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Transfusional Iron OverloadPhase 2CORDELIANCT00600938

Evaluating Use of Deferasirox as Compared to Deferoxamine in Treating Cardiac Iron Overload

A Phase 2 study testing Core Study: Deferasirox, Core Study: Deferoxamine and Extension: deferoxamine to deferasirox in people with Transfusional Iron Overload and Transfusional Hemosiderosis, run by Novartis Pharmaceuticals at 21 sites in 11 countries.

Completed

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

Official record
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Trial summary

This is a clinical research study in patients who have iron overload in the heart due to chronic blood transfusions. The study will have 2 treatment groups and will compare the safety and efficacy of chelation therapy with a medicine called deferasirox (ICL670) with another medicine called deferoxamine (DFO). Read more about this study

Who is it for?
Ages 10 to 65 years
What is being tested?
Core Study: Deferasirox, Core Study: Deferoxamine and Extension: deferoxamine to deferasirox
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
197 participants
Where
21 sitesin 11 countries
Study dates
Nov 2007to Mar 2013
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 to 65 years
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Male or female patients, aged 10 years and above, with β-thalassemia major or DBA or sideroblastic anemia on chronic transfusion therapy, having given written consent to participate in the study.
  • Patients with cardiac iron as measured by a myocardial T2* value that is ≥ 6ms but not ≥ 20 ms.
  • Patients with a lifetime history of at least 50 units of red cell transfusions, and must be receiving at least ≥10 units/yr of red blood cells transfusions.
  • Patients with a left ventricular ejection fraction (LVEF) ≥ 56 % as determined by cardiovascular magnetic resonance (CMR).
  • Patients with liver iron content (LIC) value ≥ 3 mg Fe / g dw, as determined by liver MRI.

Who cannot join

  • Patients with clinical symptoms of cardiac dysfunction.
  • Patients unable to undergo study assessments including MRI
  • Patients participating in another clinical trial or receiving an investigational drug.
  • Other protocol-defined inclusion/exclusion criteria may apply.

Trial locations and contacts

21 sites in 11 countries.

21 sites in 11 countries

Turkey (Türkiye)5 sites
  • Novartis Investigative Site

    Adana, Turkey, 01330

  • Novartis Investigative Site

    Ankara, Turkey, 06100

  • Novartis Investigative Site

    Antalya, 07070

  • Novartis Investigative Site

    Istanbul, 34093

  • Novartis Investigative Site

    Izmir, Turkey, 35040

Other trials in Turkey (Türkiye)

United Kingdom4 sites
  • Novartis Investigative Site

    Leeds, West Yorkshire, LS9 7TF

  • Novartis Investigative Site

    Leeds, LS9 7TF

  • Novartis Investigative Site

    London, N19 5NF

  • Novartis Investigative Site

    London, NW1 2PJ

Other trials in United Kingdom

Egypt2 sites
  • Novartis Investigative Site

    Al Mansurah

  • Novartis Investigative Site

    Cairo

Other trials in Egypt

Italy2 sites
  • Novartis Investigative Site

    Cagliari, CA, 09121

  • Novartis Investigative Site

    Genova, GE, 16128

Other trials in Italy

Thailand2 sites
  • Novartis Investigative Site

    Bangkok, 10330

  • Novartis Investigative Site

    Bangkok, 10700

Other trials in Thailand

Canada1 site
  • Novartis Investigative Site

    Toronto, Ontario, M5G 1X8

Other trials in Canada

China1 site
  • Novartis Investigative Site

    Nanning, Guangxi, 530021

Other trials in China

Cyprus1 site
  • Novartis Investigative Site

    Limassol, 3304

Other trials in Cyprus

Lebanon1 site
  • Novartis Investigative Site

    Hazmiyeh

Other trials in Lebanon

Taiwan1 site
  • Novartis Investigative Site

    Taipei, Taiwan, 10002

Other trials in Taiwan

United Arab Emirates1 site
  • Novartis Investigative Site

    Dubai, Dubai, 9115

Other trials in United Arab Emirates

About this study

Official title: A Multicenter, Randomized, Open-label Phase II Trial Evaluating Deferasirox Compared With Deferoxamine in Patients With Cardiac Iron Overload Due to Chronic Blood Transfusions

This is a clinical research study in patients who have iron overload in the heart due to chronic blood transfusions.

The study will have 2 treatment groups and will compare the safety and efficacy of chelation therapy with a medicine called deferasirox (ICL670) with another medicine called deferoxamine (DFO). The study is aimed at finding out which of the two medicines is the best for treating iron overload in the heart.

Patients will be treated for 12 months (core study phase). Patients who complete the core study phase will be offered to continue their study treatment in a 12 months extension phase. During the core and extension, the effects of treatment on iron overload in the heart and the liver will be evaluated using specific magnetic resonance imaging (MRI) assessments.

Being tested
Core Study: Deferasirox, Core Study: Deferoxamine, Extension: deferoxamine to deferasirox, Extension: deferasirox to deferoxamine, Deferasirox
Keywords
iron overload, cardiac iron, haemosiderosis, myocardial T2*, left ventricular ejection fraction, LVEF, cardiac dysfunction, thalassaemia, Diamond Blackfan anemia, DBA, sideroblastic anemia, myelodysplastic syndromes, MDS (low and INT-1 risk as per the IPSS for MDS), liver MRI, deferasirox, deferoxamine, ICL670, DFO, cardiovascular magnetic resonance imaging
Medical subject headings
Iron Overload, Hemochromatosis, Thalassemia, Anemia, Diamond-Blackfan, Anemia, Sideroblastic, Myelodysplastic Syndromes

What participants receive

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

  • Core Study: DeferasiroxDrug

    Also called "ICL to ICL"

    20 mg/kg/day once daily (od) for 2 weeks, followed by 30 mg/kg/day od for 1 week and a subsequent continuation of 40 mg/kg/day

  • Core Study: DeferoxamineDrug

    Also called "DFO to DFO"

    50 mg/kg/day to 60 mg/kg/day infused subcutaneously in 8- to 12-hour intervals administered 5 to 7 days/week

  • Extension: deferoxamine to deferasiroxDrug

    Also called "DFO to ICL"

    40 mg/kg deferasirox once daily administered 30 minutes before taking food.

  • Extension: deferasirox to deferoxamineDrug

    Also called "ICL to DFO"

    DFO at a target range of 50 mg/kg/day to 60 mg/kg/day via subcutaneous (sc) infusion lasting a period of 8 to 12 hrs administered for 5 to 7 days per week,

  • DeferasiroxDrug

  • DeferoxamineDrug

Study groups in NCT00600938
Study groupRoleWhat they receive
DeferasiroxExperimental20 mg/kg/day once daily (od) for 2 weeks, followed by 30 mg/kg/day od for 1 week and a subsequent continuation of 40 mg/kg/day
Receives: Drug: Core Study: Deferasirox; Drug: Deferasirox
Deferasirox PlaceboActive comparator50 mg/kg/day to 60 mg/kg/day infused subcutaneously in 8- to 12-hour intervals administered 5 to 7 days/week
Receives: Drug: Core Study: Deferoxamine; Drug: Deferoxamine
Extension: deferoxamine to deferasiroxExperimental"DFO to ICL" (patients who switched from DFO to deferasirox in extension)
Receives: Drug: Extension: deferoxamine to deferasirox
Extension: deferasirox to deferoxamineExperimental"ICL to DFO" (patients who switched from deferasirox to DFO in extension)
Receives: Drug: Extension: deferasirox to deferoxamine

What is being measured

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

  1. Core Study: Change From Baseline in Myocardial T2* (Magnetic Resonance T2-star (T2*) Technique for the Measurement of Tissue Iron) After 12 Months Treatment

    Non- inferiority in efficacy of deferasirox compared to deferoxamine (DFO) in treating cardiac iron overload as measured by T2*. A non-inferiority margin of 0.9 (90%) was applied. Due to limitations in performing heart biopsies, T2* (T2 star), a Magnetic Resonance (MR) relaxation parameter expressed in milliseconds, as is an important tool to noninvasively quantify cardiac iron concentration. Studies have shown that myocardial T2* evaluations may predict cardiac events, e.g., impaired (<56%) left ventricular ejection fraction (LVEF) is prevalent among patients with low T2*: found in 62% of patients with T2*<8 ms; 20% with T2* of 8-12 ms; and in 5% with T2* >12 ms (Tanner 2006)

    Measured: 12 Month

Secondary outcomes (20)
  1. Core Study: Cardiac Function After 12 Months of Treatment With Deferasirox vs. Deferoxamine, by Change in Left Ventricular Ejection Fraction (LVEF)

    An absolute change from baseline in LVEF after 12 months treatment with deferasirox and compared to.DFO was tested using an analysis of covariance model including baseline left ventricular ejection fraction (LVEF) as a covariate.

    Measured: 12 Month

  2. Core Study: Cardiac Function After 6 Months of Treatment With Deferasirox vs. Deferoxamine, by Change in Left Ventricular Ejection Fraction (LVEF)

    An absolute change from baseline in LVEF after 6 months treatment with deferasirox and DFO was summarized

    Measured: 6 Month

  3. Core Study: Change From Baseline in Myocardial T2* After 6 Months Treatment

    Summary statistics of T2* ratio Month 6/baseline

    Measured: 6 Month

  4. Core Study: Cardiac Function After 6 and 12 Months Treatment With Deferasirox vs. Deferoxamine, by Change in Left Ventricular End Systolic Volume Indices (LVESVI)

    An absolute change from baseline in LVESVI after 6 and 12 months treatment with deferasirox and DFO was summarized. Changes in cardiovascular magnetic resonance (CMR) measured left ventricular end systolic after 6 and 12 months treatment. Left ventricular (LV) end-systolic volume indexed to body surface area (ESVI) is a simple yet powerful echocardiographic marker of LV remodeling that can be measured easily. Left ventricular (LV) end-systolic volume (ESV) has been shown to be an important determinant of survival after myocardial infarction (MI)

    Measured: 6 Month, 12 Month

  5. Core Study: Core Study: Cardiac Function After 6 and 12 Months of Treatment With Deferasirox vs. Deferoxamine, by Change in Left Ventricular End Diastolic Volume Indices (LVEDVI)

    An absolute change from baseline in LVEDVI after 6, and 12 months treatment with deferasirox and DFO was summarized

    Measured: 6 Month, 12 Month

  6. Core Study: Cardiac Function After 6 and 12 Months of Treatment With Deferasirox vs. Deferoxamine, by Change in Left Ventricular Mass Indices (LVMI)

    An absolute change from baseline in LVMI after 6, and 12 months treatment with deferasirox and DFO was summarized

    Measured: 6 Month, 12 Month

  7. Core Study: Cardiac Function and the Proportion of Patients Dropping Out Due to Cardiac Dysfunction After Treatment With Deferasirox vs. Deferoxamine

    The number of patients withdrawn from the study due to LVEF <50%, T2* <6 ms or significant decreases in T2* ≥ 33% from baseline was provided per treatment group.

    Measured: 12 Month

  8. Core Study: Safety and Tolerability of Deferasirox vs Deferoxamine Over the 12 Months Treatment Period.

    Number of patients with adverse events, serious adverse events and death

    Measured: 12 Month

  9. Core Study: Single and Repeated Dose Pharmacokinetics of Deferasirox, Area Under the Plasma Concentration-time Curve for a Dosing Interval (AUCtau)

    The plasma level of deferasirox (ICL670) obtained in this study was summarized descriptively. Plasma concentration was plotted by patient and by visit. Descriptive statistics included the mean, median, SD, and CV, min and max. deferasirox pharmacokinetics (PK) trough levels over the 12 months of treatment and obtained PK profiles for the 40 mg/kg/day deferasirox dose, area under the plasma concentration-time curve for a dosing interval (AUCtau)

    Measured: 12 Month

  10. Core Study: Single and Repeated Dose Pharmacokinetics of Deferasirox, Maximum Plasma Concentration (Cmax)

    The plasma level of deferasirox (ICL670) obtained in this study was summarized descriptively. Plasma concentration was plotted by patient and by visit. Descriptive statistics included the mean, median, SD, and CV, min and max. deferasirox pharmacokinetics (PK) trough levels over the 12 months of treatment and obtained PK profiles for the 40 mg/kg/day deferasirox dose, maximum plasma concentration (Cmax)

    Measured: 12 Month

  11. Core Study: Single and Repeated Dose Pharmacokinetics of Deferasirox, Time Points of Concentration Data

    The plasma level of deferasirox (ICL670) obtained in this study was summarized descriptively. Plasma concentration was plotted by patient and by visit. For trough concentration assessments, a 2-mL blood sample was to be taken on arrival at the study site, i.e. prior to the patient receiving the daily deferasirox dose (pre-dose blood sample). A second 2-mL blood sample was to be taken 2 hours later (post-dose sample). At all other visits (Visits 3 - 14), a pre-dose sample was to be taken. For PK profile assessments, 3 blood samples were taken after 1, 2, and 4 hours post-dose in addition to the 2-mL pre-dose

    Measured: Month 1 and month 2 (pre-dose, 1,2 and 4 hours post-dose)

  12. Extension Study: Change From Baseline in Myocardial T2* After 24 Months Treatment

    The measured T2* values, the ratio (post-baseline / baseline T2*) at Month 6, 12, 18 and 24 was summarized for FAS population along with two-sided 95% CIs. The geometric means of the ratio was presented for all treatment groups

    Measured: Months 6, 12, 18 and 24

  13. Extension Study: Cardiac Function From Baseline to Month 24 by Change in Left Ventricular Ejection Fraction (LVEF)

    Cardiac function endpoints (LVEF) obtained by CMR at baseline, Months 6, 12, 18 and 24 were summarized by means of descriptive statistics. These analyses were conducted for the measured values as well as for the absolute changes from baseline

    Measured: Months 6, 12, 18 and 24

  14. Extension Study: Cardiac Function From Baseline to Month 24 by Change in Left Ventricular End Systolic Volume Indices (LVESVI)

    Cardiac function endpoints (LVESVI) obtained by CMR at baseline, Months 6, 12, 18 and 24 were summarized by means of descriptive statistics. These analyses were conducted for the measured values as well as for the absolute changes from baseline

    Measured: Months 6, 12, 18 and 24

  15. Extension Study: Cardiac Function From Baseline to Month 24 by Change in Left Ventricular End Diastolic Volume Indices (LVEDVI)

    Cardiac function endpoint (LVEDVI ) obtained by CMR at baseline, Months 6, 12, 18 and 24 were summarized by means of descriptive statistics. These analyses were conducted for the measured values as well as for the absolute changes from baseline

    Measured: Months 6, 12, 18 and 24

  16. Extension Study: Cardiac Function From Baseline to Month 24 by Change in Left Ventricular Mass Indices (LVMI)

    Cardiac function endpoints (LVMI) obtained by CMR at baseline, Months 6, 12, 18 and 24 were summarized by means of descriptive statistics. These analyses were conducted for the measured values as well as for the absolute changes

    Measured: Months 6, 12, 18 and 24

  17. Extension Study: The Cardiac Iron Concentration From T2* Values

    Cardiac iron concentration (derived from T2* values) at baseline, Months 6, 12, 18 and 24 were summarized by descriptive statistics. The absolute change from baseline at Months 6, 12, 18 and 24 were also summarized by treatment group. Lliver iron concentration is expressed in units (mg of iron / g of liver tissue dry weight (dw)

    Measured: Months 6, 12, 18 and 24

  18. Extension Study: Change in Liver Iron Concentration (LIC) From Baseline at Month 24

    Results of liver iron content (LIC) measurements by MRI was summarized by descriptive statistics. The absolute value and the absolute change from baseline in LIC at Months 6, 12, 18 and 24 were provided by treatment group.

    Measured: Months 6, 12, 18 and 24

  19. Extension Study: Change in Serum Ferritin From Baseline by Month

    Serum ferritin values was summarized by descriptive statistics. Absolute value and the absolute change from baseline in serum ferritin by month was provided by treatment group.

    Measured: Months 6, 12, 18 and 24

  20. Core Study: Single and Repeated Dose Pharmacokinetics of Deferasirox, Maximum Plasma Concentration (Tmax)

    The plasma level of deferasirox (ICL670) obtained in this study was summarized descriptively. Plasma concentration was plotted by patient and by visit. Descriptive statistics included the mean, median, SD, and CV, min and max. deferasirox pharmacokinetics (PK) trough levels over the 12 months of treatment and obtained PK profiles for the 40 mg/kg/day deferasirox dose, time to reach maximum plasma concentration (Tmax)

    Measured: 12 Month

Timeline

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

  1. First posted25 Jan 2008 (estimated)
  2. Study startNov 2007
  3. Primary completionMar 2013
  4. Study completionMar 2013

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
197 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00600938
Sponsor's protocol ID
CICL670A2206
Other IDs
2007-000766-20
Acronym
CORDELIA
Status last verified
Aug 2014
First submitted
14 Jan 2008
Last updated
27 Aug 2014
Data monitoring committee
Yes

Publications

  • Pennell DJ, Porter JB, Piga A, Lai YR, El-Beshlawy A, Elalfy M, Yesilipek A, Kilinc Y, Habr D, Musallam KM, Shen J, Aydinok Y; CORDELIA study investigators. Sustained improvements in myocardial T2* over 2 years in severely iron-overloaded patients with beta thalassemia major treated with deferasirox or deferoxamine. Am J Hematol. 2015 Feb;90(2):91-6. doi: 10.1002/ajh.23876. Epub 2014 Nov 19.

    PubMed 25345697
  • Pennell DJ, Porter JB, Piga A, Lai Y, El-Beshlawy A, Belhoul KM, Elalfy M, Yesilipek A, Kilinc Y, Lawniczek T, Habr D, Weisskopf M, Zhang Y, Aydinok Y; CORDELIA study investigators. A 1-year randomized controlled trial of deferasirox vs deferoxamine for myocardial iron removal in beta-thalassemia major (CORDELIA). Blood. 2014 Mar 6;123(10):1447-54. doi: 10.1182/blood-2013-04-497842. Epub 2014 Jan 2.

    PubMed 24385534

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Core Study: Deferasirox, Core Study: Deferoxamine and Extension: deferoxamine to deferasirox in people with Transfusional Iron Overload and Transfusional Hemosiderosis, run by Novartis Pharmaceuticals at 21 sites in 11 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 5 inclusion and 4 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 27 Aug 2014. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 21 sites in Turkey (Türkiye), United Kingdom, Egypt, Italy, Thailand and 6 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 27 Aug 2014). 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?

Core Study: Change From Baseline in Myocardial T2* (Magnetic Resonance T2-star (T2*) Technique for the Measurement of Tissue Iron) After 12 Months Treatment (time frame: 12 Month). 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 NCT00600938, which also lists 2 linked publications.

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 27 Aug 2014; AzTrials last refreshed its copy on 7 Nov 2026.

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