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    Clinical Trial Results:
    Multicenter, open label, prospective study to evaluate the efficacy and safety of deferasirox 30 mg/kg/day for 52 weeks, in transfusion-dependent beta-thalassemic patients with cardiac MRI T2* <20 msec

    Summary
    EudraCT number
    2008-003230-22
    Trial protocol
    IT  
    Global end of trial date
    05 May 2011

    Results information
    Results version number
    v1(current)
    This version publication date
    13 Jul 2016
    First version publication date
    05 Aug 2015
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CICL670AIT07
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00879242
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Novartis Pharma AG
    Sponsor organisation address
    CH-4002, Basel, Switzerland,
    Public contact
    Clinical Disclosure Office, Novartis Pharma AG, +41 613241111,
    Scientific contact
    Clinical Disclosure Office, Novartis Pharma AG, +41 613241111,
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    05 May 2011
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    05 May 2011
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    The main objective of the study was to evaluate the efficacy of deferasirox, administered daily at the dose of 30 mg/kg for 52 weeks, on iron overload and cardiac function in transfusion-dependent beta-thalassemic subjects with cardiac magnetic resonance imaging (MRI) T2* to be greater than (>) 5 milliseconds (msec) and less than (<) 20 msec. The study was terminated when 20 subjects (less than required sample size i.e. 50) were included due to slow study recruitment rate as well as the concomitant availability of cardiac MRI T2* data in large cohorts of subjects treated with deferasirox.
    Protection of trial subjects
    The study was in compliance with the ethical principles derived from the Declaration of Helsinki and the International Conference on Harmonization (ICH) Good Clinical Practice (GCP) Guidelines. All the local regulatory requirements pertinent to safety of trial subjects were also followed during the conduct of the trial.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    26 Feb 2009
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Italy: 20
    Worldwide total number of subjects
    20
    EEA total number of subjects
    20
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    20
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    The study was planned to be conducted at 4 centres in Italy. However, subjects were enrolled only at 2 centres.

    Pre-assignment
    Screening details
    A total of 20 subjects were enrolled into the study.

    Period 1
    Period 1 title
    Overall (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded
    Blinding implementation details
    This was an open-label study, hence no blinding was performed.

    Arms
    Arm title
    Deferasirox
    Arm description
    Subjects received body-weight stratified dose of deferasirox 30 miligrams/kilograms (mg/kg) once daily for 52 weeks.
    Arm type
    Experimental

    Investigational medicinal product name
    Deferasirox
    Investigational medicinal product code
    ICL670
    Other name
    Pharmaceutical forms
    Dispersible tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Deferasirox 30 mg/kg/day was administered for 52 weeks.

    Number of subjects in period 1
    Deferasirox
    Started
    20
    Completed
    14
    Not completed
    6
         Consent withdrawn by subject
    2
         Adverse event, non-fatal
    1
         Protocol deviation
    2
         Lack of efficacy
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Deferasirox
    Reporting group description
    Subjects received body-weight stratified dose of deferasirox 30 miligrams/kilograms (mg/kg) once daily for 52 weeks.

    Reporting group values
    Deferasirox Total
    Number of subjects
    20 20
    Age categorical
    Units: Subjects
        Adults (20-37 years)
    20 20
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    30.6 ± 4.9 -
    Gender categorical
    Units: Subjects
        Female
    11 11
        Male
    9 9

    End points

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    End points reporting groups
    Reporting group title
    Deferasirox
    Reporting group description
    Subjects received body-weight stratified dose of deferasirox 30 miligrams/kilograms (mg/kg) once daily for 52 weeks.

    Primary: Change from baseline in cardiac iron content as measured by Myocardial T2* technique at Week 52

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    End point title
    Change from baseline in cardiac iron content as measured by Myocardial T2* technique at Week 52 [1]
    End point description
    Magnetic resonance Imaging (MRI) T2* technique was used to measure tissue iron in cardiac iron overload condition. A T2* 10­-20 milliseconds (msec) indicated mild/moderate cardiac iron overload, and a T2* less than (<) 10 msec indicated severe cardiac iron overload. An unsatisfactory response was considered to be a monthly T2* improvement lower than 3% versus baseline. The analysis was performed in per-protocol (PP) population, defined as all enrolled subjects who received at least 1 dose of study drug, had no major protocol violations and completed the treatment study phase or withdrew from the study due to: a decrease of equal to or more than 1.2 msec in T2* versus baseline or a significant reduction in left ventricular ejection fraction (LVEF) according to clinical judgement, despite the deferasirox dose increase up to 40 mg/kg/day.
    End point type
    Primary
    End point timeframe
    Baseline (screening), Week 52
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No analysis provided for terminated study.
    End point values
    Deferasirox
    Number of subjects analysed
    0 [2]
    Units: milliseconds (msec)
        arithmetic mean (standard deviation)
    ±
    Notes
    [2] - Study was terminated, the required sample size for analysis was not met.
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Timeframe for AE
    Adverse event reporting additional description
    AE additional description
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    11.1
    Reporting groups
    Reporting group title
    Deferasirox 30 mg/kg/day
    Reporting group description
    Deferasirox 30 mg/kg/day

    Serious adverse events
    Deferasirox 30 mg/kg/day
    Total subjects affected by serious adverse events
         subjects affected / exposed
    2 / 20 (10.00%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Hepatic neoplasm
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lung neoplasm
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Hepatic steatosis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Appendicitis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Deferasirox 30 mg/kg/day
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    19 / 20 (95.00%)
    Vascular disorders
    Hyperaemia
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    6 / 20 (30.00%)
         occurrences all number
    8
    Chest pain
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Fatigue
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Gait disturbance
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Influenza like illness
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Malaise
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Oedema peripheral
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Pain
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Pyrexia
         subjects affected / exposed
    5 / 20 (25.00%)
         occurrences all number
    5
    Reproductive system and breast disorders
    Genital pain
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Respiratory, thoracic and mediastinal disorders
    Bronchospasm
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Cough
         subjects affected / exposed
    6 / 20 (30.00%)
         occurrences all number
    9
    Rhinorrhoea
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    2
    Throat irritation
         subjects affected / exposed
    6 / 20 (30.00%)
         occurrences all number
    10
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Blood creatinine increased
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    3
    Injury, poisoning and procedural complications
    Transfusion reaction
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    2
    Wound secretion
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Cardiac disorders
    Atrial fibrillation
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Atrial tachycardia
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    2
    Bradycardia
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Palpitations
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Headache
         subjects affected / exposed
    10 / 20 (50.00%)
         occurrences all number
    17
    Paraesthesia
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Tremor
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Blood and lymphatic system disorders
    Neutropenia
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Ear and labyrinth disorders
    Ear pain
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    2
    Vestibular neuronitis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Eye disorders
    Conjunctivitis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Foreign body sensation in eyes
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Photophobia
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    3 / 20 (15.00%)
         occurrences all number
    6
    Abdominal pain upper
         subjects affected / exposed
    5 / 20 (25.00%)
         occurrences all number
    7
    Colitis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Diarrhoea
         subjects affected / exposed
    5 / 20 (25.00%)
         occurrences all number
    5
    Flatulence
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    2
    Gastritis
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Gastrooesophageal reflux disease
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Nausea
         subjects affected / exposed
    3 / 20 (15.00%)
         occurrences all number
    3
    Toothache
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Vomiting
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    2
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Dermal cyst
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Eczema
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Pityriasis rosea
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Rash
         subjects affected / exposed
    5 / 20 (25.00%)
         occurrences all number
    6
    Skin lesion
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Renal and urinary disorders
    Dysuria
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Renal colic
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    2
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    3 / 20 (15.00%)
         occurrences all number
    3
    Back pain
         subjects affected / exposed
    4 / 20 (20.00%)
         occurrences all number
    6
    Bone pain
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Flank pain
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    2
    Myalgia
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    3
    Pain in extremity
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Infections and infestations
    Cystitis
         subjects affected / exposed
    2 / 20 (10.00%)
         occurrences all number
    2
    Ear infection
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Gastroenteritis
         subjects affected / exposed
    3 / 20 (15.00%)
         occurrences all number
    3
    Influenza
         subjects affected / exposed
    5 / 20 (25.00%)
         occurrences all number
    5
    Oral herpes
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1
    Pharyngitis
         subjects affected / exposed
    3 / 20 (15.00%)
         occurrences all number
    4
    Rhinitis
         subjects affected / exposed
    4 / 20 (20.00%)
         occurrences all number
    4
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    1 / 20 (5.00%)
         occurrences all number
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    31 Oct 2008
    • Updating the safety assessment according to latest European Union label of deferasirox regarding liver safety and symptoms of gastrointestinal ulceration and hemorrhage • Updating exclusion criteria to comply with recommendations for liver safety. Treatment has been initiated only in patients with baseline liver transaminase levels up to 5 times the upper limit of the normal range. • Information about concomitant use of other medicinal products was updated according to latest SmPC as well. • Furthermore, the statistical methods and data analysis section was modified as it was specified how changes in growth velocity parameters had to be analyzed and reported.
    18 Nov 2010
    The anticipating closure of subject enrollment was reduced to 20, prior reaching the target sample size of 50 subjects.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    The study was terminated when 20 subjects were included due to slow study recruitment rate as well as the concomitant availability of cardiac MRI T2* data in large cohorts of subjects treated with deferasirox.
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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