Trial Outcomes & Findings for A Phase III Safety Study of Ferumoxytol Compared to Ferric Carboxymaltose for the Treatment of Iron Deficiency Anemia (IDA) (NCT NCT02694978)

NCT ID: NCT02694978

Last Updated: 2023-07-25

Results Overview

All IV iron formulations carry some risk of serious hypersensitivity reactions or anaphylaxis. Signs and symptoms potentially representing hypersensitivity were recorded and adjudicated by a blinded Clinical Events Committee (CEC). Hypotension is defined as a \>30% drop in systolic blood pressure from baseline or decrease of \>20 mmHg for systolic blood pressure. Statistical analysis was only performed on composite data. A summary of serious and all other non-serious adverse events regardless of causality is located in the Reported Adverse Events module.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

2014 participants

Primary outcome timeframe

Day 1 (after first dosing) through Week 5

Results posted on

2023-07-25

Participant Flow

Participants with iron deficiency anemia (IDA), \<12.0 grams (g) per deciliter (dL) for females and \<14.0 g/dL for males within 60 days of dosing and transferrin saturation (TSAT) \<20% or Ferritin ≤100 nanograms (ng) per milliliter (mL) within 60 days of dosing and a history of unsatisfactory oral iron therapy or in whom oral iron could not be used.

Participant milestones

Participant milestones
Measure
Ferumoxytol
Participants received an IV infusion of ferumoxytol 510 milligram (mg) diluted (17 milliliter \[mL\]) in 233 mL 0.9% sodium chloride injection, United States Pharmacopeia (USP) (normal saline) (final volume 250 mL) over at least 15 minutes with a second dose 7-8 days after the first dose, for a total cumulative dose of 1.020 g.
Ferric Carboxymaltose (FCM)
Participants received an IV infusion of FCM 750 mg diluted (15 mL) in 235 mL 0.9% sodium chloride injection, USP (normal saline) (final volume 250 mL) over at least 15 minutes with a second dose 7-8 days after the first dose, for a total cumulative dose of 1.500 g.
Overall Study
STARTED
1006
1008
Overall Study
Received at Least 1 Dose of Study Drug
997
1000
Overall Study
COMPLETED
935
948
Overall Study
NOT COMPLETED
71
60

Reasons for withdrawal

Reasons for withdrawal
Measure
Ferumoxytol
Participants received an IV infusion of ferumoxytol 510 milligram (mg) diluted (17 milliliter \[mL\]) in 233 mL 0.9% sodium chloride injection, United States Pharmacopeia (USP) (normal saline) (final volume 250 mL) over at least 15 minutes with a second dose 7-8 days after the first dose, for a total cumulative dose of 1.020 g.
Ferric Carboxymaltose (FCM)
Participants received an IV infusion of FCM 750 mg diluted (15 mL) in 235 mL 0.9% sodium chloride injection, USP (normal saline) (final volume 250 mL) over at least 15 minutes with a second dose 7-8 days after the first dose, for a total cumulative dose of 1.500 g.
Overall Study
Adverse Event
10
9
Overall Study
Withdrawal by Subject
22
19
Overall Study
Lost to Follow-up
14
17
Overall Study
Death
4
1
Overall Study
Other-Decision of Participant
6
1
Overall Study
Other-Investigator's decision
1
0
Overall Study
Other-Unable to be reached
0
1
Overall Study
Other-Protocol noncompliant
2
1
Overall Study
Other-Personal reasons
3
3
Overall Study
Other-Withdrew prior to dosing
9
8

Baseline Characteristics

A Phase III Safety Study of Ferumoxytol Compared to Ferric Carboxymaltose for the Treatment of Iron Deficiency Anemia (IDA)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Ferumoxytol
n=997 Participants
Participants received an IV infusion of ferumoxytol 510 mg diluted (17 mL) in 233 mL 0.9% sodium chloride injection, USP (normal saline) (final volume 250 mL) over at least 15 minutes with a second dose 7-8 days after the first dose, for a total cumulative dose of 1.020 g.
Ferric Carboxymaltose (FCM)
n=1000 Participants
Participants received an IV infusion of FCM 750 mg diluted (15 mL) in 235 mL 0.9% sodium chloride injection, USP (normal saline) (final volume 250 mL) over at least 15 minutes with a second dose 7-8 days after the first dose, for a total cumulative dose of 1.500 g.
Total
n=1997 Participants
Total of all reporting groups
Age, Continuous
55.6 years
STANDARD_DEVIATION 17.30 • n=5 Participants
54.8 years
STANDARD_DEVIATION 17.02 • n=7 Participants
55.2 years
STANDARD_DEVIATION 17.16 • n=5 Participants
Sex: Female, Male
Female
743 Participants
n=5 Participants
776 Participants
n=7 Participants
1519 Participants
n=5 Participants
Sex: Female, Male
Male
254 Participants
n=5 Participants
224 Participants
n=7 Participants
478 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Day 1 (after first dosing) through Week 5

Population: The safety population included any randomized participant who received any amount of study drug. Treatment group was based on actual treatment.

All IV iron formulations carry some risk of serious hypersensitivity reactions or anaphylaxis. Signs and symptoms potentially representing hypersensitivity were recorded and adjudicated by a blinded Clinical Events Committee (CEC). Hypotension is defined as a \>30% drop in systolic blood pressure from baseline or decrease of \>20 mmHg for systolic blood pressure. Statistical analysis was only performed on composite data. A summary of serious and all other non-serious adverse events regardless of causality is located in the Reported Adverse Events module.

Outcome measures

Outcome measures
Measure
Ferumoxytol
n=997 Participants
Participants received an IV infusion of ferumoxytol 510 mg diluted (17 mL) in 233 mL 0.9% sodium chloride injection, USP (normal saline) (final volume 250 mL) over at least 15 minutes with a second dose 7-8 days after the first dose, for a total cumulative dose of 1.020 g.
Ferric Carboxymaltose (FCM)
n=1000 Participants
Participants received an IV infusion of FCM 750 mg diluted (15 mL) in 235 mL 0.9% sodium chloride injection, USP (normal saline) (final volume 250 mL) over at least 15 minutes with a second dose 7-8 days after the first dose, for a total cumulative dose of 1.500 g.
Participants With Treatment-Emergent (TE) Moderate To Severe Hypersensitivity Reactions (Rxns), Including Anaphylaxis, Or Moderate To Severe Hypotension
Any TE moderate to severe hypersensitivity rxn
6 Participants
7 Participants
Participants With Treatment-Emergent (TE) Moderate To Severe Hypersensitivity Reactions (Rxns), Including Anaphylaxis, Or Moderate To Severe Hypotension
Moderate hypersensitivity reaction
3 Participants
6 Participants
Participants With Treatment-Emergent (TE) Moderate To Severe Hypersensitivity Reactions (Rxns), Including Anaphylaxis, Or Moderate To Severe Hypotension
Severe hypersensitivity reaction
1 Participants
0 Participants
Participants With Treatment-Emergent (TE) Moderate To Severe Hypersensitivity Reactions (Rxns), Including Anaphylaxis, Or Moderate To Severe Hypotension
Anaphylaxis
0 Participants
0 Participants
Participants With Treatment-Emergent (TE) Moderate To Severe Hypersensitivity Reactions (Rxns), Including Anaphylaxis, Or Moderate To Severe Hypotension
Moderate hypotension
2 Participants
1 Participants
Participants With Treatment-Emergent (TE) Moderate To Severe Hypersensitivity Reactions (Rxns), Including Anaphylaxis, Or Moderate To Severe Hypotension
Severe hypotension
0 Participants
0 Participants

SECONDARY outcome

Timeframe: Day 1 (after first dosing) through Week 5

Population: The safety population included any randomized participant who received any amount of study drug. Treatment group was based on actual treatment.

All IV iron formulations carry some risk of serious hypersensitivity reactions or anaphylaxis. Signs and symptoms potentially representing hypersensitivity were recorded and adjudicated by a blinded Clinical Events Committee (CEC). A summary of serious and all other non-serious adverse events regardless of causality is located in the Reported Adverse Events module.

Outcome measures

Outcome measures
Measure
Ferumoxytol
n=997 Participants
Participants received an IV infusion of ferumoxytol 510 mg diluted (17 mL) in 233 mL 0.9% sodium chloride injection, USP (normal saline) (final volume 250 mL) over at least 15 minutes with a second dose 7-8 days after the first dose, for a total cumulative dose of 1.020 g.
Ferric Carboxymaltose (FCM)
n=1000 Participants
Participants received an IV infusion of FCM 750 mg diluted (15 mL) in 235 mL 0.9% sodium chloride injection, USP (normal saline) (final volume 250 mL) over at least 15 minutes with a second dose 7-8 days after the first dose, for a total cumulative dose of 1.500 g.
Participants With Moderate To Severe Hypersensitivity Reactions, Including Anaphylaxis, Serious Cardiovascular Events, And Death
Moderate hypersensitivity reaction
3 Participants
6 Participants
Participants With Moderate To Severe Hypersensitivity Reactions, Including Anaphylaxis, Serious Cardiovascular Events, And Death
Severe hypersensitivity reaction
1 Participants
0 Participants
Participants With Moderate To Severe Hypersensitivity Reactions, Including Anaphylaxis, Serious Cardiovascular Events, And Death
Anaphylaxis
0 Participants
0 Participants
Participants With Moderate To Severe Hypersensitivity Reactions, Including Anaphylaxis, Serious Cardiovascular Events, And Death
Serious cardiovascular event
6 Participants
13 Participants
Participants With Moderate To Severe Hypersensitivity Reactions, Including Anaphylaxis, Serious Cardiovascular Events, And Death
Death
4 Participants
2 Participants
Participants With Moderate To Severe Hypersensitivity Reactions, Including Anaphylaxis, Serious Cardiovascular Events, And Death
Any moderate to severe hypersensitivity rxn
13 Participants
20 Participants

SECONDARY outcome

Timeframe: Baseline (Day 1), Week 5

Population: Intent-to-treat (ITT) population: any randomized participant who had any exposure to study drug, based on randomized treatment assignment.

Mean change in hemoglobin from Baseline to Week 5 was calculated for each participant as: Hemoglobin Change = Hemoglobin (Week 5) - Hemoglobin (Baseline). Baseline was defined as the Day 1 value (prior to injection of study drug). The screening or most recent value prior to Day 1 was used for any participant with missing Day 1 information.

Outcome measures

Outcome measures
Measure
Ferumoxytol
n=997 Participants
Participants received an IV infusion of ferumoxytol 510 mg diluted (17 mL) in 233 mL 0.9% sodium chloride injection, USP (normal saline) (final volume 250 mL) over at least 15 minutes with a second dose 7-8 days after the first dose, for a total cumulative dose of 1.020 g.
Ferric Carboxymaltose (FCM)
n=1000 Participants
Participants received an IV infusion of FCM 750 mg diluted (15 mL) in 235 mL 0.9% sodium chloride injection, USP (normal saline) (final volume 250 mL) over at least 15 minutes with a second dose 7-8 days after the first dose, for a total cumulative dose of 1.500 g.
Mean Change In Hemoglobin From Baseline To Week 5
1.38 g/dL
Standard Deviation 1.351
1.63 g/dL
Standard Deviation 1.535

SECONDARY outcome

Timeframe: Baseline (Day 1), Week 5

Population: ITT population: any randomized participant who had any exposure to study drug, based on randomized treatment assignment.

Mean change in hemoglobin per g of iron administered from Baseline (Day 1) to Week 5 was calculated for each participant as: Hemoglobin Change = Hemoglobin (Week 5) - Hemoglobin (Baseline). Baseline was defined as the Day 1 value (prior to injection of study drug). The screening or most recent value prior to Day 1 was used for any participant with missing Day 1 information.

Outcome measures

Outcome measures
Measure
Ferumoxytol
n=997 Participants
Participants received an IV infusion of ferumoxytol 510 mg diluted (17 mL) in 233 mL 0.9% sodium chloride injection, USP (normal saline) (final volume 250 mL) over at least 15 minutes with a second dose 7-8 days after the first dose, for a total cumulative dose of 1.020 g.
Ferric Carboxymaltose (FCM)
n=1000 Participants
Participants received an IV infusion of FCM 750 mg diluted (15 mL) in 235 mL 0.9% sodium chloride injection, USP (normal saline) (final volume 250 mL) over at least 15 minutes with a second dose 7-8 days after the first dose, for a total cumulative dose of 1.500 g.
Mean Change In Hemoglobin Per Gram Of Iron Administered From Baseline To Week 5
1.35 g/dL
Standard Deviation 1.353
1.10 g/dL
Standard Deviation 1.050

Adverse Events

Ferumoxytol

Serious events: 36 serious events
Other events: 186 other events
Deaths: 0 deaths

Ferric Carboxymaltose (FCM)

Serious events: 35 serious events
Other events: 245 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Ferumoxytol
n=997 participants at risk
Participants received an IV infusion of ferumoxytol 510 mg diluted (17 mL) in 233 mL 0.9% sodium chloride injection, USP (normal saline) (final volume 250 mL) over at least 15 minutes with a second dose 7-8 days after the first dose, for a total cumulative dose of 1.020 g.
Ferric Carboxymaltose (FCM)
n=1000 participants at risk
Participants received an IV infusion of FCM 750 mg diluted (15 mL) in 235 mL 0.9% sodium chloride injection, USP (normal saline) (final volume 250 mL) over at least 15 minutes with a second dose 7-8 days after the first dose, for a total cumulative dose of 1.500 g.
Nervous system disorders
Seizure
0.20%
2/997
0.00%
0/1000
Nervous system disorders
Syncope
0.30%
3/997
0.30%
3/1000
Infections and infestations
Gastroenteritis
0.30%
3/997
0.10%
1/1000
Infections and infestations
Pneumonia
0.20%
2/997
0.00%
0/1000
Blood and lymphatic system disorders
Haemorrhagic anaemia
0.20%
2/997
0.00%
0/1000
Infections and infestations
Osteomyelitis chronic
0.10%
1/997
0.00%
0/1000
Renal and urinary disorders
Acute kidney injury
0.20%
2/997
0.00%
0/1000
Gastrointestinal disorders
Gastric ulcer haemorrhage
0.10%
1/997
0.10%
1/1000
Blood and lymphatic system disorders
Anaemia vitamin B12 deficiency
0.10%
1/997
0.00%
0/1000
Cardiac disorders
Cardiac failure congestive
0.10%
1/997
0.30%
3/1000
Cardiac disorders
Cardiorespiratory arrest
0.10%
1/997
0.00%
0/1000
Cardiac disorders
Left ventricular failure
0.10%
1/997
0.00%
0/1000
Gastrointestinal disorders
Abdominal pain
0.10%
1/997
0.00%
0/1000
Gastrointestinal disorders
Ascites
0.10%
1/997
0.00%
0/1000
Infections and infestations
Joint abscess
0.10%
1/997
0.00%
0/1000
Gastrointestinal disorders
Pancreatitis acute
0.10%
1/997
0.00%
0/1000
Immune system disorders
Anaphylactic reaction
0.10%
1/997
0.00%
0/1000
Infections and infestations
Anal abscess
0.10%
1/997
0.00%
0/1000
Infections and infestations
Cellulitis
0.10%
1/997
0.10%
1/1000
Infections and infestations
Sepsis
0.10%
1/997
0.00%
0/1000
Infections and infestations
Sepsis syndrome
0.10%
1/997
0.00%
0/1000
Injury, poisoning and procedural complications
Anastomotic ulcer
0.10%
1/997
0.00%
0/1000
Injury, poisoning and procedural complications
Intentional overdose
0.10%
1/997
0.00%
0/1000
Metabolism and nutrition disorders
Fluid overload
0.10%
1/997
0.10%
1/1000
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Adenocarcinoma of colon
0.10%
1/997
0.10%
1/1000
Nervous system disorders
Cerebrovascular accident
0.10%
1/997
0.00%
0/1000
Metabolism and nutrition disorders
Hyperkalaemia
0.10%
1/997
0.00%
0/1000
Metabolism and nutrition disorders
Hypokalaemia
0.10%
1/997
0.00%
0/1000
Musculoskeletal and connective tissue disorders
Haemarthrosis
0.10%
1/997
0.00%
0/1000
Pregnancy, puerperium and perinatal conditions
Abortion spontaneous
0.13%
1/743
0.00%
0/776
Pregnancy, puerperium and perinatal conditions
Ectopic pregnancy
0.13%
1/743
0.00%
0/776
Psychiatric disorders
Completed suicide
0.10%
1/997
0.00%
0/1000
Respiratory, thoracic and mediastinal disorders
Pleural effusion
0.10%
1/997
0.00%
0/1000
Respiratory, thoracic and mediastinal disorders
Respiratory distress
0.10%
1/997
0.00%
0/1000
Respiratory, thoracic and mediastinal disorders
Respiratory failure
0.10%
1/997
0.00%
0/1000
Skin and subcutaneous tissue disorders
Rash maculopapular
0.10%
1/997
0.00%
0/1000
Vascular disorders
Aortic stenosis
0.10%
1/997
0.00%
0/1000
Vascular disorders
Hypertensive crisis
0.10%
1/997
0.00%
0/1000
Cardiac disorders
Angina pectoris
0.00%
0/997
0.20%
2/1000
Cardiac disorders
Atrial fibrillation
0.00%
0/997
0.20%
2/1000
Psychiatric disorders
Bipolar disorder
0.00%
0/997
0.10%
1/1000
Nervous system disorders
Restless legs syndrome
0.00%
0/997
0.10%
1/1000
Cardiac disorders
Cardiac failure
0.00%
0/997
0.10%
1/1000
Cardiac disorders
Cardiac failure chronic
0.00%
0/997
0.10%
1/1000
Gastrointestinal disorders
Gastric haemorrhage
0.00%
0/997
0.10%
1/1000
Gastrointestinal disorders
Gastroduodenal ulcer
0.00%
0/997
0.10%
1/1000
Gastrointestinal disorders
Gastrointestinal haemorrhage
0.00%
0/997
0.10%
1/1000
Gastrointestinal disorders
Impaired gastric emptying
0.00%
0/997
0.10%
1/1000
Gastrointestinal disorders
Pancreatitis chronic
0.00%
0/997
0.10%
1/1000
General disorders
Chest pain
0.00%
0/997
0.10%
1/1000
Hepatobiliary disorders
Hepatitis acute
0.00%
0/997
0.10%
1/1000
Infections and infestations
Osteomyelitis
0.00%
0/997
0.10%
1/1000
Injury, poisoning and procedural complications
Fall
0.00%
0/997
0.10%
1/1000
Injury, poisoning and procedural complications
Post-procedural haemorrhage
0.00%
0/997
0.10%
1/1000
Injury, poisoning and procedural complications
Wound dehiscence
0.00%
0/997
0.10%
1/1000
Musculoskeletal and connective tissue disorders
Arthritis
0.00%
0/997
0.10%
1/1000
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Bladder cancer
0.00%
0/997
0.10%
1/1000
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Breast cancer metastatic
0.00%
0/997
0.10%
1/1000
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Metastatic uterine cancer
0.00%
0/743
0.13%
1/776
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Mixed hepatocellular cholangiocarcinoma
0.00%
0/997
0.10%
1/1000
Renal and urinary disorders
End stage renal disease
0.00%
0/997
0.10%
1/1000
Renal and urinary disorders
Haematuria
0.00%
0/997
0.10%
1/1000
Respiratory, thoracic and mediastinal disorders
Asthma
0.00%
0/997
0.10%
1/1000
Respiratory, thoracic and mediastinal disorders
Pulmonary embolism
0.00%
0/997
0.10%
1/1000
Vascular disorders
Aortic aneurysm
0.00%
0/997
0.10%
1/1000
Vascular disorders
Hypertensive emergency
0.00%
0/997
0.10%
1/1000
Vascular disorders
Hypotension
0.00%
0/997
0.10%
1/1000
Cardiac disorders
Acute myocardial infarction
0.00%
0/997
0.10%
1/1000

Other adverse events

Other adverse events
Measure
Ferumoxytol
n=997 participants at risk
Participants received an IV infusion of ferumoxytol 510 mg diluted (17 mL) in 233 mL 0.9% sodium chloride injection, USP (normal saline) (final volume 250 mL) over at least 15 minutes with a second dose 7-8 days after the first dose, for a total cumulative dose of 1.020 g.
Ferric Carboxymaltose (FCM)
n=1000 participants at risk
Participants received an IV infusion of FCM 750 mg diluted (15 mL) in 235 mL 0.9% sodium chloride injection, USP (normal saline) (final volume 250 mL) over at least 15 minutes with a second dose 7-8 days after the first dose, for a total cumulative dose of 1.500 g.
Gastrointestinal disorders
Nausea
3.5%
35/997
6.0%
60/1000
Gastrointestinal disorders
Diarrhoea
2.9%
29/997
3.3%
33/1000
Gastrointestinal disorders
Abdominal pain
1.7%
17/997
2.1%
21/1000
Gastrointestinal disorders
Constipation
1.4%
14/997
1.3%
13/1000
Gastrointestinal disorders
Vomiting
1.1%
11/997
1.3%
13/1000
General disorders
Fatigue
3.0%
30/997
3.6%
36/1000
General disorders
Chest discomfort
0.80%
8/997
1.1%
11/1000
General disorders
Pyrexia
0.70%
7/997
2.2%
22/1000
Metabolism and nutrition disorders
Hypophosphataemia
0.00%
0/997
1.8%
18/1000
Musculoskeletal and connective tissue disorders
Back pain
1.9%
19/997
1.6%
16/1000
Musculoskeletal and connective tissue disorders
Arthralgia
1.4%
14/997
1.2%
12/1000
Nervous system disorders
Headache
6.0%
60/997
8.2%
82/1000
Nervous system disorders
Dizziness
2.5%
25/997
4.0%
40/1000
Respiratory, thoracic and mediastinal disorders
Cough
1.5%
15/997
1.3%
13/1000
Respiratory, thoracic and mediastinal disorders
Dyspnoea
1.1%
11/997
1.8%
18/1000
Skin and subcutaneous tissue disorders
Pruritus
1.2%
12/997
1.1%
11/1000
Vascular disorders
Flushing
1.1%
11/997
1.6%
16/1000
Vascular disorders
Hypertension
0.70%
7/997
1.5%
15/1000
General disorders
Chest pain
1.0%
10/997
0.40%
4/1000
Skin and subcutaneous tissue disorders
Urticaria
0.30%
3/997
1.3%
13/1000

Additional Information

Medical Information

AMAG Pharmaceuticals, Inc.

Results disclosure agreements

  • Principal investigator is a sponsor employee If there is no multi-site publication within 18 months after the Study has been completed or terminated at all Study sites, and all data have been received by Sponsor, the Site, and SMO shall have the right to publish its results from the Study for non-commercial purposes, if submitted to Sponsor for review 60 days prior to submission of publication. Publication must remove all confidential information and may be delayed by up to 180 days to allow Sponsor to protect its interests.
  • Publication restrictions are in place

Restriction type: OTHER