Panhematin for Prevention of Acute Attacks of Porphyria

NCT ID: NCT02922413

Last Updated: 2026-01-30

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE2

Total Enrollment

13 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-10-30

Study Completion Date

2023-12-27

Brief Summary

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The purpose of this study is to determine if Panhematin is safe and effective for prevention of acute attacks of porphyria.

The study aims to provide high quality evidence for the use on hemin for prevention of acute attacks of porphyria. High quality studies have not been done previously for treating or preventing acute attacks with hemin. The lack of strong evidence for efficacy of hemin for treatment and prevention of attacks limits its availability for patients with acute porphyrias. Funding source: FDA Office of Orphan Product Development (FDA OOPD) FD-R-03720

Detailed Description

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This is a double-blind, randomized, placebo-controlled, parallel group trial investigating the efficacy and safety of Panhematin™ for preventing acute attacks in at least 20 subjects with well-documented acute porphyria (acute intermittent porphyria, hereditary coproporphyria or variegate porphyria). Subjects will (1.) have had frequent attacks in the past, with symptoms such as abdominal, back and/or limb pain and diagnosed after exclusion of other causes, and (2.) be on hemin prophylaxis for prevention of frequent attacks. It is expected that they will have had 6 or more attacks in one year before starting hemin prophylaxis. This would be considered justification for a preventive regimen of hemin on clinical grounds. Double blind Panhematin™ or placebo will be given. The number of doses will correspond to the number of doses that a subject receives in approximately one week for their prophylactic regimen. An interim analysis will be carried out after completion of 10 subjects to assess progress and possibly adjust the sample size. The trial consists of the following visits:

* A screening visit to determine eligibility and obtain informed consent.
* A treatment visit for administration of double blind prophylactic doses of Panhematin™ or placebo corresponding to the number of doses the subject receives for their prophylactic regimen within approximately one week.
* Follow up visit at 1, 2, 3, and 4 weeks to assess response to the infusion of Panhematin™ or placebo. These visits will be in person or by telephone.
* Additional visits may be scheduled if needed, for example for treatment of symptoms.
* Follow-up visits 3 and 6 months after the end of treatment either in person or by telephone Subjects will have laboratory documentation of one of the acute porphyrias. Molecular documentation is also expected, although rarely a causative mutation cannot be detected. Upon entry into the study they will be given in a blinded fashion one or more preventive doses of either Panhematin™ (4 mg/kg) or placebo, the number of which will correspond to the number of prophylactic doses they have been receiving within approximately one week for prophylaxis. A recurrent attack within the next 1, 2, 3 and 4 weeks will represent treatment failures. Because at study entry most subjects are expected to be on weekly prophylactic hemin treatment, and hemin is a short-acting drug, emphasis in the analysis will be on attacks occurring within 1 week after study treatment.

Any attacks that occur during the study will be treated according to standard of care, which may include Panhematin™, either at the study site or at a subject's usual treatment location.

It is intended that 20 subjects will complete treatment with blinded treatment and at least 4 weeks of follow up. A completed subject is one who meets all entrance criteria, has no exclusion criteria and completes the single dosing and at least one week of follow up, or is withdrawn because of an adverse event.

Conditions

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Acute Intermittent Porphyria Hereditary Coproporphyria Variegate Porphyria

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Two group parallel blinded study comparing active drug and placebo
Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
Administered doses are shielded from view. The pharmacy and one nurse who administers the drug intravenously will not be blinded.

Study Groups

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Hemin for injection

Double blind doses of Panhematin 4 mg/kg body weight reconstituted with 25% human albumin and infused over at least one hour.

Group Type EXPERIMENTAL

Hemin for injection

Intervention Type BIOLOGICAL

Panhematin 4 mg/kg body weight reconstituted with 25% human albumin infused intravenously over at least 1 hour.

Placebo

A double blind dose of saline.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

Saline infusion

Interventions

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Hemin for injection

Panhematin 4 mg/kg body weight reconstituted with 25% human albumin infused intravenously over at least 1 hour.

Intervention Type BIOLOGICAL

Placebo

Saline infusion

Intervention Type OTHER

Other Intervention Names

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Hematin

Eligibility Criteria

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Inclusion Criteria

1. Male or female aged 18 years
2. Willing to provide written informed consent

Exclusion Criteria

1. Symptoms such as abdominal, back or limb pain are explained by another condition, as judged by the investigator
2. Known or suspected allergy to Panhematin™ or related products
3. A known or suspected allergy to human albumin
4. Any disease or condition that the investigator judges would lead to an unacceptable risk to the patient or interfere with the successful collection of data for the trial
5. Previous randomization in this trial
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The University of Texas Medical Branch, Galveston

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Karl E Anderson, MD

Role: PRINCIPAL_INVESTIGATOR

University of Texas

Locations

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University of Texas Medical Branch

Galveston, Texas, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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FD-R-03720

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

14-0188

Identifier Type: -

Identifier Source: org_study_id

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