Trial Outcomes & Findings for Evaluate the Safety and Efficacy of Ferric Maltol Oral Suspension vs. Ferrous Sulfate Oral Liquid in Children and Adolescents Aged 2 to 17 Years With Iron-deficiency Anaemia, With a Single Arm Study in Infants Aged 1 Month to Less Than 2 Years (NCT NCT05126901)

NCT ID: NCT05126901

Last Updated: 2025-11-10

Results Overview

The change in Hb concentration from baseline to Week 12 is summarized based on the mITT Population for each treatment group using descriptive statistics summarized by mean, standard deviation, median, and range (minimum and maximum). The Randomized/ITT Population is defined as all patients who were randomized/assigned to treatment arms. The mITT Population is defined as all patients in the ITT Population who received at least 1 treatment dose.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

65 participants

Primary outcome timeframe

From baseline to week 12.

Results posted on

2025-11-10

Participant Flow

This was a multicenter study with a total of 23 clinical sites located in the United States(including Puerto Rico) and United Kingdom. A total of 65 patients were enrolled in the study.

All eligible subjects aged 1 month to less than 2 years entered a Pre-assignment phase, 1-day Pharmacokinetic assessment day following a single dose of ferric maltol oral suspension.

Participant milestones

Participant milestones
Measure
Ferric Maltol Assigned
12 weeks open-label Treatment Period for ferric maltol children aged 1 month to \<2 years
Ferric Maltol Randomized
Subjects aged 2-17 will be randomised 1:1 to receive ferric maltol oral suspension or ferrous sulfate oral liquid. The first 12 subjects randomised to ferric maltol in each age sub-group (2 - 9 yrs, 10 - 17 yrs respectively) will enter a PK phase with 2 PK days. Following PK Day 2 subjects will continue until Week 12. Once the 18 subjects in each age subgroup have finished their PK visits, they will continue until week 12. Ferrous sulfate 125 mg/ml (25 mg elemental iron) or equivalent dose was used for all children/adolescents. To maximise the iron replenishment for subjects within this group as well; aged 2 \- 17 yrs were dosed 6 mg/kg to the maximum of 4 ml BID.
Ferrous Sulfate Randomized
Patients aged 2 to 17 years were randomized 1:1 to receive ferric maltol oral suspension or ferrous sulfate oral liquid.
Overall Study
STARTED
4
31
30
Overall Study
COMPLETED
3
28
25
Overall Study
NOT COMPLETED
1
3
5

Reasons for withdrawal

Reasons for withdrawal
Measure
Ferric Maltol Assigned
12 weeks open-label Treatment Period for ferric maltol children aged 1 month to \<2 years
Ferric Maltol Randomized
Subjects aged 2-17 will be randomised 1:1 to receive ferric maltol oral suspension or ferrous sulfate oral liquid. The first 12 subjects randomised to ferric maltol in each age sub-group (2 - 9 yrs, 10 - 17 yrs respectively) will enter a PK phase with 2 PK days. Following PK Day 2 subjects will continue until Week 12. Once the 18 subjects in each age subgroup have finished their PK visits, they will continue until week 12. Ferrous sulfate 125 mg/ml (25 mg elemental iron) or equivalent dose was used for all children/adolescents. To maximise the iron replenishment for subjects within this group as well; aged 2 \- 17 yrs were dosed 6 mg/kg to the maximum of 4 ml BID.
Ferrous Sulfate Randomized
Patients aged 2 to 17 years were randomized 1:1 to receive ferric maltol oral suspension or ferrous sulfate oral liquid.
Overall Study
Withdrawal by Subject
1
1
4
Overall Study
Adverse Event
0
0
1
Overall Study
Lost to Follow-up
0
2
0

Baseline Characteristics

Evaluate the Safety and Efficacy of Ferric Maltol Oral Suspension vs. Ferrous Sulfate Oral Liquid in Children and Adolescents Aged 2 to 17 Years With Iron-deficiency Anaemia, With a Single Arm Study in Infants Aged 1 Month to Less Than 2 Years

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Ferric Maltol Assigned
n=4 Participants
12 weeks open-label Treatment Period for ferric maltol children aged 1 month to \<2 years
Ferric Maltol Randomized
n=31 Participants
Subjects aged 2-17 will be randomised 1:1 to receive ferric maltol oral suspension or ferrous sulfate oral liquid. The first 12 subjects randomised to ferric maltol in each age sub-group (2 - 9 yrs, 10 - 17 yrs respectively) will enter a PK phase with 2 PK days. Following PK Day 2 subjects will continue until Week 12. Once the 18 subjects in each age subgroup have finished their PK visits, they will continue until week 12. Ferrous sulfate 125 mg/ml (25 mg elemental iron) or equivalent dose was used for all children/adolescents. To maximise the iron replenishment for subjects within this group as well; aged 2 \- 17 yrs were dosed 6 mg/kg to the maximum of 4 ml BID.
Ferrous Sulfate Randomized
n=30 Participants
Patients aged 2 to 17 years were randomized 1:1 to receive ferric maltol oral suspension or ferrous sulfate oral liquid.
Total
n=65 Participants
Total of all reporting groups
Age, Customized
Preterm newborn infants (gestational age < 37 wks)
0 Participants
n=5 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
0 Participants
n=28 Participants
Age, Customized
Newborns (0-27 days)
0 Participants
n=5 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
0 Participants
n=28 Participants
Age, Customized
Infants and toddlers (28 days-23 months)
4 Participants
n=5 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
4 Participants
n=28 Participants
Age, Customized
Children (2-11 years)
0 Participants
n=5 Participants
10 Participants
n=20 Participants
11 Participants
n=40 Participants
21 Participants
n=28 Participants
Age, Customized
Adolescents (12-17 years)
0 Participants
n=5 Participants
21 Participants
n=20 Participants
19 Participants
n=40 Participants
40 Participants
n=28 Participants
Age, Customized
Adults (18-64 years)
0 Participants
n=5 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
0 Participants
n=28 Participants
Age, Customized
From 65-84 years
0 Participants
n=5 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
0 Participants
n=28 Participants
Age, Customized
85 years and over
0 Participants
n=5 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
0 Participants
n=28 Participants
Sex: Female, Male
Female
3 Participants
n=5 Participants
23 Participants
n=20 Participants
22 Participants
n=40 Participants
48 Participants
n=28 Participants
Sex: Female, Male
Male
1 Participants
n=5 Participants
8 Participants
n=20 Participants
8 Participants
n=40 Participants
17 Participants
n=28 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants
n=5 Participants
13 Participants
n=20 Participants
12 Participants
n=40 Participants
27 Participants
n=28 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
1 Participants
n=5 Participants
18 Participants
n=20 Participants
18 Participants
n=40 Participants
37 Participants
n=28 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
1 Participants
n=28 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
0 Participants
n=28 Participants
Race (NIH/OMB)
Asian
1 Participants
n=5 Participants
3 Participants
n=20 Participants
3 Participants
n=40 Participants
7 Participants
n=28 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
0 Participants
n=28 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
9 Participants
n=20 Participants
11 Participants
n=40 Participants
20 Participants
n=28 Participants
Race (NIH/OMB)
White
1 Participants
n=5 Participants
18 Participants
n=20 Participants
16 Participants
n=40 Participants
35 Participants
n=28 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
0 Participants
n=28 Participants
Race (NIH/OMB)
Unknown or Not Reported
2 Participants
n=5 Participants
1 Participants
n=20 Participants
0 Participants
n=40 Participants
3 Participants
n=28 Participants

PRIMARY outcome

Timeframe: From baseline to week 12.

Population: All patients that finalized Day 84 measurement were reported and analyzed. All patients with a missing Day 84 measurement were imputed using a last observation carried forward approach in which the last available post-baseline measurement was used. Post-baseline measurement was missing in 5 patients in the 2. group (mITT Ferric Maltol) , and 6 patients in the 3. group (mITT Ferrous Sulfate).

The change in Hb concentration from baseline to Week 12 is summarized based on the mITT Population for each treatment group using descriptive statistics summarized by mean, standard deviation, median, and range (minimum and maximum). The Randomized/ITT Population is defined as all patients who were randomized/assigned to treatment arms. The mITT Population is defined as all patients in the ITT Population who received at least 1 treatment dose.

Outcome measures

Outcome measures
Measure
PK Population Ferric Maltol 30mg (10-17 y) Day 1
n=24 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 7-10
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 7-10
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 30mg (10-17 y) Day 7-10
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 1
n=3 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 1
n=26 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
Change in Hemoglobin Concentration
11.5 g/L
Standard Deviation 13.97
17.7 g/L
Standard Deviation 13.61
12.5 g/L
Standard Deviation 13.89

SECONDARY outcome

Timeframe: From baseline to week 12.

Population: All patients that finalized Day 84 measurement were reported and analyzed. All patients with a missing Day 84 measurement were imputed using a last observation carried forward approach in which the last available post-baseline measurement was used. Post-baseline measurement was missing in 2 patients in the 3. group (mITT Ferrous Sulfate).

Changes in ferritin concentration from baseline to week 12 summarised based on the mITT Population for each treatment group. The Randomized/ITT Population is defined as all patients who were randomized/assigned to treatment arms. The mITT Population is defined as all patients in the ITT Population who received at least 1 treatment dose.

Outcome measures

Outcome measures
Measure
PK Population Ferric Maltol 30mg (10-17 y) Day 1
n=28 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 7-10
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 7-10
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 30mg (10-17 y) Day 7-10
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 1
n=3 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 1
n=31 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
Changes in Ferritin Concentration
20.6 μg/L
Standard Deviation 30.97
6.3 μg/L
Standard Deviation 8.74
8.1 μg/L
Standard Deviation 11.06

SECONDARY outcome

Timeframe: From baseline to week 12.

Population: All patients that finalized Day 84 measurement were reported and analyzed. All patients with a missing Day 84 measurement were imputed using a last observation carried forward approach in which the last available post-baseline measurement was used. Post-baseline measurement was missing in 2 patients in the 3. group (mITT Ferrous Sulfate).

Change in iron concentration from baseline to week 12 summarized based on the mITT Population for each treatment group. The Randomized/ITT Population is defined as all patients who were randomized/assigned to treatment arms. The mITT Population is defined as all patients in the ITT Population who received at least 1 treatment dose.

Outcome measures

Outcome measures
Measure
PK Population Ferric Maltol 30mg (10-17 y) Day 1
n=28 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 7-10
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 7-10
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 30mg (10-17 y) Day 7-10
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 1
n=3 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 1
n=31 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
Change in Iron Concentration
3.64 μmol/L
Standard Deviation 8.911
1.07 μmol/L
Standard Deviation 0.577
5.77 μmol/L
Standard Deviation 8.518

SECONDARY outcome

Timeframe: From baseline to week 12.

Population: All patients that finalized Day 84 measurement were reported and analyzed. All patients with a missing Day 84 measurement were imputed using a last observation carried forward approach in which the last available post-baseline measurement was used. Post-baseline measurement was missing in 1 patient in the 1. group (mITT Ferric Maltol Assigned) and 2 patients in the 3. group (mITT Ferrous Sulfate).

Change from baseline to Day 84 summarized based on the mITT Population for each treatment group. The Randomized/ITT Population is defined as all patients who were randomized/assigned to treatment arms. The mITT Population is defined as all patients in the ITT Population who received at least 1 treatment dose.

Outcome measures

Outcome measures
Measure
PK Population Ferric Maltol 30mg (10-17 y) Day 1
n=28 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 7-10
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 7-10
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 30mg (10-17 y) Day 7-10
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 1
n=2 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 1
n=31 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
Change in the Percentage of Transferrin Saturation
6.5 Percentage of Transferrin Saturation
Standard Deviation 12.39
2.0 Percentage of Transferrin Saturation
Standard Deviation 0.00
7.7 Percentage of Transferrin Saturation
Standard Deviation 10.14

SECONDARY outcome

Timeframe: PK parameters assessed at Day 1 (Visit 2) and Day 7-10 (Visit 3).

Population: A total of 20 patients in the ferric maltol group were included in the PK Population. Of these patients, there were 7 patients (3 female patients and 4 male patients) who were 2 to 9 years of age, 3 patients (all female patients) who were 10 to 17 years of age and who received 15 mg BID of ferric maltol, and 10 patients (9 female patients and 1 male patient) who were 10 to 17 years of age and who received 30 mg BID of ferric maltol.

Measured maximum plasma concentration (Cmax) (ng/mL) for plasma maltol glucuronide after a single dose of ferric maltol oral suspension on Visit 2 (PK Day 1) and after twice daily administrations for at least 6 days, on Visit 3 (PK Day 2) after a single morning dose. Because of the limitations of PK sampling in the pediatric patient population, data from multiple patients in the same treatment and age group had to be combined, using the naïve pooled approach, to achieve a complete set of observations over time for PK analysis. The data did not support PK parameters generation using noncompartmental analysis (NCA) without combining patients. Using validated PK software WinNonlin, the 'sparse sampling' option was utilized to treat the data as one virtual subject and thus the resulting data did not support reliable error estimates of the PK parameters.

Outcome measures

Outcome measures
Measure
PK Population Ferric Maltol 30mg (10-17 y) Day 1
n=10 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 7-10
n=7 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 7-10
n=3 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 30mg (10-17 y) Day 7-10
n=10 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 1
n=7 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 1
n=3 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
Cmax for Plasma Maltol Glucuronide
6420 ng/mL
NA
4250 ng/mL
NA
5940 ng/mL
NA
8160 ng/mL
NA
4350 ng/mL
NA
6810 ng/mL
NA

SECONDARY outcome

Timeframe: PK parameters assessed at Day 1 (Visit 2) and Day 7-10 (Visit 3).

Population: A total of 20 patients in the ferric maltol group were included in the PK Population. Of these patients, there were 7 patients (3 female patients and 4 male patients) who were 2 to 9 years of age, 3 patients (all female patients) who were 10 to 17 years of age and who received 15 mg BID of ferric maltol, and 10 patients (9 female patients and 1 male patient) who were 10 to 17 years of age and who received 30 mg BID of ferric maltol.

Time to maximum plasma concentration (Tmax) (h) for plasma maltol glucuronide after a single dose of ferric maltol oral suspension on Visit 2 (PK Day 1) and after twice daily administrations for at least 6 days, on Visit 3 (PK Day 2) after a single morning dose. Because of the limitations of PK sampling in the pediatric patient population, data from multiple patients in the same treatment and age group had to be combined, using the naïve pooled approach, to achieve a complete set of observations over time for PK analysis. The data did not support PK parameters generation using noncompartmental analysis (NCA) without combining patients. Using validated PK software WinNonlin, the 'sparse sampling' option was utilized to treat the data as one virtual subject and thus the resulting data did not support reliable error estimates of the PK parameters.

Outcome measures

Outcome measures
Measure
PK Population Ferric Maltol 30mg (10-17 y) Day 1
n=10 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 7-10
n=7 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 7-10
n=3 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 30mg (10-17 y) Day 7-10
n=10 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 1
n=7 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 1
n=3 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
Tmax for Plasma Maltol Glucuronide
0.52 h
NA
0.98 h
NA
2.78 h
NA
3.63 h
NA
1.00 h
NA
2.13 h
NA

SECONDARY outcome

Timeframe: PK parameters assessed at Day 1 (Visit 2) and Day 7-10 (Visit 3).

Population: A total of 20 patients in the ferric maltol group were included in the PK Population. Of these patients, there were 7 patients (3 female patients and 4 male patients) who were 2 to 9 years of age, 3 patients (all female patients) who were 10 to 17 years of age and who received 15 mg BID of ferric maltol, and 10 patients (9 female patients and 1 male patient) who were 10 to 17 years of age and who received 30 mg BID of ferric maltol.

Area under the plasma concentration-time curve from pre-dose (time 0) to the time of last quantifiable plasma concentration for plasma maltol glucuronide (AUC0-t) (hxng/mL) after a single dose of ferric maltol oral suspension on Visit 2 (PK Day 1) and after twice daily administrations for at least 6 days, on Visit 3 (PK Day 2) after a single morning dose. Because of the limitations of PK sampling in the pediatric patient population, data from multiple patients in the same treatment and age group had to be combined, using the naïve pooled approach, to achieve a complete set of observations over time for PK analysis. The data did not support PK parameters generation using noncompartmental analysis (NCA) without combining patients. Using validated PK software WinNonlin, the 'sparse sampling' option was utilized to treat the data as one virtual subject and thus the resulting data did not support reliable error estimates of the PK parameters.

Outcome measures

Outcome measures
Measure
PK Population Ferric Maltol 30mg (10-17 y) Day 1
n=10 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 7-10
n=7 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 7-10
n=3 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 30mg (10-17 y) Day 7-10
n=10 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 1
n=7 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 1
n=3 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
AUC0-t for Plasma Maltol Glucuronide
14600 hxng/mL
NA
5900 hxng/mL
NA
8070 hxng/mL
NA
16700 hxng/mL
NA
7670 hxng/mL
NA
12000 hxng/mL
NA

SECONDARY outcome

Timeframe: PK parameters assessed at Day 1 (Visit 2) and Day 7-10 (Visit 3).

Population: A total of 20 patients in the ferric maltol group were included in the PK Population. Of these patients, there were 7 patients (3 female patients and 4 male patients) who were 2 to 9 years of age, 3 patients (all female patients) who were 10 to 17 years of age and who received 15 mg BID of ferric maltol, and 10 patients (9 female patients and 1 male patient) who were 10 to 17 years of age and who received 30 mg BID of ferric maltol.

Measured maximum plasma concentration (Cmax) (μg/dL) for baseline corrected serum iron after a single dose of ferric maltol oral suspension on Visit 2 (PK Day 1) and after twice daily administrations for at least 6 days, on Visit 3 (PK Day 2) after a single morning dose. Because of the limitations of PK sampling in the pediatric patient population, data from multiple patients in the same treatment and age group had to be combined, using the naïve pooled approach, to achieve a complete set of observations over time for PK analysis. The data did not support PK parameters generation using noncompartmental analysis (NCA) without combining patients. Using validated PK software WinNonlin, the 'sparse sampling' option was utilized to treat the data as one virtual subject and thus the resulting data did not support reliable error estimates of the PK parameters.

Outcome measures

Outcome measures
Measure
PK Population Ferric Maltol 30mg (10-17 y) Day 1
n=10 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 7-10
n=7 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 7-10
n=3 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 30mg (10-17 y) Day 7-10
n=10 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 1
n=7 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 1
n=3 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
Cmax for Baseline Corrected Serum Iron
119 μg/dL
NA
96.5 μg/dL
NA
21.0 μg/dL
NA
364 μg/dL
NA
87.0 μg/dL
NA
40.0 μg/dL
NA

SECONDARY outcome

Timeframe: PK parameters assessed at Day 1 (Visit 2) and Day 7-10 (Visit 3).

Population: A total of 20 patients in the ferric maltol group were included in the PK Population. Of these patients, there were 7 patients (3 female patients and 4 male patients) who were 2 to 9 years of age, 3 patients (all female patients) who were 10 to 17 years of age and who received 15 mg BID of ferric maltol, and 10 patients (9 female patients and 1 male patient) who were 10 to 17 years of age and who received 30 mg BID of ferric maltol.

Time to maximum plasma concentration (Tmax) (h) for baseline corrected serum iron after a single dose of ferric maltol oral suspension on Visit 2 (PK Day 1) and after twice daily administrations for at least 6 days, on Visit 3 (PK Day 2) after a single morning dose. Because of the limitations of PK sampling in the pediatric patient population, data from multiple patients in the same treatment and age group had to be combined, using the naïve pooled approach, to achieve a complete set of observations over time for PK analysis. The data did not support PK parameters generation using noncompartmental analysis (NCA) without combining patients. Using validated PK software WinNonlin, the 'sparse sampling' option was utilized to treat the data as one virtual subject and thus the resulting data did not support reliable error estimates of the PK parameters.

Outcome measures

Outcome measures
Measure
PK Population Ferric Maltol 30mg (10-17 y) Day 1
n=10 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 7-10
n=7 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 7-10
n=3 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 30mg (10-17 y) Day 7-10
n=10 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 1
n=7 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 1
n=3 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
Tmax for Baseline Corrected Serum Iron
2.00 h
NA
2.10 h
NA
2.78 h
NA
6.63 h
NA
2.37 h
NA
2.13 h
NA

SECONDARY outcome

Timeframe: PK parameters assessed at Day 1 (Visit 2) and Day 7-10 (Visit 3).

Population: A total of 20 patients in the ferric maltol group were included in the PK Population. Of these patients, there were 7 patients (3 female patients and 4 male patients) who were 2 to 9 years of age, 3 patients (all female patients) who were 10 to 17 years of age and who received 15 mg BID of ferric maltol, and 10 patients (9 female patients and 1 male patient) who were 10 to 17 years of age and who received 30 mg BID of ferric maltol.

Area under the plasma concentration-time curve from pre-dose (time 0) to the time of last quantifiable plasma concentration for baseline corrected serum iron (AUC0-t) (hxng/mL) after a single dose of ferric maltol oral suspension on Visit 2 (PK Day 1) and after twice daily administrations for at least 6 days, on Visit 3 (PK Day 2) after a single morning dose. Because of the limitations of PK sampling in the pediatric patient population, data from multiple patients in the same treatment and age group had to be combined, using the naïve pooled approach, to achieve a complete set of observations over time for PK analysis. The data did not support PK parameters generation using noncompartmental analysis (NCA) without combining patients. Using validated PK software WinNonlin, the 'sparse sampling' option was utilized to treat the data as one virtual subject and thus the resulting data did not support reliable error estimates of the PK parameters.

Outcome measures

Outcome measures
Measure
PK Population Ferric Maltol 30mg (10-17 y) Day 1
n=10 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 7-10
n=7 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 7-10
n=3 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 30mg (10-17 y) Day 7-10
n=10 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (2-9 y) Day 1
n=7 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
PK Population Ferric Maltol 15mg (10-17 y) Day 1
n=3 Participants
The PK Population is defined as all randomized/assigned patients who had at least 1 dose of study drug and who had at least 1 evaluable post-dose PK sample.
AUC0-t for Baseline Corrected Serum Iron
374 hxμg/dL
NA
100 hxμg/dL
NA
1.93 hxμg/dL
NA
1180 hxμg/dL
NA
64.4 hxμg/dL
NA
60.1 hxμg/dL
NA

Adverse Events

Ferric Maltol Assigned

Serious events: 1 serious events
Other events: 2 other events
Deaths: 0 deaths

Ferric Maltol Randomized

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

Ferrous Sulfate Randomized

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Ferric Maltol Assigned
n=3 participants at risk
12 weeks open-label Treatment Period for ferric maltol children aged 1 month to \<2 years
Ferric Maltol Randomized
n=31 participants at risk
Subjects aged 2-17 will be randomised 1:1 to receive ferric maltol oral suspension or ferrous sulfate oral liquid. The first 12 subjects randomised to ferric maltol in each age sub-group (2 - 9 yrs, 10 - 17 yrs respectively) will enter a PK phase with 2 PK days. Following PK Day 2 subjects will continue until Week 12. Once the 18 subjects in each age subgroup have finished their PK visits, they will continue until week 12. Ferrous sulfate 125 mg/ml (25 mg elemental iron) or equivalent dose was used for all children/adolescents. To maximise the iron replenishment for subjects within this group as well; aged 2 \- 17 yrs were dosed 6 mg/kg to the maximum of 4 ml BID.
Ferrous Sulfate Randomized
n=30 participants at risk
Patients aged 2 to 17 years were randomized 1:1 to receive ferric maltol oral suspension or ferrous sulfate oral liquid.
Respiratory, thoracic and mediastinal disorders
Wheezing
33.3%
1/3 • Number of events 1 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
0.00%
0/31 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
0.00%
0/30 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.

Other adverse events

Other adverse events
Measure
Ferric Maltol Assigned
n=3 participants at risk
12 weeks open-label Treatment Period for ferric maltol children aged 1 month to \<2 years
Ferric Maltol Randomized
n=31 participants at risk
Subjects aged 2-17 will be randomised 1:1 to receive ferric maltol oral suspension or ferrous sulfate oral liquid. The first 12 subjects randomised to ferric maltol in each age sub-group (2 - 9 yrs, 10 - 17 yrs respectively) will enter a PK phase with 2 PK days. Following PK Day 2 subjects will continue until Week 12. Once the 18 subjects in each age subgroup have finished their PK visits, they will continue until week 12. Ferrous sulfate 125 mg/ml (25 mg elemental iron) or equivalent dose was used for all children/adolescents. To maximise the iron replenishment for subjects within this group as well; aged 2 \- 17 yrs were dosed 6 mg/kg to the maximum of 4 ml BID.
Ferrous Sulfate Randomized
n=30 participants at risk
Patients aged 2 to 17 years were randomized 1:1 to receive ferric maltol oral suspension or ferrous sulfate oral liquid.
Gastrointestinal disorders
Diarrhoea
33.3%
1/3 • Number of events 1 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
3.2%
1/31 • Number of events 1 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
0.00%
0/30 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
Gastrointestinal disorders
Teething
33.3%
1/3 • Number of events 1 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
0.00%
0/31 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
0.00%
0/30 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
Gastrointestinal disorders
Nausea
0.00%
0/3 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
6.5%
2/31 • Number of events 3 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
10.0%
3/30 • Number of events 3 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
Respiratory, thoracic and mediastinal disorders
Cough
33.3%
1/3 • Number of events 1 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
3.2%
1/31 • Number of events 1 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
0.00%
0/30 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
Infections and infestations
Conjunctivitis
33.3%
1/3 • Number of events 1 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
0.00%
0/31 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
0.00%
0/30 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
Blood and lymphatic system disorders
Iron deficiency anaemia
33.3%
1/3 • Number of events 1 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
0.00%
0/31 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
0.00%
0/30 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
General disorders
Pyrexia
0.00%
0/3 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
6.5%
2/31 • Number of events 2 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.
0.00%
0/30 • During the 12-week treatment period and within 2 weeks after receiving the last dose of the study drug.

Additional Information

Clinical Operations, Shield TX (UK) Ltd.

Shield TX (UK) Ltd.

Phone: +44 (0) 191 511 8500

Results disclosure agreements

  • Principal investigator is a sponsor employee Study is part of a multicenter trial, and Institution may publish the results of its part of the Study in collaboration with the other investigators, but in complete compliance with this section and with the Confidential Information section. After the multicenter publication or twelve (12) months after completion of the Study, whichever occurs first. Sponsor should be informed at least sixty (60) days prior to the planned date of submission or presentation.
  • Publication restrictions are in place

Restriction type: OTHER