Safety of ICL670 vs. Deferoxamine in Sickle Cell Disease Patients With Iron Overload Due to Blood Transfusions

August 18, 2017 updated by: Novartis Pharmaceuticals

A Randomized, Open Label, Phase II Study on Safety and Efficacy of Long Term Treatment of ICL670 Relative to Deferoxamine in Sickle Cell Disease Patients With Transfusional Hemosiderosis

The purpose of this study is to determine if the new orally active iron chelator, ICL670, is as safe as deferoxamine in preventing accumulation of iron in the body while a patient is undergoing repeated blood transfusions.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Patients who require repeated blood transfusions accumulate iron in the body as blood cells contain iron and there is no natural body mechanism to eliminate it. After a while the iron levels get high enough to be toxic to the body. The current therapy of choice is deferoxamine which does a good job of removing excess iron, but is difficult to administer. Deferoxamine requires subcutaneous (under the skin) infusions over 4 to 8 hours nightly 3 to 7 nights per week. In addition to the need to wear an infusion pump nightly, adverse reactions around the site of the injection are frequent.

Study Type

Interventional

Enrollment (Actual)

195

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Alabama
      • Mobile, Alabama, United States, 36604
        • U. of S. Alabama Medical Center
    • California
      • Loma Linda, California, United States, 92354
        • Loma Linda University Medical Center
      • Los Angeles, California, United States, 90027
        • Children's Hospital Los Angeles
      • Oakland, California, United States, 94609
        • Children's Hospital & Research Center
    • Colorado
      • Denver, Colorado, United States, 80262
        • Colorado Sickle Cell Treatment and Research Center
    • District of Columbia
      • Washington, D.C., District of Columbia, United States, 20059
        • Howard University Hospital
    • Florida
      • Tampa, Florida, United States, 33607
        • Tampa Children's Hospital at St Joseph's
    • Georgia
      • Atlanta, Georgia, United States, 30335
        • Georgia Comprehensive Sickle cell Center, Grady Hospital
      • Augusta, Georgia, United States, 30912
        • Adult Sickle Cell Clinic, Medical College of Georgia
    • Illinois
      • Chicago, Illinois, United States, 60612
        • University of Illinois at Chicago
      • Chicago, Illinois, United States, 60614
        • Children's Memorial Hospital
    • Louisiana
      • New Orleans, Louisiana, United States, 70112
        • Tulane University Sickle Cell Center
      • New Orleans, Louisiana, United States, 70118
        • Children's Hospital, Department of Hematology/Oncology
    • Massachusetts
      • Boston, Massachusetts, United States, 02118
        • Boston Medical Center
      • Boston, Massachusetts, United States, 02115
        • Children's Hospital Boston, Division of Hematology/Oncology
    • Michigan
      • Detroit, Michigan, United States, 48201
        • Karmanos Cancer Institute
    • New York
      • Brooklyn, New York, United States, 11215
        • NY Methodist Hospital
      • New York, New York, United States, 10021
        • Weill Medical College of Cornell University
      • Rochester, New York, United States, 14642
        • U. Of Rochester Medical Center
      • The Bronx, New York, United States, 10467
        • Sickle Cell Center, Montefiore Hospital
    • North Carolina
      • Winston-Salem, North Carolina, United States, 27106
        • Wake Forest University School of Medicine
    • Ohio
      • Cincinnati, Ohio, United States, 45229
        • Children's Hospital Medical Center
      • Cincinnati, Ohio, United States, 45219
        • Barrett Center, University of Cincinnati
      • Columbus, Ohio, United States, 43210
        • James Cancer Hospital
    • Pennsylvania
      • Hershey, Pennsylvania, United States, 17033
        • Penn State Milton S Hershey Medical Center
      • Philadelphia, Pennsylvania, United States, 19104
        • Children's Hospital of Philadelphia
      • Pittsburgh, Pennsylvania, United States, 15213
        • Children's Hospital of Pittsburgh
    • South Carolina
      • Columbia, South Carolina, United States, 29203
        • Liberty Hematology Oncology Center
      • Columbia, South Carolina, United States, 29203
        • Palmetto Health Clinical Trials
      • Sumter, South Carolina, United States, 29150
        • Santee Hematology/Oncology
    • Texas
      • Houston, Texas, United States, 77030
        • Baylor College of Medicine
      • Houston, Texas, United States, 77030
        • Texas Children's Hospital/Baylor College of Medicine
      • Temple, Texas, United States, 76508
        • Scott and White Memorial Hospital & Clinics
    • Virginia
      • Norfolk, Virginia, United States, 23507
        • Children's Hospital of The King's Daughter

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

2 years and older (Child, Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Age greater than or equal to 2 years
  • Sickle cell disease patients already treated with or suitable for treatment with deferoxamine 20 to 40 mg/kg/day
  • Serum ferritin greater than 1000 mg/ml
  • Liver iron content greater than 2 mg iron/g dw assessed by means of superconducting quantum interference device (SQUID) for patients who receive simple transfusions and greater than 5 mg iron/ g dw for patients who receive exchange transfusions or who have a history of intermittent blood transfusion.
  • Regular transfusion aimed at maintaining % Hb A above 50% or a previous history of simple transfusion being the recipient of at least 20 units of packed red blood cells.

Exclusion Criteria:

  • Chronic anemias other than sickle cell disease
  • Documented toxicity to deferoxamine
  • Elevated liver enzymes in the year preceeding enrollment
  • Active hepatitis B or hepatitis C
  • HIV seropositivity
  • Elevated serum creatinine or significant proteinuria
  • History of nephrotic syndrome
  • Uncontrolled systemic hypertension
  • Fever and other signs/symptoms of infection within 10 days prior to the start of the study
  • Presence of clinically relevant cataract or previous history of clinically relevant ocular toxicity related to iron chelation
  • Second or third degree AV block, clinically relevant Q-T interval prolongation, or patients requiring digoxin or other drugs that prolong the Q-T interval (other than beta-adrenergic receptor blocking agents).
  • Diseases (cardiovascular, renal, hepatic, etc.) that would prevent the patient from undergoing any of the treatment options
  • Psychiatric or addictive disorders that would prevent the patient from giving informed consent
  • History of drug or alcohol abuse within the 12 months prior to the study
  • Pregnant or breast feeding patients
  • Patients treated with systemic investigational drugs within 4 weeks or topical investigational drugs within 7 days before the start of the study
  • Patients who require concomitant therapy with hydroxyurea
  • Any surgical or medical condition that might significantly alter the absorption, distribution, metabolism or excretion of any drug, such as gastrointestinal disease or major surgery, renal disease, difficulty voiding or urinary obstruction, or impaired pancreatic function
  • Non-compliant or unreliable patients
  • Patients unable to undergo any study procedures such as the hearing or eye tests, or the liver echocardiography
  • Patients unable to undergo SQUID examination

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: ICL670 + deferoxamine
Drug: ICL670, deferoxamine
Other Names:
  • deferasirox

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Evaluate the safety and tolerability of multiple doses of ICL670
Time Frame: 1 year
1 year

Secondary Outcome Measures

Outcome Measure
Time Frame
Estimate the absolute and relative change of liver iron content (LIC) and total body iron excretion (TBIE)
Time Frame: at baseline, after 24 weeks and at 1year (end of study)
at baseline, after 24 weeks and at 1year (end of study)
Evaluate the pharmacokinetics
Time Frame: 24 hours post-dose @ 4, 12, 24 and 52 weeks
24 hours post-dose @ 4, 12, 24 and 52 weeks
Evaluate the relationship between pharmacokinetics, pharmacodynamics and safety variables
Time Frame: at 24 and 52 weks pre-dose
at 24 and 52 weks pre-dose
Evaluate the relationship between hepatic iron and potential surrogate markers
Time Frame: at screen, at washout, then every 2 weeks for the first 12 weeks followed by every 4 weeks
at screen, at washout, then every 2 weeks for the first 12 weeks followed by every 4 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Novartis Pharmaceuticals

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

May 1, 2003

Primary Completion (Actual)

July 1, 2007

Study Registration Dates

First Submitted

August 11, 2003

First Submitted That Met QC Criteria

August 12, 2003

First Posted (Estimate)

August 13, 2003

Study Record Updates

Last Update Posted (Actual)

August 22, 2017

Last Update Submitted That Met QC Criteria

August 18, 2017

Last Verified

August 1, 2017

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • CICL670A0109

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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