A safety, pharmacokinetic and pharmacodynamic investigation of deferasirox (Exjade, ICL670) in patients with transfusion-dependent anemias and iron-overload: a Phase I study in Japan

Int J Hematol. 2008 Jul;88(1):73-81. doi: 10.1007/s12185-008-0115-2. Epub 2008 Jul 4.

Abstract

The pharmacokinetics (PK) and pharmacodynamics (PD) of the once-daily, oral ironchelating agent, deferasirox (Exjade, ICL670), have been evaluated further in a Phase I, openlabel, multicenter, dose-escalation study in Japanese patients with myelodysplastic syndromes, aplastic anemia, and other anemias. Deferasirox was initially administered as a single dose of 5 (n = 6), 10 (n = 7), 20 (n = 6) or 30 (n = 7) mg/(kg day) and then after 7 days seven daily doses were administered. Linear PK (C (max) and AUC) were observed at all doses after a single dose and at steady state, and dose-dependent iron excretion was observed. Pharmacokinetic/pharmacodynamic parameters were similar to those reported in a Caucasian beta-thalassemia cohort. Following the single- and multiple-dose phases, 21 of 26 patients progressed to a 3-year extension phase of the study, where dose reductions and increases [5-30 mg/(kg day)] were allowed following safety and efficacy assessments. In the interim, 1-year data show that deferasirox was well tolerated, with generally infrequent and mild adverse events. Reductions in serum ferritin levels were observed and a negative iron balance achieved at doses of 20-30 mg/(kg day). These data suggest that deferasirox has a stable and predictable PK/PD profile, irrespective of underlying disease or race, and a predictable and manageable safety profile suitable for chronic administration.

Publication types

  • Clinical Trial, Phase I
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anemia, Aplastic / metabolism
  • Anemia, Aplastic / therapy*
  • Asian People
  • Benzoates / administration & dosage
  • Benzoates / adverse effects
  • Benzoates / pharmacokinetics*
  • Blood Transfusion*
  • Deferasirox
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Iron Chelating Agents / administration & dosage
  • Iron Chelating Agents / adverse effects
  • Iron Chelating Agents / pharmacokinetics*
  • Iron Overload / drug therapy*
  • Iron Overload / metabolism
  • Japan
  • Male
  • Middle Aged
  • Myelodysplastic Syndromes / metabolism
  • Myelodysplastic Syndromes / therapy*
  • Triazoles / administration & dosage
  • Triazoles / adverse effects
  • Triazoles / pharmacokinetics*

Substances

  • Benzoates
  • Iron Chelating Agents
  • Triazoles
  • Deferasirox