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Treatment of Iron Overload Requiring Chelation Therapy

Primary Purpose

Transfusional Iron Overload, Iron Overload, Iron Chelation

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
SPD602
Deferasirox
Sponsored by
Shire
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Transfusional Iron Overload

Eligibility Criteria

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

Inclusion Criteria:

These criteria are to be met at the Screening Visit (Visit 1), the Washout Visit (Visit 2), and the Baseline Visit (Visit 3), if reassessed.

  • An understanding, ability, and willingness to fully comply with study procedures and restrictions.
  • Ability to voluntarily provide written, signed, and dated (personally or via a legally authorized representative) informed consent as applicable to participate in the study before completing any study-related procedures.
  • Subjects 18 years of age or older at the time of signing consent.
  • Female subjects should be one of the following:

    1. Post-menopausal (12 consecutive months of spontaneous amenorrhea)
    2. Surgically sterile, or
    3. Females of child-bearing potential must have a negative serum Beta-HCG pregnancy test at the Screening Visit (Visit 1) and a negative urine pregnancy test at the Baseline Visit (Visit 3). Females of child-bearing potential must agree to abstain from sexual activity that could result in pregnancy or agree to use acceptable methods of contraception.
  • Subjects with beta-thalassemia who have received at least 100mL/kg of packed red blood cells (or >20 transfusion units) and who have iron overload (transfusional hemosiderosis) requiring chronic treatment with an iron chelator.
  • Serum ferritin >500µg/L at the Screening Visit (Visit 1).
  • Baseline LIC (last MRI assessment prior to Day 1) greater than or equal to 2.0mg and less than 30.0mg iron per g (equivalent dry weight, liver) determined by FerriScan® R2 MRI.

    8. Mean of the previous 3 pre-transfusion hemoglobin concentrations greater than or equal to 7.5g/dL assessed at the Screening Visit (Visit 1) (1 value from clinical laboratory tests taken at the Screening Visit [Visit 1] and the previous 2 historical values available).

Exclusion Criteria:

  • Severe iron overload including: (a) cardiac T2* MRI less than 10.0ms; or (b) LIC by FerriScan® R2 MRI greater than or equal to 30.0mg/g liver (dw) as assessed at the Screening Visit (Visit 1).
  • Iron overload from causes other than transfusional siderosis.
  • Subjects with thalassemia intermedia
  • Unable to undergo MRI assessment.
  • Cardiac LVEF less than 50% at baseline testing by MRI.
  • Subjects with documented liver failure (presence of portal hypertension, hepatic edema, ascites, cirrhosis), Child-Pugh C hepatic impairment, or biliary disorder.
  • Platelet count <100 x 109/L at the Screening Visit (Visit 1).
  • Absolute neutrophils counts of <1500mm3 at the Screening Visit (Visit 1).
  • Evidence of renal insufficiency eg, creatinine clearance <60mL/min or serum creatinine >1.5x ULN at the Screening Visit (Visit 1).
  • Clinically significant laboratory assessments at the Screening Visit (Visit 1).
  • Significant proteinuria: urinary protein/creatinine ratio >1.0 in a non-first void urine sample at the Screening Visit (Visit 1).
  • Current or recurrent disease that could affect the action, absorption, or disposition of the investigational product, or clinical or laboratory assessments.
  • Current or relevant history of physical or psychiatric illness, any medical disorder that may require treatment or make the subject unlikely to fully complete the study, or any condition, including pregnancy, that presents undue risk from the investigational product or procedures.
  • Current use of any medication contraindicated in the deferasirox prescribing information/SmPC.
  • Known or suspected intolerance or hypersensitivity to SSP-004184AQ, deferasirox, closely-related compounds, or any of the stated ingredients in either medication.
  • Known history of alcohol or other substance abuse within the last year.
  • Within 30 days prior to the Baseline Visit (Visit 3):

    1. Have used an investigational product
    2. Have been enrolled in a clinical study (including vaccine studies) that, in the investigator's opinion, may impact this study.
  • History of malignancy within the past 5 years, with the exception of basal cell or squamous cell skin carcinoma or cervical carcinoma in situ or completely resected colon carcinoma in situ.
  • Insufficient venous access that precludes prescribed blood draws for safety laboratory assessments.
  • Pregnant or lactating females.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    SPD602

    Deferasirox

    Arm Description

    Outcomes

    Primary Outcome Measures

    Change in Liver Iron Concentration (LIC) from Baseline Utilizing R2 Magnetic Resonance Imaging (MRI)

    Secondary Outcome Measures

    Response Rate Utilizing R2* MRI
    Change in Cardiac Iron Concentration (CIC) from baseline Utilizing T2* MRI
    Change in Serum Ferritin Levels from Baseline
    Change in Pancreas Iron Concentration (PIC) from Baseline Utilizing R2* MRI
    Left Ventricular Ejection Fraction (LVEF) Utilizing MRI
    Gastrointestinal Symptom Rating Scale
    Total Neuropathy Score nurse (TNSn)

    Full Information

    First Posted
    August 20, 2013
    Last Updated
    June 1, 2021
    Sponsor
    Shire
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01927913
    Brief Title
    Treatment of Iron Overload Requiring Chelation Therapy
    Official Title
    A 48-week, Open-label, 2-arm, Parallel-group, Randomized Exploratory Study to Assess Liver Iron Concentration Measured by FerriScan® (R2) Magnetic Resonance Imaging in B-thalassemia Subjects Administered SPD602 (SSP-004184AQ) or Exjade® (Deferasirox) for Treatment of Chronic Transfusional Iron Overload
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2021
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    This study was withdrawn until the evaluation of the nonclinical rat findings is complete.
    Study Start Date
    November 20, 2014 (Anticipated)
    Primary Completion Date
    October 30, 2015 (Anticipated)
    Study Completion Date
    October 30, 2015 (Anticipated)

    3. Sponsor/Collaborators

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

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The purpose of this open-label study is to assess liver iron concentration using MRI imaging in subjects with beta-thalassemia when administered with either SPD602 or deferasirox for the treatment of chronic transfusional iron overload.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Transfusional Iron Overload, Iron Overload, Iron Chelation, Beta-thalassemia, Transfusional Hemosiderosis, Iron Metabolism Disorders, Metabolic Diseases

    7. Study Design

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

    8. Arms, Groups, and Interventions

    Arm Title
    SPD602
    Arm Type
    Experimental
    Arm Title
    Deferasirox
    Arm Type
    Active Comparator
    Intervention Type
    Drug
    Intervention Name(s)
    SPD602
    Other Intervention Name(s)
    SSP-004184AQ
    Intervention Description
    32, 50 or 75 mg/kg/day BID, capsule
    Intervention Type
    Drug
    Intervention Name(s)
    Deferasirox
    Other Intervention Name(s)
    Exjade®
    Intervention Description
    Per approved country specific label
    Primary Outcome Measure Information:
    Title
    Change in Liver Iron Concentration (LIC) from Baseline Utilizing R2 Magnetic Resonance Imaging (MRI)
    Time Frame
    48 Weeks
    Secondary Outcome Measure Information:
    Title
    Response Rate Utilizing R2* MRI
    Time Frame
    48 weeks
    Title
    Change in Cardiac Iron Concentration (CIC) from baseline Utilizing T2* MRI
    Time Frame
    48 weeks
    Title
    Change in Serum Ferritin Levels from Baseline
    Time Frame
    48 weeks
    Title
    Change in Pancreas Iron Concentration (PIC) from Baseline Utilizing R2* MRI
    Time Frame
    48 weeks
    Title
    Left Ventricular Ejection Fraction (LVEF) Utilizing MRI
    Time Frame
    48 weeks
    Title
    Gastrointestinal Symptom Rating Scale
    Time Frame
    48 weeks
    Title
    Total Neuropathy Score nurse (TNSn)
    Time Frame
    48 weeks

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: These criteria are to be met at the Screening Visit (Visit 1), the Washout Visit (Visit 2), and the Baseline Visit (Visit 3), if reassessed. An understanding, ability, and willingness to fully comply with study procedures and restrictions. Ability to voluntarily provide written, signed, and dated (personally or via a legally authorized representative) informed consent as applicable to participate in the study before completing any study-related procedures. Subjects 18 years of age or older at the time of signing consent. Female subjects should be one of the following: Post-menopausal (12 consecutive months of spontaneous amenorrhea) Surgically sterile, or Females of child-bearing potential must have a negative serum Beta-HCG pregnancy test at the Screening Visit (Visit 1) and a negative urine pregnancy test at the Baseline Visit (Visit 3). Females of child-bearing potential must agree to abstain from sexual activity that could result in pregnancy or agree to use acceptable methods of contraception. Subjects with beta-thalassemia who have received at least 100mL/kg of packed red blood cells (or >20 transfusion units) and who have iron overload (transfusional hemosiderosis) requiring chronic treatment with an iron chelator. Serum ferritin >500µg/L at the Screening Visit (Visit 1). Baseline LIC (last MRI assessment prior to Day 1) greater than or equal to 2.0mg and less than 30.0mg iron per g (equivalent dry weight, liver) determined by FerriScan® R2 MRI. 8. Mean of the previous 3 pre-transfusion hemoglobin concentrations greater than or equal to 7.5g/dL assessed at the Screening Visit (Visit 1) (1 value from clinical laboratory tests taken at the Screening Visit [Visit 1] and the previous 2 historical values available). Exclusion Criteria: Severe iron overload including: (a) cardiac T2* MRI less than 10.0ms; or (b) LIC by FerriScan® R2 MRI greater than or equal to 30.0mg/g liver (dw) as assessed at the Screening Visit (Visit 1). Iron overload from causes other than transfusional siderosis. Subjects with thalassemia intermedia Unable to undergo MRI assessment. Cardiac LVEF less than 50% at baseline testing by MRI. Subjects with documented liver failure (presence of portal hypertension, hepatic edema, ascites, cirrhosis), Child-Pugh C hepatic impairment, or biliary disorder. Platelet count <100 x 109/L at the Screening Visit (Visit 1). Absolute neutrophils counts of <1500mm3 at the Screening Visit (Visit 1). Evidence of renal insufficiency eg, creatinine clearance <60mL/min or serum creatinine >1.5x ULN at the Screening Visit (Visit 1). Clinically significant laboratory assessments at the Screening Visit (Visit 1). Significant proteinuria: urinary protein/creatinine ratio >1.0 in a non-first void urine sample at the Screening Visit (Visit 1). Current or recurrent disease that could affect the action, absorption, or disposition of the investigational product, or clinical or laboratory assessments. Current or relevant history of physical or psychiatric illness, any medical disorder that may require treatment or make the subject unlikely to fully complete the study, or any condition, including pregnancy, that presents undue risk from the investigational product or procedures. Current use of any medication contraindicated in the deferasirox prescribing information/SmPC. Known or suspected intolerance or hypersensitivity to SSP-004184AQ, deferasirox, closely-related compounds, or any of the stated ingredients in either medication. Known history of alcohol or other substance abuse within the last year. Within 30 days prior to the Baseline Visit (Visit 3): Have used an investigational product Have been enrolled in a clinical study (including vaccine studies) that, in the investigator's opinion, may impact this study. History of malignancy within the past 5 years, with the exception of basal cell or squamous cell skin carcinoma or cervical carcinoma in situ or completely resected colon carcinoma in situ. Insufficient venous access that precludes prescribed blood draws for safety laboratory assessments. Pregnant or lactating females.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Study Director
    Organizational Affiliation
    Takeda
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Learn more about this trial

    Treatment of Iron Overload Requiring Chelation Therapy

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