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CompletedNCT03993288Updated Jul 12, 2021Results posted

Study to Test the Hypothesis of Non-inferior Efficacy and Safety of Ferrum Lek® (Iron (III) Hydroxide Polymaltosate), 100 mg Chewable Tablets (Lek d.d., Slovenia), as Compared With MALTOFER® (Vifor S.A., Switzerland), in Subjects With Mild and Moderate Iron Deficiency Anemia.

A Phase 3 interventional study of Ferrum Lek® (iron (III) hydroxide polymaltosate), 100 mg chewable tablets (Lek d.d., Slovenia) and MALTOFER® (iron (III) hydroxide polymaltosate), 100 mg chewable tablets (Vifor S.A., Switzerland) in Mild and Moderate Iron-deficiency Anaemia, sponsored by Sandoz. Completed at 18 sites in Russian Federation. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-07-12.

Sponsored by Sandoz · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
267
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this study was to evaluate non-inferiority for efficacy and safety of Ferrum Lek® (iron (III) hydroxide polymaltosate), 100 mg chewable tablets (Lek d.d., Slovenia), compared to MALTOFER® (Vifor S.A., Switzerland), in the treatment of patients with mild and moderate iron-deficiency anaemia.

Read the detailed description

This was a multi-centric, open-label, randomized, prospective, comparative, parallel-group, active-controlled, phase III clinical trial (in the Russian Federation).

The purpose of this study was to evaluate non-inferiority for efficacy and safety of Ferrum Lek® (iron (III) hydroxide polymaltosate), compared to MALTOFER®, in the treatment of patients with mild and moderate iron-deficiency anaemia.

Participants underwent screening for up to 7 days. Eligible participants were randomized in 1:1 ratio to two treatment arms.

Subjects in Group 1 received 2 tablets per day (200 mg) of chewable tablets Ferrum Lek® during or immediately after meals; once daily.

Subjects in Group 2 (reference product) received 2 tablets per day (200 mg) of chewable tablets Maltofer® during or immediately after meals; once daily.

The subjects received the medicinal products daily for 12 weeks. After the last scheduled study site visit, a follow-up visit (by phone) was scheduled 14 days after the completion of the active treatment period (day 98±2) to record any delayed adverse events.

02

Conditions studied

  • Mild and Moderate Iron-deficiency Anaemia

Keywords

  • Ferrum Lek® (iron (III) hydroxide polymaltosate)
  • mild and moderate iron-deficiency anaemia
03

In context

Anemia

1,733 studies on the registry are indexed under Anemia; 246 are open to participants now.

This study's enrollment of 267 is above the median of 94 across 1,291 interventional studies indexed under Anemia.

Browse Anemia studies →

Lead sponsor

Sandoz is the lead sponsor of 136 studies on the registry; none are open to participants now.

Of its 10 completed or terminated interventional studies of FDA-regulated products, 5 (50%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. The signed and dated written informed consent prior to participation in the study.
  2. Men and women aged 18 and older (by the time of screening).
  3. Outpatients.
  4. Diagnosed iron-deficiency anemia, based on two criteria:

    1. hemoglobin level below 110 g/L (in men and women), but above 80 g/L,
    2. serum ferritin levels below 30 µg/L.

Exclusion criteria

Exclusion Criteria:

  1. Administration of any iron-containing drugs during the last 3 months.
  2. History of erythropoietin drugs administration.
  3. Hypersensitivity to iron therapy (both Oral and/or IV administration) and other components of the study drugs.
  4. Hormone therapy (including the use of androgens/anabolic steroids) or administration of drugs that inhibit blood formation, less than 3 months before the start of the study.
  5. History of severe allergic reactions or drug intolerance.
  6. Fructose intolerance, glucose-galactose malabsorption syndrome, and sucrase-isomaltase deficiency.
  7. Pregnant or lactating women, or women intending to become pregnant during the study.
  8. Failure of iron therapy for iron-deficiency anaemia in a subject's past medical history.
  9. Heme metabolism disorders (e.g., sideroachrestic anaemia, lead anaemia, thalassaemia).
  10. Iron overload including haemochromatosis and hemosiderosis
  11. Other causes of anemia, apart from iron deficiency, including:

    1. Haemolysis (determined as per analyses results at screening, or as per anamnestic data),
    2. Vitamin B12 and folic acid deficiency (as per the screening data),
    3. Chronic kidney disease (creatinine clearance at screening is below 90 ml/min (based on Cockcroft-Gault Formula)),
    4. Systemic connective tissue diseases, chronic infectious diseases requiring regular therapy (as per the past medical history), and other conditions which may, in the investigator's opinion, be accompanied by anaemia of chronic diseases.
  12. Dysfunction of the thyroid gland (based on the data obtained at screening).
  13. Laboratory and clinical signs of an active inflammatory process for 10 days before screening.
  14. AST, ALT, and total bilirubin levels exceeding the upper limit of normal 1.5 times and more.
  15. Clinically apparent hypothyroidism, in the investigator's opinion.
  16. Malignant diseases, including blood and lymphoid tissue disorders (leukemia, Hodgkin disease, myelodysplastic syndrome, myeloma, etc.) at screening or in the past medical history, provided that the remission was less than 5 years before screening.
  17. Signs of bone marrow aplasia at screening or history of bone marrow aplasia.
  18. The necessity of parenteral iron therapy, i.e. the following cases:

    1. impaired absorption in case of an intestinal pathology (enteritis, coeliac disease, malabsorption, small intestinal resection, stomach resection, including the duodenum);
    2. exacerbation of gastric or duodenal ulcer;
    3. the necessity of quick iron saturation, e.g. in patients with iron-deficiency anaemia with upcoming surgery;
    4. continuous vast blood loss and other causes, at the discretion of the investigator.
  19. Known presence of an active infection caused by Helicobacter pylori. In case of presence of Helicobacter pylori, a subject may be enrolled after eradicative therapy.
  20. Concomitant diseases and conditions, which, in the investigator's opinion, pose risk to a subject's safety in case of his/her participation in the study, or able to affect the safety data analysis in case of exacerbation of this disease/condition during the study, including:

    1. Myocardial infarction or stroke within 6 months before screening.
    2. Unstable angina;
    3. Severe arrhythmia, not controlled by drug therapy;
    4. Decompensated diabetes mellitus;
    5. Nephrological disorders;
    6. Other significant diseases, at the discretion of the investigator.
  21. HIV infection (as per the screening data or the results of analysis performed within 6 months before screening).
  22. Known or suspected drug or alcohol abuse for the last 2 years.
  23. Suspected poor adherence of a subject (e.g., due to mental disorders).
  24. Participation in any clinical drug studies less than 3 months before the study.
  25. Blood donation / blood transfusion within 30 days prior to screening or planned blood transfusion at time of screening.
  26. History of smoking, unless leave off smoking > 6 months.
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
267 participants (actual)

Study arms

  • Experimental
    Ferrum Lek

    Participants received Ferrum Lek® 2 tablets daily (200 mg) for 12 weeks

    Drug: Ferrum Lek® (iron (III) hydroxide polymaltosate), 100 mg chewable tablets (Lek d.d., Slovenia)

  • Active comparator
    MALTOFER

    Participants received MALTOFER® 2 tablets daily (200 mg) for 12 weeks

    Drug: MALTOFER® (iron (III) hydroxide polymaltosate), 100 mg chewable tablets (Vifor S.A., Switzerland)

Interventions

  • DrugFerrum Lek® (iron (III) hydroxide polymaltosate), 100 mg chewable tablets (Lek d.d., Slovenia)

    Participants received Ferrum Lek® 2 tablets daily (200 mg) for 12 weeks

  • DrugMALTOFER® (iron (III) hydroxide polymaltosate), 100 mg chewable tablets (Vifor S.A., Switzerland)

    Participants received MALTOFER® 2 tablets daily (200 mg) for 12 weeks

06

What researchers measure

Primary outcomes

  1. Change From Baseline in Blood Hemoglobin Level (g/L)

    Changes in blood hemoglobin level (g/L) after 12-weeks of iron-deficiency anaemia treatment, a non-inferiority comparison, as compared with the baseline value (screening visit) between Ferrum Lek® and MALTOFER® groups

    Time frame: Baseline and Week 12

Secondary outcomes

  1. Change From Baseline in Serum Iron

    Change in average values of iron metabolism parameter serum iron during the treatment period

    Time frame: Baseline, Week 4, 8 and 12

  2. Change From Baseline in Transferrin

    Change in average values of iron metabolism parameter transferrin during the treatment period

    Time frame: Baseline, Week 4, 8 and 12

  3. Change From Baseline in Percent Transferrin Saturation

    Change in average values of iron metabolism parameter percent transferrin saturation during the treatment period

    Time frame: Baseline, Week 4, 8 and 12

  4. Change From Baseline in Ferritin

    Change in average values of iron metabolism parameter ferritin during the treatment period

    Time frame: Baseline, Week 4, 8 and 12

  5. Number of Participants With Response to the Therapy

    Response to the therapy is determined as an increase in hemoglobin level by 20 g/L and more after 12-weeks of treatment

    Time frame: Baseline and Week 12

07

Results

Posted Jul 12, 2021

Participant flow

Participants were enrolled from 18 sites in the Russian Federation.

Participant flow — Overall Study
MilestoneFerrum LekMALTOFER
Started133134
Intention-to-treat (itt) population123129
Safety analysis set133134
Completed123129
Not completed105
Withdrew: Lost to follow-up21
Withdrew: Non-compliance to the inclusion criteria01
Withdrew: Wrong randomization01
Withdrew: Improper enrollment01
Withdrew: Prescribed with prohibited concomitant therapy10
Withdrew: Developed sae20
Withdrew: Consent withdrawal10
Withdrew: Did not follow the treatment schedule10
Withdrew: Did not follow the treatment regimen10
Withdrew: Adverse event10
Withdrew: Withdrawal by subject11

Outcome measures

PrimaryChange From Baseline in Blood Hemoglobin Level (g/L)

Changes in blood hemoglobin level (g/L) after 12-weeks of iron-deficiency anaemia treatment, a non-inferiority comparison, as compared with the baseline value (screening visit) between Ferrum Lek® and MALTOFER® groups

Time frame:
Baseline and Week 12
Reported as:
Mean · g/L
Change From Baseline in Blood Hemoglobin Level (g/L)
g/LFerrum LekMALTOFER
Change From Baseline in Blood Hemoglobin Level (g/L)18.33 ± 15.0518.52 ± 14.57
Statistical analysis
  • Ferrum Lek vs MALTOFER · ANCOVA · p = 0.0032 · Mean difference (net): -0.24 · 95% CI -4.86 to 4.38
SecondaryChange From Baseline in Serum Iron

Change in average values of iron metabolism parameter serum iron during the treatment period

Time frame:
Baseline, Week 4, 8 and 12
Reported as:
Mean · micromoles/liter
Change From Baseline in Serum Iron
micromoles/literFerrum LekMALTOFER
Week 41.76 ± 7.353.42 ± 6.57
Week 84.09 ± 9.624.34 ± 9.19
Week 125.16 ± 9.566.12 ± 8.28
SecondaryChange From Baseline in Transferrin

Change in average values of iron metabolism parameter transferrin during the treatment period

Time frame:
Baseline, Week 4, 8 and 12
Reported as:
Mean · g/L
Change From Baseline in Transferrin
g/LFerrum LekMALTOFER
Week 4-0.15 ± 0.31-0.14 ± 0.38
Week 8-0.22 ± 0.41-0.22 ± 0.41
Week 12-0.24 ± 0.41-0.25 ± 0.43
SecondaryChange From Baseline in Percent Transferrin Saturation

Change in average values of iron metabolism parameter percent transferrin saturation during the treatment period

Time frame:
Baseline, Week 4, 8 and 12
Reported as:
Mean · percent transferrin saturation
Change From Baseline in Percent Transferrin Saturation
percent transferrin saturationFerrum LekMALTOFER
Week 42.46 ± 5.824.44 ± 8.04
Week 88.25 ± 12.545.47 ± 9.45
Week 127.27 ± 12.028.03 ± 10.14
SecondaryChange From Baseline in Ferritin

Change in average values of iron metabolism parameter ferritin during the treatment period

Time frame:
Baseline, Week 4, 8 and 12
Reported as:
Mean · microgram/liter
Change From Baseline in Ferritin
microgram/literFerrum LekMALTOFER
Week 43.48 ± 11.27.35 ± 33.76
Week 84.9 ± 14.724.49 ± 15.42
Week 127.62 ± 20.246.55 ± 15.87
SecondaryNumber of Participants With Response to the Therapy

Response to the therapy is determined as an increase in hemoglobin level by 20 g/L and more after 12-weeks of treatment

Time frame:
Baseline and Week 12
Reported as:
Count of participants · Participants
Number of Participants With Response to the Therapy
ParticipantsFerrum LekMALTOFER
Number of Participants With Response to the Therapy5956

Adverse events

Collected over Adverse Events were collected for 14 weeks (12 weeks treatment period plus 2 weeks follow up).. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Ferrum Lek1/133 (0.8%)2/133 (1.5%)54/133 (40.6%)
MALTOFER0/134 (0%)0/134 (0%)47/134 (35.1%)
Most frequent serious events
Most frequent serious events
EventFerrum LekMALTOFER
MenometrorrhagiaReproductive system and breast disorders1/1330/134
EncephalopathyNervous system disorders1/1330/134
Most frequent other events
Most frequent other events
EventFerrum LekMALTOFER
Stool discolorationGastrointestinal disorders26/13320/134
DiarrhoeaGastrointestinal disorders13/1339/134
Abdominal painGastrointestinal disorders9/1336/134
ConstipationGastrointestinal disorders8/1337/134
HeadacheNervous system disorders5/1338/134
NasopharyngitisInfections and infestations4/1338/134
NauseaGastrointestinal disorders7/1335/134
DyspepsiaGastrointestinal disorders6/1337/134

Baseline characteristics

Age, Continuous
Age, Continuous(years)Ferrum LekMALTOFERTotal
Mean39.68 (18 to 71)38.16 (18 to 73)38.92 (18 to 73)
Sex: Female, Male
Sex: Female, Male(Participants)Ferrum LekMALTOFERTotal
Female124125249
Male9918
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)Ferrum LekMALTOFERTotal
Asian224
Caucasian131132263
08

Study locations

18 sites
  • Sandoz Investigative Site
    Krasnogorsk, 143408, Russian Federation
  • Sandoz Investigative Site
    Moscow, 119121, Russian Federation
  • Sandoz Investigative Site
    Saint-Petersburg, 188643, Russian Federation
  • Sandoz Investigative Site
    Saint-Petersburg, 191186, Russian Federation
  • Sandoz Investigative Site
    Saint-Petersburg, 192177, Russian Federation
  • Sandoz Investigative Site
    Saint-Petersburg, 193232, Russian Federation
  • Sandoz Investigative Site
    Saint-Petersburg, 194354, Russian Federation
  • Sandoz Investigative Site
    Saint-Petersburg, 194356, Russian Federation
  • Sandoz Investigative Site
    Saint-Petersburg, 195197, Russian Federation
  • Sandoz Investigative Site
    Saint-Petersburg, 196143, Russian Federation
  • Sandoz Investigative Site
    Saint-Petersburg, 197706, Russian Federation
  • Sandoz Investigative Site
    Saint-Petersburg, 198207, Russian Federation
  • Sandoz Investigative Site
    Saint-Petersburg, 198328, Russian Federation
  • Sandoz Investigative Site
    Saint-Petersburg, 199178, Russian Federation
  • Sandoz Investigative Site
    Saint-Petersburg, 199226, Russian Federation
  • Sandoz Investigative Site
    Saint-Petersburg, 199406, Russian Federation
  • Sandoz Investigative Site
    Smolensk, 214019, Russian Federation
  • Sandoz Investigative Site
    Yaroslavl, 150003, Russian Federation
09

References and documents

Study documents

  • Study protocol · Mar 20, 2019
  • Statistical analysis plan · Apr 6, 2020

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Yes — Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations.

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 12, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT03993288
Lead sponsor
Sandoz
Responsible party
Sponsor
First posted
Jun 20, 2019
Start date
Jun 27, 2019
Primary completion
Jun 18, 2020
Completion
Jun 18, 2020
Results posted
Jul 12, 2021
Last update
Jul 12, 2021

Study contacts

Sandoz
study director · Sandoz

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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