Efficacy and Safety Study of Deferasirox in Patients With Non-transfusion Dependent Thalassemia

Overview

Assessed the efficacy of deferasirox in patients with non-transfusion dependent thalassemia based on change in liver iron concentration from baseline after 52 weeks of treatment. Provided further assessment of the long-term efficacy and safety of deferasirox in NTDT patients with iron overload (LIC ≥ 5 mg Fe/g liver dw and SF ≥ 300 ng/mL) for up to 260 weeks.

Full Title of Study: “An Open Label, Multi-center, Efficacy and Safety Study of Deferasirox in Iron Overloaded Patients With Non-transfusion Dependent Thalassemia”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: January 3, 2015

Interventions

  • Drug: deferasirox
    • Deferasirox dispersible tablets at strengths of 125 mg, 250 mg, and 500 mg were administered by oral daily dosing.

Arms, Groups and Cohorts

  • Other: Deferasirox
    • All patients were treated with 10mg/kg/day deferasirox with dose adjustments after 4 weeks of treatment according to baseline Liver Iron Concentration (LIC).

Clinical Trial Outcome Measures

Primary Measures

  • Absolute Change in Liver Iron Content (LIC) at 52 Weeks From Baseline
    • Time Frame: Baseline, 52 weeks
    • Absolute change in liver iron concentration measured by MRI from baseline after 52 weeks of treatment

Secondary Measures

  • Percentage of Participants With Baseline LIC>15 Achieving LIC<5 mg Fe/g dw
    • Time Frame: 5 years
    • The percentage of participants with baseline LIC>15 mg Fe/g dw achieving an LIC <5 mg Fe/g dw during the study
  • Time to Achieving LIC <5 mg Fe/g dw
    • Time Frame: 5 years
    • Time to achieving LIC <5 mg Fe/g dw for participants with baseline LIC>15 mg Fe/g dw during the study
  • Time From Target LIC of 3 mg Fe/g dw to the First LIC ≥5 mg Fe/g dw in the Follow up Period
    • Time Frame: post-baseline, up to 260 weeks
    • Time from the target LIC <3 mg Fe/g dw to the first LIC ≥5 mg Fe/g dw in the follow-up period
  • Absolute Change in Health-related Outcomes Using Medical Outcomes Study Form 36 (SF-36v2)
    • Time Frame: Baseline, 52, 104 & 156 Weeks
    • The SF-36 is a self-administered questionnaire for adults (from 18 years of age) and contains 36 items which measure: Physical functioning, Role limitation due to physical health problems, Bodily pain, General health perceptions, Vitality, Social functioning, Role limitations due to emotional problems and General mental health . The higher values indicate a better evaluation of health. Range: 0 to 100 [0 (worst possible health state measured by the questionnaire) to 100 (best possible health state)].
  • Absolute Change in Health-related Outcomes Using the Pediatric Quality of Life Questionnaire (PedsQL™)
    • Time Frame: Baseline, 52, 104 & 156 Weeks
    • The PedsQL™ is a modular approach to measuring health-related quality of life (HRQOL) in children and adolescents. The 23-item PedsQL™ Generic Core Scales encompass the essential core domains for pediatric HRQOL measurement: 1) Physical Functioning (8 items), 2) Emotional Functioning (5 items), 3) Social Functioning (5 items), and 4) School Functioning (5 items). The Generic Core Scales are designed to enable comparisons across patient and healthy populations. The higher values indicate a better evaluation of health. Range: 0 to 100 [0 (worst possible health state measured by the questionnaire) to 100 (best possible health state)].
  • Absolute Change in LIC From Baseline Over Time
    • Time Frame: 24, 52, 76, 104, 128, 156, 180, 208, 232, 260 Weeks
    • Absolute change in serum ferritin from baseline over time up to 260 weeks
  • Serum Ferritin (SF) vs LIC at Baseline and EOS (Week 260 + 30 Days Follow-up)
    • Time Frame: Baseline, End of Study (EOS): Week 260 + 30 days follow up
    • Correlation between serum ferritin and LIC is assessed using scatter plots with pearson correlation coefficient and simple linear model.
  • Correlation Analysis for Absolute Change in LIC and Serum Ferritin at Week 24 and EOS (Week 260 + 30 Days Follow-up)
    • Time Frame: Week 24, End of Study (EOS): Week 260 + 30 days follow up
    • Correlation for absolute change between LIC and serum ferritin was assessed using scatter plots with pearson correlation coefficient and simple linear model.
  • Absolute Change in LIC From Baseline After 52 Weeks of Treatment by Underlying Non-transfusion Dependent Thalassemia (NTDT) Syndrome
    • Time Frame: Baseline, 52 Weeks
    • Absolute change in liver iron concentration measured by MRI from baseline after 52 weeks of treatment by underlying NTDT syndrome. The 4 underlying disease types: Beta-thalassemia intermedia (N =69), HbE beta-thalassemia (N = 24), Alpha-thalassemia intermedia (HbH disease) (N = 40), Other, specify (N = 1)
  • Absolute Change in Serum Ferritin From Baseline After 52 Weeks
    • Time Frame: Baseline, 52 weeks
    • Absolute change in serum ferritin from baseline after 52 weeks of treatment
  • PK Parameters: AUCtau
    • Time Frame: pre-dose (0 hour), and at 2, and 4 hours at Week 4
    • The pharmacokinetic parameter, AUCtau was determined using non-compartmental method(s) for deferasirox and its iron complex. AUC=area under the concentration-time curve during a dosing interval at steady state (amount × time × volume).
  • PK Parameters: Cmax
    • Time Frame: pre-dose (0 hour), and at 2, and 4 hours at Week 4
    • The pharmacokinetic parameter, Cmax, was determined using non-compartmental method(s) for deferasirox and its iron complex. Cmax (maximum/peak plasma drug concentration after drug administration)=amount × volume
  • PK Parameters: Tmax
    • Time Frame: pre-dose (0 hour), and at 2, and 4 hours at Week 4
    • The pharmacokinetic parameter, Tmax, may be determined using non-compartmental method(s) for deferasirox and its iron complex. Tmax=time to reach maximum/peak concentration following drug administration.
  • Plasma Pharmacokinetics (PK) Deferasirox Concentrations
    • Time Frame: Weeks 12 & 24: pre-dose (0hr), 2hr & 4hr post-dose
    • Blood samples for PK evaluation were collected for a sub-group of patients. The patient had to have been on treatment without dose adjustment or treatment interruption (for any reason) for at least 4 consecutive days prior to scheduled PK sampling visit. If there was a dosage change or interruption within 4 days of the visit, no PK blood samples was collected, and an appropriate comment had to be made on the PK CRF page.

Participating in This Clinical Trial

Inclusion Criteria

Non-transfusion dependent congenital or chronic anemia inclusive of beta-thalassemia intermedia, HbE beta-thalassemia or alpha-thalassemia intermedia (HbH disease)/ Liver iron concentration >/= 5 mg Fe/g dw Serum Ferritin >/= 300 ng/mL Exclusion Criteria:

HbS-beta Thalassemia, anticipated regular transfusion program during the study, blood transfusion 6 months prior to study start, significant proteinuria, creatinine clearance </= 40 ml/min, serum creatinine > ULN, ALT >5 x ULN, active hepatitis B or C, cirrhosis Pediatrics Only: A patient's weight of at least 20 kg is required to allow dosing of 5 mg/kg with one tablet of 125 mg

Gender Eligibility: All

Minimum Age: 10 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Novartis Pharmaceuticals
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Novartis Pharmaceuticals, Study Director, Novartis Pharmaceuticals

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