Iron Deficiency Anaemia, Iron Deficiency Anemia
Conditions
Keywords
Iron Deficiency Anaemia, Iron Deficiency Anemia, IDA, Intravenous iron replacement therapy, Iron isomaltoside, Ferric derisomaltose, Monofer, Monoferric, Monover, Monofar, Monoferro
Brief summary
Evaluate safety and efficacy of iron isomaltoside/ferric derisomaltose (Monofer®/Monoferric®) compared with iron sucrose (Venofer®), in subjects diagnosed with IDA.
Detailed description
IDA is highly prevalent condition in subjects with cancer and gastrointestinal diseases such as inflammatory bowel diseases, menstruating or pregnant women, and subjects who have undergone bariatric procedure or surgery. IDA can have a substantial medical and quality of life (QoL) burden. Treatment of subjects diagnosed with IDA includes controlling the bleeding and replenishing lost iron. This study was designed to evaluate the safety and efficacy of iron isomaltoside/ferric derisomaltose compared with iron sucrose in subjects diagnosed with IDA. In a subfraction of 35 subjects treated with iron isomaltoside/ferric derisomaltose, ECG and iron will be frequently measured. The study subjects received either a single intravenous (IV) dose of iron isomaltoside/ferric derisomaltose (1000 mg at baseline) or iron sucrose (200 mg IV injections at baseline and repeated according to standard practice or physician choice up to a maximum of five times within the first two weeks starting at baseline; a cumulative dose of 1000 mg was recommended). The study subjects were monitored for up to 8 weeks from baseline.
Interventions
Iron isomaltoside/ferric derisomaltose (Monofer®/Monoferric®; 100 mg/mL) was the test product in this trial. The dose of iron isomaltoside/ferric derisomaltose for the individual subject was set to 1000 mg. The dose was diluted in 100 mL 0.9 % sodium chloride (100 mL bags) and administered as a single IV infusion over approximately 20 minutes.
Iron sucrose (Venofer®; 20 mg elemental iron/mL) was the comparator in this trial. Iron sucrose was administered as 200 mg undiluted IV injections over approximately 2-5 minutes and repeated according to standard practice or physician choice up to a maximum of five times within the first two weeks starting at baseline. A cumulative dose of 1000 mg was recommended.
Sponsors
Study design
Eligibility
Inclusion criteria
includes: 1. Men or women ≥ 18 years 2. Subjects having IDA caused by different etiologies 3. Subjects with intolerance to oral iron therapy or a need for rapid repletion of iron stores: 4. Haemoglobin (Hb) ≤ 11 g/dL 5. Transferrin Saturation (TSAT) \< 20 % 6. S-ferritin \< 100 ng/mL 7. Willingness to participate and signing the informed consent form
Exclusion criteria
includes : 1. Anemia predominantly caused by factors other than IDA 2. Hemochromatosis or other iron storage disorders 3. Previous serious hypersensitivity reactions to any IV iron compound 4. Erythropoiesis stimulating agent (ESA) treatment 5. Prior to screening or during the trial period; has or will be treated with a red blood cell transfusion, radiotherapy, and/or chemotherapy 6. Will require a surgical procedure that necessitated general anesthesia prior to screening or during the trial period 7. Alanine aminotransferase and/or aspartate aminotransferase \> 3 times upper limit of normal 8. Required dialysis for treatment of chronic kidney disease (CKD) 9. Alcohol or drug abuse within the past 6 months 10. Pregnant or nursing women
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Hemoglobin (Hb) From Baseline to Week 8 | Baseline to week 8 | Efficacy Evaluate the effect on the hemoglobin (Hb) level following treatment with iron isomaltoside/ferric derisomaltose vs iron sucrose in subjects with iron deficiency anaemia (IDA) . Response was defined as change from baseline in hemoglobin (Hb) to week 8, i.e. ability to increase Hb in subjects with IDA, when oral iron preparations were ineffective or could not be used or in whom the screening Hb measurement in Investigators' opinion were sufficiently low to require rapid repletion of iron stores. |
| Incidence of Protocol-defined Serious or Severe Hypersensitivity Reactions | Baseline to week 8 | Safety For this endpoint, the number of participants with serious or severe hypersensitivity reactions were evaluated. The hypersensitivity reactions that were included in the analysis were those that started on or after the first dose of randomised treatment (i.e. treatment emergent). The terms used to define hypersensitivity were those specified by the Standardised MedDRA Queries (SMQ) for hypersensitivity, plus four additional terms: loss of consciousness, seizure, syncope, unresponsiveness. The potential hypersensitivity AEs were adjudicated in a blinded fashion by an independent Clinical Endpoint Adjudication Committee (CEAC). Results show only those participants that had adjudicated and confirmed serious or severe hypersensitivity reactions. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| S-phosphate <2 mg/dL at Any Time From Baseline to Week 1, 2, 4, and 8 | Baseline, week 1, 2, 4, and 8 | Safety Results show the number of subjects who had s-phosphate \<2 mg/dL at any time from baseline to week 1, 2, 4, or 8. |
| Hb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8 | Baseline, week 1, 2, 4, and 8 | Efficacy Results show responders to the treatment. A subject was considered a Hb responder to a certain week if an increase in Hb of at least 2 g/dL from baseline to the week in question was observed (week 1, 2, 4, and 8). |
| Time to Change in Hb Concentration ≥2 g/dL | Baseline, week 1, 2, 4, and 8 | Efficacy Time to change in Hb concentration ≥2 g/dL. Subjects who achieved Hb concentration increase of ≥2 g/dL (from baseline to week 1, 2, 4, or 8). For responders, time to Hb response was defined as the scheduled time from baseline until the visit where the first Hb response was measured. |
| Hb Concentration of >12 g/dL at Any Time From Week 1 to Week 8 | Week 1 to week 8 | Efficacy Hb concentration of \>12 g/dL at any time from week 1 to week 8. Results show the number of participants who achieved Hb concentration of \>12 g/dL at any time from week 1 to week 8. |
| Hb Concentration Increase of ≥2 g/dL at Any Time From Week 1 to Week 8 | Week 1 to week 8 | Efficacy Results show the number of participants who achieved Hb concentration increase of ≥2 g/dL at any time from week 1 to week 8. |
| S-Ferritin Concentration of ≥100 ng/mL and Transferrin Saturation (TSAT) of 20-50% at Any Time From Week 1 to Week 8 | Week 1 to week 8 | Efficacy Proportion of subjects reaching the composite endpoint of s-ferritin concentration ≥100 ng/mL and TSAT of 20-50% at any time from week 1 to 8. |
| Change in Hb Concentration From Baseline to Week 1, 2, and 4 | Baseline, week 1, 2, and 4 | Efficacy Change in Hb concentration from baseline to week 1, 2, and 4. |
| Change in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8 | Baseline, week 1, 2, 4, and 8 | Efficacy Change in s-ferritin concentration from baseline to weeks 1, 2, 4, and 8. |
| Composite Cardiovascular Adverse Events (AEs) | Baseline, week 1, 2, and 8 | Safety Results show the composite cardiovascular adverse events (AEs), that started on or after the first dose of randomised treatment (i.e. treatment emergent) up to week 8. The reported potential cardiovascular AEs were adjudicated in a blinded fashion by an independent Clinical Endpoint Adjudication Committee (CEAC). The potential cardiovascular AEs included the following: * Death due to any cause * Non-fatal myocardial infarction * Non-fatal stroke * Unstable angina requiring hospitalisation * Congestive heart failure requiring hospitalisation or medical intervention * Arrhythmias * Hypertension * Hypotension Results show only those participants that had adjudicated and confirmed treatment-emergent composite cardiovascular AEs. |
| Change in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8 | Baseline, week 1, 2, 4, and 8 | Efficacy Changes in the concentrations of serum iron (s-iron) from baseline to week 1, 2, 4, and 8. |
| Change in Fatigue Symptoms From Baseline to Week 1, 2, and 8 | Baseline, week 1, 2, and 8 | Efficacy Change in fatigue symptoms from baseline to week 1, 2, and 8 was measured by the Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale. The Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale consisted of 13 items ranging from 0 (not at all) to 4 (very much), except items #7 and #8 which are reversed scored. The total score range is 0-52. A score of less than 30 indicated severe fatigue, and the higher the score, the better outcome/quality of life (QoL). If more than 50% of the items for a subject at a given visit were missing, the total score was not calculated. Total score was calculated as shown below: Total score= Sum of individual scores x 13 / Number of items answered |
| Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Cost of Public Transport/Taxi And Parking | Baseline | Pharmacoeconomics The Intervals in Screening for Diabetic Retinopathy (ISDR) questionnaire at the baseline visit assessed the resources used by subjects to receive treatment. Resources used on other trial activities were not included. ISDR responses were summarised using descriptive statistics. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the 2 treatment groups is different, however, (i.e. up to a factor 5 in the iron sucrose treatment group). |
| Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Return Journey by Car | Baseline | Pharmacoeconomics The Intervals in Screening for Diabetic Retinopathy (ISDR) questionnaire at the baseline visit assessed the resources used by subjects to receive treatment. Resources used on other trial activities were not included. ISDR responses were summarised using descriptive statistics. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the 2 treatment groups is different, however, (i.e. up to a factor 5 in the iron sucrose treatment group). |
| Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Time Spent on Visit/Helping on Visit | Baseline | Pharmacoeconomics The Intervals in Screening for Diabetic Retinopathy (ISDR) questionnaire at the baseline visit assessed the resources used by subjects to receive treatment. Resources used on other trial activities were not included. ISDR responses were summarised using descriptive statistics. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the 2 treatment groups is different, however, (i.e. up to a factor 5 in the iron sucrose treatment group). |
| Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend Visits | Baseline | Pharmacoeconomics The Intervals in Screening for Diabetic Retinopathy (ISDR) questionnaire at the baseline visit assessed the resources used by subjects to receive treatment. Resources used on other trial activities were not included. ISDR responses were summarised using descriptive statistics. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the 2 treatment groups is different, however, (i.e. up to a factor 5 in the iron sucrose treatment group). |
| Health Care Resource Use Questionnaire | Baseline | Pharmacoeconomics Resources used by the health care staff (per administration), measured by the health care resource use questionnaire. The questionnaire assessed the time used by the health care staff during administration of the investigational product and the administration time (including the observational time). The health care participants included in the evaluation were: investigator, pharmacist, physician, study coordinator, study nurse. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the treatment groups is different (i.e. up to a factor 5 more frequent in the iron sucrose treatment group). |
| Change in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8 | Baseline, week 1, 2, 4, and 8 | Efficacy Changes in transferrin saturation (TSAT) from baseline to week 1, 2, 4, and 8. TSAT is the value of serum iron divided by the total iron-binding capacity and the unit is %, which referrers to % of iron-binding sites of transferrin being occupied by iron. |
| Time to First Composite Cardiovascular Safety AE | Baseline, week 1, 2, 4, and 8 | Safety Time to first composite cardiovascular AE was defined as the actual time in days from first dose of treatment until the date of the composite cardiovascular AE. For subjects not reporting a composite cardiovascular AE, the time was censored at the date of the last attended visit. Only the adjudicated and confirmed composite cardiovascular safety AEs, as judged by the CEAC, were considered for this endpoint. Time to first composite cardiovascular AE was defined as the actual time in days from first dose of treatment until the date of the composite cardiovascular AE. For subjects not reporting a composite cardiovascular AE, the time was censored at the date of the last attended visit. |
Countries
United States
Participant flow
Recruitment details
A total of 3108 subjects were screened and 1512 subjects were randomised in the trial.
Pre-assignment details
Subjects who did not have a documented history of intolerance of oral iron for at least 1 month within the last 9 months had a run-in period. During the run-in period, the subject received oral iron for up to 1 month in order to document intolerance or lack of response to oral iron.Subjects were monitored for AEs indicative of iron intolerance.
Participants by arm
| Arm | Count |
|---|---|
| Iron Isomaltoside/Ferric Derisomaltose Iron isomaltoside/ferric derisomaltose, administered IV | 1,009 |
| Iron Sucrose Iron sucrose, administered IV | 503 |
| Total | 1,512 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 7 | 3 |
| Overall Study | Death | 1 | 0 |
| Overall Study | Enrolment error | 0 | 1 |
| Overall Study | Lack of Efficacy | 1 | 0 |
| Overall Study | Lost to Follow-up | 49 | 21 |
| Overall Study | No treatment | 7 | 2 |
| Overall Study | Physician Decision | 9 | 4 |
| Overall Study | Protocol Violation | 0 | 2 |
| Overall Study | Sponsor decision | 0 | 1 |
| Overall Study | Withdrawal by Subject | 28 | 20 |
Baseline characteristics
| Characteristic | Iron Sucrose | Iron Isomaltoside/Ferric Derisomaltose | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 63 Participants | 107 Participants | 170 Participants |
| Age, Categorical Between 18 and 65 years | 440 Participants | 902 Participants | 1342 Participants |
| Age, Continuous | 43.8 years STANDARD_DEVIATION 14.4 | 44.1 years STANDARD_DEVIATION 14.8 | 44.0 years STANDARD_DEVIATION 14.7 |
| Current smoker NO | 423 Participants | 876 Participants | 1299 Participants |
| Current smoker YES | 80 Participants | 133 Participants | 213 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 205 Participants | 387 Participants | 592 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 298 Participants | 622 Participants | 920 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race/Ethnicity, Customized Arabic | 2 Participants | 0 Participants | 2 Participants |
| Race/Ethnicity, Customized Caucasian | 1 Participants | 0 Participants | 1 Participants |
| Race/Ethnicity, Customized Haitian | 1 Participants | 0 Participants | 1 Participants |
| Race/Ethnicity, Customized Hispanic | 3 Participants | 3 Participants | 6 Participants |
| Race/Ethnicity, Customized Latino | 0 Participants | 1 Participants | 1 Participants |
| Race/Ethnicity, Customized Mix race (Black & White) | 0 Participants | 3 Participants | 3 Participants |
| Race/Ethnicity, Customized Other (not declared) | 2 Participants | 1 Participants | 3 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 1 Participants | 4 Participants | 5 Participants |
| Race (NIH/OMB) Asian | 4 Participants | 8 Participants | 12 Participants |
| Race (NIH/OMB) Black or African American | 223 Participants | 484 Participants | 707 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 3 Participants | 3 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 2 Participants | 1 Participants | 3 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 9 Participants | 5 Participants | 14 Participants |
| Race (NIH/OMB) White | 264 Participants | 504 Participants | 768 Participants |
| Region of Enrollment United States | 503 participants | 1009 participants | 1512 participants |
| Sex: Female, Male Female | 456 Participants | 892 Participants | 1348 Participants |
| Sex: Female, Male Male | 47 Participants | 117 Participants | 164 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 1 / 989 | 0 / 494 |
| other Total, other adverse events | 31 / 989 | 16 / 494 |
| serious Total, serious adverse events | 21 / 989 | 13 / 494 |
Outcome results
Change in Hemoglobin (Hb) From Baseline to Week 8
Efficacy Evaluate the effect on the hemoglobin (Hb) level following treatment with iron isomaltoside/ferric derisomaltose vs iron sucrose in subjects with iron deficiency anaemia (IDA) . Response was defined as change from baseline in hemoglobin (Hb) to week 8, i.e. ability to increase Hb in subjects with IDA, when oral iron preparations were ineffective or could not be used or in whom the screening Hb measurement in Investigators' opinion were sufficiently low to require rapid repletion of iron stores.
Time frame: Baseline to week 8
Population: Intention to treat (ITT). All randomised subjects.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | Change in Hemoglobin (Hb) From Baseline to Week 8 | 2.49 g/dL |
| Iron Sucrose | Change in Hemoglobin (Hb) From Baseline to Week 8 | 2.49 g/dL |
Incidence of Protocol-defined Serious or Severe Hypersensitivity Reactions
Safety For this endpoint, the number of participants with serious or severe hypersensitivity reactions were evaluated. The hypersensitivity reactions that were included in the analysis were those that started on or after the first dose of randomised treatment (i.e. treatment emergent). The terms used to define hypersensitivity were those specified by the Standardised MedDRA Queries (SMQ) for hypersensitivity, plus four additional terms: loss of consciousness, seizure, syncope, unresponsiveness. The potential hypersensitivity AEs were adjudicated in a blinded fashion by an independent Clinical Endpoint Adjudication Committee (CEAC). Results show only those participants that had adjudicated and confirmed serious or severe hypersensitivity reactions.
Time frame: Baseline to week 8
Population: Safety analysis set. All randomised subjects who received at least one dose of the investigational product.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | Incidence of Protocol-defined Serious or Severe Hypersensitivity Reactions | 3 Participants |
| Iron Sucrose | Incidence of Protocol-defined Serious or Severe Hypersensitivity Reactions | 2 Participants |
Change in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8
Efficacy Changes in the concentrations of serum iron (s-iron) from baseline to week 1, 2, 4, and 8.
Time frame: Baseline, week 1, 2, 4, and 8
Population: ITT. All randomised subjects.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | Change in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8 | Week 4 | 31.2 μg/dL | Standard Deviation 49.7 |
| Iron Isomaltoside/Ferric Derisomaltose | Change in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8 | Week 1 | 63.2 μg/dL | Standard Deviation 69.7 |
| Iron Isomaltoside/Ferric Derisomaltose | Change in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8 | Week 2 | 38.8 μg/dL | Standard Deviation 58.1 |
| Iron Isomaltoside/Ferric Derisomaltose | Change in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8 | Week 8 | 24.2 μg/dL | Standard Deviation 53.3 |
| Iron Sucrose | Change in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8 | Week 8 | 27.6 μg/dL | Standard Deviation 32.7 |
| Iron Sucrose | Change in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8 | Week 4 | 35.1 μg/dL | Standard Deviation 33.2 |
| Iron Sucrose | Change in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8 | Week 2 | 37.0 μg/dL | Standard Deviation 51.6 |
| Iron Sucrose | Change in Concentrations of Serum Iron (S-iron) From Baseline to Week 1, 2, 4, and 8 | Week 1 | 22.4 μg/dL | Standard Deviation 44.4 |
Change in Fatigue Symptoms From Baseline to Week 1, 2, and 8
Efficacy Change in fatigue symptoms from baseline to week 1, 2, and 8 was measured by the Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale. The Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale consisted of 13 items ranging from 0 (not at all) to 4 (very much), except items #7 and #8 which are reversed scored. The total score range is 0-52. A score of less than 30 indicated severe fatigue, and the higher the score, the better outcome/quality of life (QoL). If more than 50% of the items for a subject at a given visit were missing, the total score was not calculated. Total score was calculated as shown below: Total score= Sum of individual scores x 13 / Number of items answered
Time frame: Baseline, week 1, 2, and 8
Population: ITT. All randomised subjects.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | Change in Fatigue Symptoms From Baseline to Week 1, 2, and 8 | Week 1 | 7.98 score on a scale | Standard Deviation 10.41 |
| Iron Isomaltoside/Ferric Derisomaltose | Change in Fatigue Symptoms From Baseline to Week 1, 2, and 8 | Week 2 | 10.74 score on a scale | Standard Deviation 11.58 |
| Iron Isomaltoside/Ferric Derisomaltose | Change in Fatigue Symptoms From Baseline to Week 1, 2, and 8 | Week 8 | 14.08 score on a scale | Standard Deviation 12.7 |
| Iron Sucrose | Change in Fatigue Symptoms From Baseline to Week 1, 2, and 8 | Week 2 | 11.89 score on a scale | Standard Deviation 11.35 |
| Iron Sucrose | Change in Fatigue Symptoms From Baseline to Week 1, 2, and 8 | Week 1 | 7.38 score on a scale | Standard Deviation 9.38 |
| Iron Sucrose | Change in Fatigue Symptoms From Baseline to Week 1, 2, and 8 | Week 8 | 15.36 score on a scale | Standard Deviation 12.87 |
Change in Hb Concentration From Baseline to Week 1, 2, and 4
Efficacy Change in Hb concentration from baseline to week 1, 2, and 4.
Time frame: Baseline, week 1, 2, and 4
Population: ITT. All randomised subjects.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | Change in Hb Concentration From Baseline to Week 1, 2, and 4 | Week 2 | 1.49 g/dL | Standard Deviation 1.13 |
| Iron Isomaltoside/Ferric Derisomaltose | Change in Hb Concentration From Baseline to Week 1, 2, and 4 | Week 1 | 0.70 g/dL | Standard Deviation 0.85 |
| Iron Isomaltoside/Ferric Derisomaltose | Change in Hb Concentration From Baseline to Week 1, 2, and 4 | Week 4 | 2.15 g/dL | Standard Deviation 1.27 |
| Iron Sucrose | Change in Hb Concentration From Baseline to Week 1, 2, and 4 | Week 1 | 0.47 g/dL | Standard Deviation 0.69 |
| Iron Sucrose | Change in Hb Concentration From Baseline to Week 1, 2, and 4 | Week 2 | 1.25 g/dL | Standard Deviation 0.93 |
| Iron Sucrose | Change in Hb Concentration From Baseline to Week 1, 2, and 4 | Week 4 | 2.13 g/dL | Standard Deviation 1.1 |
Change in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8
Efficacy Change in s-ferritin concentration from baseline to weeks 1, 2, 4, and 8.
Time frame: Baseline, week 1, 2, 4, and 8
Population: ITT. All randomised subjects.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | Change in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8 | Week 1 | 373.5 ng/mL | Standard Deviation 228.9 |
| Iron Isomaltoside/Ferric Derisomaltose | Change in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8 | Week 2 | 211.8 ng/mL | Standard Deviation 152.4 |
| Iron Isomaltoside/Ferric Derisomaltose | Change in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8 | Week 4 | 98.0 ng/mL | Standard Deviation 103.9 |
| Iron Isomaltoside/Ferric Derisomaltose | Change in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8 | Week 8 | 49.0 ng/mL | Standard Deviation 79.7 |
| Iron Sucrose | Change in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8 | Week 8 | 58.7 ng/mL | Standard Deviation 104.8 |
| Iron Sucrose | Change in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8 | Week 1 | 105.7 ng/mL | Standard Deviation 79.1 |
| Iron Sucrose | Change in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8 | Week 4 | 109.2 ng/mL | Standard Deviation 108.7 |
| Iron Sucrose | Change in S-ferritin Concentration From Baseline to Weeks 1, 2, 4, and 8 | Week 2 | 169.9 ng/mL | Standard Deviation 129.8 |
Change in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8
Efficacy Changes in transferrin saturation (TSAT) from baseline to week 1, 2, 4, and 8. TSAT is the value of serum iron divided by the total iron-binding capacity and the unit is %, which referrers to % of iron-binding sites of transferrin being occupied by iron.
Time frame: Baseline, week 1, 2, 4, and 8
Population: ITT. All randomised subjects.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | Change in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8 | Week 1 | 16.68 percentage of saturation | Standard Deviation 15.66 |
| Iron Isomaltoside/Ferric Derisomaltose | Change in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8 | Week 2 | 12.33 percentage of saturation | Standard Deviation 13.46 |
| Iron Isomaltoside/Ferric Derisomaltose | Change in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8 | Week 4 | 11.63 percentage of saturation | Standard Deviation 12.09 |
| Iron Isomaltoside/Ferric Derisomaltose | Change in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8 | Week 8 | 9.01 percentage of saturation | Standard Deviation 12.58 |
| Iron Sucrose | Change in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8 | Week 8 | 8.87 percentage of saturation | Standard Deviation 9.03 |
| Iron Sucrose | Change in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8 | Week 1 | 5.84 percentage of saturation | Standard Deviation 10.52 |
| Iron Sucrose | Change in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8 | Week 4 | 11.08 percentage of saturation | Standard Deviation 8.59 |
| Iron Sucrose | Change in Transferrin Saturation (TSAT) From Baseline to Week 1, 2, 4, and 8 | Week 2 | 10.58 percentage of saturation | Standard Deviation 12.67 |
Composite Cardiovascular Adverse Events (AEs)
Safety Results show the composite cardiovascular adverse events (AEs), that started on or after the first dose of randomised treatment (i.e. treatment emergent) up to week 8. The reported potential cardiovascular AEs were adjudicated in a blinded fashion by an independent Clinical Endpoint Adjudication Committee (CEAC). The potential cardiovascular AEs included the following: * Death due to any cause * Non-fatal myocardial infarction * Non-fatal stroke * Unstable angina requiring hospitalisation * Congestive heart failure requiring hospitalisation or medical intervention * Arrhythmias * Hypertension * Hypotension Results show only those participants that had adjudicated and confirmed treatment-emergent composite cardiovascular AEs.
Time frame: Baseline, week 1, 2, and 8
Population: Safety analysis set. All randomised subjects who received at least one dose of the investigational product.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | Composite Cardiovascular Adverse Events (AEs) | 8 Participants |
| Iron Sucrose | Composite Cardiovascular Adverse Events (AEs) | 6 Participants |
Hb Concentration Increase of ≥2 g/dL at Any Time From Week 1 to Week 8
Efficacy Results show the number of participants who achieved Hb concentration increase of ≥2 g/dL at any time from week 1 to week 8.
Time frame: Week 1 to week 8
Population: ITT. All randomised subjects.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | Hb Concentration Increase of ≥2 g/dL at Any Time From Week 1 to Week 8 | 687 Participants |
| Iron Sucrose | Hb Concentration Increase of ≥2 g/dL at Any Time From Week 1 to Week 8 | 340 Participants |
Hb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8
Efficacy Results show responders to the treatment. A subject was considered a Hb responder to a certain week if an increase in Hb of at least 2 g/dL from baseline to the week in question was observed (week 1, 2, 4, and 8).
Time frame: Baseline, week 1, 2, 4, and 8
Population: ITT. All randomised subjects.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | Hb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8 | Responder YES week 1 | 51 Participants |
| Iron Isomaltoside/Ferric Derisomaltose | Hb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8 | Responder YES week 2 | 297 Participants |
| Iron Isomaltoside/Ferric Derisomaltose | Hb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8 | Responder YES week 4 | 514 Participants |
| Iron Isomaltoside/Ferric Derisomaltose | Hb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8 | Responder YES week 8 | 606 Participants |
| Iron Sucrose | Hb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8 | Responder YES week 8 | 309 Participants |
| Iron Sucrose | Hb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8 | Responder YES week 1 | 12 Participants |
| Iron Sucrose | Hb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8 | Responder YES week 4 | 250 Participants |
| Iron Sucrose | Hb Concentration Increase of ≥2 g/dL From Baseline to Week 1, 2, 4, and 8 | Responder YES week 2 | 94 Participants |
Hb Concentration of >12 g/dL at Any Time From Week 1 to Week 8
Efficacy Hb concentration of \>12 g/dL at any time from week 1 to week 8. Results show the number of participants who achieved Hb concentration of \>12 g/dL at any time from week 1 to week 8.
Time frame: Week 1 to week 8
Population: ITT. All randomised subjects.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | Hb Concentration of >12 g/dL at Any Time From Week 1 to Week 8 | 484 Participants |
| Iron Sucrose | Hb Concentration of >12 g/dL at Any Time From Week 1 to Week 8 | 225 Participants |
Health Care Resource Use Questionnaire
Pharmacoeconomics Resources used by the health care staff (per administration), measured by the health care resource use questionnaire. The questionnaire assessed the time used by the health care staff during administration of the investigational product and the administration time (including the observational time). The health care participants included in the evaluation were: investigator, pharmacist, physician, study coordinator, study nurse. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the treatment groups is different (i.e. up to a factor 5 more frequent in the iron sucrose treatment group).
Time frame: Baseline
Population: ITT. All randomised subjects.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | Health Care Resource Use Questionnaire | Time spent per site staff median | 1.08 hours |
| Iron Isomaltoside/Ferric Derisomaltose | Health Care Resource Use Questionnaire | Time spent per subject median | 3.38 hours |
| Iron Sucrose | Health Care Resource Use Questionnaire | Time spent per site staff median | 1.00 hours |
| Iron Sucrose | Health Care Resource Use Questionnaire | Time spent per subject median | 3.00 hours |
Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Cost of Public Transport/Taxi And Parking
Pharmacoeconomics The Intervals in Screening for Diabetic Retinopathy (ISDR) questionnaire at the baseline visit assessed the resources used by subjects to receive treatment. Resources used on other trial activities were not included. ISDR responses were summarised using descriptive statistics. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the 2 treatment groups is different, however, (i.e. up to a factor 5 in the iron sucrose treatment group).
Time frame: Baseline
Population: ITT. All randomised subjects.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Cost of Public Transport/Taxi And Parking | Cost of public transport/taxi | 5.0 US dollars ($) |
| Iron Isomaltoside/Ferric Derisomaltose | Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Cost of Public Transport/Taxi And Parking | Cost of parking | 0.0 US dollars ($) |
| Iron Sucrose | Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Cost of Public Transport/Taxi And Parking | Cost of public transport/taxi | 5.0 US dollars ($) |
| Iron Sucrose | Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Cost of Public Transport/Taxi And Parking | Cost of parking | 0.0 US dollars ($) |
Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend Visits
Pharmacoeconomics The Intervals in Screening for Diabetic Retinopathy (ISDR) questionnaire at the baseline visit assessed the resources used by subjects to receive treatment. Resources used on other trial activities were not included. ISDR responses were summarised using descriptive statistics. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the 2 treatment groups is different, however, (i.e. up to a factor 5 in the iron sucrose treatment group).
Time frame: Baseline
Population: ITT. All randomised subjects.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend Visits | In employment, YES | 529 participants |
| Iron Isomaltoside/Ferric Derisomaltose | Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend Visits | Took time off work to attend, YES | 233 participants |
| Iron Isomaltoside/Ferric Derisomaltose | Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend Visits | Assistance by others to attend visit, YES | 211 participants |
| Iron Isomaltoside/Ferric Derisomaltose | Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend Visits | Others took time off work to attend, YES | 64 participants |
| Iron Sucrose | Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend Visits | Others took time off work to attend, YES | 32 participants |
| Iron Sucrose | Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend Visits | In employment, YES | 258 participants |
| Iron Sucrose | Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend Visits | Assistance by others to attend visit, YES | 111 participants |
| Iron Sucrose | Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Participants/Others Who Took Time Off Work to Attend Visits | Took time off work to attend, YES | 113 participants |
Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Return Journey by Car
Pharmacoeconomics The Intervals in Screening for Diabetic Retinopathy (ISDR) questionnaire at the baseline visit assessed the resources used by subjects to receive treatment. Resources used on other trial activities were not included. ISDR responses were summarised using descriptive statistics. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the 2 treatment groups is different, however, (i.e. up to a factor 5 in the iron sucrose treatment group).
Time frame: Baseline
Population: ITT. All randomised subjects.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Return Journey by Car | 15.0 miles |
| Iron Sucrose | Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Return Journey by Car | 15.0 miles |
Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Time Spent on Visit/Helping on Visit
Pharmacoeconomics The Intervals in Screening for Diabetic Retinopathy (ISDR) questionnaire at the baseline visit assessed the resources used by subjects to receive treatment. Resources used on other trial activities were not included. ISDR responses were summarised using descriptive statistics. The data for this endpoint show the responses at baseline for both treatment groups. The frequency of drug administration between the 2 treatment groups is different, however, (i.e. up to a factor 5 in the iron sucrose treatment group).
Time frame: Baseline
Population: ITT. All randomised subjects.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Time Spent on Visit/Helping on Visit | Time spent on visit | 2.0 Hours |
| Iron Isomaltoside/Ferric Derisomaltose | Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Time Spent on Visit/Helping on Visit | Total time spent helping on visit | 2.0 Hours |
| Iron Sucrose | Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Time Spent on Visit/Helping on Visit | Time spent on visit | 2.0 Hours |
| Iron Sucrose | Intervals in Screening for Diabetic Retinopathy (ISDR) Questionnaire, Time Spent on Visit/Helping on Visit | Total time spent helping on visit | 2.0 Hours |
S-Ferritin Concentration of ≥100 ng/mL and Transferrin Saturation (TSAT) of 20-50% at Any Time From Week 1 to Week 8
Efficacy Proportion of subjects reaching the composite endpoint of s-ferritin concentration ≥100 ng/mL and TSAT of 20-50% at any time from week 1 to 8.
Time frame: Week 1 to week 8
Population: ITT. All randomised subjects.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | S-Ferritin Concentration of ≥100 ng/mL and Transferrin Saturation (TSAT) of 20-50% at Any Time From Week 1 to Week 8 | 680 Participants |
| Iron Sucrose | S-Ferritin Concentration of ≥100 ng/mL and Transferrin Saturation (TSAT) of 20-50% at Any Time From Week 1 to Week 8 | 164 Participants |
S-phosphate <2 mg/dL at Any Time From Baseline to Week 1, 2, 4, and 8
Safety Results show the number of subjects who had s-phosphate \<2 mg/dL at any time from baseline to week 1, 2, 4, or 8.
Time frame: Baseline, week 1, 2, 4, and 8
Population: Safety analysis set. All randomised subjects who received at least one dose of the investigational product.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | S-phosphate <2 mg/dL at Any Time From Baseline to Week 1, 2, 4, and 8 | 38 Participants |
| Iron Sucrose | S-phosphate <2 mg/dL at Any Time From Baseline to Week 1, 2, 4, and 8 | 11 Participants |
Time to Change in Hb Concentration ≥2 g/dL
Efficacy Time to change in Hb concentration ≥2 g/dL. Subjects who achieved Hb concentration increase of ≥2 g/dL (from baseline to week 1, 2, 4, or 8). For responders, time to Hb response was defined as the scheduled time from baseline until the visit where the first Hb response was measured.
Time frame: Baseline, week 1, 2, 4, and 8
Population: ITT. All randomised subjects.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | Time to Change in Hb Concentration ≥2 g/dL | 28 Days |
| Iron Sucrose | Time to Change in Hb Concentration ≥2 g/dL | 28 Days |
Time to First Composite Cardiovascular Safety AE
Safety Time to first composite cardiovascular AE was defined as the actual time in days from first dose of treatment until the date of the composite cardiovascular AE. For subjects not reporting a composite cardiovascular AE, the time was censored at the date of the last attended visit. Only the adjudicated and confirmed composite cardiovascular safety AEs, as judged by the CEAC, were considered for this endpoint. Time to first composite cardiovascular AE was defined as the actual time in days from first dose of treatment until the date of the composite cardiovascular AE. For subjects not reporting a composite cardiovascular AE, the time was censored at the date of the last attended visit.
Time frame: Baseline, week 1, 2, 4, and 8
Population: Safety analysis set. All randomised subjects who received at least one dose of the investigational product.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Iron Isomaltoside/Ferric Derisomaltose | Time to First Composite Cardiovascular Safety AE | NA Week |
| Iron Sucrose | Time to First Composite Cardiovascular Safety AE | NA Week |