inal tract and the complex itself does not enter the systemic circulation.
Clinical efficacy
IBD Studies
The safety and efficacy of Feraccru for the treatment of iron deficiency anaemia was studied in 128 patients (age range 18-76 years; 45 males and 83 females) with inactive to mildly active IBD (58 patients with Ulcerative Colitis [UC] and 70 patients with Crohn's disease [CD]) and baseline Hb concentrations between 9.5 g/dL and 12 / 13 g/dL for females / males. Patients were enrolled in one combined randomised, placebo-controlled clinical study (AEGIS 1/2). 69 % of the patients with UC had a SCCAI score ≤2 and 31 % a SCCAI score of 3. 83 % of the patients with CD had a CDAI-score <150 and 17 % a CDAI-score >150-220. All patients had discontinued from prior oral ferrous product (OFP) treatment: more than 60 % of the subjects stopped taking prior OFP due to adverse events. The median time since last dose of OFP was 22 months in the experimental group and 17 months in the placebo arm. 52 % of the patients in AEGIS 1 and 33 % in AEGIS 2 had a disease flare in the previous 6 months. The median (min-max) time since last disease flare was around 7 months (0.0-450 months). Subjects were randomised to receive either 30 mg Feraccru twice daily or a matched placebo control for 12 weeks. The difference between the change from baseline for Feraccru compared to placebo at week 12 was 2.25 g/dL (p<0.0001). Following completion of the 12-week placebo-controlled phase of the studies, all subjects were switched to Feraccru 30 mg twice daily open-label treatment for a further 52 weeks.
The results for the other key efficacy endpoints are shown in Table 2.
Table 2: Summary of Other Key Efficacy Endpoints (AEGIS 1/2)
Endpoint
Hb change (g/dL) from Baseline* at Week 4
Mean (SE)
Hb change (g/dL) from Baseline* at Week 8
Mean(SE)
Proportion of subjects that achieved normalised Hb at Week 12 (%)
Proportion of subjects that achieved ≥1 g/dL change in Hb at Week 12 (%)
Proportion of subjects that achieved ≥2 g/dL change in Hb at Week 12 (%)
Feraccru (N=64)
1.06 (0.08)***
1.79 (0.11)***
66
78
56
Placebo (N=64)
0.02 (0.08)
0.06 (0.11)
12
11
0
* Hb at Baseline mean (SE): Feraccru 11.0 (1.027) g/dL, Placebo 11.1 (0.851) g/dL; ***p<0.0001 compared to placebo group;
An increase of ≥1 g/dL change in Hb at Week 12 was achieved in 90 % and 69 % of the ulcerative colitis (N=29) and Crohn's Disease (N=35) subgroups, respectively. An increase of ≥2 g/dL change in Hb at Week 12 was achieved in 62 % and 51 % of the ulcerative colitis and Crohn's Disease subgroups, respectively. Iron deficiency was also shown to be corrected by increase in ferritin levels in both studies. Mean ferritin (μg/L) levels in subjects taking feraccru improved steadily from baseline (mean 8.6 μg/L [SD 6.77]) to Week 12 (mean 26.0 μg/L [SD 30.57]), a mean overall improvement of 17.4 μg/L. Ferritin continued to rise over long-term treatment with Feraccru (mean 68.9 μg/L [SD 96.24] at 64 weeks, a mean overall improvement of 60.3 μg/L).
The European Medicines Agency has deferred the obligation to submit the results of studies with Feraccru in one or more subsets of the paediatric population in iron deficient anaemia (see section 4.2 for information on paediatric use).
5.2 Pharmacokinetic properties
Absorption and elimination
The pharmacokinetic properties of Feraccru was assessed through measurement of plasma and urine concentrations of maltol and maltol glucuronide, toget |
