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Safety and Pharmacodynamic Study of an Oral Iron Chelator Given for 6 Months to Patients With Iron Overload

Primary Purpose

Transfusional Iron Overload, Beta-thalassemia

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
SPD602 (FBS0701, SSP-004184)
Sponsored by
Shire
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Transfusional Iron Overload focused on measuring Beta-thalassemia, Sickle cell anemia, Transfusional iron overload, Iron overload, Iron chelation

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Transfusional iron overload due to: hereditary anemias such as sickle cell disease, β-thalassemia and Diamond-Blackfan anemia; acquired anemias such as Myelodysplastic Syndrome and other forms of bone marrow failure. Patients must also be transfusion-dependent and require chronic treatment with deferoxamine, deferasirox, and/or deferiprone.
  • Willing to discontinue all existing iron chelation therapies throughout study period.
  • Serum ferritin greater than 500 ng/mL at Screening.
  • Baseline liver iron concentration and cardiac MRI T2* per protocol requirements.
  • Mean of the previous three pre-transfusion hemoglobin concentrations greater than or equal to 7.5 g/dL.
  • Agrees to use an approved method of contraception throughout study period.

Exclusion Criteria:

  • As a result of medical review, physical examination or Screening investigations, the Principal Investigator considers the patient unfit for the study.
  • Non-elective hospitalization within the 30 days prior to Baseline testing. (Patients with sickle cell anemia who are admitted to the hospital for management of sickle crisis pain whose uncomplicated hospital course was four days or less and who, 14 days prior to Baseline testing, have returned to their previous health status are acceptable.)
  • Evidence of clinically relevant oral, cardiovascular, gastrointestinal, hepatic, renal, endocrine, pulmonary, neurologic, psychiatric, immunologic, bone marrow or skin disorder as determined by the Investigator.
  • Evidence of significant renal insufficiency; possible examples include: serum creatinine above the upper limit of normal, proteinuria greater than 2 gm per day or calculated creatinine clearance of less than 60 mL/minute.
  • Cardiac left ventricular ejection fraction outside of protocol requirements.
  • Known sensitivity to magnesium stearate, croscarmellose sodium or FBS0701.
  • Platelet count below 100,000/µL and/or absolute neutrophil count less than 1500/mm3 at Screening and <50% at Baseline testing by MRI
  • Alkaline phosphatase, AST or ALT outside of protocol requirements.
  • Liver Function Tests: ALT >5 times the local upper limit of normal on two occasions in the previous 12 months or ALT at Screening >200 IU/L
  • Use of any investigational agent within the 30 days prior to the Baseline testing.

Sites / Locations

  • Children's Hospital and Research Center of Oakland
  • Children's Hospital of Boston
  • Ospedale Regionale Microcitemie
  • Centro della Microcitemia e delle Anemie Congenite
  • Thalassemia Center San Luigi Hospital
  • Siriraj Hospital, Mahidol University
  • Pediatric Hematology, Ege University Hospital
  • University College London Hospital
  • Whittington Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

SPD602 (16mg)

SPD602 (32mg)

Arm Description

Outcomes

Primary Outcome Measures

Change From Baseline in Liver Iron Concentration (LIC) at 96 Weeks
LIC was determined by R2 Magnetic Resonance Imaging (MRI).

Secondary Outcome Measures

Maximum Plasma Concentration (Cmax) of SPD602
Cmax is a term that refers to the maximum (or peak) concentration that a drug achieves in the body after the drug has been administered.
Area Under The Steady-state Plasma Concentration-time Curve (AUC) of SPD602
AUC can be used as a measure of drug exposure. It is derived from drug concentration and time so it gives a measure of how much and how long a drug stays in a body.

Full Information

First Posted
August 19, 2010
Last Updated
May 30, 2021
Sponsor
Shire
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1. Study Identification

Unique Protocol Identification Number
NCT01186419
Brief Title
Safety and Pharmacodynamic Study of an Oral Iron Chelator Given for 6 Months to Patients With Iron Overload
Official Title
A Phase 2, 24 Week, Randomized, Open Label, Multi-Center Study to Assess the Safety, Tolerability, and Pharmacodynamics of FBS0701 in the Treatment of Chronic Iron Overload Requiring Chelation Therapy, With a 72 Week Dosing Extension
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Completed
Study Start Date
August 13, 2010 (Actual)
Primary Completion Date
January 8, 2013 (Actual)
Study Completion Date
January 8, 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Shire

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this research study is to evaluate the safety of two doses of FBS0701, a new oral iron chelator, and its effectiveness in clearing iron from the liver. FBS0701 is a medication taken by mouth that causes the body to get rid of iron. Iron chelators are used in patients with β-thalassemia and other forms of anemia who experience iron overload - iron increases in the body as a result of regularly required blood transfusions. Patients who qualify will be randomized to receive one of two doses of FBS0701 for up to 24 weeks (6 months) with a total study duration of up to 33 weeks. These patients will be eligible to participate in a dosing extension for up to 72 weeks. The maximum duration of dosing will be up to 96 weeks. The safety of patients will be monitored frequently during the study by physical exams, ECGs, and blood tests. To assess the amount of iron in the liver and heart, each patient must undergo 6 MRI scans during the study. Patients will not need to stay in the hospital for this study but will need to visit the outpatient clinic up to 28 times over the 96 week period. Patients currently taking an iron chelator will be required to stop for a total of up to 26 weeks. The results of this study will help to determine if FBS0701 may be effective as an iron chelator.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Transfusional Iron Overload, Beta-thalassemia
Keywords
Beta-thalassemia, Sickle cell anemia, Transfusional iron overload, Iron overload, Iron chelation

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
51 (Actual)

8. Arms, Groups, and Interventions

Arm Title
SPD602 (16mg)
Arm Type
Experimental
Arm Title
SPD602 (32mg)
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
SPD602 (FBS0701, SSP-004184)
Intervention Description
Oral FBS0701 taken one time daily for up to 96 weeks.
Primary Outcome Measure Information:
Title
Change From Baseline in Liver Iron Concentration (LIC) at 96 Weeks
Description
LIC was determined by R2 Magnetic Resonance Imaging (MRI).
Time Frame
Baseline and 96 weeks
Secondary Outcome Measure Information:
Title
Maximum Plasma Concentration (Cmax) of SPD602
Description
Cmax is a term that refers to the maximum (or peak) concentration that a drug achieves in the body after the drug has been administered.
Time Frame
92 weeks
Title
Area Under The Steady-state Plasma Concentration-time Curve (AUC) of SPD602
Description
AUC can be used as a measure of drug exposure. It is derived from drug concentration and time so it gives a measure of how much and how long a drug stays in a body.
Time Frame
92 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Transfusional iron overload due to: hereditary anemias such as sickle cell disease, β-thalassemia and Diamond-Blackfan anemia; acquired anemias such as Myelodysplastic Syndrome and other forms of bone marrow failure. Patients must also be transfusion-dependent and require chronic treatment with deferoxamine, deferasirox, and/or deferiprone. Willing to discontinue all existing iron chelation therapies throughout study period. Serum ferritin greater than 500 ng/mL at Screening. Baseline liver iron concentration and cardiac MRI T2* per protocol requirements. Mean of the previous three pre-transfusion hemoglobin concentrations greater than or equal to 7.5 g/dL. Agrees to use an approved method of contraception throughout study period. Exclusion Criteria: As a result of medical review, physical examination or Screening investigations, the Principal Investigator considers the patient unfit for the study. Non-elective hospitalization within the 30 days prior to Baseline testing. (Patients with sickle cell anemia who are admitted to the hospital for management of sickle crisis pain whose uncomplicated hospital course was four days or less and who, 14 days prior to Baseline testing, have returned to their previous health status are acceptable.) Evidence of clinically relevant oral, cardiovascular, gastrointestinal, hepatic, renal, endocrine, pulmonary, neurologic, psychiatric, immunologic, bone marrow or skin disorder as determined by the Investigator. Evidence of significant renal insufficiency; possible examples include: serum creatinine above the upper limit of normal, proteinuria greater than 2 gm per day or calculated creatinine clearance of less than 60 mL/minute. Cardiac left ventricular ejection fraction outside of protocol requirements. Known sensitivity to magnesium stearate, croscarmellose sodium or FBS0701. Platelet count below 100,000/µL and/or absolute neutrophil count less than 1500/mm3 at Screening and <50% at Baseline testing by MRI Alkaline phosphatase, AST or ALT outside of protocol requirements. Liver Function Tests: ALT >5 times the local upper limit of normal on two occasions in the previous 12 months or ALT at Screening >200 IU/L Use of any investigational agent within the 30 days prior to the Baseline testing.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Study Director
Organizational Affiliation
Takeda
Official's Role
Study Director
Facility Information:
Facility Name
Children's Hospital and Research Center of Oakland
City
Oakland
State/Province
California
ZIP/Postal Code
94609
Country
United States
Facility Name
Children's Hospital of Boston
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Ospedale Regionale Microcitemie
City
Cagliari
Country
Italy
Facility Name
Centro della Microcitemia e delle Anemie Congenite
City
Genoa
Country
Italy
Facility Name
Thalassemia Center San Luigi Hospital
City
Orbassano
Country
Italy
Facility Name
Siriraj Hospital, Mahidol University
City
Bangkok
Country
Thailand
Facility Name
Pediatric Hematology, Ege University Hospital
City
Izmir
Country
Turkey
Facility Name
University College London Hospital
City
London
Country
United Kingdom
Facility Name
Whittington Hospital
City
London
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
24452753
Citation
Wood JC, Zhang P, Rienhoff H, Abi-Saab W, Neufeld E. R2 and R2* are equally effective in evaluating chronic response to iron chelation. Am J Hematol. 2014 May;89(5):505-8. doi: 10.1002/ajh.23673. Epub 2014 Mar 3.
Results Reference
derived
PubMed Identifier
22251482
Citation
Neufeld EJ, Galanello R, Viprakasit V, Aydinok Y, Piga A, Harmatz P, Forni GL, Shah FT, Grace RF, Porter JB, Wood JC, Peppe J, Jones A, Rienhoff HY Jr. A phase 2 study of the safety, tolerability, and pharmacodynamics of FBS0701, a novel oral iron chelator, in transfusional iron overload. Blood. 2012 Apr 5;119(14):3263-8. doi: 10.1182/blood-2011-10-386268. Epub 2012 Jan 17.
Results Reference
derived
PubMed Identifier
21173101
Citation
Rienhoff HY Jr, Viprakasit V, Tay L, Harmatz P, Vichinsky E, Chirnomas D, Kwiatkowski JL, Tapper A, Kramer W, Porter JB, Neufeld EJ. A phase 1 dose-escalation study: safety, tolerability, and pharmacokinetics of FBS0701, a novel oral iron chelator for the treatment of transfusional iron overload. Haematologica. 2011 Apr;96(4):521-5. doi: 10.3324/haematol.2010.034405. Epub 2010 Dec 20.
Results Reference
derived

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Safety and Pharmacodynamic Study of an Oral Iron Chelator Given for 6 Months to Patients With Iron Overload

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