Multicentre, randomised, controlled, 2-arm open-label prospective pilot study to evaluate efficacy and safety of ferric carboxymaltose (FCM) in treatment of anaemia in subjects with multiple myeloma (MM) initiating chemotherapy. The subjects will be screened for eligibility within 4 weeks prior to inclusion and randomised to receive intravenous infusions of FCM or standard care (the subjects may be treated according to the local institutional practice if requiring symptomatic management of anaemia). Thereafter the visits are scheduled at Weeks 0, 2, 4, 6 and 8.
Patients will be randomised into two groups. One will receive active FCM treatment and the other group will receive local standard of care. Active treatment group: Subjects will receive a total dose of 1,000 mg iron as FCM on the day of the first scheduled chemotherapy cycle or within 24 hours before or after receiving chemotherapy. In subjects of weight ≤66 kg, the first dose (500 mg) will be administered on the day of the first scheduled chemotherapy cycle and the second dose (500 mg) on the next study visit. Standard of care group: Subjects will be treated according to the local institutional practice if requiring management of symptomatic anaemia. Intravenous iron should only be used to treat absolute iron deficiency (as defined as ferritin less than the lower limit of normal based on the test reference ranges). Patients with absolute iron deficiency are not eligible for inclusion to the study. Rescue medication to manage anaemia is permitted in both arms at the discretion of the treating physician and/or per institutional practice.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
3
Subjects will receive a single dose of 1,000 mg iron as FCM infusion at baseline. Subjects of bw ≤66 kg will receive a single dose of 500 mg iron as FCM infusion at baseline (Week 0) and at Visit 3 (Week 2). Ferric carboxymaltose will be administered on the same day with chemotherapy treatment or within 24 hours before or after the chemotherapy. For subjects with bw ≤66 kg, if no chemotherapy planned for the visit 4 (Week 2), the second FCM dose should be infused independent of chemotherapy.
Hopital Sud
Rennes, France
Theagenion Cancer Center
Thessaloniki, Greece
Change in haemoglobin (Hb) from baseline to Weeks 4, 6 and 8
Mean change in Hb from baseline to Weeks 4, 6 and 8 (end of treatment) in the absence of any red cell transfusion or erythropoiesis stimulating agents (ESA) treatment.
Time frame: week 4, 6 and 8 post baseline
Percentage of subjects with blood Hb response of at least 1 g/dL
Percentage of subjects with blood Hb response of at least 1 g/dL in the absence of any red cell transfusion or ESA treatment.
Time frame: 12 weeks post baseline
Percentage of subjects with a blood Hb correction to at least 12 g/dL
Percentage of subjects with a blood Hb correction to at least 12 g/dL in the absence of any red cell transfusion or ESA treatment
Time frame: 12 weeks post baseline
Time to Hb response defined as increase in Hb equal to or more than 1 g/dL
Median time to Hb response defined as increase in Hb equal to or more than 1 g/dL in the absence of any red cell transfusion or ESA treatment
Time frame: Baseline until end of study (week 8)
Subjects receiving red blood cell transfusions or subjects treated with ESA
Proportion of subjects receiving red blood cell transfusions or subjects treated with ESA during the study period
Time frame: Baseline until end of study (week 8)
Adverse events
Adverse events: type, nature, incidence and outcome
Time frame: Baseline until end of study (week 8)
Transfusion/treatment with ESA
Time to transfusion/treatment with ESA
Time frame: Baseline until end of study (week 8)
Change in serum ferritin from baseline to Weeks 2, 4, 6 and 8
Mean change in serum ferritin from baseline to Weeks 2, 4, 6 and 8
Time frame: week 2, 4, 6, and 8 post baseline
Change in transferrin saturation (TSAT) from baseline to Weeks 2, 4, 6 and 8
Mean change in TSAT from baseline to Weeks 2, 4, 6 and 8
Time frame: week 2, 4, 6, and 8 post baseline
Change in serum iron from baseline to Weeks 2, 4, 6 and 8
Mean change in serum iron from baseline to Weeks 2, 4, 6 and 8
Time frame: week 2, 4, 6, and 8 post baseline
Change in endogenous erythropoietin from baseline to Weeks 2, 4, 6 and 8
Mean change in endogenous erythropoietin from baseline to Weeks 2, 4, 6 and 8
Time frame: week 2, 4, 6, and 8 post baseline
Change in blood reticulocyte haemoglobin content/red blood cell size factor from baseline to Weeks 2, 4, 6 and 8
Mean change in blood reticulocyte haemoglobin content/red blood cell size factor from baseline to Weeks 2, 4, 6 and 8
Time frame: week 2, 4, 6, and 8 post baseline
Change in percentage of hypochromic red cells/percentage of low Hb density from baseline to Weeks 2, 4, 6 and 8
Mean change in percentage of hypochromic red cells/percentage of low Hb density from baseline to Weeks 2, 4, 6 and 8
Time frame: week 2, 4, 6, and 8 post baseline
Change in hepcidin from baseline to Weeks 2, 4, 6 and 8
Mean change in hepcidin from baseline to Weeks 2, 4, 6 and 8
Time frame: week 2, 4, 6, and 8 post baseline
Change in interleukin-6 from baseline to Weeks 2, 4, 6 and 8
Mean change in interleukin-6 from baseline to Weeks 2, 4, 6 and 8
Time frame: week 2, 4, 6, and 8 post baseline
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