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Placebo-Controlled Study to Investigate the Efficacy & Safety of Injectafer in the Treatment of RLS

A Double-Blinded, Multi-Center, Randomized, Placebo-Controlled Study to Investigate the Efficacy and Safety of Injectafer (Ferric Carboxymaltose) in the Treatment of Restless Legs Syndrome (RLS)

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02397057
Enrollment
209
Registered
2015-03-24
Start date
2015-01-31
Completion date
2018-01-31
Last updated
2021-10-12

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

Conditions

Restless Legs Syndrome (RLS)

Brief summary

This will be a Phase III, double blinded, multi-center, randomized, placebo-controlled study. Eligible subjects will be randomized in a 1:1 ratio to receive Injectafer or Placebo on days 0 and 5. All treated subjects will be followed for efficacy and safety for 12 months. The subject's participation in the study will be for approximately 1 year from Day 0.

Detailed description

This will be a Phase III, double blinded, multi-center, randomized, placebo-controlled study. Eligible subjects will be randomized in a 1:1 ratio to receive Injectafer or Placebo on days 0 and 5. All treated subjects will be followed for efficacy and safety for 12 months. Subjects will visit the clinic on Days 0 and 5 for treatment, and then on Days 14, 42, 168, and 365. In between the clinic visits subjects will be contacted remotely on Days 84, 126, 210, 252, 294, and 336. The subject's participation in the study will be for approximately 1 year from Day 0.

Interventions

OTHERPlacebo

Sponsors

American Regent, Inc.
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

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

Inclusion criteria

1. Male or female subject's ≥18 years of age, willing and able to give informed consent to the study. 2. RLS symptoms affirming diagnosis. The IRLS Diagnostic Criteria must be met: 1. An urge (distressing need) to move the legs usually associated with painful or uncomfortable sensations in the legs. The urge to move may be present without the uncomfortable sensations. The arms or other body parts may be involved in addition to the legs. 2. The urge to move or unpleasant sensations are worse or exclusively present at rest or inactivity, such as lying down or sitting. 3. The urge to move or unpleasant sensations are partially/temporarily relieved with walking or moving the legs. 4. The urge to move or unpleasant sensations are worse in the evening or night than during the day or only occur in the evening or night. When symptoms are severe, the worsening at night may not be noticeable but must have been previously present. 3. Subjects should be on monotherapy for RLS. Treatment should be stable for at least 8 weeks prior to screening (See approved RLS Therapies/Regimen in Appendix III). 4. A score ≥15 on the IRLS Rating Scale at screening and on Day 0 prior to dosing. 5. Subjects on anti-depressants and sleep medications must be on a stable dose for at least 6 months. 6. Subject has regular sleep hours between 9 pm and 9 am. 7. Subjects at risk for pregnancy must have a negative pregnancy test at baseline and be practicing an acceptable form of birth control: have had a hysterectomy or tubal ligation, or otherwise be incapable of pregnancy, or have practiced any of the following methods of contraception for at least one month prior to study entry: hormonal contraceptives, spermicide with barrier, intrauterine device, or partner sterility.

Exclusion criteria

1. RLS 2° to other disease or injury. 2. Disorders that require treatment with the same medications used for RLS include: peripheral neuropathy and neurodegenerative disorders (i.e. Parkinson's Disease or Dementia). 3. Stage 4 - 5 CKD, subjects on dialysis or anticipated to start dialysis while participating in this study. 4. Any pain related (e.g., frequent muscle cramps, myalgia, fibromyalgia) or sleep related disorders (e.g. sleep apnea, unless on stable Continuous Positive Airway Pressure \[CPAP\]) which may confound the outcome measures. 5. Subjects with multiple sclerosis. 6. History of neuroleptic akathisia. 7. Parenteral iron use within 6 weeks prior to screening. 8. History of \>10 blood transfusions in the past 2 years. 9. Anticipated need for blood transfusion during the study. 10. Known hypersensitivity reaction to any component of Injectafer® (Ferric Carboxymaltose). 11. Previously randomized to Injectafer® (FCM or VIT-45) in a clinical trial. 12. Current, active or acute or chronic infection other than viral upper respiratory tract infection 13. Malignancy (other than basal or squamous cell skin cancer or the subject has been cancer free for ≥ 5 years). 14. Pregnant or lactating women. 15. Seizure disorder currently being treated with medication. 16. Baseline ferritin ≥300 ng/mL. 17. Baseline TSAT ≥45%. 18. History of hemochromatosis, hemosiderosis, or other iron storage disorders. 19. AST or ALT greater than 2 times the upper limit of normal (ULN). 20. Hemoglobin greater than the ULN. 21. Known positive hepatitis B antigen (HBsAg), unless positive test can be attributed to receipt of hepatitis B vaccination in childhood or hepatitis C viral antibody (HCV) with evidence of active hepatitis (i.e., AST/ALT greater than the upper limit of normal). 22. Known positive HIV-1/HIV-2 antibodies (anti-HIV). 23. Received an investigational drug within 30 days before randomization. 24. Chronic alcohol or drug abuse within the past 6 months. 25. Any other pre-existing laboratory abnormality, medical condition or disease, which per the investigator may put the subject at risk if they participate in the study. 26. Subject unable or unwilling to comply with the study requirements.

Design outcomes

Primary

MeasureTime frameDescription
International Restless Legs Syndrome (IRLS) Total Score Change From Baseline on Day 42Baseline and Day 42Summary of the actual values of IRLS total score on baseline and Day 42, and the change from baseline to Day 42. Eligible subjects were to have met the following requirements prior to receiving additional treatment: A baseline score ≥ 15 on the International Restless Legs Syndrome (IRLS) Rating Scale. The minimum score is 15 with the maximum of 40. A score of less than 15 is not an indicator of RLS. However, a score of 15 or greater is an indicator of RLS. Further increase indicates more severe disease.
Proportion of Patients Rated as Much or Very Much Improved With the Clinical Global Impression (CGI) Performed by Investigator (CGI-I)Day 42Responder is defined as subjects rated as much or very much improved with the CGI-I on Day 42. Summary of the number (percentage) of CGI-I responder. Per the protocol, the he CGI is a 3-item observer-rated scale that measures illness severity (CGIS), global improvement or change (CGIC) and therapeutic response. The scale requires the clinician to assess how much the patient's illness has improved or worsened relative to a baseline state at the beginning of the intervention.

Secondary

MeasureTime frameDescription
Fatigue Linear Analog Scale Change From BaselineBaseline and Day 42The Fatigue Linear Analog Scale is a self-assessment scale in which a 100 mm line is used to measure the severity of fatigue and its effect on a person's activities and lifestyle. The scale severity measure ranges from No Fatigue to Worst Possible Fatigue.
Clinical Global Impression-Improvement (CGI-S) by SubjectDay 42Similar to the CGI-I except this is self-reported, 7-item scale for assessment of symptoms after treatment with the rating as: 1, very much improved; 2, much improved; 3, minimally improved; 4, no change; 5, minimally worse; 6, much worse; or 7, very much worse.
Time Off Pre-Enrollment Prescribed Restless Legs Syndrome (RLS) MedicationsTime from Day 5 to Day 365Subjects could start tapering off pre-enrollment prescribed RLS medications after Day 5 until Day 365.
Medical Outcomes Study(MOS) Sleep Scale Change From Baseline to Day 42Change from Baseline and Day 42.The MOS-Sleep scale, is a 12-item standardized, validated questionnaire for assessing sleep disturbance, sleep adequacy, somnolence, quantity of sleep, snoring, and awakening short of breath or with a headache which has been demonstrated to be sensitive to RLS treatment effects. This questionnaire provides information about sleep quality. Individual questions can be used for analysis but summary or index scores of a group of questions, is more commonly used in analysis. The quantity of sleep dimension is the average number of hours of sleep per night reported by the patient and the optimal sleep is a dichotomized version that is yes when the number of hours of sleep is 7 or 8. The scores of the dimensions and of the sleep problem index were converted to a 0 to 100 scale, with higher scores reflecting more of the attribute implied by the name (e.g. greater sleep disturbance, greater adequacy of sleep).
Restless Legs Syndrome Quality of Life (RLS-QLI) Change From Baseline to Day 42.Baseline and Day 42The Restless Legs Syndrome Quality of Life (RLS-QLI) instrument, a self-assessment, 17-item questionnaire with four scales identified through factor analysis: Daily Function, Social Function, Sleep Quality, and Emotional Well-Being, developed to facilitate clinical research on RLS. Scoring Instructions below: 1. Social Function = Sum (Items 1, 2, 3, 4), subtract 4, divide by 16, multiply by 100 2. Daily Function = Sum (Items 5, 6, 13,14, 15, 16), subtract 6, divide by 24, multiply by 100 3. Sleep Quality = Sum (Item 7, 8, 9, 17), subtract 4, divide by 18, multiply by 100 4. Emotional Well-being = Sum (Items 10, 11, 12), subtract 3, divide by 12, multiply by 100 Note: Resulting scores range between 0-100. Higher scores on the RLS-QLI indicate a lower quality of life. Lower scores indicate a higher quality of life.

Countries

United States

Participant flow

Participants by arm

ArmCount
Injectafer
Two doses of Injectafer 750 mg undiluted dose at 100 mg/minute given 5 days apart for a total of 1500 mgs. Injectafer
105
Normal Saline
IV Placebo (15ml of Normal Saline) IV push at 2ml/minute Placebo
103
Total208

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event01
Overall StudyDeath10
Overall StudyLost to Follow-up43
Overall StudyPhysician Decision01
Overall StudySubject did not receive study drug01
Overall StudyWithdrawal by Subject67

Baseline characteristics

CharacteristicTotalInjectaferNormal Saline
Age, Continuous57.6 Years
STANDARD_DEVIATION 13.01
58.3 Years
STANDARD_DEVIATION 12.31
56.9 Years
STANDARD_DEVIATION 13.73
Ethnicity (NIH/OMB)
Hispanic or Latino
21 Participants12 Participants9 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
187 Participants93 Participants94 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Height167.3 cm
STANDARD_DEVIATION 9.4
167.6 cm
STANDARD_DEVIATION 9.4
167 cm
STANDARD_DEVIATION 9.4
Iron intolerance
No
207 Participants104 Participants103 Participants
Iron intolerance
Yes
1 Participants1 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
1 Participants1 Participants0 Participants
Race (NIH/OMB)
Black or African American
6 Participants2 Participants4 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
1 Participants1 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
200 Participants101 Participants99 Participants
Region of Enrollment
Europe
132 participants65 participants67 participants
Region of Enrollment
United States
76 participants42 participants34 participants
RLS Medication-Related Augmentation
Definitive augmentation
40 Participants23 Participants17 Participants
RLS Medication-Related Augmentation
No augmentation
104 Participants51 Participants53 Participants
RLS Medication-Related Augmentation
Uncertain augmentation
64 Participants31 Participants33 Participants
Sex: Female, Male
Female
140 Participants69 Participants71 Participants
Sex: Female, Male
Male
68 Participants36 Participants32 Participants
Weight81 kg
STANDARD_DEVIATION 21.1
82.8 kg
STANDARD_DEVIATION 21.4
79.1 kg
STANDARD_DEVIATION 20.8

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
1 / 1070 / 101
other
Total, other adverse events
72 / 10719 / 101
serious
Total, serious adverse events
6 / 1074 / 101

Outcome results

Primary

International Restless Legs Syndrome (IRLS) Total Score Change From Baseline on Day 42

Summary of the actual values of IRLS total score on baseline and Day 42, and the change from baseline to Day 42. Eligible subjects were to have met the following requirements prior to receiving additional treatment: A baseline score ≥ 15 on the International Restless Legs Syndrome (IRLS) Rating Scale. The minimum score is 15 with the maximum of 40. A score of less than 15 is not an indicator of RLS. However, a score of 15 or greater is an indicator of RLS. Further increase indicates more severe disease.

Time frame: Baseline and Day 42

Population: One subject did not receive study drug and was excluded from the safety and Full analysis set population.

ArmMeasureGroupValue (MEAN)Dispersion
InjectaferInternational Restless Legs Syndrome (IRLS) Total Score Change From Baseline on Day 42Baseline24.1 score on a scaleStandard Deviation 6.27
InjectaferInternational Restless Legs Syndrome (IRLS) Total Score Change From Baseline on Day 42Day 4215.6 score on a scaleStandard Deviation 8.69
InjectaferInternational Restless Legs Syndrome (IRLS) Total Score Change From Baseline on Day 42Change from Baseline to Day 42-8.7 score on a scaleStandard Deviation 8.44
Normal SalineInternational Restless Legs Syndrome (IRLS) Total Score Change From Baseline on Day 42Baseline24.5 score on a scaleStandard Deviation 6.05
Normal SalineInternational Restless Legs Syndrome (IRLS) Total Score Change From Baseline on Day 42Day 4218.7 score on a scaleStandard Deviation 8.94
Normal SalineInternational Restless Legs Syndrome (IRLS) Total Score Change From Baseline on Day 42Change from Baseline to Day 42-5.9 score on a scaleStandard Deviation 9.07
Primary

Proportion of Patients Rated as Much or Very Much Improved With the Clinical Global Impression (CGI) Performed by Investigator (CGI-I)

Responder is defined as subjects rated as much or very much improved with the CGI-I on Day 42. Summary of the number (percentage) of CGI-I responder. Per the protocol, the he CGI is a 3-item observer-rated scale that measures illness severity (CGIS), global improvement or change (CGIC) and therapeutic response. The scale requires the clinician to assess how much the patient's illness has improved or worsened relative to a baseline state at the beginning of the intervention.

Time frame: Day 42

Population: Responder(a), n/m(b) : a : Responder was defined as subjects rated as much or very much improved with the CGI-I.~b : n is the number of responders; m is number of subjects who had non-missing results at the visit.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
InjectaferProportion of Patients Rated as Much or Very Much Improved With the Clinical Global Impression (CGI) Performed by Investigator (CGI-I)38 Participants
Normal SalineProportion of Patients Rated as Much or Very Much Improved With the Clinical Global Impression (CGI) Performed by Investigator (CGI-I)25 Participants
p-value: 0.36995% CI: [0.7, 2.63]Regression, Logistic
Secondary

Clinical Global Impression-Improvement (CGI-S) by Subject

Similar to the CGI-I except this is self-reported, 7-item scale for assessment of symptoms after treatment with the rating as: 1, very much improved; 2, much improved; 3, minimally improved; 4, no change; 5, minimally worse; 6, much worse; or 7, very much worse.

Time frame: Day 42

Population: Observed cases (n/m(a) \[%\])~a: n is the number of subjects of the category, m is number of subjects who have non-missing results at the visit.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
InjectaferClinical Global Impression-Improvement (CGI-S) by SubjectMinimal change31 Participants
InjectaferClinical Global Impression-Improvement (CGI-S) by SubjectMinimally worse2 Participants
InjectaferClinical Global Impression-Improvement (CGI-S) by SubjectMuch improved30 Participants
InjectaferClinical Global Impression-Improvement (CGI-S) by SubjectMuch worse3 Participants
InjectaferClinical Global Impression-Improvement (CGI-S) by SubjectNo Change10 Participants
InjectaferClinical Global Impression-Improvement (CGI-S) by SubjectVery much worse1 Participants
InjectaferClinical Global Impression-Improvement (CGI-S) by SubjectVery much improved10 Participants
Normal SalineClinical Global Impression-Improvement (CGI-S) by SubjectVery much worse1 Participants
Normal SalineClinical Global Impression-Improvement (CGI-S) by SubjectVery much improved7 Participants
Normal SalineClinical Global Impression-Improvement (CGI-S) by SubjectMuch improved19 Participants
Normal SalineClinical Global Impression-Improvement (CGI-S) by SubjectMinimal change16 Participants
Normal SalineClinical Global Impression-Improvement (CGI-S) by SubjectNo Change12 Participants
Normal SalineClinical Global Impression-Improvement (CGI-S) by SubjectMinimally worse11 Participants
Normal SalineClinical Global Impression-Improvement (CGI-S) by SubjectMuch worse4 Participants
Secondary

Fatigue Linear Analog Scale Change From Baseline

The Fatigue Linear Analog Scale is a self-assessment scale in which a 100 mm line is used to measure the severity of fatigue and its effect on a person's activities and lifestyle. The scale severity measure ranges from No Fatigue to Worst Possible Fatigue.

Time frame: Baseline and Day 42

Population: One subject did not receive study drug and was excluded from the Safety and Full Analysis Set Populations.

ArmMeasureGroupValue (MEAN)Dispersion
InjectaferFatigue Linear Analog Scale Change From BaselineBaseline49.78 units on a scaleStandard Deviation 26.32
InjectaferFatigue Linear Analog Scale Change From BaselineDay 4238.90 units on a scaleStandard Deviation 26.25
InjectaferFatigue Linear Analog Scale Change From BaselineChange from Baseline to Day 42-9.98 units on a scaleStandard Deviation 27.55
Normal SalineFatigue Linear Analog Scale Change From BaselineBaseline57.34 units on a scaleStandard Deviation 23.61
Normal SalineFatigue Linear Analog Scale Change From BaselineDay 4242.57 units on a scaleStandard Deviation 27.13
Normal SalineFatigue Linear Analog Scale Change From BaselineChange from Baseline to Day 42-16.50 units on a scaleStandard Deviation 28.32
Secondary

Medical Outcomes Study(MOS) Sleep Scale Change From Baseline to Day 42

The MOS-Sleep scale, is a 12-item standardized, validated questionnaire for assessing sleep disturbance, sleep adequacy, somnolence, quantity of sleep, snoring, and awakening short of breath or with a headache which has been demonstrated to be sensitive to RLS treatment effects. This questionnaire provides information about sleep quality. Individual questions can be used for analysis but summary or index scores of a group of questions, is more commonly used in analysis. The quantity of sleep dimension is the average number of hours of sleep per night reported by the patient and the optimal sleep is a dichotomized version that is yes when the number of hours of sleep is 7 or 8. The scores of the dimensions and of the sleep problem index were converted to a 0 to 100 scale, with higher scores reflecting more of the attribute implied by the name (e.g. greater sleep disturbance, greater adequacy of sleep).

Time frame: Change from Baseline and Day 42.

Population: Only participants with Sleep disturbance are included.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
InjectaferMedical Outcomes Study(MOS) Sleep Scale Change From Baseline to Day 42-13.086 score on a scaleStandard Error 1.829
Normal SalineMedical Outcomes Study(MOS) Sleep Scale Change From Baseline to Day 42-9.015 score on a scaleStandard Error 1.902
Comparison: LOCF, ANCOVA Analysisp-value: 0.110895% CI: [-9.083, 0.941]ANCOVA
Secondary

Restless Legs Syndrome Quality of Life (RLS-QLI) Change From Baseline to Day 42.

The Restless Legs Syndrome Quality of Life (RLS-QLI) instrument, a self-assessment, 17-item questionnaire with four scales identified through factor analysis: Daily Function, Social Function, Sleep Quality, and Emotional Well-Being, developed to facilitate clinical research on RLS. Scoring Instructions below: 1. Social Function = Sum (Items 1, 2, 3, 4), subtract 4, divide by 16, multiply by 100 2. Daily Function = Sum (Items 5, 6, 13,14, 15, 16), subtract 6, divide by 24, multiply by 100 3. Sleep Quality = Sum (Item 7, 8, 9, 17), subtract 4, divide by 18, multiply by 100 4. Emotional Well-being = Sum (Items 10, 11, 12), subtract 3, divide by 12, multiply by 100 Note: Resulting scores range between 0-100. Higher scores on the RLS-QLI indicate a lower quality of life. Lower scores indicate a higher quality of life.

Time frame: Baseline and Day 42

Population: One subject did not receive study drug and was excluded from the Safety and Full Analysis Set Populations.

ArmMeasureGroupValue (MEAN)Dispersion
InjectaferRestless Legs Syndrome Quality of Life (RLS-QLI) Change From Baseline to Day 42.Baseline55.6 units on a scaleStandard Deviation 15
InjectaferRestless Legs Syndrome Quality of Life (RLS-QLI) Change From Baseline to Day 42.Day 4265.2 units on a scaleStandard Deviation 15.49
InjectaferRestless Legs Syndrome Quality of Life (RLS-QLI) Change From Baseline to Day 42.Change from Baseline to Day 429.0 units on a scaleStandard Deviation 12.48
Normal SalineRestless Legs Syndrome Quality of Life (RLS-QLI) Change From Baseline to Day 42.Baseline54.3 units on a scaleStandard Deviation 13.08
Normal SalineRestless Legs Syndrome Quality of Life (RLS-QLI) Change From Baseline to Day 42.Day 4262.8 units on a scaleStandard Deviation 14.9
Normal SalineRestless Legs Syndrome Quality of Life (RLS-QLI) Change From Baseline to Day 42.Change from Baseline to Day 428.7 units on a scaleStandard Deviation 14.61
Secondary

Time Off Pre-Enrollment Prescribed Restless Legs Syndrome (RLS) Medications

Subjects could start tapering off pre-enrollment prescribed RLS medications after Day 5 until Day 365.

Time frame: Time from Day 5 to Day 365

Population: Full Analysis Set Population. Subjects who discontinued or completed the study before an intervention were censored at the last study visit.~Subjects Receiving RLS Intervention after Day 5.

ArmMeasureValue (MEAN)
InjectaferTime Off Pre-Enrollment Prescribed Restless Legs Syndrome (RLS) Medications34 days
Normal SalineTime Off Pre-Enrollment Prescribed Restless Legs Syndrome (RLS) Medications61 days
p-value: 0.0002Chi-squared, Corrected

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026