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Iron Deficiency AnaemiaPhase 3NCT03237065

Incidence of Hypophosphatemia After Treatment With Iron Isomaltoside/Ferric Derisomaltose or Ferric Carboxymaltose in Subjects With Iron Deficiency Anaemia

A Phase 3 study testing Iron isomaltoside/ferric derisomaltose and Ferric carboxymaltose in people with Iron Deficiency Anaemia and Iron Deficiency Anemia, run by Pharmacosmos A/S at 15 sites in United States.

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

The trial was designed to evaluate the incidence of unintended hypophosphatemia (low level of phosphate in the blood) in subjects with iron deficiency anaemia (IDA). Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Iron isomaltoside/ferric derisomaltose and Ferric carboxymaltose
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
122 participants
Where
15 sitesUnited States
Study dates
30 Oct 2017to 29 May 2018
Phase
Phase 3
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

  • Subjects having IDA caused by different aetiologies
  • Haemoglobin (Hb) ≤ 11 g/dL
  • Body weight > 50 kg
  • Serum ferritin (S-ferritin) < 100 ng/mL
  • Estimated Glomerular Filtration Rate (eGFR) ≥ 65 mL/min/1.73 m2
  • Serum phosphate (S-phosphate) > 2.5 mg/dL
  • Intolerance or unresponsiveness to oral iron
  • Willingness to participate and signing the Informed Consent Form (ICF)

Who cannot join

  • Acute bleeding > 500 mL within 72 hours
  • Anaemia predominantly caused by factors other than IDA
  • Hemochromatosis or other iron storage disorders
  • Previous serious hypersensitivity reactions to any IV iron compounds
  • Treatment with IV iron within the last 30 days prior to screening
  • Treatment with erythropoietin or erythropoietin-stimulation agents
Show all 19Show fewer
  • Red blood cell transfusion, radiotherapy, and/or chemotherapy
  • Received an investigational drug within the last 30 days prior to screening
  • Planned surgical procedure within the trial period
  • Hepatic enzymes > 3 times upper limit of normal
  • Surgery under anaesthetic within the last 30 days prior to screening
  • Any non-viral infection within the last 30 days prior to screening
  • Alcohol or drug abuse within the past 6 months
  • Vitamin D deficiency
  • Untreated hyperparathyroidism
  • Kidney transplantation
  • Active malignant disease, disease-free for less than 5 years
  • History of a psychological illness or seizures
  • Pregnant or nursing women.

Trial locations and contacts

15 sites in 1 country.

15 sites in 1 country

United States15 sites
  • Pharmacosmos Investigational Site

    Albuquerque, New Mexico, 87102

  • Pharmacosmos Investigational Site

    Doral, Florida, 33122

  • Pharmacosmos investigational Site

    Flint, Michigan, 48504

  • Pharmacosmos Investigational Site

    Idaho Falls, Idaho, 83404

  • Pharmacosmos Investigational Site

    Las Vegas, Nevada, 89146

  • Pharmacosmos Investigational Site

    Miami, Florida, 33144

  • Pharmacosmos Investigational Site

    Miami, Florida, 33165

  • Pharmacosmos Investigational Site

    Miami Lakes, Florida, 33014

  • Pharmacosmos Investigational Site

    Morehead City, North Carolina, 28557

  • Pharmacosmos Investigational Site

    Muscle Shoals, Alabama, 35661

  • Pharmacosmos Investigational Site

    Oak Brook, Illinois, 60523

  • Pharmacosmos Investigational Site

    Orlando, Florida, 32819

  • Pharmacosmos Investigational Site

    Raleigh, North Carolina, 27607

  • Pharmacosmos Investigational Site

    St Louis, Missouri, 63119

  • Pharmacosmos Investigational Site

    Winston-Salem, North Carolina, 27103

Other trials in United States

About this study

Official title: A Randomized, Open-label, Comparative Trial Comparing the Incidence of Hypophosphatemia in Relation to Treatment With Iron Isomaltoside/Ferric Derisomaltose and Ferric Carboxymaltose in Subjects With Iron Deficiency Anaemia (Phosphare-IDA-05)

The trial was designed to evaluate the incidence of unintended hypophosphatemia (low level of phosphate in the blood) in subjects with iron deficiency anaemia (IDA).

Read the detailed description

This trial was designed to evaluate the effect of IV iron isomaltoside/ferric derisomaltose compared with IV ferric carboxymaltose on s-phosphate in subjects with IDA caused by different etiologies.

The subjects received either a single intravenous (IV) dose of iron isomaltoside/ferric derisomaltose (1000 mg at baseline) or two IV doses of ferric carboxymaltose (one dose 750 mg at baseline and a second dose 750 mg on day 7; cumulative dose: 1500 mg). The study subjects were monitored for up to 35 days from baseline.

Being tested
Iron isomaltoside/ferric derisomaltose, Ferric carboxymaltose
Keywords
Iron Deficiency Anaemia, Iron Deficiency Anemia, IDA, Iron deficiency, Intravenous iron replacement therapy, Iron isomaltoside, Ferric derisomaltose, Hypophosphatemia, Ferric carboxymaltose, Monofer, Monoferric, Monover, Monofar, Monoferro
Medical subject headings
Anemia, Iron-Deficiency, Iron Deficiencies, Hypophosphatemia

What participants receive

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

  • Iron isomaltoside/ferric derisomaltoseDrug

    Also called Monofer®, Monoferric®, Monover®, Monofar®, Monoferro®

    Iron isomaltoside/ferric derisomaltose (Monofer®/Monoferric®; 100 mg/mL) was the test product in this trial.

    The dose of iron isomaltoside/ferric derisomaltose for the individual subject was a single IV infusion of 1000 mg (10 mL containing 1000 mg iron isomaltoside/ferric derisomaltose diluted in 100 mL 0.9 % sodium chloride), given over approximately 20 minutes (50 mg iron/min) at baseline (cumulative dose: 1000 mg).

  • Ferric carboxymaltoseDrug

    Also called Injectafer®, Ferinject®

    Ferric carboxymaltose (Injectafer®; 50 mg/mL) was the comparator in this trial. The dose of ferric carboxymaltose for the individual subject was 750 mg, infused over at least 15 minutes at baseline and on day 7 (cumulative dose: 1500 mg).

Study groups in NCT03237065
Study groupRoleWhat they receive
Iron isomaltoside/ferric derisomaltoseExperimentalAdministered IV
Receives: Drug: Iron isomaltoside/ferric derisomaltose
Ferric carboxymaltoseActive comparatorAdministered IV
Receives: Drug: Ferric carboxymaltose

What is being measured

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

  1. Incidence of Hypophosphatemia (S-phosphate Level <2 mg/dL)

    Safety

    The incidence of hypophosphatemia (defined as s-phosphate <2 mg/dL) at any time from baseline up to day 35.

    Measured: Baseline to day 35

Secondary outcomes (16)
  1. Time With Hypophosphatemia ( S-phosphate Level <2.0 mg/dL)

    Safety

    Time with hypophosphatemia (i.e. time with s-phosphate level < 2.0 mg/dL) from baseline up to day 35.

    The time with hypophosphatemia was calculated as the actual number of days from the first day where s-phosphate was <2 mg/dL until the first day when s-phosphate was ≥2 mg/dL. If the subject did not reach s-phosphate ≥2 mg/dL, the subject was regarded as censored on day 35.

    Measured: Baseline to day 35

  2. Proportion of Subjects With Hypophosphatemia on Day 35 (S-phosphate Level <2.0 mg/dL)

    Safety

    Evaluate the proportion of subjects with hypophosphatemia (s-phosphate level <2.0 mg/dL) on day 35.

    Measured: Baseline to day 35

  3. Absolute [∆] Changes in S-phosphate From Baseline to Day 1, 7, 8, 14, 21, and 35

    Safety

    Absolute [∆] changes in s-phosphate from baseline to day 1, 7, 8, 14, 21, and 35.

    Measured: Baseline, days 1, 7, 8, 14, 21, and 35

  4. Relative [%] Changes in S-phosphate From Baseline to Day 1, 7, 8, 14, 21, and 35

    Safety

    Relative [%] changes in s-phosphate from baseline to day 1, 7, 8, 14, 21, and 35.

    Measured: Baseline, days 1, 7, 8, 14, 21, and 35

  5. Change From Baseline in Fractional Phosphate Urinary Excretion

    Safety

    Change in absolute fractional phosphate urinary excretion from baseline to days 1, 7, 8, 14, 21, and 35.

    Fractional excretion of phosphate (FEPi) is calculated as ([phosphate in urine X creatinine in serum]/[phosphate in serum X creatinine in urine]) X 100, and the unit is %.

    Measured: Baseline, days 1, 7, 8, 14, 21, and 35

  6. Change in Concentration of (Intact) Fibroblast Growth Factor 23 (iFGF23) From Baseline to Day 1, 7, 8, 14, 21, and 35

    Safety

    Change in concentration of (Intact) Fibroblast Growth Factor 23 (iFGF23) from baseline to day 1, 7, 8, 14, 21, and 35.

    Measured: Baseline, days 1, 7, 8, 14, 21, and 35

  7. Change in C-terminal Fibroblast Growth Factor 23 (cFGF23) From Baseline to Days 1, 7, 8, 14, 21, and 35

    Safety

    Change in C-terminal Fibroblast Growth Factor 23 (cFGF23) from baseline to days 1, 7, 8, 14, 21, and 35.

    Measured: Baseline, days 1, 7, 8, 14, 21, and 35

  8. Change in Vitamin 25-Hydroxyvitamin D (Vitamin D 25) From Baseline to Days 1, 7, 8, 14, 21, and 35

    Safety

    Change in vitamin 25-Hydroxyvitamin D (vitamin D 25) from baseline to days 1, 7, 8, 14, 21, and 35.

    Measured: Baseline, days 1, 7, 8, 14, 21, and 35

  9. Change in 1,25-Dihydroxyvitamin D (Vitamin D 1.25) From Baseline to Days 1, 7, 8, 14, 21, and 35

    Safety

    Change in 1,25-Dihydroxyvitamin D (vitamin D 1.25) from baseline to days 1, 7, 8, 14, 21, and 35.

    Measured: Baseline, days 1, 7, 8, 14, 21, and 35

  10. Change in 24,25-Dihydroxyvitamin D (Vitamin D 24.25) From Baseline to Days 1, 7, 8, 14, 21, and 35

    Safety

    Change in 24,25-Dihydroxyvitamin D (vitamin D 24.25) from baseline to days 1, 7, 8, 14, 21, and 35.

    Measured: Baseline, days 1, 7, 8, 14, 21, and 35

  11. Change in Intact Parathyroid Hormone (PTH) From Baseline to Days 1, 7, 8, 14, 21, and 35

    Safety

    Change in intact Parathyroid hormone (PTH) from baseline to days 1, 7, 8, 14, 21, and 35.

    Measured: Baseline, days 1, 7, 8, 14, 21, and 35

  12. Change in Ionized Calcium From Baseline to Days 1, 7, 8, 14, 21, and 35

    Safety

    Change in ionized calcium from baseline to days 1, 7, 8, 14, 21, and 35.

    Measured: Baseline, days 1, 7, 8, 14, 21, and 35

  13. Incidence of Protocol-defined Serious or Severe Hypersensitivity Reactions

    Safety

    For this endpoint, the number of participants with serious or severe hypersensitivity reactions were evaluated.

    Measured: Baseline to day 35

  14. Change in Hemoglobin (Hb) Per Gram Iron From Baseline to Days 1, 7, 8, 14, 21, and 35

    Efficacy

    Change in hemoglobin (Hb) per gram iron from baseline to days 1, 7, 8, 14, 21, and 35.

    Measured: Baseline, days 1, 7, 8, 14, 21, and 35

  15. Change in S-ferritin From Baseline to Days 1, 7, 8, 14, 21, and 35

    Efficacy

    Change in s-ferritin from baseline to days 1, 7, 8, 14, 21, and 35.

    Measured: Baseline, days 1, 7, 8, 14, 21, and 35

  16. Change in Transferrin Saturation (TSAT) From Baseline to Days 1, 7, 8, 14, 21, and 35

    Efficacy

    Change in Transferrin Saturation (TSAT) from baseline to days 1, 7, 8, 14, 21, and 35.

    TSAT is the value of serum iron divided by the total iron-binding capacity and the unit is %, which referrers to % of iron-binding sites of transferrin being occupied by iron.

    Measured: Baseline, days 1, 7, 8, 14, 21, and 35

Timeline

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

  1. First posted2 Aug 2017
  2. Study start30 Oct 2017
  3. Primary completion29 May 2018
  4. Study completion29 May 2018

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
122 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03237065
Sponsor's protocol ID
P-Monofer-IDA-05
Status last verified
Feb 2020
First submitted
6 Jul 2017
Last updated
25 Feb 2020
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Wolf M, Rubin J, Achebe M, Econs M, Peacock M, Imel E, Thomsen L, Carpenter T, Weber T, Zoller H. Effects of iron isomaltoside versus ferric carboxymaltose on hormonal control of phosphate homeostasis: The PHOSPHARE-IDA04/05 randomized controlled trials. Journal of the Endocrine Society, Volume 3, Issue Supplement_1, April-May 2019, OR13-3, https://doi.org/10.1210/js.2019-OR13-3

  • Wolf M, Rubin J, Achebe M, Econs MJ, Peacock M, Imel EA, Thomsen LL, Carpenter TO, Weber T, Brandenburg V, Zoller H. Effects of Iron Isomaltoside vs Ferric Carboxymaltose on Hypophosphatemia in Iron-Deficiency Anemia: Two Randomized Clinical Trials. JAMA. 2020 Feb 4;323(5):432-443. doi: 10.1001/jama.2019.22450.

    PubMed 32016310

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Iron isomaltoside/ferric derisomaltose and Ferric carboxymaltose in people with Iron Deficiency Anaemia and Iron Deficiency Anemia, run by Pharmacosmos A/S at 15 sites in United States.

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 8 inclusion and 19 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 Feb 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 15 sites in United States. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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 25 Feb 2020). 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?

Incidence of Hypophosphatemia (S-phosphate Level <2 mg/dL) (time frame: Baseline to day 35). 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 NCT03237065, 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 25 Feb 2020.

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