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Hereditary HemochromatosisPhase 2NCT03203850

Study to Evaluate the Efficacy and Safety of Deferasirox Film-coated Tablet Versus Phlebotomy in Patients With Hereditary Hemochromatosis (HH)

A Phase 2 study testing Deferasirox FCT and Phlebotomy in people with Hereditary Hemochromatosis, run by Novartis Pharmaceuticals at 11 sites in 7 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The purpose of this study was to evaluate the efficacy and safety of deferasirox film coated tablet (FCT) versus phlebotomy for the management of iron overload in adults with Hereditary Hemochromatosis (HH) at risk of iron-related morbidity. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Hereditary Hemochromatosis
What is being tested?
Deferasirox FCT and Phlebotomy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
45 participants
Where
11 sitesin 7 countries
Study dates
11 Jan 2018to 17 Apr 2023
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Written informed consent must be obtained prior to any screening procedures.
  • Patients eligible for inclusion must meet all following criteria prior to receiving study treatment:
  • 1. Male or female ≥ 18-years-old 2. Documented genotype testing confirming homozygous for the C282Y mutation (C282Y/C282Y) 3. Transferrin saturation ≥ 45% (at either screening visit) 4. Serum ferritin (SF) ≥ 500 μg/L (at either screening visit)
  • -

Who cannot join

  • Medical conditions that preclude inclusion:
  • Iron overload not due to HH
  • Condition which might significantly alter the absorption, distribution, metabolism or excretion of oral deferasirox
  • Systemic disease which prevents taking study treatment or any contraindication to phlebotomy
  • Inflammatory condition or immunological disease which may interfere with the SF interpretation, such as an active infection, collagen vascular disorders, irritable bowel syndrome, lupus, or immune thrombocytopenia
  • Significantly impaired gastrointestinal function or disease that may significantly alter the absorption of oral deferasirox, e.g. ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or small bowel resection.
Show all 38Show fewer
  • Psychiatric or addictive disorder which prevent giving informed consent or undergoing any of the treatment options or unwilling or unable to comply with the protocol
  • Uncontrolled or significant cardiac disease or symptomatic cardiac arrhythmias, e.g., sustained ventricular tachycardia and clinically significant second or third degree AV block without a pacemaker.
  • Illicit drug use and/or alcohol use, defined as an average alcohol consumption greater than one standard drink a day for women or two standard drinks a day for men within the 12 months prior to enrolment. A standard drink is generally considered to be 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits
  • Cirrhosis, including Child-Pugh class A, B, and C, diagnosed by liver biopsy, elastography, radiologic exams, or clinical criteria
  • Active hepatitis B or C (hepatitis B carrier will be allowed)
  • History of HIV seropositivity (ELISA or Western blot)
  • Organ transplant recipient
  • Malignancy of any organ system, treated or untreated, within the past 5 years whether or not there is evidence of local recurrence or metastases, except localized basal cell carcinoma of the skin, or any history of hepatocellular carcinoma
  • Concomitant therapy that precludes enrollment:
  • Prior iron chelation therapy
  • Prohibited concomitant medications with deferasirox
  • Abnormal Laboratory Values:
  • Significant anemia that contraindicates phlebotomy (males with hemoglobin < 130g/L, females with hemoglobin < 120g/L) in both screening visit samples
  • Platelets ≤ 50 x 109/L in both screening visit samples
  • Urine protein/urine creatinine ratio > 1.0 mg/mg in both non-first void urine screening visit samples
  • Creatinine clearance ≤ 40 ml/min, or use the locally approved contraindication limit in prescribing information if it is stricter, in both screening visit samples
  • Serum creatinine > 1.5 x ULN in both screening visit samples
  • ALT ≥ 5 x ULN in both screening visit samples
  • Total bilirubin > 1.5 x ULN in both screening visit samples
  • Participation in an investigational study:
  • Observational registry study is allowable
  • Within 30 days prior to enrollment or within 5-half-lives of an investigational product, whichever is longer
  • Treatment with a systemic investigational drug within 4 weeks or topical investigational drug within 7 days of starting the study
  • Pregnancy and contraception:
  • Pregnant or nursing (lactating) women
  • Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless using basic methods of contraception, such as:
  • Total abstinence Periodic abstinence (calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are unacceptable methods.
  • Female sterilization (bilateral oophorectomy with or without hysterectomy), total hysterectomy, or tubal ligation at least six weeks before taking study treatment. If oophorectomy alone, hormone levels must confirm menopause.
  • Male sterilization (at least 6 months prior to screening). The vasectomized male must be the sole partner.
  • Barrier methods of contraception: condom or occlusive cap For UK: spermicidal foam/gel/film/cream/vaginal suppository
  • Placement of an intrauterine device or intrauterine system
  • Women considered as post-menopausal and not of childbearing potential are allowed to be enrolled in the trial if they have had 12 months of natural (spontaneous) amenorrhea with an expected clinical profile, e.g., age appropriate and history of vasomotor symptoms.

Trial locations and contacts

11 sites in 7 countries.

11 sites in 7 countries

Spain3 sites
  • Novartis Investigative Site

    Barakaldo, Vizcaya, 48903

  • Novartis Investigative Site

    Las Palmas de Gran Canaria, 35010

  • Novartis Investigative Site

    Manresa, Espana, 08241

Other trials in Spain

France2 sites
  • Novartis Investigative Site

    Limoges, 87042

  • Novartis Investigative Site

    Rennes, 35043

Other trials in France

Slovakia2 sites
  • Novartis Investigative Site

    Bratislava, 831 01

  • Novartis Investigative Site

    Bratislava, 85107

Other trials in Slovakia

Belgium1 site
  • Novartis Investigative Site

    Leuven, 3000

Other trials in Belgium

Romania1 site
  • Novartis Investigative Site

    Sibiu, 550245

Other trials in Romania

Russia1 site
  • Novartis Investigative Site

    Moscow, 125167

Other trials in Russia

Switzerland1 site
  • Novartis Investigative Site

    Lugano, 6900

Other trials in Switzerland

About this study

Official title: A Phase II, Multicenter, Open-label, Randomized Two-year Study to Evaluate the Efficacy and Safety of Deferasirox Film-coated Tablet Versus Phlebotomy in Patients With Hereditary Hemochromatosis.

The purpose of this study was to evaluate the efficacy and safety of deferasirox film coated tablet (FCT) versus phlebotomy for the management of iron overload in adults with Hereditary Hemochromatosis (HH) at risk of iron-related morbidity. This evaluation provided information on the two treatment options in terms of the rate of response of proportion of patients reaching the study target SF ≤ 100 μg/L and their associated safety profiles.

In addition to exploring the safety and efficacy of deferasirox FCT in hereditary hemochromatosis (HH), this study is being conducted to fulfill an FDA post-marketing requirement [PMC 750-10 (Exjade) /PMR 2888-8 (Jadenu)] to provide additional randomized data to confirm the ocular safety profile of deferasirox through detailed ocular assessments in patients treated with deferasirox FCT for 2 years.

Read the detailed description

This was a Phase II, multicenter, open-label, randomized two-year study in adults with Hereditary Hemochromatosis (HH) confirmed by HH genotype with iron overload. Eligible subjects were identified during a 4-week screening period, then randomized in a 2:1 ratio to be treated with deferasirox FCT or phlebotomy for up to 24 months (104 weeks).

Being tested
Deferasirox FCT, Phlebotomy
Keywords
hereditary hemochromatosis, ICL670, deferasirox FCT, iron overload
Medical subject headings
Hemochromatosis, Iron Overload

What participants receive

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

  • Deferasirox FCTDrug

    Also called ICL670

    Taken orally once per day (QD) as a film coated tablet (FCT)

  • PhlebotomyProcedure or surgery

    according to investigator's decision

Study groups in NCT03203850
Study groupRoleWhat they receive
Deferasirox FCT ArmExperimentalAn initial dose of deferasirox FCT 7 mg/kg/day was used for 3 months (12 weeks), then was adjusted according to the serum ferritin (SF) level. Deferasirox was interrupted when the study-defined target SF ≤ 100 μg/L was achieved. Deferasirox was to be reinitiated when SF ≥ 300 μg/L, according to deferasirox label.
Receives: Drug: Deferasirox FCT
phlebotomyActive comparatorPhlebotomy was conducted at a frequency determined by the physician. Phlebotomy was interrupted when the study-defined target SF ≤ 100 μg/L was achieved. Phlebotomy was to be reinitiated when SF > 100 μg/L, based on standard of care practice.
Receives: Procedure: Phlebotomy

What is being measured

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

  1. Proportion of Patients Achieving Target SF ≤ 100 μg/L for the First Time

    Proportion of participants achieving target serum ferritin (SF) ≤ 100 μg/L on or before Month 24. Participants were considered responders if they met response criteria (target SF ≤100 µg/L) on or before Month 24 (Week 104) during the treatment phase. Any participant who discontinued treatment prematurely before meeting such criterion and participants with unknown or missing SF by Month 24 were counted as non-responder.

    Measured: Up to Month 24

Secondary outcomes (12)
  1. Number of Participants With Ocular Treatment Emergent Adverse Events (AEs)

    Number of participants with at least one ocular treatment emergent adverse event (new or worsening from baseline).

    Measured: Adverse events were reported from first dose of study treatment until end of study treatment plus 30 days post treatment, up to a maximum duration of approximately 108 weeks.

  2. Number of Participants With Ocular Treatment Emergent Adverse Events (AEs) by Preferred Term

    Number of participants with at least one ocular treatment emergent adverse event (new or worsening from baseline). Preferred terms are based on Medical Dictionary of Regulatory Activities (MedDRA) version 26.0.

    Measured: Adverse events were reported from first dose of study treatment until end of study treatment plus 30 days post treatment, up to a maximum duration of approximately 108 weeks.

  3. Number of Participants With Treatment Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)

    Number of participants with treatment emergent AEs (any AE regardless of seriousness), AEs leading to study treatment discontinuation, and SAEs.

    Measured: Adverse events were reported from first dose of study treatment until end of study treatment plus 30 days post treatment, up to a maximum duration of approximately 108 weeks.

  4. Number of Adverse Events in Participants Who Had Study Treatment Interrupted Due to SF ≤ 100 μg/L and Re-initiated Study Treatment When ≥ 300 μg/L

    Number of participants with Adverse Events who interrupt deferasirox FCT at least once due to SF level ≤ 100 μg/L and re-initiate therapy at SF level ≥ 300 μg/L.

    There were no participants that re-initiated therapy when reached 300 ug/L.

    Measured: Up to 24 months

  5. Categorical Analysis of logMAR Score Changes From Baseline to Best Post-baseline Changes in One Eye With More Extreme Change

    Visual acuity was measured using an Early Treatment Diabetic Retinopathy Study (ETDRS) chart. A letter score was calculated based on the number of letters that could correctly be identified from specified distances. For low luminance and standard acuity measures, visual acuity was described on a logMAR scale for all measures. For including acuity obtained with the ETDRS letter score, the values were converted to a logMAR scale, using the following formula: logMAR = 1.7-0.02*ETDRS score. With this conversion, a difference from baseline of 0.1 logMAR = 5-letter difference in visual acuity, 0.2 logMAR = 10-letter difference, 0.3 logMAR = 15-letter difference, 0.4 logMAR = 20-letter difference, 0.5 logMAR = 25-letter difference and 0.6 logMAR = 30-letter difference. Decrease in logMAR score category from baseline indicates improvement in visual acuity. The best change from baseline amongst all post baseline visit is presented.

    Measured: Baseline, Weeks 24, 52, 76 and 104.

  6. Categorical Analysis of logMAR Score Changes From Baseline to Worst Post-baseline Changes in One Eye With More Extreme Change

    Visual acuity was measured using an Early Treatment Diabetic Retinopathy Study (ETDRS) chart. A letter score was calculated based on the number of letters that could correctly be identified from specified distances. For low luminance and standard acuity measures, visual acuity was described on a logMAR scale for all measures. For including acuity obtained with the ETDRS letter score, the values were converted to a logMAR scale, using the following formula: logMAR = 1.7-0.02*ETDRS score. With this conversion, a difference from baseline of 0.1 logMAR = 5-letter difference in visual acuity, 0.2 logMAR = 10-letter difference, 0.3 logMAR = 15-letter difference, 0.4 logMAR = 20-letter difference, 0.5 logMAR = 25-letter difference and 0.6 logMAR = 30-letter difference. Increase in logMAR score from baseline indicates worsening in visual acuity. The worst change from baseline amongst all post baseline visit is presented.

    Measured: Baseline, Weeks 24, 52, 76 and 104.

  7. Categorical Analysis of Worst Post-baseline Values of Intraocular Pressure in One Eye With More Extreme Change

    Intraocular pressure was measured by tonometry. Intraocular pressure values >5 to ≤21 mmHg were considered normal. The worst post-baseline value corresponds to the worst outcome amongst all post baseline visit

    Measured: Weeks 24, 52, 76 and 104

  8. Categorical Analysis of Changes in Intraocular Pressure From Baseline to Best/Worst Post-baseline Changes in One Eye With More Extreme Change

    Intraocular pressure was measured by tonometry. A decrease in intraocular pressure from baseline indicated improvement.

    Measured: Baseline, up to Week 104

  9. Number of Participants With Slit Lamp Results for Any Evaluation and Worst Eye

    Slit lamp examination was used to evaluate lids, cornea, conjunctiva, iris, anterior chamber, aqueous flare, aqueous inflammatory cells and lens. Any post-baseline abnormalities (not present at baseline) in slit lamp examination were assesses by the investigator and classified as insignificant or clinically significant. Number of participants with slit lamp results (normal, insignificant, significant, missing) for any evaluation and worst eye are reported.

    Measured: Baseline, up to Week 104

  10. Number of Participants With an Increase From Baseline of ≥1 and ≥2 in LOCS III Grades

    Lens Opacities Classification System III (LOCS III) grading scales include lens opacities defined as nuclear opalescence (NO), nuclear color (NC), cortical (C) cataract and posterior subcapsular (P) cataract with several degrees of extend, i.e. severity. The LOCS III scale for nuclear opalescence and for nuclear color ranges from 0 to 6. The LOCS III scale for cortical cataract and posterior subcapsular cataract opacity ranges from 0 to 5. For all scales, higher values indicate higher opacity, opalescence, or color (range: NO0/NC0/C0/P0 to NO6/NC6/C5/P5).

    Number of participants with an increase from baseline of ≥1 and increase of ≥2 in LOCS III grades is reported.

    Measured: Baseline, up to Week 104

  11. Number of Participants With Fundus Oculi Results for Any Evaluation and Worst Eye

    Fundus oculi examination was used to evaluate peripheral retina, macula, optic nerve, and vitreous hemorrhage. Any post-baseline abnormalities (not present at baseline) in fundus oculi examination were assessed by the investigator and classified as insignificant or clinically significant. Number of participants with fundus oculi results (normal, insignificant, significant, missing) for any evaluation and worst eye are reported.

    Measured: Baseline, up to Week 104

  12. Time to Response (TTR)

    Time to response (TTR) is defined as the time from the date of randomization to the date of the first time the SF achieved a value ≤ 100 μg/L during the treatment phase. Participants who did not achieve SF ≤ 100 μg/L were censored as follows: at the last serum ferritin assessment date on or before month 24 (week 104), at the day of randomization if a subject does not have any post-baseline serum ferritin value or at the death date. TTR was analyzed using the Kaplan-Meier method.

    Measured: Up to Month 24

Timeline

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

  1. First posted29 Jun 2017
  2. Study start11 Jan 2018
  3. Primary completion17 Apr 2023
  4. Study completion17 Apr 2023

Why it stopped: Due to enrolment challenge

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
45 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03203850
Sponsor's protocol ID
CICL670F2203
Other IDs
2016-002529-12, 2016
Status last verified
May 2024
First submitted
22 Jun 2017
Last updated
9 Oct 2024
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Deferasirox FCT and Phlebotomy in people with Hereditary Hemochromatosis, run by Novartis Pharmaceuticals at 11 sites in 7 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 38 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: stopped early, as of the sponsor's last update on 9 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 11 sites in Spain, France, Slovakia, Belgium, Romania and 2 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 7 Jun 2024). 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?

Proportion of Patients Achieving Target SF ≤ 100 μg/L for the First Time (time frame: Up to Month 24). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 9 Oct 2024.

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