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Extension: deferoxamine to deferasirox

Phase 2

Transfusional Iron Overload | Small molecule | Other |Novartis AG|Last Updated: Aug 27, 2014

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedACTIVE_CONTROLLEDDMC
Total Trials1
Total Enrollment197
FDA Designations
No designations recorded
Clinical Trials (1)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT00600938Evaluating Use of Deferasirox as Compared to Deferoxamine in Treating Cardiac Iron OverloadPHASE2 COMPLETED 197Nov 1, 2007Mar 1, 2013Aug 27, 201421 Canada, China +9
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Study Endpoints
Primary Endpoints
Core Study: Change From Baseline in Myocardial T2* (Magnetic Resonance T2-star (T2*) Technique for the Measurement of Tissue Iron) After 12 Months Treatment
12 Month

Non- inferiority in efficacy of deferasirox compared to deferoxamine (DFO) in treating cardiac iron overload as measured by T2\*. A non-inferiority margin of 0.9 (90%) was applied. Due to limitations in performing heart biopsies, T2\* (T2 star), a Magnetic Resonance (MR) relaxation parameter expressed in milliseconds, as is an important tool to noninvasively quantify cardiac iron concentration. Studies have shown that myocardial T2\* evaluations may predict cardiac events, e.g., impaired (\<56%) left ventricular ejection fraction (LVEF) is prevalent among patients with low T2\*: found in 62% of patients with T2\*\<8 ms; 20% with T2\* of 8-12 ms; and in 5% with T2\* \>12 ms (Tanner 2006)

Secondary Endpoints
Core Study: Cardiac Function After 12 Months of Treatment With Deferasirox vs. Deferoxamine, by Change in Left Ventricular Ejection Fraction (LVEF)
12 Month
Core Study: Cardiac Function After 6 Months of Treatment With Deferasirox vs. Deferoxamine, by Change in Left Ventricular Ejection Fraction (LVEF)
6 Month
Core Study: Change From Baseline in Myocardial T2* After 6 Months Treatment
6 Month
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Study Design & Arms
AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
DeferasiroxEXPERIMENTAL20 mg/kg/day once daily (od) for 2 weeks, followed by 30 mg/kg/day od for 1 week and a subsequent continuation of 40 mg/kg/day
Deferasirox PlaceboACTIVE_COMPARATOR50 mg/kg/day to 60 mg/kg/day infused subcutaneously in 8- to 12-hour intervals administered 5 to 7 days/week
Extension: deferoxamine to deferasiroxEXPERIMENTAL"DFO to ICL" (patients who switched from DFO to deferasirox in extension)
Extension: deferasirox to deferoxamineEXPERIMENTAL"ICL to DFO" (patients who switched from deferasirox to DFO in extension)
Interventions
NameTypeDescription
Core Study: DeferasiroxDRUG20 mg/kg/day once daily (od) for 2 weeks, followed by 30 mg/kg/day od for 1 week and a subsequent continuation of 40 mg/kg/day
Core Study: DeferoxamineDRUG50 mg/kg/day to 60 mg/kg/day infused subcutaneously in 8- to 12-hour intervals administered 5 to 7 days/week
Extension: deferoxamine to deferasiroxDRUG40 mg/kg deferasirox once daily administered 30 minutes before taking food.
Extension: deferasirox to deferoxamineDRUGDFO at a target range of 50 mg/kg/day to 60 mg/kg/day via subcutaneous (sc) infusion lasting a period of 8 to 12 hrs administered for 5 to 7 days per week,
DeferasiroxDRUG -
DeferoxamineDRUG -
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Eligibility Criteria
Age Range10 Years — 65 Years
SexALL
Healthy VolunteersNo
Study Sites21

Inclusion criteria: * Male or female patients, aged 10 years and above, with β-thalassemia major or DBA or sideroblastic anemia on chronic transfusion therapy, having given written consent to participate in the study. * Patients with cardiac iron as measured by a myocardial T2\* value that is ≥ 6ms...

Countries:CanadaChinaCyprusEgyptItalyLebanonTaiwanThailandTurkey (Türkiye)United Arab EmiratesUnited Kingdom
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