm Type
Experimental
Arm Description
Treatment with Feraccru® 30 mg hard capsules (Ferric maltol 30 mg). One capsule twice daily, morning and evening, on an empty stomach for 12 weeks
Intervention Type
Drug
Intervention Name(s)
Ferric maltol 30 mg (Feraccru®)
Intervention Description
Feraccru® 30 mg hard capsules will be used. Each capsule contains 30 mg iron (as ferric maltol), 91.5 mg of lactose, 0.5 mg of Allura Red AC (E129) and 0.3 mg Sunset Yellow FCF (E110) as excipients with known effects
Primary Outcome Measure Information:
Title
Change in hemoglobin level from baseline to week 12
Description
measurement of hemoglobin in blood
Time Frame
baseline to week 12
Secondary Outcome Measure Information:
Title
Change in hemoglobin from baseline to week 6
Description
measurement of hemoglobin in blood
Time Frame
baseline to week 6
Title
Change in serum ferritin levels from baseline to week 6 and 12
Description
measurement of serum ferritin levels
Time Frame
baseline to week 6 and baseline to week 12
Title
Change in transferrin saturation from baseline to week 6 and 12
Description
measurement of transferrin saturation
Time Frame
baseline to week 6 and baseline to week 12
Title
Change in 6 min walking distance from baseline to week 12
Description
measurement of functional exercise capacity
Time Frame
baseline to week 12
Title
Change in serum NT-proBNP from baseline to weeks 6 and 12
Description
measurement of serum NT-proBNP
Time Frame
baseline to week 6 and baseline to week 12
Title
Change in echocardiographic markers of right ventricular function from baseline to week 12 (1)
Description
measurement of right atrial area
Time Frame
from baseline to week 12
Title
Change in echocardiographic markers of right ventricular function from baseline to week 12 (2)
Description
measurement of right ventricular diameter
Time Frame
from baseline to week 12
Title
Change in echocardiographic markers of right ventricular function from baseline to week 12 (3)
Description
measurement of fractional area change
Time Frame
from baseline to week 12
Title
Change in echocardiographic markers of right ventricular function from baseline to week 12 (4)
Description
measurement of tricuspid annular plane systolic excursion
Time Frame
from baseline to week 12
Title
Change in World Health Organization Functional Class (WHO FC) from baseline to week 6 and week 12
Description
measurement of different parameter according to an evaluated process
Time Frame
from baseline to week 6 and week 12
Other Pre-specified Outcome Measures:
Title
Incidence of Adverse Events [Safety and Tolerability]
Description
Number of Adverse Events
Time Frame
first application of IMP until 4 weeks after treatment discontinuation
Title
Incidence of Serious Adverse Events [Safety and Tolerability]
Description
Number of Serious Adverse Events
Time Frame
first application of IMP until 4 weeks after treatment discontinuation
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Signed written informed consent prior to any study-related procedure and willingness to comply with treatment and follow-up procedures
Male and female patients ≥18 years at day of inclusion
Patients capable of understanding the investigational nature, potential risks and benefits of the clinical trial
Patients with a diagnosis of PH confirmed by a (historical) right heart catheterization showing a mean pulmonary artery pressure ≥25 mmHg at rest and stable PH medication for at least 3 months.
6 min walk distance >50 m
Mild-to-moderate iron-deficiency anemia as defined by a hemoglobin concentration ≥7 g/dl and <12 g/dl in females or ≥8 g/dl and <13 g/dl in males, and serum ferritin <100 µg/l, or 100-300 µg/l and transferrin saturation <20% at screening
Prevention of pregnancy:
Women without childbearing potential defined as follows:
at least 6 weeks after surgical sterilization by bilateral tubal ligation or bilateral oophorectomy or
hysterectomy or uterine agenesis or
≥ 50 years and in postmenopausal state ≥ 1 year or
< 50 years and in postmenopausal state ≥ 1 year with serum FSH > 40 IU/l and serum oestrogen < 30 ng/l or a negative oestrogen test or
Women of childbearing potential with a negative ß-HCG pregnancy test at screening who agree to meet one of the following criteria from the time of screening, during the study and for a period of four weeks following the last administration of study medication:
correct use of contraception methods. The following are acceptable: hormonal contraceptives (combined oral contraceptives and oestrogen-free pills with desogestrel, implants, transdermal patches, hormonal vaginal devices or injections with prolonged release), intrauterine device (IUS) or a barrier method, e.g. condom or occlusive cap (diaphragm or cervical/vault caps) with spermicide (foam, gel, film, cream or suppository)
true abstinence (periodic abstinence and withdrawal are not acceptable methods of contraception)
sexual relationship only with female partners and/or sterile male partners
Exclusion Criteria:
Active hematological disorders other than iron-deficiency anemia
Other medical condition that according to the investigator's assessment is causing or contributing to anemia
Active malignancy
Active infectious disease
Active bleeding
Severe renal insufficiency (glomerular filtration rate <30 ml/min)
Severe liver injury as indicated by serum aminotransferases >3 x upper limit of normal or bilirubin levels >50 µmol/l
Ongoing oral or intravenous iron supplementation
Hemoglobin <7 g/dl in females or <8 g/dl in males at screening
Concomitant erythropoietin medication
Pregnancy or lactation period
Subject has received any investigational medication or any investigational device within 30 days prior to the first dose of study medication or is actively participating in any investigational drug/devices trial, or is scheduled to receive an investigational drug/device during the course of the study.
Known or suspected hypersensitivity to any of the active substances or any excipients of the investigational medicinal product
Known haemochromatosis or other iron overload syndromes
Patients who have been receiving repeated (>1) blood transfusions during the past 6 months
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marius Hoeper, Prof. Dr.
Organizational Affiliation
Hannover Medical School, Department of Pneumology
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hannover Medical School
City
Hannover
ZIP/Postal Code
30625
Country
Germany
12. IPD Sharing Statement
Citations:
PubMed Identifier
32444411
Citation
Olsson KM, Fuge J, Brod T, Kamp JC, Schmitto J, Kempf T, Bauersachs J, Hoeper MM. Oral iron supplementation with ferric maltol in patients with pulmonary hypertension. Eur Respir J. 2020 Nov 12;56(5):2000616. doi: 10.1183/13993003.00616-2020. Print 2020 Nov.
Results Reference
derived
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ORal IrON Supplementation With Ferric Maltol in Patients With Pulmonary Hypertension (ORION-PH-1)
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