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    Clinical Trial Results:
    A prospective, non-controlled, safety trial of intravenous iron isomaltoside 1000 (Monofer®) administered by a high dosing regimen in subjects with inflammatory bowel disease (PROMISE)

    Due to the EudraCT – Results system being out of service between 31 July 2015 and 12 January 2016, these results have been published in compliance with revised timelines.
    Summary
    EudraCT number
    2011-003121-94
    Trial protocol
    DK   SE   NL  
    Global end of trial date
    27 Nov 2014

    Results information
    Results version number
    v1(current)
    This version publication date
    15 Apr 2016
    First version publication date
    15 Apr 2016
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    P-Monofer-IBD-02
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01599702
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Pharmacosmos A/S
    Sponsor organisation address
    Roervangsvej 30, Holbaek, Denmark, DK-4300
    Public contact
    Clinical trial disclosure desk, Pharmacosmos A/S, +45 59485935, trial@pharmacosmos.com
    Scientific contact
    Clinical trial disclosure desk, Pharmacosmos A/S, +45 59485935, trial@pharmacosmos.com
    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
    27 Nov 2014
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    27 Nov 2014
    Global end of trial reached?
    Yes
    Global end of trial date
    27 Nov 2014
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of the study is to evaluate the safety of a high IV iron dosing regimen of iron isomaltoside 1000 in subjects with IDA secondary to IBD.
    Protection of trial subjects
    The protocol and amendments were approved by local ethics committees/Institutional Review Boards and competent authorities. The trial was conducted in accordance with good clinical practice and the Declaration of Helsinki. Informed consent was obtained in writing prior to any trial-related activities.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    24 Jul 2012
    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
    Netherlands: 5
    Country: Number of subjects enrolled
    Sweden: 4
    Country: Number of subjects enrolled
    Denmark: 12
    Worldwide total number of subjects
    21
    EEA total number of subjects
    21
    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)
    19
    From 65 to 84 years
    2
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Subjects were screened in the period 24 July 2012 to 4 September 2014. The trial took place at 6 sites: 3 sites in Sweden (no subjects were enrolled at 2 of these sites), 2 in Denmark, and 1 in Netherlands.

    Pre-assignment
    Screening details
    Subjects who were ≥18 years of age, diagnosed with IBD in all activity stages, and with a Hb level of <12 g/dL for women and Hb <13 g/dL for men were eligible to participate. Subjects with CRP above the upper limit of normal (ULN) had to have a ferritin level <100 µg/L, whereas subjects with a CRP ≤ULN had to have a ferritin level <30 µg/L.

    Period 1
    Period 1 title
    Overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Group A1, 1500 mg iron isomaltoside 1000
    Arm description
    The single dose of 1500 mg Iron isomaltoside 1000 was administered at baseline in the 1500 mg group. Iron isomaltoside 1000 were diluted in 100 mL normal saline (0.9% sodium chloride) and administered by infusion over approximately 15 min.
    Arm type
    Experimental

    Investigational medicinal product name
    Iron isomaltoside 1000
    Investigational medicinal product code
    ATC code: B03AC
    Other name
    Monofer, Monover, Monofar, Monoferro
    Pharmaceutical forms
    Solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Based upon the Hb level and body weight, the subjects were divided into 4 treatment groups: Group A1, women: 10 ≤ Hb < 12 g/dL and men: 11 ≤ Hb < 13 g/dL with a body weight <70 kg received 1500 mg iron. Group A2, women: 10 ≤ Hb < 12 g/dL and men: 11 ≤ Hb < 13 g/dL with a body weight ≥70 kg received 2000 mg iron. Group B1, women: Hb < 10 g/dL and men: Hb < 11 g/dL with a body weight <70 kg received 2500 mg iron. Group B2, women: Hb < 10 g/dL and men: Hb < 11 g/dL with a body weight ≥70 kg received 3000 mg iron. The single dose of 1500 mg was administered at baseline, whereas the cumulative doses of 2000 mg were administered in 1 or 2 doses, and the cumulative doses of 2500 mg and 3000 mg were administered in 2 doses. All administrations were diluted in 100 mL normal saline and administered by infusion over app 15 min. Iron isomaltoside 1000 is available as a dark brown, non-transparent aqueous solution for injection/infusion containing 100 mg iron/mL with pH between 5.0 and 7.0.

    Arm title
    Group A2, 2000 mg iron isomaltoside 1000
    Arm description
    The cumulative doses of 2000 mg were administered in 1 or 2 doses (subjects enrolled according to the original protocol received 2000 mg in one dose, and subjects enrolled according to the amended protocol received 2000 mg in two doses). Iron isomaltoside 1000 were diluted in 100 mL normal saline (0.9% sodium chloride) and administered by infusion over approximately 15 min.
    Arm type
    Experimental

    Investigational medicinal product name
    Iron isomaltoside 1000
    Investigational medicinal product code
    ATC code: B03AC
    Other name
    Monofer, Monover, Monofar, Monoferro
    Pharmaceutical forms
    Solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Based upon the Hb level and body weight, the subjects were divided into 4 treatment groups: Group A1, women: 10 ≤ Hb < 12 g/dL and men: 11 ≤ Hb < 13 g/dL with a body weight <70 kg received 1500 mg iron. Group A2, women: 10 ≤ Hb < 12 g/dL and men: 11 ≤ Hb < 13 g/dL with a body weight ≥70 kg received 2000 mg iron. Group B1, women: Hb < 10 g/dL and men: Hb < 11 g/dL with a body weight <70 kg received 2500 mg iron. Group B2, women: Hb < 10 g/dL and men: Hb < 11 g/dL with a body weight ≥70 kg received 3000 mg iron. The single dose of 1500 mg was administered at baseline, whereas the cumulative doses of 2000 mg were administered in 1 or 2 doses, and the cumulative doses of 2500 mg and 3000 mg were administered in 2 doses. All administrations were diluted in 100 mL normal saline and administered by infusion over app 15 min. Iron isomaltoside 1000 is available as a dark brown, non-transparent aqueous solution for injection/infusion containing 100 mg iron/mL with pH between 5.0 and 7.0.

    Arm title
    Group B1, 2500 mg iron isomaltoside 1000
    Arm description
    The cumulative dose of 2500 mg were administered in 2 doses. Iron isomaltoside 1000 were diluted in 100 mL normal saline (0.9% sodium chloride) and administered by infusion over approximately 15 min.
    Arm type
    Experimental

    Investigational medicinal product name
    Iron isomaltoside 1000
    Investigational medicinal product code
    ATC code: B03AC
    Other name
    Monofer, Monover, Monofar, Monoferro
    Pharmaceutical forms
    Solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Based upon the Hb level and body weight, the subjects were divided into 4 treatment groups: Group A1, women: 10 ≤ Hb < 12 g/dL and men: 11 ≤ Hb < 13 g/dL with a body weight <70 kg received 1500 mg iron. Group A2, women: 10 ≤ Hb < 12 g/dL and men: 11 ≤ Hb < 13 g/dL with a body weight ≥70 kg received 2000 mg iron. Group B1, women: Hb < 10 g/dL and men: Hb < 11 g/dL with a body weight <70 kg received 2500 mg iron. Group B2, women: Hb < 10 g/dL and men: Hb < 11 g/dL with a body weight ≥70 kg received 3000 mg iron. The single dose of 1500 mg was administered at baseline, whereas the cumulative doses of 2000 mg were administered in 1 or 2 doses, and the cumulative doses of 2500 mg and 3000 mg were administered in 2 doses. All administrations were diluted in 100 mL normal saline and administered by infusion over app 15 min. Iron isomaltoside 1000 is available as a dark brown, non-transparent aqueous solution for injection/infusion containing 100 mg iron/mL with pH between 5.0 and 7.0.

    Arm title
    Group B2, 3000 mg iron isomaltoside 1000
    Arm description
    The cumulative dose of 3000 mg were administered in 2 doses. Iron isomaltoside 1000 were diluted in 100 mL normal saline (0.9% sodium chloride) and administered by infusion over approximately 15 min.
    Arm type
    Experimental

    Investigational medicinal product name
    Iron isomaltoside 1000
    Investigational medicinal product code
    ATC code: B03AC
    Other name
    Monofer, Monover, Monofar, Monoferro
    Pharmaceutical forms
    Solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Based upon the Hb level and body weight, the subjects were divided into 4 treatment groups: Group A1, women: 10 ≤ Hb < 12 g/dL and men: 11 ≤ Hb < 13 g/dL with a body weight <70 kg received 1500 mg iron. Group A2, women: 10 ≤ Hb < 12 g/dL and men: 11 ≤ Hb < 13 g/dL with a body weight ≥70 kg received 2000 mg iron. Group B1, women: Hb < 10 g/dL and men: Hb < 11 g/dL with a body weight <70 kg received 2500 mg iron. Group B2, women: Hb < 10 g/dL and men: Hb < 11 g/dL with a body weight ≥70 kg received 3000 mg iron. The single dose of 1500 mg was administered at baseline, whereas the cumulative doses of 2000 mg were administered in 1 or 2 doses, and the cumulative doses of 2500 mg and 3000 mg were administered in 2 doses. All administrations were diluted in 100 mL normal saline and administered by infusion over app 15 min. Iron isomaltoside 1000 is available as a dark brown, non-transparent aqueous solution for injection/infusion containing 100 mg iron/mL with pH between 5.0 and 7.0.

    Number of subjects in period 1
    Group A1, 1500 mg iron isomaltoside 1000 Group A2, 2000 mg iron isomaltoside 1000 Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Started
    7
    8
    4
    2
    Completed
    6
    8
    4
    2
    Not completed
    1
    0
    0
    0
         Protocol deviation
    1
    -
    -
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Group A1, 1500 mg iron isomaltoside 1000
    Reporting group description
    The single dose of 1500 mg Iron isomaltoside 1000 was administered at baseline in the 1500 mg group. Iron isomaltoside 1000 were diluted in 100 mL normal saline (0.9% sodium chloride) and administered by infusion over approximately 15 min.

    Reporting group title
    Group A2, 2000 mg iron isomaltoside 1000
    Reporting group description
    The cumulative doses of 2000 mg were administered in 1 or 2 doses (subjects enrolled according to the original protocol received 2000 mg in one dose, and subjects enrolled according to the amended protocol received 2000 mg in two doses). Iron isomaltoside 1000 were diluted in 100 mL normal saline (0.9% sodium chloride) and administered by infusion over approximately 15 min.

    Reporting group title
    Group B1, 2500 mg iron isomaltoside 1000
    Reporting group description
    The cumulative dose of 2500 mg were administered in 2 doses. Iron isomaltoside 1000 were diluted in 100 mL normal saline (0.9% sodium chloride) and administered by infusion over approximately 15 min.

    Reporting group title
    Group B2, 3000 mg iron isomaltoside 1000
    Reporting group description
    The cumulative dose of 3000 mg were administered in 2 doses. Iron isomaltoside 1000 were diluted in 100 mL normal saline (0.9% sodium chloride) and administered by infusion over approximately 15 min.

    Reporting group values
    Group A1, 1500 mg iron isomaltoside 1000 Group A2, 2000 mg iron isomaltoside 1000 Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000 Total
    Number of subjects
    7 8 4 2 21
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    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)
    0
        From 65-84 years
    0
        85 years and over
    0
    Age continuous
    Age is calculated by subtracting the screening visit date with the birth date.
    Units: years
        arithmetic mean (standard deviation)
    33.3 ± 13.9 51 ± 11.7 47.3 ± 19.6 33.5 ± 2.1 -
    Gender categorical
    Units: Subjects
        Female
    7 6 3 0 16
        Male
    0 2 1 2 5
    Subject analysis sets

    Subject analysis set title
    Safety analysis set
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The safety population (N=21) included all subjects who were randomised and received at least one dose of the trial drug.

    Subject analysis sets values
    Safety analysis set
    Number of subjects
    21
    Age categorical
    Units: Subjects
        In utero
        Preterm newborn infants (gestational age < 37 wks)
        Newborns (0-27 days)
        Infants and toddlers (28 days-23 months)
        Children (2-11 years)
        Adolescents (12-17 years)
        Adults (18-64 years)
        From 65-84 years
        85 years and over
    Age continuous
    Age is calculated by subtracting the screening visit date with the birth date.
    Units: years
        arithmetic mean (standard deviation)
    42.7 ± 15.3
    Gender categorical
    Units: Subjects
        Female
    16
        Male
    5

    End points

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    End points reporting groups
    Reporting group title
    Group A1, 1500 mg iron isomaltoside 1000
    Reporting group description
    The single dose of 1500 mg Iron isomaltoside 1000 was administered at baseline in the 1500 mg group. Iron isomaltoside 1000 were diluted in 100 mL normal saline (0.9% sodium chloride) and administered by infusion over approximately 15 min.

    Reporting group title
    Group A2, 2000 mg iron isomaltoside 1000
    Reporting group description
    The cumulative doses of 2000 mg were administered in 1 or 2 doses (subjects enrolled according to the original protocol received 2000 mg in one dose, and subjects enrolled according to the amended protocol received 2000 mg in two doses). Iron isomaltoside 1000 were diluted in 100 mL normal saline (0.9% sodium chloride) and administered by infusion over approximately 15 min.

    Reporting group title
    Group B1, 2500 mg iron isomaltoside 1000
    Reporting group description
    The cumulative dose of 2500 mg were administered in 2 doses. Iron isomaltoside 1000 were diluted in 100 mL normal saline (0.9% sodium chloride) and administered by infusion over approximately 15 min.

    Reporting group title
    Group B2, 3000 mg iron isomaltoside 1000
    Reporting group description
    The cumulative dose of 3000 mg were administered in 2 doses. Iron isomaltoside 1000 were diluted in 100 mL normal saline (0.9% sodium chloride) and administered by infusion over approximately 15 min.

    Subject analysis set title
    Safety analysis set
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The safety population (N=21) included all subjects who were randomised and received at least one dose of the trial drug.

    Primary: Type and incidence of adverse drug reactions

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    End point title
    Type and incidence of adverse drug reactions [1]
    End point description
    Type and incidence of adverse drug reaction. The analysis was performed on the safety population.
    End point type
    Primary
    End point timeframe
    The endpoint covered the complete trial period.
    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: The primary endpoint is type and incidence of adverse drug reactions since this was a safety trial. The endpoint is described purely descriptively and no statistical analysis was performed.
    End point values
    Group A1, 1500 mg iron isomaltoside 1000 Group A2, 2000 mg iron isomaltoside 1000 Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Number of subjects analysed
    7
    8
    4
    2
    Units: Number of adverse drug reactions
    4
    3
    0
    2
    No statistical analyses for this end point

    Secondary: Change in haemoglobin from baseline to week 1

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    End point title
    Change in haemoglobin from baseline to week 1
    End point description
    Change in haemoglobin from baseline to week 1. Analysis performed on the safety analysis set.
    End point type
    Secondary
    End point timeframe
    Change in haemoglobin from baseline to week 1.
    End point values
    Group A1, 1500 mg iron isomaltoside 1000 Group A2, 2000 mg iron isomaltoside 1000 Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Number of subjects analysed
    6
    8
    4
    2
    Units: g/dL
        median (full range (min-max))
    0.8 (-0.1 to 1)
    0.55 (-0.6 to 1.5)
    1.3 (1.1 to 1.4)
    1.3 (1.1 to 1.5)
    No statistical analyses for this end point

    Secondary: Change in haemoglobin from baseline to week 4

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    End point title
    Change in haemoglobin from baseline to week 4
    End point description
    Change in haemoglobin from baseline to week 4. Analysis performed on the safety analysis set.
    End point type
    Secondary
    End point timeframe
    Change in haemoglobin from baseline to week 4.
    End point values
    Group A1, 1500 mg iron isomaltoside 1000 Group A2, 2000 mg iron isomaltoside 1000 Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Number of subjects analysed
    6
    7
    4
    1
    Units: g/dL
        median (full range (min-max))
    2.05 (0.9 to 2.9)
    1.7 (0.6 to 3.5)
    3.15 (0.3 to 3.9)
    4 (4 to 4)
    No statistical analyses for this end point

    Secondary: Change in haemoglobin from baseline to week 8

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    End point title
    Change in haemoglobin from baseline to week 8
    End point description
    Change in haemoglobin from baseline to week 8. Analysis performed on the safety analysis set.
    End point type
    Secondary
    End point timeframe
    Change in haemoglobin from baseline to week 8.
    End point values
    Group A1, 1500 mg iron isomaltoside 1000 Group A2, 2000 mg iron isomaltoside 1000 Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Number of subjects analysed
    6
    8
    4
    2
    Units: g/dL
        median (full range (min-max))
    2.35 (0.5 to 3.8)
    2.65 (1 to 4.2)
    2.5 (-0.1 to 4.1)
    3.9 (3.2 to 4.6)
    No statistical analyses for this end point

    Secondary: Change in haemoglobin from baseline to week 9

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    End point title
    Change in haemoglobin from baseline to week 9 [2]
    End point description
    Change in haemoglobin from baseline to week 9. Analysis performed on the safety analysis set.
    End point type
    Secondary
    End point timeframe
    Change in haemoglobin from baseline to week 9.
    Notes
    [2] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Patients in group A1 and A2 was only enrolled for 8 weeks, whereas patients in group B1 and B2 were enrolled in 16 weeks. Therefore, no data is available for patients in group A1 and A2 after week 8.
    End point values
    Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Number of subjects analysed
    4
    2
    Units: g/dL
        median (full range (min-max))
    2.25 (1.4 to 4)
    4.45 (4.1 to 4.8)
    No statistical analyses for this end point

    Secondary: Change in haemoglobin from baseline to week 12

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    End point title
    Change in haemoglobin from baseline to week 12 [3]
    End point description
    Change in haemoglobin from baseline to week 12. Analysis performed on the safety analysis set.
    End point type
    Secondary
    End point timeframe
    Change in haemoglobin from baseline to week 12.
    Notes
    [3] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Patients in group A1 and A2 was only enrolled for 8 weeks, whereas patients in group B1 and B2 were enrolled in 16 weeks. Therefore, no data is available for patients in group A1 and A2 after week 8.
    End point values
    Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Number of subjects analysed
    4
    2
    Units: g/dL
        median (full range (min-max))
    3.1 (0.9 to 4.3)
    5 (4.8 to 5.2)
    No statistical analyses for this end point

    Secondary: Change in haemoglobin from baseline to week 16

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    End point title
    Change in haemoglobin from baseline to week 16 [4]
    End point description
    Change in haemoglobin from baseline to week 16. Analysis performed on the safety analysis set.
    End point type
    Secondary
    End point timeframe
    Change in haemoglobin from baseline to week 16.
    Notes
    [4] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Patients in group A1 and A2 was only enrolled for 8 weeks, whereas patients in group B1 and B2 were enrolled in 16 weeks. Therefore, no data is available for patients in group A1 and A2 after week 8.
    End point values
    Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Number of subjects analysed
    4
    2
    Units: g/dL
        median (full range (min-max))
    2.45 (-0.7 to 4.4)
    4.95 (4.9 to 5)
    No statistical analyses for this end point

    Secondary: Change in s-ferritin from baseline to week 1

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    End point title
    Change in s-ferritin from baseline to week 1
    End point description
    Change in s-ferritin from baseline to week 1. Analysis performed on the safety analysis set.
    End point type
    Secondary
    End point timeframe
    Change in s-ferritin from baseline to week 1.
    End point values
    Group A1, 1500 mg iron isomaltoside 1000 Group A2, 2000 mg iron isomaltoside 1000 Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Number of subjects analysed
    6
    8
    4
    2
    Units: ug/L
        median (full range (min-max))
    723.5 (524 to 1432)
    732.5 (526 to 1194)
    752 (335 to 1106)
    428 (401 to 455)
    No statistical analyses for this end point

    Secondary: Change in s-ferritin from baseline to week 4

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    End point title
    Change in s-ferritin from baseline to week 4
    End point description
    Change in s-ferritin from baseline to week 4. Analysis performed on the safety analysis set.
    End point type
    Secondary
    End point timeframe
    Change in s-ferritin from baseline to week 4.
    End point values
    Group A1, 1500 mg iron isomaltoside 1000 Group A2, 2000 mg iron isomaltoside 1000 Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Number of subjects analysed
    5
    8
    4
    1
    Units: ug/L
        median (full range (min-max))
    180 (96 to 700)
    336 (149 to 483)
    154 (64 to 357)
    45 (45 to 45)
    No statistical analyses for this end point

    Secondary: Change in s-ferritin from baseline to week 8

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    End point title
    Change in s-ferritin from baseline to week 8
    End point description
    Change in s-ferritin from baseline to week 8. Analysis performed on the safety analysis set.
    End point type
    Secondary
    End point timeframe
    Change in s-ferritin from baseline to week 8.
    End point values
    Group A1, 1500 mg iron isomaltoside 1000 Group A2, 2000 mg iron isomaltoside 1000 Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Number of subjects analysed
    6
    8
    4
    2
    Units: ug/L
        median (full range (min-max))
    142 (59 to 458)
    225 (83 to 417)
    65 (6 to 272)
    55.5 (10 to 101)
    No statistical analyses for this end point

    Secondary: Change in s-ferritin from baseline to week 9.

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    End point title
    Change in s-ferritin from baseline to week 9. [5]
    End point description
    Change in s-ferritin from baseline to week 9. Analysis performed on the safety analysis set.
    End point type
    Secondary
    End point timeframe
    Change in s-ferritin from baseline to week 9.
    Notes
    [5] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Patients in group A1 and A2 was only enrolled for 8 weeks, whereas patients in group B1 and B2 were enrolled in 16 weeks. Therefore, no data is available for patients in group A1 and A2 after week 8.
    End point values
    Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Number of subjects analysed
    4
    2
    Units: ug/L
        median (full range (min-max))
    259 (162 to 1753)
    428 (372 to 484)
    No statistical analyses for this end point

    Secondary: Change in s-ferritin from baseline to week 12

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    End point title
    Change in s-ferritin from baseline to week 12 [6]
    End point description
    Change in s-ferritin from baseline to week 12. Analysis performed on the safety analysis set.
    End point type
    Secondary
    End point timeframe
    Change in s-ferritin from baseline to week 12.
    Notes
    [6] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Patients in group A1 and A2 was only enrolled for 8 weeks, whereas patients in group B1 and B2 were enrolled in 16 weeks. Therefore, no data is available for patients in group A1 and A2 after week 8.
    End point values
    Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Number of subjects analysed
    4
    2
    Units: ug/L
        median (full range (min-max))
    96 (58 to 765)
    182 (89 to 275)
    No statistical analyses for this end point

    Secondary: Change in s-ferritin from baseline to week 16

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    End point title
    Change in s-ferritin from baseline to week 16 [7]
    End point description
    Change in s-ferritin from baseline to week 16. Analysis performed on the safety analysis set.
    End point type
    Secondary
    End point timeframe
    Change in s-ferritin from baseline to week 16.
    Notes
    [7] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Patients in group A1 and A2 was only enrolled for 8 weeks, whereas patients in group B1 and B2 were enrolled in 16 weeks. Therefore, no data is available for patients in group A1 and A2 after week 8.
    End point values
    Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Number of subjects analysed
    4
    2
    Units: ug/L
        median (full range (min-max))
    33 (5 to 615)
    178.5 (19 to 338)
    No statistical analyses for this end point

    Secondary: Change in transferrin saturation from baseline to week 1

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    End point title
    Change in transferrin saturation from baseline to week 1
    End point description
    Change in transferrin saturation from baseline to week 1. Analysis performed on the safety analysis set.
    End point type
    Secondary
    End point timeframe
    Change in transferrin saturation from baseline to week 1.
    End point values
    Group A1, 1500 mg iron isomaltoside 1000 Group A2, 2000 mg iron isomaltoside 1000 Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Number of subjects analysed
    5
    8
    4
    2
    Units: percentage
        median (full range (min-max))
    26 (11 to 54)
    19.5 (11 to 39)
    26 (6 to 34)
    13.5 (11 to 16)
    No statistical analyses for this end point

    Secondary: Change in transferrin saturation from baseline to week 4.

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    End point title
    Change in transferrin saturation from baseline to week 4.
    End point description
    Change in transferrin saturation from baseline to week 4. Analysis performed on the safety analysis set.
    End point type
    Secondary
    End point timeframe
    Change in transferrin saturation from baseline to week 4.
    End point values
    Group A1, 1500 mg iron isomaltoside 1000 Group A2, 2000 mg iron isomaltoside 1000 Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Number of subjects analysed
    4
    8
    4
    1
    Units: percentage
        median (full range (min-max))
    23.5 (12 to 29)
    16.5 (10 to 27)
    13 (2 to 21)
    9 (9 to 9)
    No statistical analyses for this end point

    Secondary: Change in transferrin saturation from baseline to week 8

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    End point title
    Change in transferrin saturation from baseline to week 8
    End point description
    Change in transferrin saturation from baseline to week 8. Analysis performed on the safety analysis set.
    End point type
    Secondary
    End point timeframe
    Change in transferrin saturation from baseline to week 8.
    End point values
    Group A1, 1500 mg iron isomaltoside 1000 Group A2, 2000 mg iron isomaltoside 1000 Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Number of subjects analysed
    5
    8
    4
    2
    Units: percentage
        median (full range (min-max))
    32 (15 to 38)
    19 (2 to 23)
    4.5 (-1 to 11)
    13 (9 to 17)
    No statistical analyses for this end point

    Secondary: Change in transferrin saturation from baseline to week 9

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    End point title
    Change in transferrin saturation from baseline to week 9 [8]
    End point description
    Change in transferrin saturation from baseline to week 9. Analysis performed on the safety analysis set.
    End point type
    Secondary
    End point timeframe
    Change in transferrin saturation from baseline to week 9.
    Notes
    [8] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Patients in group A1 and A2 was only enrolled for 8 weeks, whereas patients in group B1 and B2 were enrolled in 16 weeks. Therefore, no data is available for patients in group A1 and A2 after week 8.
    End point values
    Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Number of subjects analysed
    4
    2
    Units: percentage
        median (full range (min-max))
    10 (4 to 29)
    33 (14 to 52)
    No statistical analyses for this end point

    Secondary: Change in transferrin saturation from baseline to week 12

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    End point title
    Change in transferrin saturation from baseline to week 12 [9]
    End point description
    Change in transferrin saturation from baseline to week 12. Analysis performed on the safety analysis set.
    End point type
    Secondary
    End point timeframe
    Change in transferrin saturation from baseline to week 12.
    Notes
    [9] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Patients in group A1 and A2 was only enrolled for 8 weeks, whereas patients in group B1 and B2 were enrolled in 16 weeks. Therefore, no data is available for patients in group A1 and A2 after week 8.
    End point values
    Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Number of subjects analysed
    4
    2
    Units: percentage
        median (full range (min-max))
    10.5 (3 to 24)
    25 (23 to 27)
    No statistical analyses for this end point

    Secondary: Change in transferrin saturation from baseline to week 16

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    End point title
    Change in transferrin saturation from baseline to week 16 [10]
    End point description
    Change in transferrin saturation from baseline to week 16. Analysis performed on the safety analysis set.
    End point type
    Secondary
    End point timeframe
    Change in transferrin saturation from baseline to week 16.
    Notes
    [10] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Patients in group A1 and A2 was only enrolled for 8 weeks, whereas patients in group B1 and B2 were enrolled in 16 weeks. Therefore, no data is available for patients in group A1 and A2 after week 8.
    End point values
    Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Number of subjects analysed
    4
    2
    Units: percentage
        median (full range (min-max))
    9 (2 to 19)
    13.5 (6 to 21)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From the time a subject had signed the ICF and until he/she had completed the trial, all AEs/SAEs were collected in the CRF.
    Adverse event reporting additional description
    All AEs classified as serious and/or related to the study drug were followed by the principle investigator (PI) until the subject had recovered, recovered with sequelae, or died, and until all queries related to the AEs had been resolved. All other AEs were followed by the PI until the subject had recovered or until EOS whichever came first.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    17.0
    Reporting groups
    Reporting group title
    Group A1, 1500 mg iron isomaltoside 1000
    Reporting group description
    The single dose of 1500 mg Iron isomaltoside 1000 was administered at baseline in the 1500 mg group. Iron isomaltoside 1000 were diluted in 100 mL normal saline (0.9% sodium chloride) and administered by infusion over approximately 15 min.

    Reporting group title
    Group A2, 2000 mg iron isomaltoside 1000
    Reporting group description
    The cumulative doses of 2000 mg were administered in 1 or 2 doses (subjects enrolled according to the original protocol received 2000 mg in one dose, and subjects enrolled according to the amended protocol received 2000 mg in two doses). Iron isomaltoside 1000 were diluted in 100 mL normal saline (0.9% sodium chloride) and administered by infusion over approximately 15 min.

    Reporting group title
    Group B1, 2500 mg iron isomaltoside 1000
    Reporting group description
    The cumulative dose of 2500 mg were administered in 2 doses. Iron isomaltoside 1000 were diluted in 100 mL normal saline (0.9% sodium chloride) and administered by infusion over approximately 15 min.

    Reporting group title
    Group B2, 3000 mg iron isomaltoside 1000
    Reporting group description
    The cumulative dose of 3000 mg were administered in 2 doses. Iron isomaltoside 1000 were diluted in 100 mL normal saline (0.9% sodium chloride) and administered by infusion over approximately 15 min.

    Serious adverse events
    Group A1, 1500 mg iron isomaltoside 1000 Group A2, 2000 mg iron isomaltoside 1000 Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 7 (0.00%)
    0 / 8 (0.00%)
    0 / 4 (0.00%)
    0 / 2 (0.00%)
         number of deaths (all causes)
    0
    0
    0
    0
         number of deaths resulting from adverse events
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Group A1, 1500 mg iron isomaltoside 1000 Group A2, 2000 mg iron isomaltoside 1000 Group B1, 2500 mg iron isomaltoside 1000 Group B2, 3000 mg iron isomaltoside 1000
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    6 / 7 (85.71%)
    6 / 8 (75.00%)
    3 / 4 (75.00%)
    2 / 2 (100.00%)
    Surgical and medical procedures
    Tooth extraction
         subjects affected / exposed
    1 / 7 (14.29%)
    0 / 8 (0.00%)
    0 / 4 (0.00%)
    0 / 2 (0.00%)
         occurrences all number
    1
    0
    0
    0
    General disorders and administration site conditions
    Chills
         subjects affected / exposed
    0 / 7 (0.00%)
    1 / 8 (12.50%)
    0 / 4 (0.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    1
    0
    0
    Pyrexia
         subjects affected / exposed
    1 / 7 (14.29%)
    0 / 8 (0.00%)
    0 / 4 (0.00%)
    0 / 2 (0.00%)
         occurrences all number
    1
    0
    0
    0
    Immune system disorders
    Hypersensitivity
         subjects affected / exposed
    1 / 7 (14.29%)
    0 / 8 (0.00%)
    0 / 4 (0.00%)
    0 / 2 (0.00%)
         occurrences all number
    1
    0
    0
    0
    Seasonal allergy
         subjects affected / exposed
    0 / 7 (0.00%)
    1 / 8 (12.50%)
    0 / 4 (0.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    1
    0
    0
    Reproductive system and breast disorders
    Ovarian cyst
         subjects affected / exposed
    0 / 7 (0.00%)
    0 / 8 (0.00%)
    1 / 4 (25.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    0 / 7 (0.00%)
    0 / 8 (0.00%)
    1 / 4 (25.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Investigations
    Faecal calprotectin increased
         subjects affected / exposed
    1 / 7 (14.29%)
    1 / 8 (12.50%)
    0 / 4 (0.00%)
    0 / 2 (0.00%)
         occurrences all number
    1
    1
    0
    0
    Haemoglobin decreased
         subjects affected / exposed
    0 / 7 (0.00%)
    0 / 8 (0.00%)
    2 / 4 (50.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    0
    2
    0
    Haematocrit decreased
         subjects affected / exposed
    0 / 7 (0.00%)
    0 / 8 (0.00%)
    1 / 4 (25.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Mean cell haemoglobin concentration decreased
         subjects affected / exposed
    0 / 7 (0.00%)
    0 / 8 (0.00%)
    1 / 4 (25.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Mean cell volume increased
         subjects affected / exposed
    0 / 7 (0.00%)
    0 / 8 (0.00%)
    1 / 4 (25.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Red blood cell count decreased
         subjects affected / exposed
    0 / 7 (0.00%)
    0 / 8 (0.00%)
    1 / 4 (25.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Transferrin decreased
         subjects affected / exposed
    0 / 7 (0.00%)
    0 / 8 (0.00%)
    1 / 4 (25.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Vitamin D decreased
         subjects affected / exposed
    0 / 7 (0.00%)
    0 / 8 (0.00%)
    0 / 4 (0.00%)
    1 / 2 (50.00%)
         occurrences all number
    0
    0
    0
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    1 / 7 (14.29%)
    0 / 8 (0.00%)
    0 / 4 (0.00%)
    0 / 2 (0.00%)
         occurrences all number
    1
    0
    0
    0
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    0 / 7 (0.00%)
    1 / 8 (12.50%)
    0 / 4 (0.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    1
    0
    0
    Eye disorders
    Eye allergy
         subjects affected / exposed
    0 / 7 (0.00%)
    0 / 8 (0.00%)
    0 / 4 (0.00%)
    1 / 2 (50.00%)
         occurrences all number
    0
    0
    0
    2
    Gastrointestinal disorders
    Dyspepsia
         subjects affected / exposed
    0 / 7 (0.00%)
    1 / 8 (12.50%)
    1 / 4 (25.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    2
    1
    0
    Abdominal pain
         subjects affected / exposed
    0 / 7 (0.00%)
    1 / 8 (12.50%)
    1 / 4 (25.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    1
    1
    0
    Abdominal pain upper
         subjects affected / exposed
    0 / 7 (0.00%)
    0 / 8 (0.00%)
    1 / 4 (25.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Aphthous stomatitis
         subjects affected / exposed
    0 / 7 (0.00%)
    0 / 8 (0.00%)
    1 / 4 (25.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Constipation
         subjects affected / exposed
    1 / 7 (14.29%)
    0 / 8 (0.00%)
    0 / 4 (0.00%)
    0 / 2 (0.00%)
         occurrences all number
    1
    0
    0
    0
    Crohn's disease
         subjects affected / exposed
    1 / 7 (14.29%)
    0 / 8 (0.00%)
    0 / 4 (0.00%)
    0 / 2 (0.00%)
         occurrences all number
    1
    0
    0
    0
    Defaecation urgency
         subjects affected / exposed
    0 / 7 (0.00%)
    0 / 8 (0.00%)
    0 / 4 (0.00%)
    1 / 2 (50.00%)
         occurrences all number
    0
    0
    0
    1
    Diarrhoea
         subjects affected / exposed
    1 / 7 (14.29%)
    0 / 8 (0.00%)
    0 / 4 (0.00%)
    0 / 2 (0.00%)
         occurrences all number
    1
    0
    0
    0
    Irritable bowel syndrome
         subjects affected / exposed
    0 / 7 (0.00%)
    0 / 8 (0.00%)
    1 / 4 (25.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Nausea
         subjects affected / exposed
    0 / 7 (0.00%)
    1 / 8 (12.50%)
    0 / 4 (0.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    1
    0
    0
    Vomiting
         subjects affected / exposed
    1 / 7 (14.29%)
    0 / 8 (0.00%)
    0 / 4 (0.00%)
    0 / 2 (0.00%)
         occurrences all number
    1
    0
    0
    0
    Skin and subcutaneous tissue disorders
    Skin ulcer
         subjects affected / exposed
    0 / 7 (0.00%)
    0 / 8 (0.00%)
    1 / 4 (25.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Renal and urinary disorders
    Renal pain
         subjects affected / exposed
    0 / 7 (0.00%)
    1 / 8 (12.50%)
    0 / 4 (0.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    1
    0
    0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    1 / 7 (14.29%)
    0 / 8 (0.00%)
    0 / 4 (0.00%)
    0 / 2 (0.00%)
         occurrences all number
    1
    0
    0
    0
    Bone pain
         subjects affected / exposed
    0 / 7 (0.00%)
    0 / 8 (0.00%)
    1 / 4 (25.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Neck pain
         subjects affected / exposed
    0 / 7 (0.00%)
    1 / 8 (12.50%)
    0 / 4 (0.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    1
    0
    0
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    0 / 7 (0.00%)
    2 / 8 (25.00%)
    0 / 4 (0.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    2
    0
    0
    Erysipelas
         subjects affected / exposed
    0 / 7 (0.00%)
    0 / 8 (0.00%)
    1 / 4 (25.00%)
    0 / 2 (0.00%)
         occurrences all number
    0
    0
    1
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    22 Jan 2013
    • Change in address of the biostatistician • Enrolment period was increased from 6 months to 18 months • The maximum single dosing of iron isomaltoside 1000 was reduced from 2000 mg to 1500 mg • Addition of a secondary safety endpoint “number of AEs of special interest (i.e. hypersensitivity reactions or hypotension at pre-specified time points in relation to administration of trial drug)” • The secondary efficacy endpoints were clarified and aligned with previous studies • Revised 6th exclusion criteria from “decompensated liver cirrhosis and/or known chronic viral hepatitis” to “decompensated liver cirrhosis or active hepatitis” • Urogenital examination was excluded from the physical examination • Added a section on re-screening of the subjects • Clarified reporting procedure of AEs • An interim analysis was planned in order to evaluate the safety and efficacy of the high dosing of iron isomaltoside 1000

    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.
    None reported
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