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Chronic Iron Overload Due to Transfusion-dependant AnemiasPhase 2NCT02125877

Phase II Study to Investigate the Benefits of an Improved Deferasirox Formulation (Film-coated Tablet)

A Phase 2 study testing Deferasirox dispersible tablet and Defearisox film-coated tablet in people with Chronic Iron Overload Due to Transfusion-dependant Anemias, run by Novartis Pharmaceuticals at 51 sites in 16 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Assessed the new film-coated tablet formulation to the currently approved dispersible tablet formulation with regards to overall safety, Gastrointestinal (GI) tolerability, palatability, satisfaction and compliance Read more about this study

Who is it for?
Ages 10 years and older
What is being tested?
Deferasirox dispersible tablet and Defearisox film-coated tablet
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
173 participants
Where
51 sitesin 16 countries
Study dates
8 Jul 2014to 24 Feb 2016
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 10 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Male and female patients aged ≥ 10 years
  • Patients with transfusion-dependent thalassemia and iron overload, requiring deferasirox DT at doses of ≥ 30 mg/kg/day as per the investigator's decision OR Patients with very low, low or intermediate (int) risk myelodysplastic syndrome (MDS) and iron overload, requiring deferasirox DT at doses of ≥ 20 mg/kg/day as per the investigator's decision.
  • History of transfusion of at least 20 PRBC units and anticipated to be transfused with at least 8 units of PRBCs annually during the study
  • Serum ferritin > 1000 ng/mL, measured at screening Visit 1 and screening Visit 2 (the mean value will be used for eligibility criteria).

Who cannot join

  • Creatinine clearance below the contraindication limit in the locally approved prescribing information. Creatinine clearance will be estimated from serum creatinine at screening Visit 1 and screening Visit 2 and the mean value will be used for eligibility criteria.
  • Serum creatinine > 1.5 xULN at screening measured at screening Visit 1 and screening Visit 2 (the mean value will be used for eligibility criteria).
  • ALT (SGPT) > 5xULN, unless LIC confirmed as >10 mg Fe/dw within 6 months prior to screening visit 1.
  • Significant proteinuria as indicated by a urinary protein/creatinine ratio > 0.5 mg/mg in a non-first void urine sample at screening Visit 1 or screening Visit 2.
  • Patients with significant impaired gastrointestinal (GI) function or GI disease that may significantly alter the absorption of oral deferasirox (e.g. ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection).
  • Liver disease with severity of Child-Pugh Class B or C

Trial locations and contacts

51 sites in 16 countries.

51 sites in 16 countries

Italy14 sites
  • Novartis Investigative Site

    Brindisi, BR, 72100

  • Novartis Investigative Site

    Cagliari, ITA, 09121

  • Novartis Investigative Site

    Catania, CT, 95125

  • Novartis Investigative Site

    Cona, FE, 44100

  • Novartis Investigative Site

    Genova, GE, 16128

  • Novartis Investigative Site

    Genova, GE, 16132

  • Novartis Investigative Site

    Lecce, LE, 73100

  • Novartis Investigative Site

    Milan, MI, 20122

  • Novartis Investigative Site

    Milan, MI, 20162

  • Novartis Investigative Site

    Naples, 80138

  • Novartis Investigative Site

    Palermo, PA, 90127

  • Novartis Investigative Site

    Palermo, PA, 90146

  • Novartis Investigative Site

    Reggio Calabria, RC, 89100

  • Novartis Investigative Site

    Verona, VR, 37126

Other trials in Italy

Germany7 sites
  • Novartis Investigative Site

    Berlin, 13353

  • Novartis Investigative Site

    Dresden, 01307

  • Novartis Investigative Site

    Goslar, 38642

  • Novartis Investigative Site

    Hanover, 30170

  • Novartis Investigative Site

    Leipzig, 04103

  • Novartis Investigative Site

    Mannheim, Baden-Wurttemberg, 68305

  • Novartis Investigative Site

    Potsdam, 14467

Other trials in Germany

United States5 sites
  • Children's Hospital Boston Department of Hematology

    Boston, Massachusetts, 02115

  • Lurie Children's Hospital of Chicago Onc Dept

    Chicago, Illinois, 60611

  • Weill Cornell Medical College-Cornell University Onc Dept

    New York, New York, 10021

  • Children's Hospital of Orange County Onc Dept

    Orange, California, 92868-3874

  • Children's Hospital of Philadelphia Onc. Dept

    Philadelphia, Pennsylvania, 19104-4399

Other trials in United States

Saudi Arabia4 sites
  • Novartis Investigative Site

    Dammam, 15215

  • Novartis Investigative Site

    Dammam, 40145

  • Novartis Investigative Site

    Jeddah, 21589

  • Novartis Investigative Site

    Riyadh, 11472

Other trials in Saudi Arabia

Greece3 sites
  • Novartis Investigative Site

    Athens, GR, GR-115 27

  • Novartis Investigative Site

    Patra - RIO, GR, 265 04

  • Novartis Investigative Site

    Thessaloniki, GR, 546 42

Other trials in Greece

Austria2 sites
  • Novartis Investigative Site

    Linz, A-4010

  • Novartis Investigative Site

    Vienna, 1140

Other trials in Austria

France2 sites
  • Novartis Investigative Site

    Lille, 59020

  • Novartis Investigative Site

    Paris, 75010

Other trials in France

Malaysia2 sites
  • Novartis Investigative Site

    Kuala Lumpur, 50589

  • Novartis Investigative Site

    Pulau Pinang, 10990

Other trials in Malaysia

Spain2 sites
  • Novartis Investigative Site

    Barcelona, 08041

  • Novartis Investigative Site

    Madrid, 28033

Other trials in Spain

Thailand2 sites
  • Novartis Investigative Site

    Bangkok, 10400

  • Novartis Investigative Site

    Bangkok, 10700

Other trials in Thailand

United Arab Emirates2 sites
  • Novartis Investigative Site

    Al Ain - Abu Dhabi, United Arab Emirates

  • Novartis Investigative Site

    Dubai, 9115

Other trials in United Arab Emirates

United Kingdom2 sites
  • Novartis Investigative Site

    London, N19 5NF

  • Novartis Investigative Site

    London, NW1 2PJ

Other trials in United Kingdom

Argentina1 site
  • Novartis Investigative Site

    Buenos Aires, C1221ADC

Other trials in Argentina

Lebanon1 site
  • Novartis Investigative Site

    Hazmiyeh, Beirut, PO Box 213

Other trials in Lebanon

Mexico1 site
  • Novartis Investigative Site

    Mexico City, Mexico City, 06726

Other trials in Mexico

Russia1 site
  • Novartis Investigative Site

    Moscow, Russia, 117198

Other trials in Russia

About this study

Official title: A Randomized, Open-label, Multicenter, Two Arm, Phase II Study to Investigate the Benefits of an Improved Deferasirox Formulation (Film-coated Tablet)

Assessed the new film-coated tablet formulation to the currently approved dispersible tablet formulation with regards to overall safety, Gastrointestinal (GI) tolerability, palatability, satisfaction and compliance

Being tested
Deferasirox dispersible tablet, Defearisox film-coated tablet
Keywords
Iron overload, Chelation, Thalassemia, Myelodysplastic syndrome (MDS), Transfusional hemisiderosis, Deferasirox, ICL670, Dispersible tablet, Film-coated tablet
Medical subject headings
Iron Overload, Thalassemia, Myelodysplastic Syndromes

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Deferasirox dispersible tabletDrug

    Also called ICL670, DT (dispersible tablet)

    Deferasirox DT was provided as 125 mg, 250 mg and 500 mg dispersible tablets for oral use.

  • Defearisox film-coated tabletDrug

    Also called ICL670, FCT (film-coated tablet)

    Deferasirox FCT was provided as 90 mg, 180 mg and 360 mg film-coated tablets for oral use.

Study groups in NCT02125877
Study groupRoleWhat they receive
Deferasirox dispersible tablet (DFX-DT)Active comparatorIron chelation naïve participants received DFX-DT 20 mg/kg/day once daily orally from weeks 1 - 4. After week 4, the dose could be adjusted by +/- 5 to 10 mg/kg/day, with a maximum dose of 40 mg/kg/day. Iron chelation pre-treated participants were supposed to start on a dose that was equivalent to their pre-washout dose.
Receives: Drug: Deferasirox dispersible tablet
Deferasirox film-coated tablet (DFX-FCT)ExperimentalParticipants received DFX-FCT 14 mg/kg/day once daily orally from weeks 1 - 4. After week 4, the dose could be adjusted by +/- 3.5 to 7 mg/kg/day, with a maximum dose of 28 mg/kg/day. Iron chelation pre-treated participants were supposed to start on a dose that was equivalent to their pre-washout dose
Receives: Drug: Defearisox film-coated tablet

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Overall Safety as Measured by Frequency of Adverse Events

    The percentage of participants with adverse events, serious adverse events and deaths was assessed.

    Measured: 28 weeks

  2. Overall Safety as Measured by Changes in Laboratory Values From Baseline

    The percentage of participants with post-baseline laboratory values meeting specified criteria for notable/extended range was assessed. The following laboratory parameters were measured: platelet count, absolute neutrophils, serum creatinine , creatinine clearance, urinary protein/urinary creatinine ratio, alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Note that within data categories, creat = creatinine, cons = consecutive, ULN = upper limit of normal and urin = urinary.

    Measured: baseline (BL), 30 weeks

Secondary outcomes (10)
  1. Frequency of Selected Gastro-intestinal (GI) Adverse Events

    The percentage of participants with any GI adverse event, diarrhea, constipation, nausea, vomiting, abdominal pain was assessed.

    Measured: 28 weeks

  2. Mean Domain Scores of the Modified Satisfaction With Iron Chelation Therapy (Modified SICT)

    The modified SICT consisted of 13 items that represent 3 domains: adherence, satisfaction and concerns. The adherence domain consisted of 7 items, 6 which were measured using a 5-point response scale and was calculated by summing the 6 items. The score range from 6 to 30 and higher scores indicated worse adherence. The satisfaction domain consisted of 3 items, 2 which were measured using a 5-point response scale and was calculated by summing the 2 items. The score range from 2 to 10 and higher scores indicated worse satisfaction. The concerns domain consisted of 3 items to address any concerns or worries with his/her medication. All 3 items were measured on a 5-point response scale and were calculated by summing the 3 items. The score range from 3 to 15 and higher scores indicated fewer concerns. For all three domains, the meaningful difference between two treatment arms was determined to be 1 point.

    Measured: weeks 2, 3, 13 and 24 (end of treatment or within 7 days of last dose)

  3. Palatability Questionnaire Score

    The palatability questionnaire consisted of 4 items. The first item measured the taste and aftertaste of the medication and were scored a on a 5-point response scale. The second item offered an additional response option of "no aftertaste". The last 2 items referred to whether the medication was taken, i.e. swallowed or vomited, and how the participant perceived the amount of medication to be taken. The palatability summary score was calculated using a scoring matrix from items 1, 3 and 4 scores and the score ranges from 0 - 11. Higher scores indicated the best palatability. A meaningful difference between two treatment arms was determined to be 1 point.

    Measured: weeks 2, 3, 13 and 24 (end of treatment or within 7 days of last dose)

  4. Weekly Average of Daily Scores of the Gastrointestinal (GI) Symptom Diary

    The GI symptom diary consisted of 6 items, five which were scored using a 0 - 10 rating scale with item appropriate anchors to rate the symptom, for example, Pain in your belly: 0 = no pain and 10 = worst pain. The GI diary summary score was created using the 10 point response scale for the 5 items. The GI symptom daily diary had a minimum score of 0 and a maximum score of 50. The weekly average score for the 7 days was calculated for each individual item and the GI summary score was created from these weekly averages. Higher scores indicated worse symptoms. A meaningful difference between two treatment arms was determined to be 0.3 point.

    Measured: weeks -1, 4, 8, 12, 16, 20, 24

  5. Number of Participants With Weekly Average Compliance of Medication Consumption

    A compliance questionnaire assessed whether the medication was taken. Weekly average compliance was calculated when there were at least four non-missing daily responses.

    Measured: Weeks 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24

  6. Weekly Dose Violation Rate

    The dose violation is defined as a dose either missed completely or not taken in accordance with the timing instruction (no later than 12:00 pm. The rate was calculated as [number of dose violations/drug exposure (days)] x 100.

    Measured: weeks 1, 4, 8, 12, 16, 20, 24

  7. Area Under the Plasma Concentration-time Curve From Time Zero to the Last Quantifiable Concentration (AUClast)

    Blood samples were collected to assess AUClast.

    Measured: week 1, day 1: pre-dose (0 hour) and 1, 2, 3, 4, 8 and 24 hours post dose; week 3, day 1: pre-dose (0 hour) and 1, 2, 3, 4, 8 and 24 hours post dose

  8. Observed Maximum Plasma Concentration Following Drug Administration (Cmax)

    Blood samples were collected to assess Cmax.

    Measured: week 1, day 1: pre-dose (0 hour) and 1, 2, 3, 4, 8 and 24 hours post dose; week 3, day 1: pre-dose (0 hour) and 1, 2, 3, 4, 8 and 24 hours post dose

  9. Time to Reach the Maximum Plasma Concentration After Drug Administration (Tmax)

    Blood samples were collected to assess Tmax.

    Measured: week 1, day 1: pre-dose (0 hour) and 1, 2, 3, 4, 8 and 24 hours post dose; week 3, day 1: pre-dose (0 hour) and 1, 2, 3, 4, 8 and 24 hours post dose

  10. Dererasirox Plasma Concentration

    Blood samples were collected to assess deferasirox concentration. Dose-adjusted calculations are presented: (concentration/actual dose)*20 for participants on DFX-DT and (concentration/actual dose)*14 for participants on DFX-FCT.

    Measured: Week 3, day 1, pre-dose (0 hour (h)) and 2 h post-dose; week 13, day 1, pre-dose (0 hour (h)) and 2 h post-dose; and week 21, day 1, pre-dose (0 hour (h)) and 2 h post-dose

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Apr 2014 (estimated)
  2. Study start8 Jul 2014
  3. Primary completion24 Feb 2016
  4. Study completion24 Feb 2016

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
173 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02125877
Sponsor's protocol ID
CICL670F2201
Status last verified
Jul 2017
First submitted
26 Apr 2014
Last updated
25 Jul 2017
Data monitoring committee
No

Publications

  • Taher AT, Origa R, Perrotta S, Kouraklis A, Ruffo GB, Kattamis A, Goh AS, Huang V, Zia A, Herranz RM, Porter JB. Patient-reported outcomes from a randomized phase II study of the deferasirox film-coated tablet in patients with transfusion-dependent anemias. Health Qual Life Outcomes. 2018 Nov 19;16(1):216. doi: 10.1186/s12955-018-1041-5.

    PubMed 30453981

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Deferasirox dispersible tablet and Defearisox film-coated tablet in people with Chronic Iron Overload Due to Transfusion-dependant Anemias, run by Novartis Pharmaceuticals at 51 sites in 16 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 25 Jul 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 51 sites in Italy, Germany, United States, Saudi Arabia, Greece and 11 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 18 Oct 2016). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Overall Safety as Measured by Frequency of Adverse Events (time frame: 28 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02125877, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Jul 2017.

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