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Dose Finding and Safety Study of Deferoxamine in Patients With Brain Hemorrhage (DFO In ICH)

This study has been completed.
National Institute of Neurological Disorders and Stroke (NINDS)
Massachusetts General Hospital
Medical College of Wisconsin
Medical University of South Carolina
Hartford Hospital
Information provided by (Responsible Party):
Magdy Selim, Beth Israel Deaconess Medical Center Identifier:
First received: January 10, 2008
Last updated: February 27, 2017
Last verified: February 2017

Animal studies show that the breakdown of blood results in iron accumulation in the brain after brain hemorrhage (ICH); and that iron plays a role in brain injury in ICH patients. Deferoxamine (DFO) has been extensively used in clinical practice for more than 30 years to remove excessive iron from the body, and has been shown to provide some benefit in animal studies of ICH. Therefore, we plan to undertake this study to evaluate the safety and tolerability of treatment with DFO in patients with ICH, and to determine the maximal tolerated dose to be used in future studies to determine if treatment with DFO can improve the outcome of patients with ICH.

Our main objectives are: 1) to evaluate the safety and tolerability of varying doses of DFO, by determining the treatment related adverse events, in patients with ICH; and 2) to determine the maximal tolerated dose to be adopted in subsequent studies to test the efficacy of DFO in improving outcome after ICH.

We hypothesize that DFO is well-tolerated and has minimal serious adverse effects in patients with ICH; and that treatment with DFO will improve patients' outcome. The results can potentially bring into account new means to improve the outcome of patients with ICH. ICH is a frequent cause of disability and death. A successful study demonstrating the efficacy of iron-modifying therapy would be of considerable public health significance.

Condition Intervention Phase
Intracerebral Hemorrhage
Drug: Deferoxamine Mesylate
Phase 1

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: No masking
Primary Purpose: Other
Official Title: Safety and Tolerability of Deferoxamine in Acute Cerebral Hemorrhage

Resource links provided by NLM:

Further study details as provided by Beth Israel Deaconess Medical Center:

Primary Outcome Measures:
  • Dose-limiting toxicities [ Time Frame: First 7 days of hospitalization or diacharge, whichever occurs earlier ]

Enrollment: 20
Study Start Date: July 2008
Study Completion Date: April 2010
Primary Completion Date: January 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1
All participants will receive various dose-regimens of the study drug (deferoxamine mesylate). Each dose cohort will consist of at least 3 subjects.
Drug: Deferoxamine Mesylate
Various dose-regimens ranging from 7 mg/kg to 125 mg/kg (with a maximum allowable total daily dose of 6000 mg at any of the tested dose tiers, regardless of patient's weight), administered daily by IV infusion for three consecutive days.

Detailed Description:
An open-label, safety, tolerability, and dose-finding study using the continuous reassessment method.

Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Age ≥ 18 years
  2. The diagnosis of ICH is confirmed by brain CT scan.
  3. The first dose of the study drug can be administered within 18 hours of ICH symptom onset.
  4. Signed and dated informed consent is obtained
  5. Stable clinical and neurological status. Patients whose clinical or neurological status significantly deteriorates compared to presentation prior to administration of the study drug will be excluded.

Exclusion Criteria:

  1. Previous chelation therapy or known hypersensitivity to DFO products
  2. Abnormal renal function (serum creatinine > 2 mg/dl)
  3. Known severe iron deficiency anemia
  4. Planned surgical evacuation of ICH prior to administration of the study drug
  5. Patients with suspected secondary ICH related to tumour, coagulopathy, ruptured aneurysm or arteriovenous malformation, or venous sinus thrombosis
  6. Evidence of significant shift of midline brain structure (> 10 mm) or herniation on imaging studies.
  7. Deep coma (Glasgow Coma Score (GCS) = 3-5) upon presentation
  8. Taking iron supplements or prochlorperazine
  9. Patients with heart failure taking > 500 mg of vitamin C daily
  10. Known hearing impairment
  11. Systolic blood pressure < 100 mmHg or diastolic blood pressure < 60 mmHg, confirmed by 3 consecutive readings
  12. Significant chronic respiratory insufficiency
  13. Known pregnancy (or positive pregnancy test), or breast-feeding
  14. Patients known or suspected of not being able to comply with the study protocol due to alcoholism, drug dependency, incompliance, or any other cause.
  15. Any condition which, in the judgement of the investigator, might increase the risk to the patient
  16. Life expectancy of less than 90 days due to co-morbid conditions
  17. Concurrent participation in another research protocol for investigation of another experimental therapy
  18. Pre-existing Do Not Resuscitate (DNR) order, or indication that a new DNR order will be implemented within the first 48 hours of hospitalization. -
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Please refer to this study by its identifier: NCT00598572

United States, Massachusetts
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States, 02215
Sponsors and Collaborators
Beth Israel Deaconess Medical Center
National Institute of Neurological Disorders and Stroke (NINDS)
Massachusetts General Hospital
Medical College of Wisconsin
Medical University of South Carolina
Hartford Hospital
Principal Investigator: Magdy Selim, MD, PhD Beth Israel Deaconess Medical Center
  More Information

Responsible Party: Magdy Selim, Professor of Neurology, Beth Israel Deaconess Medical Center Identifier: NCT00598572     History of Changes
Other Study ID Numbers: 2007P000288
1R01NS057127-01A1 ( US NIH Grant/Contract Award Number )
Study First Received: January 10, 2008
Last Updated: February 27, 2017
Individual Participant Data  
Plan to Share IPD: No

Keywords provided by Beth Israel Deaconess Medical Center:
Intracerebral hemorrhage

Additional relevant MeSH terms:
Cerebral Hemorrhage
Pathologic Processes
Intracranial Hemorrhages
Cerebrovascular Disorders
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Vascular Diseases
Cardiovascular Diseases
Iron Chelating Agents
Chelating Agents
Sequestering Agents
Molecular Mechanisms of Pharmacological Action processed this record on May 23, 2017