Safety and Efficacy of Deferasirox in Patients With Transfusion Dependent Iron Overload - a Non-comparative Extension Study

Sponsor
Novartis Pharmaceuticals (Industry)
Overall Status
Completed
CT.gov ID
NCT01033747
Collaborator
(none)
70
4
2
59
17.5
0.3

Study Details

Study Description

Brief Summary

The purpose of this study is to assess the safety and the effects on liver iron of Deferasirox when given for a long treatment period in patients with transfusion dependent iron overload.

Condition or Disease Intervention/Treatment Phase
Phase 2/Phase 3

Study Design

Study Type:
Interventional
Actual Enrollment :
70 participants
Allocation:
Non-Randomized
Intervention Model:
Single Group Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A 5-year Open Label, Non-comparative Extension to a Randomized, Open-label, Phase IIa Study to Evaluate Safety, Tolerability and the Effects on Liver Iron Concentration of Repeated Doses of 10 and 20 mg/kg/Day of Deferasirox in Comparison With 40 mg/kg/Day Deferoxamine in Patients With Transfusion-dependent Iron Overload
Study Start Date :
Feb 1, 2003
Actual Primary Completion Date :
Jan 1, 2008
Actual Study Completion Date :
Jan 1, 2008

Arms and Interventions

Arm Intervention/Treatment
Experimental: Deferasirox

Deferasirox group consists of all participants who were initially randomized to 10 and 20 mg/kg/day deferasirox orally daily in the main study and remained on the same treatment during the comparative prolongation study (NCT00379483) and at the beginning of the 5-year non-comparative study

Drug: Deferasirox
10 mg/kg or 30 mg/kg orally daily

Experimental: Deferasirox Crossover

Deferasirox Crossover group consists of participants who were initially randomized to 40 mg/kg/day deferoxamine (DFO)subcutaneously in the main study and comparative prolongation study and crossed over to 5mg/kg/day to 30 mg/kg/day deferasirox orally daily at the beginning of the 5-year non-comparative extension study

Drug: Deferasirox
5 mg/kg or 30 mg/kg orally daily

Outcome Measures

Primary Outcome Measures

  1. The Relative Change From Baseline in Liver Iron Content (LIC) After Prolonged Use of Deferasirox [Baseline to 7 Years]

    The mean percentage change in liver iron content (LIC) as assessed by superconducting quantum interference device (SQUID) was evaluated by comparing the LIC at the start of Deferasirox treatment to the LIC at the end of the 5 year extension study for participants who were treated with Deferasirox for more than 3.5 years. LIC is expressed in milligrams of iron per gram of liver dry weight (mgFe/g dw). Relative change = 1- (Change in LIC from Baseline/Baseline level) x 100.

Secondary Outcome Measures

  1. Relative Change in Serum Ferritin From Baseline to 3.5 Years [Baseline to 3.5 years]

    The mean percentage change in serum ferritin was evaluated by comparing the serum ferritin level at the start of Deferasirox treatment to the serum ferritin level collected 18 months following the start of the extension study. Serum ferritin is measured in micrograms per Liter. Relative Change = 1- (Change in ferritin level from Baseline/Baseline level) x 100.

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  • Patients Currently participating in the 9-month comparative prolongation of extension phase of the original study.

  • Patients currently participating in the food-effect sub-study, according to amendment

  • Ability to provide written informed consent prior to participation in this non-comparative extension study.

  • Female patients sexually active must use double-barrier contraception, oral contraceptive plus barrier contraceptive, or must have undergone clinically documented total hysterectomy and/or ovariectomy, or tubal ligation.

  • Body weight of at least 35 kg.

Exclusion Criteria:
  • Pregnant or breastfeeding patients.

  • History of non-compliance to medical regimens and patients who are considered potentially unreliable.

  • Proteinuria > 300 mg/L second void morning urine.

  • Patients with serum creatinine above the upper limit normal.

Other protocol-defined inclusion/exclusion criteria may apply.

Contacts and Locations

Locations

Site City State Country Postal Code
1 Novartis Investigative Site Cagliari Italy
2 Novartis Investigative Site Genova Italy
3 Novartis Investigative Site Milan Italy
4 Novartis Investigative Site Torino Italy

Sponsors and Collaborators

  • Novartis Pharmaceuticals

Investigators

  • Study Director: Novartis Pharmaceuticals, Novartis Pharmaceuticals

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
, ,
ClinicalTrials.gov Identifier:
NCT01033747
Other Study ID Numbers:
  • CICL670A0105E2
First Posted:
Dec 16, 2009
Last Update Posted:
Aug 11, 2011
Last Verified:
Jul 1, 2011
Keywords provided by , ,
Additional relevant MeSH terms:

Study Results

Participant Flow

Recruitment Details This 5 year extension study includes participants treated in one or more studies: a 1 year main study to evaluate the safety,tolerability and the effects of 2 doses of deferasirox on liver iron content in comparison to standard chelation therapy with DFO, a 3 week food effect sub-study and a 12-21 month prolongation phase(NCT00379483).
Pre-assignment Detail
Arm/Group Title Deferasirox Deferasirox Crossover
Arm/Group Description Deferasirox group consists of all participants who were initially randomized to 10 mg/kg or 20 mg/kg deferasirox orally daily in the main study and remained on deferasirox treatment during the comparative prolongation study (NCT00379483) and at the beginning of the 5-year non-comparative extension study Deferasirox Crossover group consists of participants who were initially randomized to 40 mg/kg/day deferoxamine (DFO) subcutaneously in the main study and comparative prolongation study and crossed over to 5 mg to 30 mg/kg/day deferasirox orally daily at the beginning of the 5-year non-comparative extension study
Period Title: Overall Study
STARTED 51 19
COMPLETED 14 4
NOT COMPLETED 37 15

Baseline Characteristics

Arm/Group Title Deferasirox Deferasirox Crossover Total
Arm/Group Description Deferasirox group consists of all participants who were initially randomized to 10 mg/kg or 20 mg/kg deferasirox orally daily in the main study and remained on deferasirox treatment during the comparative prolongation study (NCT00379483) and at the beginning of the 5-year non-comparative extension study Deferasirox Crossover group consists of participants who were initially randomized to 40 mg/kg/day deferoxamine (DFO) subcutaneously in the main study and comparative prolongation study and crossed over to 5 mg to 30 mg/kg/day deferasirox orally daily at the beginning of the 5-year non-comparative extension study Total of all reporting groups
Overall Participants 51 19 70
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]
24.7
(5.43)
23.8
(3.76)
24.5
(5.02)
Age, Customized (participants) [Number]
16 to 49
50
98%
19
100%
69
98.6%
50 to 65 years
1
2%
0
0%
1
1.4%
Sex: Female, Male (Count of Participants)
Female
35
68.6%
10
52.6%
45
64.3%
Male
16
31.4%
9
47.4%
25
35.7%
Region of Enrollment (participants) [Number]
Italy
51
100%
19
100%
70
100%

Outcome Measures

1. Primary Outcome
Title The Relative Change From Baseline in Liver Iron Content (LIC) After Prolonged Use of Deferasirox
Description The mean percentage change in liver iron content (LIC) as assessed by superconducting quantum interference device (SQUID) was evaluated by comparing the LIC at the start of Deferasirox treatment to the LIC at the end of the 5 year extension study for participants who were treated with Deferasirox for more than 3.5 years. LIC is expressed in milligrams of iron per gram of liver dry weight (mgFe/g dw). Relative change = 1- (Change in LIC from Baseline/Baseline level) x 100.
Time Frame Baseline to 7 Years

Outcome Measure Data

Analysis Population Description
All participants in the full analysis set treated with deferasirox for more than 3.5 years.
Arm/Group Title Deferasirox Deferasirox Crossover
Arm/Group Description Deferasirox group consists of all participants who were initially randomized to 10 mg/kg or 20 mg/kg deferasirox orally daily in the main study and remained on deferasirox treatment during the comparative prolongation study (NCT00379483) and at the beginning of the 5-year non-comparative extension study Deferasirox Crossover group consists of participants who were initially randomized to 40 mg/kg/day deferoxamine (DFO) subcutaneously in the main study and comparative prolongation study and crossed over to 5 mg to 30 mg/kg/day deferasirox orally daily at the beginning of the 5-year non-comparative extension study
Measure Participants 36 8
Mean (Full Range) [Percent change]
-21.9
(47.11)
-23.1
(33.38)
2. Secondary Outcome
Title Relative Change in Serum Ferritin From Baseline to 3.5 Years
Description The mean percentage change in serum ferritin was evaluated by comparing the serum ferritin level at the start of Deferasirox treatment to the serum ferritin level collected 18 months following the start of the extension study. Serum ferritin is measured in micrograms per Liter. Relative Change = 1- (Change in ferritin level from Baseline/Baseline level) x 100.
Time Frame Baseline to 3.5 years

Outcome Measure Data

Analysis Population Description
All participants comprised of the full analysis set were evaluated for the change in serum ferritin.
Arm/Group Title Deferasirox Deferasirox Crossover
Arm/Group Description Deferasirox group consists of all participants who were initially randomized to 10 mg/kg or 20 mg/kg deferasirox orally daily in the main study and remained on deferasirox treatment during the comparative prolongation study (NCT00379483) and at the beginning of the 5-year non-comparative extension study Deferasirox Crossover group consists of participants who were initially randomized to 40 mg/kg/day deferoxamine (DFO) subcutaneously in the main study and comparative prolongation study and crossed over to 5 mg to 30 mg/kg/day deferasirox orally daily at the beginning of the 5-year non-comparative extension study
Measure Participants 51 19
Mean (Full Range) [Percent change]
32.4
33.2

Adverse Events

Time Frame
Adverse Event Reporting Description
Arm/Group Title Deferasirox Deferasirox Crossover
Arm/Group Description Deferasirox group consists of all participants who were initially randomized to 10 mg/kg or 20 mg/kg deferasirox orally daily in the main study and remained on the same deferasirox treatment during the comparative prolongation study(NCT00379483)and at the beginning of the 5-year non-comparative extension study Deferasirox Crossover group consists of participants who were initially randomized to 40 mg/kg/day deferoxamine (DFO)subcutaneously in the main study and comparative prolongation study and crossed over to 5 mg/kg to 30 mg/kg deferasirox orally daily at the beginning of the 5-year non-comparative extension study.
All Cause Mortality
Deferasirox Deferasirox Crossover
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total / (NaN) / (NaN)
Serious Adverse Events
Deferasirox Deferasirox Crossover
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 18/51 (35.3%) 2/19 (10.5%)
Blood and lymphatic system disorders
Extramedullary haemopoiesis 1/51 (2%) 0/19 (0%)
Cardiac disorders
Arrhythmia 1/51 (2%) 0/19 (0%)
Atrial fibrillation 1/51 (2%) 0/19 (0%)
Gastrointestinal disorders
Abdominal pain 2/51 (3.9%) 0/19 (0%)
General disorders
Chest pain 1/51 (2%) 0/19 (0%)
Oedema peripheral 1/51 (2%) 0/19 (0%)
Pyrexia 1/51 (2%) 0/19 (0%)
Hepatobiliary disorders
Cholecystitis 1/51 (2%) 0/19 (0%)
Infections and infestations
Bacterial infection 1/51 (2%) 0/19 (0%)
Bronchitis 1/51 (2%) 0/19 (0%)
Bronchopneumonia 1/51 (2%) 0/19 (0%)
Gastroenteritis 0/51 (0%) 1/19 (5.3%)
Nasal abscess 1/51 (2%) 0/19 (0%)
Pyelonephritis 1/51 (2%) 0/19 (0%)
Injury, poisoning and procedural complications
Femur fracture 1/51 (2%) 0/19 (0%)
Head injury 1/51 (2%) 0/19 (0%)
Injury 1/51 (2%) 0/19 (0%)
Neck injury 1/51 (2%) 0/19 (0%)
Radius fracture 1/51 (2%) 0/19 (0%)
Tendon injury 0/51 (0%) 1/19 (5.3%)
Investigations
Electrocardiogram QT prolonged 1/51 (2%) 0/19 (0%)
Metabolism and nutrition disorders
Diabetic ketoacidosis 1/51 (2%) 0/19 (0%)
Metabolic acidosis 1/51 (2%) 0/19 (0%)
Metabolic disorder 1/51 (2%) 0/19 (0%)
Musculoskeletal and connective tissue disorders
Arthralgia 2/51 (3.9%) 0/19 (0%)
Back pain 1/51 (2%) 0/19 (0%)
Bone pain 1/51 (2%) 0/19 (0%)
Tendon disorder 1/51 (2%) 0/19 (0%)
Nervous system disorders
Headache 0/51 (0%) 1/19 (5.3%)
Monoparesis 1/51 (2%) 0/19 (0%)
Paraesthesia 0/51 (0%) 1/19 (5.3%)
Pregnancy, puerperium and perinatal conditions
Pregnancy 1/51 (2%) 0/19 (0%)
Renal and urinary disorders
Renal colic 3/51 (5.9%) 0/19 (0%)
Respiratory, thoracic and mediastinal disorders
Asthma 1/51 (2%) 0/19 (0%)
Nasal septum deviation 1/51 (2%) 0/19 (0%)
Nasal turbinate hypertrophy 1/51 (2%) 0/19 (0%)
Surgical and medical procedures
Cholecystectomy 1/51 (2%) 0/19 (0%)
Splenectomy 1/51 (2%) 0/19 (0%)
Surgery 1/51 (2%) 0/19 (0%)
Vascular disorders
Thrombophlebitis 2/51 (3.9%) 0/19 (0%)
Venous thrombosis 1/51 (2%) 0/19 (0%)
Other (Not Including Serious) Adverse Events
Deferasirox Deferasirox Crossover
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 50/51 (98%) 19/19 (100%)
Blood and lymphatic system disorders
Lymphadenopathy 3/51 (5.9%) 0/19 (0%)
Cardiac disorders
Cardiac failure 2/51 (3.9%) 1/19 (5.3%)
Palpitations 7/51 (13.7%) 1/19 (5.3%)
Tachycardia 6/51 (11.8%) 5/19 (26.3%)
Ear and labyrinth disorders
Ear pain 5/51 (9.8%) 2/19 (10.5%)
Vertigo 9/51 (17.6%) 4/19 (21.1%)
Endocrine disorders
Hypogonadism 5/51 (9.8%) 0/19 (0%)
Eye disorders
Chalazion 3/51 (5.9%) 0/19 (0%)
Conjunctivitis 3/51 (5.9%) 0/19 (0%)
Conjunctivitis allergic 5/51 (9.8%) 2/19 (10.5%)
Eyelid oedema 0/51 (0%) 1/19 (5.3%)
Scotoma 0/51 (0%) 1/19 (5.3%)
Gastrointestinal disorders
Abdominal distension 1/51 (2%) 3/19 (15.8%)
Abdominal pain 24/51 (47.1%) 5/19 (26.3%)
Abdominal pain upper 22/51 (43.1%) 6/19 (31.6%)
Aphthous stomatitis 0/51 (0%) 1/19 (5.3%)
Colitis 1/51 (2%) 1/19 (5.3%)
Constipation 3/51 (5.9%) 4/19 (21.1%)
Diarrhoea 20/51 (39.2%) 8/19 (42.1%)
Dyspepsia 9/51 (17.6%) 2/19 (10.5%)
Enteritis 8/51 (15.7%) 3/19 (15.8%)
Gastritis 6/51 (11.8%) 2/19 (10.5%)
Nausea 19/51 (37.3%) 4/19 (21.1%)
Rectal prolapse 0/51 (0%) 1/19 (5.3%)
Toothache 8/51 (15.7%) 1/19 (5.3%)
Vomiting 16/51 (31.4%) 1/19 (5.3%)
General disorders
Asthenia 20/51 (39.2%) 4/19 (21.1%)
Chest discomfort 1/51 (2%) 1/19 (5.3%)
Chest pain 4/51 (7.8%) 2/19 (10.5%)
Gravitational oedema 0/51 (0%) 1/19 (5.3%)
Influenza like illness 9/51 (17.6%) 1/19 (5.3%)
Oedema peripheral 10/51 (19.6%) 0/19 (0%)
Pyrexia 31/51 (60.8%) 9/19 (47.4%)
Infections and infestations
Bronchitis 12/51 (23.5%) 1/19 (5.3%)
Cystitis 4/51 (7.8%) 2/19 (10.5%)
Dysentery 1/51 (2%) 1/19 (5.3%)
Ear infection 3/51 (5.9%) 2/19 (10.5%)
Fungal skin infection 2/51 (3.9%) 2/19 (10.5%)
Gastroenteritis 9/51 (17.6%) 2/19 (10.5%)
Hordeolum 3/51 (5.9%) 0/19 (0%)
Influenza 25/51 (49%) 7/19 (36.8%)
Localised infection 1/51 (2%) 1/19 (5.3%)
Nasopharyngitis 17/51 (33.3%) 5/19 (26.3%)
Oral herpes 3/51 (5.9%) 0/19 (0%)
Paronychia 0/51 (0%) 1/19 (5.3%)
Pharyngitis 34/51 (66.7%) 6/19 (31.6%)
Pharyngotonsillitis 2/51 (3.9%) 2/19 (10.5%)
Rhinitis 29/51 (56.9%) 7/19 (36.8%)
Sinusitis 6/51 (11.8%) 1/19 (5.3%)
Tonsillitis 7/51 (13.7%) 3/19 (15.8%)
Tooth abscess 9/51 (17.6%) 1/19 (5.3%)
Tooth infection 0/51 (0%) 1/19 (5.3%)
Tracheitis 6/51 (11.8%) 1/19 (5.3%)
Urinary tract infection 7/51 (13.7%) 3/19 (15.8%)
Vaginal infection 6/51 (11.8%) 0/19 (0%)
Vulvovaginal candidiasis 0/51 (0%) 1/19 (5.3%)
Vulvovaginal mycotic infection 0/51 (0%) 1/19 (5.3%)
Wound infection 0/51 (0%) 1/19 (5.3%)
Injury, poisoning and procedural complications
Limb injury 2/51 (3.9%) 1/19 (5.3%)
Muscle strain 1/51 (2%) 1/19 (5.3%)
Neck injury 0/51 (0%) 2/19 (10.5%)
Pelvic fracture 0/51 (0%) 1/19 (5.3%)
Skeletal injury 3/51 (5.9%) 0/19 (0%)
Thermal burn 1/51 (2%) 1/19 (5.3%)
Transfusion reaction 4/51 (7.8%) 1/19 (5.3%)
Investigations
Beta 2 microglobulin increased 6/51 (11.8%) 0/19 (0%)
Beta 2 microglobulin urine increased 4/51 (7.8%) 0/19 (0%)
Blood folate decreased 2/51 (3.9%) 1/19 (5.3%)
Blood phosphorus decreased 0/51 (0%) 1/19 (5.3%)
Blood thyroid stimulating hormone increased 0/51 (0%) 1/19 (5.3%)
Gamma-glutamyltransferase increased 3/51 (5.9%) 0/19 (0%)
Transaminases increased 4/51 (7.8%) 1/19 (5.3%)
Vitamin C decreased 8/51 (15.7%) 1/19 (5.3%)
Vitamin E decreased 4/51 (7.8%) 0/19 (0%)
Metabolism and nutrition disorders
Diabetes mellitus 1/51 (2%) 1/19 (5.3%)
Hypocalcaemia 2/51 (3.9%) 1/19 (5.3%)
Hypokalaemia 3/51 (5.9%) 1/19 (5.3%)
Metabolic acidosis 0/51 (0%) 1/19 (5.3%)
Zinc deficiency 4/51 (7.8%) 1/19 (5.3%)
Musculoskeletal and connective tissue disorders
Arthralgia 16/51 (31.4%) 2/19 (10.5%)
Back pain 29/51 (56.9%) 9/19 (47.4%)
Bone pain 8/51 (15.7%) 3/19 (15.8%)
Flank pain 4/51 (7.8%) 0/19 (0%)
Muscle spasms 4/51 (7.8%) 1/19 (5.3%)
Musculoskeletal chest pain 0/51 (0%) 2/19 (10.5%)
Musculoskeletal pain 7/51 (13.7%) 0/19 (0%)
Myalgia 3/51 (5.9%) 0/19 (0%)
Neck pain 7/51 (13.7%) 0/19 (0%)
Osteoporosis 3/51 (5.9%) 3/19 (15.8%)
Pain in extremity 10/51 (19.6%) 2/19 (10.5%)
Torticollis 2/51 (3.9%) 1/19 (5.3%)
Nervous system disorders
Dizziness 5/51 (9.8%) 1/19 (5.3%)
Headache 29/51 (56.9%) 9/19 (47.4%)
Hypoaesthesia 1/51 (2%) 1/19 (5.3%)
Paraesthesia 2/51 (3.9%) 3/19 (15.8%)
Presyncope 8/51 (15.7%) 1/19 (5.3%)
Sciatica 5/51 (9.8%) 2/19 (10.5%)
Psychiatric disorders
Anxiety 4/51 (7.8%) 0/19 (0%)
Depression 4/51 (7.8%) 0/19 (0%)
Insomnia 4/51 (7.8%) 1/19 (5.3%)
Renal and urinary disorders
Dysuria 7/51 (13.7%) 1/19 (5.3%)
Glycosuria 1/51 (2%) 1/19 (5.3%)
Micturition disorder 0/51 (0%) 1/19 (5.3%)
Nephrolithiasis 5/51 (9.8%) 0/19 (0%)
Nephropathy toxic 1/51 (2%) 2/19 (10.5%)
Nocturia 0/51 (0%) 1/19 (5.3%)
Pollakiuria 0/51 (0%) 2/19 (10.5%)
Proteinuria 0/51 (0%) 1/19 (5.3%)
Renal colic 7/51 (13.7%) 1/19 (5.3%)
Renal tubular disorder 0/51 (0%) 1/19 (5.3%)
Strangury 2/51 (3.9%) 1/19 (5.3%)
Reproductive system and breast disorders
Amenorrhoea 4/51 (7.8%) 1/19 (5.3%)
Dysmenorrhoea 3/51 (5.9%) 1/19 (5.3%)
Genital discharge 1/51 (2%) 1/19 (5.3%)
Genital haemorrhage 0/51 (0%) 2/19 (10.5%)
Pruritus genital 0/51 (0%) 1/19 (5.3%)
Vulvovaginal pruritus 2/51 (3.9%) 1/19 (5.3%)
Respiratory, thoracic and mediastinal disorders
Asthma 3/51 (5.9%) 0/19 (0%)
Cough 36/51 (70.6%) 7/19 (36.8%)
Nasal congestion 1/51 (2%) 1/19 (5.3%)
Oropharyngeal pain 23/51 (45.1%) 7/19 (36.8%)
Rhinitis allergic 3/51 (5.9%) 0/19 (0%)
Skin and subcutaneous tissue disorders
Erythema 3/51 (5.9%) 0/19 (0%)
Koilonychia 0/51 (0%) 1/19 (5.3%)
Pruritus 5/51 (9.8%) 2/19 (10.5%)
Rash 2/51 (3.9%) 3/19 (15.8%)
Rash papular 1/51 (2%) 1/19 (5.3%)
Skin lesion 3/51 (5.9%) 0/19 (0%)
Urticaria 4/51 (7.8%) 0/19 (0%)
Surgical and medical procedures
Tooth extraction 0/51 (0%) 1/19 (5.3%)
Vascular disorders
Hypotension 5/51 (9.8%) 2/19 (10.5%)

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.

The terms and conditions of Novartis' agreements with its investigators may vary. However, Novartis does not prohibit any investigator from publishing. Any publications from a single-site are postponed until the publication of the pooled data (i.e., data from all sites) in the clinical trial.

Results Point of Contact

Name/Title Study Director
Organization Novartis Pharmaceuticals
Phone 862 778-8300
Email
Responsible Party:
, ,
ClinicalTrials.gov Identifier:
NCT01033747
Other Study ID Numbers:
  • CICL670A0105E2
First Posted:
Dec 16, 2009
Last Update Posted:
Aug 11, 2011
Last Verified:
Jul 1, 2011