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    Clinical Trial Results:
    A Multi-center, Open-label, Single Arm Study to Characterize the Pharmacokinetics and Pharmacodynamics Profile of Intravenous Ferric Carboxymaltose in Pediatric Subjects 1 –17 years old with Iron Deficiency Anemia (IDA)

    Summary
    EudraCT number
    2014-004232-19
    Trial protocol
    PL  
    Global end of trial date
    22 Jan 2017

    Results information
    Results version number
    v1(current)
    This version publication date
    24 Apr 2021
    First version publication date
    24 Apr 2021
    Other versions
    Summary report(s)
    2014-004232-19_CSR Synopsis_13Jun2017

    Trial information

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    Trial identification
    Sponsor protocol code
    1VIT13036
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02410213
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Luitpold Pharmaceuticals, Inc
    Sponsor organisation address
    800 Adams Avenue, Norristown, United States, PA 19403
    Public contact
    Mark A. Falone, American Regent, mfalone@americanregent.com
    Scientific contact
    Mark A. Falone, American Regent, mfalone@americanregent.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
    01 Jun 2017
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    22 Jan 2017
    Global end of trial reached?
    Yes
    Global end of trial date
    22 Jan 2017
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objectives of this study are to characterize the pharmacokinetics and determine appropriate dosing and safety of Ferric Carboxymaltose for the pediatric population suffering from iron deficiency (ID) with anemia.
    Protection of trial subjects
    The parent(s)/guardian(s) and the minors, if appropriate for age, were informed by the Investigator about the nature of the study, along with the aims, methods, anticipated benefits, potential hazards, and discomfort that participation may have entailed. Written informed consent and assent were obtained from the parent(s)/guardian(s) and the minors, if appropriate for age. The study protocol and the informed consent form were submitted to the Independent Ethics Committee (IEC) or Institutional Review Board (IRB) for review and approval before study initiation. The study was conducted in accordance with recognized international scientific and ethical standards, including but not limited to the International Conference on Harmonization guideline for Good Clinical Practice (ICH GCP) and the original principles embodied in the Declaration of Helsinki.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    19 Feb 2015
    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
    Russian Federation: 5
    Country: Number of subjects enrolled
    Poland: 30
    Worldwide total number of subjects
    35
    EEA total number of subjects
    30
    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)
    3
    Children (2-11 years)
    14
    Adolescents (12-17 years)
    18
    Adults (18-64 years)
    0
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    The study was conducted at eight sites in Poland and at two sites in Russia between 19 February 2015 and 22 January 2017.

    Pre-assignment
    Screening details
    The screening period, starting at Day -14 and following obtainment of informed consent/assent, was of maximum 14 days to allow for all screening results to be obtained and validated.

    Pre-assignment period milestones
    Number of subjects started
    35
    Number of subjects completed
    35

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

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Cohort 1
    Arm description
    Subjects assigned to cohort 1 received a single dose of FCM at 7.5 mg/kg.
    Arm type
    Experimental

    Investigational medicinal product name
    Ferric Carboxymaltose
    Investigational medicinal product code
    FCM
    Other name
    Pharmaceutical forms
    Solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    7.5 mg/kg single dose intravenous at 100 mg/min

    Arm title
    Cohort 2
    Arm description
    Subjects assigned to cohort 2 received a single dose of FCM at 15 mg/kg with a maximum single dose of 150 mg.
    Arm type
    Experimental

    Investigational medicinal product name
    Ferric Carboxymaltose
    Investigational medicinal product code
    FCM
    Other name
    Pharmaceutical forms
    Solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    15 mg/kg single dose intravenous at 100 mg/min, maximum single dose 150 mg

    Number of subjects in period 1
    Cohort 1 Cohort 2
    Started
    16
    19
    Completed
    16
    19

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Cohort 1
    Reporting group description
    Subjects assigned to cohort 1 received a single dose of FCM at 7.5 mg/kg.

    Reporting group title
    Cohort 2
    Reporting group description
    Subjects assigned to cohort 2 received a single dose of FCM at 15 mg/kg with a maximum single dose of 150 mg.

    Reporting group values
    Cohort 1 Cohort 2 Total
    Number of subjects
    16 19 35
    Age categorical
    Mean age of subjects assigned to cohort 1 received a single dose of FCM at 7.5 mg/kg was 9.1 years. Mean age of subjects assigned to cohort 1 received a single dose of FCM at 15 mg/kg was 10.3 years.
    Units: Subjects
        Infants and toddlers (28 days-23 months)
    0
        Children (2-11 years)
    0
        Adolescents (12-17 years)
    0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    9.1 ± 6.13 10.3 ± 5.77 -
    Gender categorical
    Units: Subjects
        Female
    10 9 19
        Male
    6 10 16

    End points

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    End points reporting groups
    Reporting group title
    Cohort 1
    Reporting group description
    Subjects assigned to cohort 1 received a single dose of FCM at 7.5 mg/kg.

    Reporting group title
    Cohort 2
    Reporting group description
    Subjects assigned to cohort 2 received a single dose of FCM at 15 mg/kg with a maximum single dose of 150 mg.

    Primary: Hemoglobin

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    End point title
    Hemoglobin [1]
    End point description
    Mean increases in hemoglobin from baseline to Day 35
    End point type
    Primary
    End point timeframe
    Baseline Day 35
    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 formal hypothesis testing was planned for this study. Only descriptive, summary statistics were planned for assessment of dosing and safety.
    End point values
    Cohort 1 Cohort 2
    Number of subjects analysed
    16
    19
    Units: g/dL
        arithmetic mean (standard deviation)
    1.9 ± 1.38
    2.8 ± 1.15
    No statistical analyses for this end point

    Primary: Ferritin

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    End point title
    Ferritin [2]
    End point description
    Mean increases in ferritin from baseline to Day 35
    End point type
    Primary
    End point timeframe
    Baseline Day 35
    Notes
    [2] - 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 formal hypothesis testing was planned for this study. Only descriptive, summary statistics were planned for assessment of dosing and safety.
    End point values
    Cohort 1 Cohort 2
    Number of subjects analysed
    16
    19
    Units: ng/mL
        arithmetic mean (standard deviation)
    35.1 ± 98.22
    52.4 ± 31.7
    No statistical analyses for this end point

    Primary: TSAT

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    End point title
    TSAT [3]
    End point description
    Mean increases in TSAT from baseline to Day 35
    End point type
    Primary
    End point timeframe
    Baseline Day 35
    Notes
    [3] - 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 formal hypothesis testing was planned for this study. Only descriptive, summary statistics were planned for assessment of dosing and safety.
    End point values
    Cohort 1 Cohort 2
    Number of subjects analysed
    16
    19
    Units: %
        arithmetic mean (standard deviation)
    9.9 ± 11.54
    13.5 ± 6.88
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Day 0 to Day 35
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    17.0
    Reporting groups
    Reporting group title
    Cohort 1
    Reporting group description
    -

    Reporting group title
    Cohort 2
    Reporting group description
    -

    Serious adverse events
    Cohort 1 Cohort 2
    Total subjects affected by serious adverse events
         subjects affected / exposed
    2 / 16 (12.50%)
    0 / 19 (0.00%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Infections and infestations
    Sinusitis
         subjects affected / exposed
    1 / 16 (6.25%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 16 (6.25%)
    0 / 19 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Cohort 1 Cohort 2
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    9 / 16 (56.25%)
    12 / 19 (63.16%)
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    0 / 16 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Aspartate aminotransferase increased
         subjects affected / exposed
    0 / 16 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Vascular disorders
    Hot flush
         subjects affected / exposed
    1 / 16 (6.25%)
    0 / 19 (0.00%)
         occurrences all number
    1
    0
    Hypertension
         subjects affected / exposed
    0 / 16 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    1 / 16 (6.25%)
    1 / 19 (5.26%)
         occurrences all number
    1
    1
    Blood and lymphatic system disorders
    Lymphadenitis
         subjects affected / exposed
    0 / 16 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    General disorders and administration site conditions
    Hyperthermia
         subjects affected / exposed
    0 / 16 (0.00%)
    2 / 19 (10.53%)
         occurrences all number
    0
    2
    Infusion site pruritus
         subjects affected / exposed
    1 / 16 (6.25%)
    0 / 19 (0.00%)
         occurrences all number
    1
    0
    Injection site pain
         subjects affected / exposed
    0 / 16 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Pyrexia
         subjects affected / exposed
    2 / 16 (12.50%)
    0 / 19 (0.00%)
         occurrences all number
    2
    0
    Thirst
         subjects affected / exposed
    1 / 16 (6.25%)
    0 / 19 (0.00%)
         occurrences all number
    1
    0
    Eye disorders
    Blepharospasm
         subjects affected / exposed
    0 / 16 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    0 / 16 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Abdominal pain upper
         subjects affected / exposed
    0 / 16 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Aphthous stomatitis
         subjects affected / exposed
    0 / 16 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Constipation
         subjects affected / exposed
    1 / 16 (6.25%)
    0 / 19 (0.00%)
         occurrences all number
    1
    0
    Enteritis
         subjects affected / exposed
    0 / 16 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Gastroduodentitis
         subjects affected / exposed
    0 / 16 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Gastrooesophageal reflux disease
         subjects affected / exposed
    0 / 16 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Haematochezia
         subjects affected / exposed
    1 / 16 (6.25%)
    0 / 19 (0.00%)
         occurrences all number
    1
    0
    Haemorrhoidal haemorrhage
         subjects affected / exposed
    0 / 16 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Respiratory, thoracic and mediastinal disorders
    Dysphonia
         subjects affected / exposed
    1 / 16 (6.25%)
    0 / 19 (0.00%)
         occurrences all number
    1
    0
    Dyspnoea exertional
         subjects affected / exposed
    0 / 16 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Epistaxis
         subjects affected / exposed
    0 / 16 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Rhinorhoea
         subjects affected / exposed
    0 / 16 (0.00%)
    3 / 19 (15.79%)
         occurrences all number
    0
    3
    Wheezing
         subjects affected / exposed
    1 / 16 (6.25%)
    1 / 19 (5.26%)
         occurrences all number
    1
    1
    Skin and subcutaneous tissue disorders
    Pruritus
         subjects affected / exposed
    0 / 16 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Rash
         subjects affected / exposed
    2 / 16 (12.50%)
    1 / 19 (5.26%)
         occurrences all number
    2
    1
    Rash papular
         subjects affected / exposed
    1 / 16 (6.25%)
    0 / 19 (0.00%)
         occurrences all number
    1
    0
    Urticaria
         subjects affected / exposed
    0 / 16 (0.00%)
    3 / 19 (15.79%)
         occurrences all number
    0
    3
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    0 / 16 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Pharyngitis
         subjects affected / exposed
    0 / 16 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1
    Respiratory tract infection
         subjects affected / exposed
    1 / 16 (6.25%)
    0 / 19 (0.00%)
         occurrences all number
    1
    0
    Sinusitis
         subjects affected / exposed
    1 / 16 (6.25%)
    0 / 19 (0.00%)
         occurrences all number
    1
    0
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 16 (6.25%)
    2 / 19 (10.53%)
         occurrences all number
    1
    2
    Urinary tract infection
         subjects affected / exposed
    1 / 16 (6.25%)
    0 / 19 (0.00%)
         occurrences all number
    1
    0
    Viral pharyngitis
         subjects affected / exposed
    0 / 16 (0.00%)
    1 / 19 (5.26%)
         occurrences all number
    0
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    29 Jul 2014
    Amendment #1 incorporated the following changes/additions: - The sample size rationale was revised to include equal age distribution within each cohort. - Exclusion criterion #3 was revised to exclude subjects with a body mass index ≤5th percentile by age. - The study design was changed to Phase 2. - Additional wording in section 7.1 “All laboratory values at the end of the study/Day 35 that have been deemed clinical significant by the Investigator should be followed until they are back into normal range”.
    08 Oct 2014
    Amendment #2 incorporated the following changes: - Exclusion criterion #4 (male or female subjects 1 year of age weighing <12 kg) was added. - Exclusion criterion #12 (significant blood loss [>100 mL] within the last 3 months or any current bleeding disorders or anticipated need for surgery that may result in significant blood loss [>100 mL]) was deleted. - The total blood volume requirement was decreased from 72 mL to 44.5 mL. - Injectafer® was replaced with FCM throughout the protocol.

    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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    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
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