Iron Deficiency Anemia
Conditions
Keywords
Functional Iron Deficiency Anemia (Functional IDA), Myelodysplastic Syndromes (MDS), Myelofibrosis (MF), Myelodysplastic Syndrome (MDS), Myeloproliferative Neoplasm Overlap Syndromes (MPN)
Brief summary
This study aims to explore the safety and preliminary efficacy of a response-guided dose titration of KER-047 in the treatment of functional IDA (Iron deficiency anemia) in MDS (Myelodysplastic syndrome), MF(Myelofibrosis), and MDS/MPN (Myeloproliferative neoplasm) overlap syndromes.
Detailed description
This is a Phase 2 multicenter, open-label study being conducted to evaluate the safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PD), and preliminary efficacy of response-guided dose titration of KER-047 in adult participants with functional iron deficiency anemia (IDA) associated with myelodysplastic syndrome (MDS), myelofibrosis (MF), and myelodysplastic syndrome/myeloproliferative neoplasm (MDS/MPN) overlap syndromes. Approximately 20 patients will be enrolled. Dosing of KER-047 may be adjusted based on safety/tolerability and treatment response. The study will be conducted in 2 parts: Part 1 Initial Titration Strategy and Part 2 Cohort Expansion or Alternate Titration Strategy. The total planned duration of participation for an individual participant is approximately 32 weeks (4-week screening phase, 24-week treatment period, and 4-week follow-up period). For participants in the extension phase, the maximum duration of participation would be approximately 104 weeks (2 years) (4-week screening phase, 24-week treatment period, 18 month \[72 weeks\] extension period, and 4-week follow-up period).
Interventions
DRUGKER-047
Oral tablet, daily (or every other day) administration
Sponsors
Keros Therapeutics, Inc.
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
2 parts: Part 1 Initial Titration Strategy and Part 2 Cohort Expansion or Alternate Titration Strategy
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Male or female ≥18 years of age, at the time of signing informed consent. * One of the following: 1. Diagnosis of MDS according to the 2016 World Health Organization (WHO) classification that meets Revised International Prognostic Scoring System (IPSS-R) classification of very low, low, or intermediate risk disease with bone marrow blast percentage \<5% within 6 months prior to Day 1 (D1). 2. Diagnosis of primary myelofibrosis, post polycythemia vera MF, or post-essential thrombocytopenia MF according to the 2017 WHO criteria with bone marrow and peripheral blood blast percentage \<2%, or stable between 2% to 5% over 6 months. 3. Diagnosis of MDS/MPN overlap syndromes according to the 2016 WHO classification, with bone marrow blast percentage \<5% within 6 months prior to D1. * Anemia with iron-restricted erythropoiesis as assessed by laboratory criteria during screening. * Ability to understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use protected health information in accordance with national and local study participant privacy regulations. * Females of childbearing potential and sexually active males must meet the contraception requirements as outlined in the protocol.
Exclusion criteria
* Active infection within 14 days of D1. * IPSS-R score indicating high or very high risk MDS, accelerated myelofibrosis (defined as \>10% blasts), or diagnosis of acute leukemia. * Diagnosis of hemolytic anemia. * Diagnosis of porphyria. * Anemia due to blood loss 28 days prior to D1. * Diagnosis of thalassemia, thalassemia trait, or other hemoglobinopathy. * History of drug or alcohol abuse, as defined by the Investigator, within the past 2 years. * History of stroke, arterial embolism, or deep venous thrombosis within 6 months prior to D1. * Known positive for human immunodeficiency virus, active infectious hepatitis B virus or active infectious hepatitis C virus.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Body weight (in kg) | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To determine safety and tolerability of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Dose limiting toxicities (DLTs) | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To determine safety and tolerability of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Percentage of participants experiencing Treatment-related AEs (Adverse events) | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To determine safety and tolerability of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Number of participants discontinuing due to AEs (Adverse events) | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To determine safety and tolerability of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Change from Baseline in clinical laboratory values | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To determine the safety and tolerability based on changes from baseline in select clinical laboratory parameters including: Alkaline phosphatase, Alanine Aminotransferase, Aspartate Aminotransferase, Gamma Glutamyl Transferase, Glucose, Potassium, Sodium, Total bilirubin, Folate, WBC count, Platelet Count, Reticulocyte Count, Transferrin Saturation percentage. Note - Select safety parameters will be listed as separate outcomes during results update. |
| Systolic Blood Pressure | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To determine safety and tolerability of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Diastolic Blood Pressure | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To determine safety and tolerability of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Respiratory rate | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To determine safety and tolerability of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Heart rate | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To determine safety and tolerability of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Body temperature | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To determine safety and tolerability of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Fridericia corrected QT interval via 12-lead Electrocardiogram (ECG) | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To determine safety and tolerability of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| QT interval via 12-lead Electrocardiogram (ECG) | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To determine safety and tolerability of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| QRS interval via 12-lead Electrocardiogram (ECG) | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To determine safety and tolerability of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| PR interval via 12-lead Electrocardiogram (ECG) | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To determine safety and tolerability of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Percentage of participants experiencing Treatment-emergent adverse events (TEAEs) | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To determine safety and tolerability of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline in hepcidin concentration | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To evaluate the Pharmacodynamic (PD) effects of KER-047 on iron metabolism in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Change from baseline in hemoglobin (Hgb) | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To evaluate the effect of KER-047 on anemia in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Proportion of participants who have Hgb increase of ≥1.0 g/dL (0.6 mmol/L) | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To evaluate the effect of KER-047 on anemia in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Proportion of participants who have Hgb increase of ≥1.5 g/dL (0.9 mmol/L) | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To evaluate the effect of KER-047 on anemia in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Proportion of RBC-transfused participants who achieve ≥8 weeks of transfusion independence during any consecutive period up to End of Treatment | Up to 29 weeks or up to 101 weeks if in the treatment extension | To evaluate the effect of KER-047 on anemia in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Plasma KER-047 and any metabolites concentration, summarized by time point | Week 1 and Week 13 in Part 1 and 2 | To evaluate the Pharmacokinetic (PK) of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Estimated peak plasma concentration (Cmax) | Week 1 and Week 13 in Part 1 and 2 | To evaluate the Pharmacokinetic (PK) of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Time to peak plasma concentration (Tmax) | Week 1 and Week 13 in Part 1 and 2 | To evaluate the Pharmacokinetic (PK) of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Area under the plasma KER-047 concentration curve (AUClast) | Week 1 and Week 13 in Part 1 and 2 | To evaluate the Pharmacokinetic (PK) of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Mean trough (Ctrough) plasma KER-047 and metabolites of interest concentration | Up to 25 weeks | To evaluate the Pharmacokinetic (PK) of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Plasma KER-047 and metabolites of interest accumulation (Rac) | Up to 25 weeks | To evaluate the Pharmacokinetic (PK) of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Determination of steady-state (as appropriate) | Up to 25 weeks | To evaluate the Pharmacokinetic (PK) of KER-047 in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
| Change from baseline in reticulocyte hemoglobin content (RET-He) | Up to 29 weeks in Part 1 or up to 101 weeks if continuing in the treatment extension | To evaluate the Pharmacodynamic (PD) effects of KER-047 on iron metabolism in participants with functional IDA associated with MDS, MF, and MDS/MPN overlap syndromes |
Countries
Australia, Israel
Outcome results
None listed