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    Clinical Trial Results:
    A Phase II, Multicenter, Open Label, Single Arm Study of SAR302503 in Subjects Previously Treated with Ruxolitinib and with a Current Diagnosis of Intermediate or High-Risk Primary Myelofibrosis, Post-Polycythemia Vera Myelofibrosis, or Post-Essential Thrombocythemia Myelofibrosis

    Summary
    EudraCT number
    2011-005226-21
    Trial protocol
    GB   NL   AT   ES   DE   IT   BE  
    Global end of trial date
    29 Apr 2014

    Results information
    Results version number
    v1(current)
    This version publication date
    23 May 2016
    First version publication date
    15 Jul 2015
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    ARD12181
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01523171
    WHO universal trial number (UTN)
    U1111-1124-0967
    Sponsors
    Sponsor organisation name
    Sanofi aventis recherche & développement
    Sponsor organisation address
    1 avenue Pierre Brossolette, Chilly-Mazarin, France, 91380
    Public contact
    Trial Transparency Team, Sanofi aventis recherche & développement, Contact-us@sanofi.com
    Scientific contact
    Trial Transparency Team, Sanofi aventis recherche & développement, Contact-us@sanofi.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
    12 Jun 2014
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    29 Apr 2014
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    To evaluate the efficacy of once daily dose of SAR302503 in subjects previously treated with ruxolitinib and with a current diagnosis of intermediate-1 with symptoms, intermediate-2 or high-risk primary myelofibrosis (PMF), post-polycythemia vera myelofibrosis (Post-PV MF), or post-essential thrombocythemia myelofibrosis (Post-ET MF) based on the reduction of spleen volume at the end of 6 treatment cycles.
    Protection of trial subjects
    Subjects were fully informed of all pertinent aspects of the clinical trial as well as the possibility to discontinue at any time in language and terms appropriate for the subject and considering the local culture. During the course of the trial, subjects were provided with individual subject cards indicating the nature of the trial the subject is participating, contact details and any information needed in the event of a medical emergency. Collected personal data and human biological samples were processed in compliance with the Sanofi-Aventis Group Personal Data Protection Charter ensuring that the Group abides by the laws governing personal data protection in force in all countries in which it operates.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    30 Apr 2012
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Netherlands: 15
    Country: Number of subjects enrolled
    Spain: 5
    Country: Number of subjects enrolled
    United Kingdom: 6
    Country: Number of subjects enrolled
    Austria: 1
    Country: Number of subjects enrolled
    Belgium: 6
    Country: Number of subjects enrolled
    France: 12
    Country: Number of subjects enrolled
    Germany: 8
    Country: Number of subjects enrolled
    Italy: 10
    Country: Number of subjects enrolled
    United States: 33
    Country: Number of subjects enrolled
    Canada: 1
    Worldwide total number of subjects
    97
    EEA total number of subjects
    63
    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)
    36
    From 65 to 84 years
    61
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    The study was conducted at 36 sites in 10 countries. A total of 97 subjects were enrolled between 30 April 2012 and 02 August 2013.

    Pre-assignment
    Screening details
    All 97 enrolled subjects were treated.

    Period 1
    Period 1 title
    Overall study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Fedratinib
    Arm description
    Fedratinib in consecutive 28-day cycles until disease progression or unacceptable toxicity.
    Arm type
    Experimental

    Investigational medicinal product name
    Fedratinib
    Investigational medicinal product code
    SAR302503
    Other name
    Pharmaceutical forms
    Capsule, hard
    Routes of administration
    Oral use
    Dosage and administration details
    Once daily flexible dosing regimen (200 to 600 mg/day) with starting dose of 400 mg/day.

    Number of subjects in period 1
    Fedratinib
    Started
    97
    Completed
    0
    Not completed
    97
         DP-abdominal pain and progressive leucocytosis
    1
         Disease progression (DP)
    6
         Adverse event
    18
         Study terminated by sponsor
    63
         Allogenic stem cell transplant
    1
         Consent withdrawn by subject
    8

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Fedratinib
    Reporting group description
    Fedratinib in consecutive 28-day cycles until disease progression or unacceptable toxicity.

    Reporting group values
    Fedratinib Total
    Number of subjects
    97 97
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    66.5 ( 8.1 ) -
    Gender categorical
    Units: Subjects
        Female
    44 44
        Male
    53 53

    End points

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    End points reporting groups
    Reporting group title
    Fedratinib
    Reporting group description
    Fedratinib in consecutive 28-day cycles until disease progression or unacceptable toxicity.

    Primary: Response Rate: Percentage of Subjects With >=35% Reduction From Baseline in Spleen Volume at End of Cycle 6

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    End point title
    Response Rate: Percentage of Subjects With >=35% Reduction From Baseline in Spleen Volume at End of Cycle 6 [1]
    End point description
    Spleen volume was measured by central imaging MRI (CT scan in subjects with contraindications for MRI). Analysis was performed on Per Protocol (PP) population defined as all treated subjects with a baseline and at least one post-baseline MRI/CT scan of spleen volume, and had no important protocol deviations that could impact on efficacy outcome. Last observation carried forward (LOCF) method was used to impute the missing data.
    End point type
    Primary
    End point timeframe
    Baseline, End of Cycle 6
    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 statistical analysis was planned for this single arm study.
    End point values
    Fedratinib
    Number of subjects analysed
    83
    Units: percentage of subjects
        number (confidence interval 95%)
    55.4 (44.1 to 66.3)
    No statistical analyses for this end point

    Secondary: Symptom Response Rate: Percentage of Subjects with >=50% Reduction From Baseline in the Total Symptom Score Using MFSAF at End of Cycle 6

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    End point title
    Symptom Response Rate: Percentage of Subjects with >=50% Reduction From Baseline in the Total Symptom Score Using MFSAF at End of Cycle 6
    End point description
    The key MF-associated symptoms were assessed using the modified Myelofibrosis Symptom Assessment Form (MFSAF) Diary: night sweats, pruritus, abdominal discomfort, early satiety, pain under ribs on left side, and bone or muscle pain. These were measured on a scale from 0 (absent) to 10 (worst imaginable). Then Total symptom score (range 0 to 60) was defined as the sum of the scores for each of the 6 symptoms of MFSAF. Higher score indicated greater severity of symptoms. Analysis was performed on MFSAF analysis population defined as all treated subjects with baseline and at least 1 post-baseline evaluable assessment of total symptom score.
    End point type
    Secondary
    End point timeframe
    Baseline, End of Cycle 6
    End point values
    Fedratinib
    Number of subjects analysed
    90
    Units: percentage of subjects
        number (confidence interval 95%)
    25.6 (16.9 to 35.8)
    No statistical analyses for this end point

    Secondary: Duration of Splenic Response

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    End point title
    Duration of Splenic Response
    End point description
    Splenic response was defined as >=35% reduction in volume of spleen from baseline to the end of Cycle 6, measured by MRI/CT scan.
    End point type
    Secondary
    End point timeframe
    Month 6
    End point values
    Fedratinib
    Number of subjects analysed
    0 [2]
    Units: days
        median (full range (min-max))
    ( to )
    Notes
    [2] - Endpoint not analysed due to SAR302503 clinical program/study termination for safety reasons.
    No statistical analyses for this end point

    Secondary: Percentage of Subjects with a ≥50% Reduction From Baseline in Length of Spleen by Palpation at End of Cycle 6

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    End point title
    Percentage of Subjects with a ≥50% Reduction From Baseline in Length of Spleen by Palpation at End of Cycle 6
    End point description
    Intent-to-treat population included all enrolled and treated subjects.
    End point type
    Secondary
    End point timeframe
    Baseline, End of Cycle 6
    End point values
    Fedratinib
    Number of subjects analysed
    97
    Units: percentage of subjects
        number (not applicable)
    30.9
    No statistical analyses for this end point

    Secondary: Response Rate: Percentage of Subjects With ≥35% Reduction From Baseline in Spleen Volume Measured by MRI or CT Scan at End of Cycle 3

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    End point title
    Response Rate: Percentage of Subjects With ≥35% Reduction From Baseline in Spleen Volume Measured by MRI or CT Scan at End of Cycle 3
    End point description
    Analysis was performed on PP population.
    End point type
    Secondary
    End point timeframe
    Baseline, End of Cycle 3
    End point values
    Fedratinib
    Number of subjects analysed
    83
    Units: percentage of subjects
        number (not applicable)
    47
    No statistical analyses for this end point

    Secondary: Percent Change From Baseline in Spleen Volume Measured by MRI or CT Scan at End of Cycle 3 and Cycle 6

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    End point title
    Percent Change From Baseline in Spleen Volume Measured by MRI or CT Scan at End of Cycle 3 and Cycle 6
    End point description
    Analysis was performed on PP population.
    End point type
    Secondary
    End point timeframe
    Baseline, End of Cycle 3, 6
    End point values
    Fedratinib
    Number of subjects analysed
    83
    Units: percent change
    median (full range (min-max))
        End of Cycle 3 (n=20)
    -24.3 (-60.6 to 22)
        End of Cycle 6 (n=83)
    -34.01 (-72.7 to 114.8)
    No statistical analyses for this end point

    Secondary: Plasma Concentration of Fedratinib

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    End point title
    Plasma Concentration of Fedratinib
    End point description
    Analysis was performed on pharmacokinetic population defined as all subjects who received at least 1 (even partial) cycle of study treatment and had evaluable drug concentration data.
    End point type
    Secondary
    End point timeframe
    Pre-dose (Hour 0), 0.5, 2.5 hours post-dose on Day 1 of Cycle 1, 2, pre-dose (Hour 0) on Day 1 of Cycle 4
    End point values
    Fedratinib
    Number of subjects analysed
    97
    Units: ng/mL
    arithmetic mean (standard deviation)
        Cycle 1 Predose (0 hours) (n=94)
    1 ( 0 )
        Cycle 1 Day 1 (0.5 to 2 hours) (n=93)
    924.8 ( 605.4 )
        Cycle 1 Day 1 (2.5 to 4 hours) (n=93)
    1302.8 ( 708.6 )
        Cycle 2 Day 1 Predose (0 hours) (n=85)
    1150.1 ( 652.5 )
        Cycle 2 Day 1 (0.5 to 2 hours) (n=85)
    1873.4 ( 1081 )
        Cycle 2 Day 1 (2.5 to 4 hours) (n=87)
    2143 ( 906.6 )
        Cycle 4 Day 1 Predose (0 hours) (n=69)
    1258.7 ( 594.9 )
    No statistical analyses for this end point

    Secondary: Percentage of Subjects With Janus Kinase 2 (JAK2) V617F Mutation

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    End point title
    Percentage of Subjects With Janus Kinase 2 (JAK2) V617F Mutation
    End point description
    End point type
    Secondary
    End point timeframe
    Day 1 of Cycle 1 and 4, End of Cycle 6
    End point values
    Fedratinib
    Number of subjects analysed
    0 [3]
    Units: subjects
        number (not applicable)
    Notes
    [3] - Endpoint was not analyzed due to clinical program and study termination for safety reasons.
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All Adverse Events (AE) were collected from signature of the informed consent form up to the final visit (Week 79) regardless of seriousness or relationship to investigational product. Analysis was performed on safety population.
    Adverse event reporting additional description
    Reported adverse events and deaths are treatment emergent that is AEs that developed/worsened and death occurred during the ‘on treatment period’ (from the first dose of study drug to 30 days after last dose of drug).
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    17.0
    Reporting groups
    Reporting group title
    Fedratinib
    Reporting group description
    Fedratinib in consecutive 28-day cycles until disease progression or unacceptable toxicity.

    Serious adverse events
    Fedratinib
    Total subjects affected by serious adverse events
         subjects affected / exposed
    33 / 97 (34.02%)
         number of deaths (all causes)
    7
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Acute Myeloid Leukaemia
         subjects affected / exposed
    2 / 97 (2.06%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    Squamous Cell Carcinoma
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Shock
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Vasculitis
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Disease Progression
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    General Physical Health Deterioration
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Pyrexia
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Reproductive system and breast disorders
    Benign Prostatic Hyperplasia
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute Respiratory Failure
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Chronic Obstructive Pulmonary Disease
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Epistaxis
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dyspnoea
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypoxia
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pleural Disorder
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pleural Effusion
         subjects affected / exposed
    3 / 97 (3.09%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Pulmonary Embolism
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory Failure
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Psychiatric disorders
    Panic Attack
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Platelet Count Decreased
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Post Procedural Haemorrhage
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Fall
         subjects affected / exposed
    2 / 97 (2.06%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Splenic Rupture
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Acute Coronary Syndrome
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Atrial Fibrillation
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac Failure
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Myocardial Ischaemia
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sick Sinus Syndrome
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ventricular Tachycardia
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Encephalopathy
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hydrocephalus
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Splenomegaly
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pancytopenia
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Thrombotic Thrombocytopenic Purpura
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Eye disorders
    Photophobia
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hiatus Hernia
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Upper Gastrointestinal Haemorrhage
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Oesophageal Varices Haemorrhage
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Cholecystitis
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cholestasis
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Renal Failure Acute
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Arthritis
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Temporomandibular Joint Syndrome
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Gastroenteritis
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cellulitis
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Influenza
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lung Infection
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    4 / 97 (4.12%)
         occurrences causally related to treatment / all
    2 / 4
         deaths causally related to treatment / all
    0 / 1
    Sepsis
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Staphylococcal Sepsis
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    2 / 97 (2.06%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Hyperkalaemia
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Tumour Lysis Syndrome
         subjects affected / exposed
    1 / 97 (1.03%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Fedratinib
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    95 / 97 (97.94%)
    Investigations
    Alanine Aminotransferase Increased
         subjects affected / exposed
    6 / 97 (6.19%)
         occurrences all number
    9
    Aspartate Aminotransferase Increased
         subjects affected / exposed
    6 / 97 (6.19%)
         occurrences all number
    8
    Blood Creatinine Increased
         subjects affected / exposed
    8 / 97 (8.25%)
         occurrences all number
    10
    Lipase Increased
         subjects affected / exposed
    7 / 97 (7.22%)
         occurrences all number
    10
    Weight Decreased
         subjects affected / exposed
    9 / 97 (9.28%)
         occurrences all number
    9
    Injury, poisoning and procedural complications
    Contusion
         subjects affected / exposed
    6 / 97 (6.19%)
         occurrences all number
    6
    Nervous system disorders
    Headache
         subjects affected / exposed
    13 / 97 (13.40%)
         occurrences all number
    15
    Dizziness
         subjects affected / exposed
    11 / 97 (11.34%)
         occurrences all number
    14
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    47 / 97 (48.45%)
         occurrences all number
    86
    Thrombocytopenia
         subjects affected / exposed
    26 / 97 (26.80%)
         occurrences all number
    39
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    12 / 97 (12.37%)
         occurrences all number
    12
    Fatigue
         subjects affected / exposed
    15 / 97 (15.46%)
         occurrences all number
    16
    Oedema Peripheral
         subjects affected / exposed
    6 / 97 (6.19%)
         occurrences all number
    7
    Pain
         subjects affected / exposed
    5 / 97 (5.15%)
         occurrences all number
    5
    Pyrexia
         subjects affected / exposed
    10 / 97 (10.31%)
         occurrences all number
    10
    Social circumstances
    Blood Product Transfusion Dependent
         subjects affected / exposed
    8 / 97 (8.25%)
         occurrences all number
    8
    Gastrointestinal disorders
    Abdominal Pain
         subjects affected / exposed
    11 / 97 (11.34%)
         occurrences all number
    18
    Abdominal Pain Upper
         subjects affected / exposed
    7 / 97 (7.22%)
         occurrences all number
    7
    Constipation
         subjects affected / exposed
    20 / 97 (20.62%)
         occurrences all number
    24
    Nausea
         subjects affected / exposed
    54 / 97 (55.67%)
         occurrences all number
    74
    Dyspepsia
         subjects affected / exposed
    5 / 97 (5.15%)
         occurrences all number
    5
    Diarrhoea
         subjects affected / exposed
    59 / 97 (60.82%)
         occurrences all number
    79
    Vomiting
         subjects affected / exposed
    40 / 97 (41.24%)
         occurrences all number
    52
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    13 / 97 (13.40%)
         occurrences all number
    14
    Dyspnoea
         subjects affected / exposed
    12 / 97 (12.37%)
         occurrences all number
    13
    Epistaxis
         subjects affected / exposed
    7 / 97 (7.22%)
         occurrences all number
    8
    Oropharyngeal Pain
         subjects affected / exposed
    6 / 97 (6.19%)
         occurrences all number
    7
    Skin and subcutaneous tissue disorders
    Pruritus
         subjects affected / exposed
    16 / 97 (16.49%)
         occurrences all number
    18
    Night Sweats
         subjects affected / exposed
    6 / 97 (6.19%)
         occurrences all number
    6
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    5 / 97 (5.15%)
         occurrences all number
    6
    Back Pain
         subjects affected / exposed
    5 / 97 (5.15%)
         occurrences all number
    5
    Bone Pain
         subjects affected / exposed
    7 / 97 (7.22%)
         occurrences all number
    7
    Muscle Spasms
         subjects affected / exposed
    8 / 97 (8.25%)
         occurrences all number
    9
    Myalgia
         subjects affected / exposed
    6 / 97 (6.19%)
         occurrences all number
    6
    Pain In Extremity
         subjects affected / exposed
    6 / 97 (6.19%)
         occurrences all number
    6
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    5 / 97 (5.15%)
         occurrences all number
    5
    Respiratory Tract Infection
         subjects affected / exposed
    5 / 97 (5.15%)
         occurrences all number
    5
    Upper Respiratory Tract Infection
         subjects affected / exposed
    6 / 97 (6.19%)
         occurrences all number
    6
    Urinary Tract Infection
         subjects affected / exposed
    12 / 97 (12.37%)
         occurrences all number
    15
    Metabolism and nutrition disorders
    Decreased Appetite
         subjects affected / exposed
    9 / 97 (9.28%)
         occurrences all number
    9

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    23 Feb 2012
    It included following statements: 1. Updated exclusion criteria of subjects who may be at risk for liver function test (LFT) abnormalities. 2. Add more frequent monitoring LFTs (ALT, AST and bilirubin [total and direct]) during the first 3 cycles of treatment and in case severe liver enzyme elevations occur at any time during study treatment. 3. Explicit instructions given on dose modifications in case LFT abnormalities are detected. 4. Clarified the concomitant medication section regarding the recommendation to not use oral contraceptives and hormonal replacement therapies that include estrogen (ie, ethinyl estradiol) and progesterone (ie, levonorgestrel) during study treatment.
    28 Nov 2012
    It included following statements: Updated to include an interim analysis and interim report performed after approximately one-third of subjects were enrolled and completed 3 cycles of treatment. Increased the study sample size to 70 subjects in an attempt to provide sufficient statistical power (at least 90%) for testing response rate beyond a clinically important threshold: 10% response rate; for this other Janus kinase 2 (JAK2) treatment - refractory population; in addition, the increased sample size was to allow sufficient evaluations for subgroups. Expanded study to include subjects who were intolerant to or allergic to ruxolitinib after receiving ruxolitinib treatment for less than 14 days. Revised to Include subjects categorized as intermediate-1 with symptoms. Changed the risk classification algorithm for myelofibrosis from the original International Prognostic Scoring System to the newer Dynamic International Prognostic Scoring System. Reduced the wash-out period of ruxolitinib before taking the first dose of SAR302503 from 30 to 14 days and the wash-out period of hydroxyurea before taking the first dose of SAR302503 from 14 days to 1 day due to short half-life period of each drug. Updated to allow assessment of bone marrow in <14 days after discontinuing ruxolitinib or hydroxyurea during the screening period. Amended the concomitant medication section to include recent information that SAR302503 is likely a moderate-to-potent inhibitor of CYP3A4. Updated the tumor genomics section to add an additional whole blood sample (6 mL) collection predose at baseline (Cycle 1/Day 1), at Cycle 4 Day 1, and at the end of Cycle 6 to analyze potential molecular pathways associated with response/resistance to JAK2 treatment. Also added that mutation analysis would be performed on MPN-related genes in progenitor cells at single cell level to determine clonal architecture of PMN and its evolution during SAR302503 treatment.

    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.
    Due to clinical program and study termination, for safety reasons, only the primary efficacy endpoint, spleen response (SR) at end of cycle (EOC) 6, SR at EOC 3, the symptom response rate, and spleen size by palpation at EOC 6 were analyzed.
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    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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