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Evaluation of the Efficacy in Decreasing Iron Absorption in Patients With Congenital Dyserythropoietic Anemia Type I by Treatment With LOSEC

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01795794
Recruitment Status : Unknown
Verified February 2013 by Soroka University Medical Center.
Recruitment status was:  Not yet recruiting
First Posted : February 21, 2013
Last Update Posted : February 27, 2013
Information provided by (Responsible Party):
Soroka University Medical Center

Brief Summary:

Congenital Dyserythropoietic Anemia Type I (CDAI) is a recessive autosomal disease caused by ineffective erythropoiesis that causes Anemia & accumulation of iron due to increased absorption of iron in the intestine.

The iron is being accumulated in the body & causes damage of the liver, heart & endocrine glands.

The standard follow up of iron levels is done by ferritin blood test & although the test is not accurate it is the most available.

Medical treatment to removal of iron excess from the body is given in ferritin levels of 500-1000.

3 drugs are approved in the market:

  • Deferoxamine, given subcutaneous during the night, 5-7 nights/week and therefore is less used today.
  • Deferiprone-given 3 times a day, is a weaker chelator, although it seems like it is good to give it in combination with one of the 2 other drugs because it removes the iron from the heart's cells better.

A rare but severe adverse effect is Agranulocytosis. This drug is usually not given in childbirths.

-The 3rd drug which is mostly in use today is Deferasirox, given once daily, but has also adverse effects, among them- damage of liver & kidney function, damage to the digestive system, hearing and seeing.

Iron is being absorbed in acidic area, & thus drugs which decrease the acidity like hydrogen pump's inhibitors, can inhibit the absorption of iron, and indeed there are reports that these drugs decrease the absorption of iron and were used as treatment to hemochromatosis as well.

Those hydrogen pump's inhibitors have also adverse effects. The rarest but most severe is intestine infection by Clostridium.

In children, reports of adverse effects are minimal- mostly headaches & abdominal pains and nosocomial infections. In adults, there are reports of fractures, magnesium deficiency & vitamin B12 deficiency. All in all, the adverse effects are rare & uncommon.

Condition or disease Intervention/treatment Phase
CDA Type I Drug: omeprazole Phase 4

Detailed Description:

The aim of this study is to check whether treatment with drug which inhibits the hydrogen pump and therefore decreases acidity, will reduce the iron's absorption in patients with CDA TYPE I and whether it will be possible to use it for a period instead of giving drugs which have much more adverse effects, for removal of iron excess from the body.

Therefore, we would like to enroll 10-12 patients over 30 kg who can swallow tablets (age over 12) and whose ferritin levels are higher from the normal range, but still don't require medical treatment (ferritin levels between 400-700).

These patients will be given LOSEC 20 mg X 1/day for 6 months. That group will be her own control group in the 6 months later. Drug will be dispensed to the patients.

In the beginning of the study, after signing Informed Consent Form, blood tests will be taken for Complete Blood Count, iron levels, iron saturation, ferritin, complete chemistry panel, including calcium & magnesium.

Same tests will be taken after 3 and 6 months and also 3 and 6 months after end of treatment.

In every event of fever, headaches, abdominal pain or diarrhea, patients need to apply the doctor and report.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 12 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Study Start Date : April 2013
Estimated Primary Completion Date : December 2013
Estimated Study Completion Date : December 2013

Arm Intervention/treatment
Experimental: LOSEC
LOSEC will be given 20 mg X 1/day for 6 months and then for the next 6 months the same group will be the "control" group of herself.
Drug: omeprazole
Other Name: losec

Primary Outcome Measures :
  1. evaluate number of adverse effects per patient treated with LOSEC + levels of iron, ferritin,complete blood count and chemistry panel. [ Time Frame: 1 year ]

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Ages Eligible for Study:   12 Years and older   (Child, Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • patients with CDAI
  • over 30 kg
  • can swallow tablets
  • ferritin levels higher than the normal range but still don't require treatment.

Exclusion Criteria:

  • N.A
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Responsible Party: Soroka University Medical Center Identifier: NCT01795794    
Other Study ID Numbers: sor034612ctil
First Posted: February 21, 2013    Key Record Dates
Last Update Posted: February 27, 2013
Last Verified: February 2013
Additional relevant MeSH terms:
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Anti-Ulcer Agents
Gastrointestinal Agents
Proton Pump Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action