Restless Legs Syndrome
Conditions
Brief summary
The purpose of this study is to to establish proof-of-concept for efficacy of iron isomaltoside 1000 in subjects with Restless Legs Syndrome. The study is a randomised, comparative, double-blind study with a 3 months extension. Subjects with restless leg syndrome (RLS) will be randomised 2:1 to one of the following treat-ment groups: * Group A (42 subjects): 1000 mg iron isomaltoside 1000 * Group B (21 subjects): Placebo infusion Furthermore, non-responders, who continue to meet entry requirements, will receive 1000 mg iron isomaltoside 1000 at week 6.
Detailed description
RLS is a disorder of sensation with a prevalence of around 2-5 % of the population. RLS is extremely responsive to dopaminergic agents, but a second issue is that iron deficiency states may precipitate RLS in as much as 25-30 % of subjects with iron deficiency. RLS appears to be related to deficits in brain iron content and metabolism. Magnetic resonance imaging (MRI) images demonstrate a decrease in substantia nigra and red nucleus iron content. The severity of this decrease in brain iron content is correlated with the severity of symptoms. A number of patients are quite resistant to dietary iron repletion but do resolve symptoms with high doses of intravenous (IV) iron. For the individual subject, there will be 4 phases to the study which includes teleconferences (TCs) and 2 visits. The treatment and treatment evaluation is the main study.
Interventions
Intravenous treatment
DRUGSodium Chloride 0.9%
Intravenous treatment
Sponsors
BioStata
Laboratory Corporation of America
Pharmacosmos A/S
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Age ≥ 18 years 2. Diagnosis of RLS based upon the CH-RLSq and HTDI 3. IRLS score ≥ 15 at baseline evaluation when off RLS medications 4. Willingness to participate and signing the informed consent form
Exclusion criteria
1. S-ferritin \> 300 ng/mL and/or TfS \> 50 % 2. Iron overload or disturbances in utilisation of iron (e.g. haemochromatosis and haemo-siderosis) 3. Known hypersensitivity to IV iron or any excipients in the investigational drug prod-ucts 4. Pregnant or nursing women. In order to avoid pregnancy, women of childbearing po-tential have to use adequate contraception (e.g. intrauterine devices, hormonal contra-ceptives, or double barrier method) during the whole study period and 7 days after the last dosing 5. History of active asthma within the last 5 years 6. Decompensated liver cirrhosis or active hepatitis (defined as ASAT or ALAT \> 3 times upper limit of normal) 7. Active acute or chronic infections (assessed by clinical judgement supplied with WBC and CRP) 8. Rheumatoid arthritis with symptoms or signs of active inflammation 9. Pregnant or nursing women 10. Previous IV iron treatment for RLS 11. IV iron treatment within 1 year prior to screening 12. Blood transfusion within 4 weeks prior to screening 13. Planned elective surgery during the study 14. Participation in any other interventional study where the study drug has not passed 5 half-lives prior to the screening 15. Any other medical condition that, in the opinion of the Investigator, may cause the subject to be unsuitable for the completion of the study or place the subject at potential risk from being in the study, e.g. history of multiple allergies, a malignancy, uncon-trolled hypertension, unstable ischaemic heart disease, or uncontrolled diabetes melli-tus
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To measure the change in RLS symptoms from baseline to week 6 measured by the clinical global impression (CGI) score | 6 weeks |
Secondary
| Measure | Time frame |
|---|---|
| Change in RLS symptoms from baseline to week 4 and month 2 and 3 measured by the CGI score | 3 months |
| Change in RLS symptoms from baseline to week 4 and 6 and month 2 and 3 measured by the International Restless Legs Scale (IRLS) | from baseline to t = 12 weeks |
| Time from baseline to start of RLS medication | from baseline to t = 6 weeks |
| Time from baseline to start of RLS medication or non-response (CGI ≥ 3 at week 6) | from baseline to t = 6 weeks |
Other
| Measure | Time frame | Description |
|---|---|---|
| Type and incidence of adverse drug reactions (ADRs) | from baseline to t = 18 weeks | — |
| Number of adverse events (AEs) of special interest | from baseline to t = 18 weeks | (i.e. hypersensitivity symptoms such as: urticaria, oedema, bronchospasm, hypotension, cardiorespiratory arrest, syn-cope, unresponsiveness, or loss of consciousness at pre-specified time points in relation to administration of study drug) |
| Change in haematology parameters, s-sodium, s-potassium, s-calcium, s-phosphate, s-urea, s-creatinine, s-albumin, s-bilirubin, aspartate aminotransferase (ASAT), and ala-nine aminotransferase (ALAT) from baseline to week 6 and month 3 | from baseline to t = 18 weeks | — |
| Change in vital signs (heart rate and blood pressure) during drug administration | from baseline to t = 18 weeks | — |
| Clinical significant electrocardiogram (ECG) during drug administration | from baseline to t = 18 weeks | — |
Outcome results
None listed