Skip to content

Efficacy and Safety of Ferriprox® in Patients With Sickle Cell Disease or Other Anemias

The Efficacy and Safety of Ferriprox® for the Treatment of Transfusional Iron Overload in Patients With Sickle Cell Disease or Other Anemias

Status
Terminated
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02041299
Acronym
FIRST
Enrollment
230
Registered
2014-01-22
Start date
2014-04-17
Completion date
2019-06-18
Last updated
2021-08-10

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Iron Overload, Other Anemias, Sickle Cell Disease

Keywords

sickle cell disease, Iron overload, Deferiprone, Ferriprox, deferoxamine, Chelation

Brief summary

This research is being done so that we can look at the safety and efficacy of deferiprone in people with sickle cell disease or other anemias. Deferiprone is a drug that removes iron from the body. We will be comparing deferiprone with deferoxamine, another drug that removes iron from the body.

Detailed description

Deferiprone (brand name Ferriprox®) is an iron chelator that is approved in the United States and over 60 other countries for the treatment of iron overload in patients with thalassemia, when other treatments are inadequate. This study has been designed to evaluate the efficacy, safety, and tolerability of deferiprone vs. deferoxamine in patients who have SCD or other anemias, and who require chelation because of the extra iron they are taking in through blood transfusions. About 300 people from North America, South America, Europe, and the Middle East will take part in this study. Participants will be randomized in a 2:1 ratio to receive therapy for 52 weeks with either deferiprone or deferoxamine, another type of iron chelator. Patients who are randomized to the deferiprone group can choose to get the drug as either tablets or liquid, and must take it three times daily. Patients who are randomized to the deferoxamine group will receive it as a subcutaneous infusion that lasts from 8 to 12 hours and is given 5 to 7 days per week. For both drugs, the starting dosage is based on how much extra iron they have taken in through transfusions in the last 3 months and on the severity of iron load, as measured by serum ferritin levels in the blood and by the amount of iron in the liver and the heart. For deferiprone, the starting dosage will be increased each week over the first 3 weeks; and for both drugs, the dosage may be adjusted up or down during the study based on the level of iron overload and on safety considerations. Patients will need to have their blood count checked every week for the first 26 weeks, then every other week for the remaining 26 weeks; they will also have to give a blood sample for more detailed safety testing every month; and to give a blood sample for the measurement of serum ferritin every 3 months. Every six months, they will undergo an ECG and an MRI scan, and will be asked to complete a quality of life survey. At the end of the 52 weeks, participants will be invited to enter a 2-year study in which all patients will receive deferiprone, including those who were randomized to receive deferoxamine in the first year.

Interventions

DRUGDeferiprone
DRUGDeferoxamine

Sponsors

ApoPharma
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
2 Years to No maximum
Healthy volunteers
No

Inclusion criteria

1. Male or female ≥ 2 years of age; 2. Have sickle cell disease (confirmed by Hb electrophoresis or more specific tests) or other conditions with iron overload from repeated blood transfusions (see

Exclusion criteria

for exceptions); 3. Baseline LIC \>7 mg/g dw (measured by MRI); 4. Patients who have received no less than 20 transfusions of RBCs; 5. Patients who have received at least 1 transfusion per year in the last 2 years and who are expected to have a continuing requirement (based on Investigator's judgement) during the duration of the trial

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in Liver Iron Concentration (LIC)Change from baseline to Week 52LIC was measured by MRI. A score \>7 mg/g dw is indicative of iron overload.

Secondary

MeasureTime frameDescription
Change From Baseline in Cardiac IronChange from baseline to Week 52Cardiac iron is measured by MRI in milliseconds (ms). A score of less than 20 ms is indicative of cardiac iron overload.
Change From Baseline in Serum FerritinChange from baseline to Week 52Serum ferritin provides a measure of iron level in the blood. Normal levels of serum ferritin are under 300 µg/L for females and 400 µg/L for males.
Change in Patient-reported Quality of Life, as Measured by the Short Form Health Survey (SF-36) or the Child Health Questionnaire (CHQ-PF50).Change from baseline to Week 52Adult patients completed the SF-36 questionnaire and minors completed the CHQ-PF50. These questionnaires yield a profile of functional health and well-being, based on 8 scales of physical and mental health measures: Physical Functioning, Role Limitations due to Physical Health, Bodily Pain, General Health Perceptions, Vitality, Social Functioning, Role Limitations due to Emotional Problems, and Mental Health (MH), and summary scores are produced for physical well-being and mental well-being. The summaries are scored from 0-100, with higher scores reflecting better outcomes.

Countries

Brazil, Canada, Egypt, Saudi Arabia, Tunisia, Turkey (Türkiye), United Kingdom, United States

Participant flow

Participants by arm

ArmCount
Deferiprone
Number of patients who received deferiprone
152
Deferoxamine
Number of patients who received deferoxamine
76
Total228

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event93
Overall StudyLost to Follow-up41
Overall StudyPatient stopped dosing on unknown date10
Overall StudyPhysician Decision11
Overall StudyProtocol Violation114
Overall StudyRequired bone marrow transplant01
Overall StudyTermination of the study73
Overall StudyWithdrawal by Subject137

Baseline characteristics

CharacteristicDeferiproneDeferoxamineTotal
Age, Continuous16.9 years
STANDARD_DEVIATION 10.2
16.9 years
STANDARD_DEVIATION 8.5
16.9 years
STANDARD_DEVIATION 9.6
Cardiac iron at baseline33.52 milliseconds
STANDARD_DEVIATION 6.26
33.87 milliseconds
STANDARD_DEVIATION 6.17
33.64 milliseconds
STANDARD_DEVIATION 6.22
Ethnicity (NIH/OMB)
Hispanic or Latino
10 Participants6 Participants16 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
142 Participants70 Participants212 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Liver iron concentration at baseline16.54 mg iron per gram of liver dry weight
STANDARD_DEVIATION 7.49
15.97 mg iron per gram of liver dry weight
STANDARD_DEVIATION 7.2
16.26 mg iron per gram of liver dry weight
STANDARD_DEVIATION 7.3
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
23 Participants14 Participants37 Participants
Race (NIH/OMB)
More than one race
9 Participants6 Participants15 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
120 Participants56 Participants176 Participants
Region of Enrollment
Brazil
9 Participants7 Participants16 Participants
Region of Enrollment
Canada
1 Participants1 Participants2 Participants
Region of Enrollment
Egypt
105 Participants51 Participants156 Participants
Region of Enrollment
Saudi Arabia
8 Participants3 Participants11 Participants
Region of Enrollment
Tunisia
6 Participants1 Participants7 Participants
Region of Enrollment
Turkey
1 Participants1 Participants2 Participants
Region of Enrollment
United Kingdom
6 Participants5 Participants11 Participants
Region of Enrollment
United States
16 Participants7 Participants23 Participants
Serum ferritin level at baseline4125.4 micrograms per liter
STANDARD_DEVIATION 2407.4
4055.3 micrograms per liter
STANDARD_DEVIATION 2708.5
4101.89 micrograms per liter
STANDARD_DEVIATION 2505.66
Sex: Female, Male
Female
69 Participants38 Participants107 Participants
Sex: Female, Male
Male
83 Participants38 Participants121 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
1 / 1521 / 76
other
Total, other adverse events
134 / 15267 / 76
serious
Total, serious adverse events
40 / 15214 / 76

Outcome results

Primary

Change From Baseline in Liver Iron Concentration (LIC)

LIC was measured by MRI. A score \>7 mg/g dw is indicative of iron overload.

Time frame: Change from baseline to Week 52

Population: Intent-to-treat population

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
DeferiproneChange From Baseline in Liver Iron Concentration (LIC)-4.13 mg of iron per gram of liver dry weightStandard Error 0.5
DeferoxamineChange From Baseline in Liver Iron Concentration (LIC)-4.38 mg of iron per gram of liver dry weightStandard Error 0.59
p-value: 0.039996.01% CI: [-0.97, 1.48]ANCOVA
Secondary

Change From Baseline in Cardiac Iron

Cardiac iron is measured by MRI in milliseconds (ms). A score of less than 20 ms is indicative of cardiac iron overload.

Time frame: Change from baseline to Week 52

Population: Intent-to-treat population

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
DeferiproneChange From Baseline in Cardiac Iron-0.022068 millisecondsStandard Error 0.021133
DeferoxamineChange From Baseline in Cardiac Iron-0.021773 millisecondsStandard Error 0.025261
Comparison: Data for this measure were log-transformed.p-value: 0.039996.01% CI: [-0.054247, 0.053657]ANCOVA
Secondary

Change From Baseline in Serum Ferritin

Serum ferritin provides a measure of iron level in the blood. Normal levels of serum ferritin are under 300 µg/L for females and 400 µg/L for males.

Time frame: Change from baseline to Week 52

Population: Intent-to-treat

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
DeferiproneChange From Baseline in Serum Ferritin-385.83 micrograms per literStandard Error 234.05
DeferoxamineChange From Baseline in Serum Ferritin-760.89 micrograms per literStandard Error 289.4
p-value: 0.039996.01% CI: [-260.63, 1010.76]ANCOVA
Secondary

Change in Patient-reported Quality of Life, as Measured by the Short Form Health Survey (SF-36) or the Child Health Questionnaire (CHQ-PF50).

Adult patients completed the SF-36 questionnaire and minors completed the CHQ-PF50. These questionnaires yield a profile of functional health and well-being, based on 8 scales of physical and mental health measures: Physical Functioning, Role Limitations due to Physical Health, Bodily Pain, General Health Perceptions, Vitality, Social Functioning, Role Limitations due to Emotional Problems, and Mental Health (MH), and summary scores are produced for physical well-being and mental well-being. The summaries are scored from 0-100, with higher scores reflecting better outcomes.

Time frame: Change from baseline to Week 52

Population: Due to administrative and other issues, a majority of participants were missing scores. Evaluable data were obtained from 35 DFP and 19 DFO patients for the SF-36, and from 60 DFP and 23 DFO patients for the CHQ.

ArmMeasureGroupValue (MEAN)Dispersion
DeferiproneChange in Patient-reported Quality of Life, as Measured by the Short Form Health Survey (SF-36) or the Child Health Questionnaire (CHQ-PF50).SF-36 Physical Summary43.1 score on a scaleStandard Error 1.8
DeferiproneChange in Patient-reported Quality of Life, as Measured by the Short Form Health Survey (SF-36) or the Child Health Questionnaire (CHQ-PF50).SF-36 Mental Summary44.7 score on a scaleStandard Error 2.7
DeferiproneChange in Patient-reported Quality of Life, as Measured by the Short Form Health Survey (SF-36) or the Child Health Questionnaire (CHQ-PF50).CHQ-PF50 Physical Summary29.3 score on a scaleStandard Error 1.8
DeferiproneChange in Patient-reported Quality of Life, as Measured by the Short Form Health Survey (SF-36) or the Child Health Questionnaire (CHQ-PF50).CHQ-PF50 Psychosocial Summary42.5 score on a scaleStandard Error 1.5
DeferoxamineChange in Patient-reported Quality of Life, as Measured by the Short Form Health Survey (SF-36) or the Child Health Questionnaire (CHQ-PF50).CHQ-PF50 Psychosocial Summary41.3 score on a scaleStandard Error 2.1
DeferoxamineChange in Patient-reported Quality of Life, as Measured by the Short Form Health Survey (SF-36) or the Child Health Questionnaire (CHQ-PF50).SF-36 Physical Summary43.0 score on a scaleStandard Error 2
DeferoxamineChange in Patient-reported Quality of Life, as Measured by the Short Form Health Survey (SF-36) or the Child Health Questionnaire (CHQ-PF50).CHQ-PF50 Physical Summary30.5 score on a scaleStandard Error 2.4
DeferoxamineChange in Patient-reported Quality of Life, as Measured by the Short Form Health Survey (SF-36) or the Child Health Questionnaire (CHQ-PF50).SF-36 Mental Summary40.9 score on a scaleStandard Error 2.9
p-value: 0.9214ANCOVA
Comparison: Comparison of treatment groups on change in score on SF-36 Mental Summaryp-value: 0.1174ANCOVA
Comparison: Comparison of treatment groups on change in score on CHQ-PF50 Physical Summaryp-value: 0.6488ANCOVA
Comparison: Comparison of treatment groups on change in score on CHQ-PF50 Psychosocial Summaryp-value: 0.5915ANCOVA

Source: ClinicalTrials.gov · Data processed: Feb 14, 2026