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Clinical Trial Details — Status: Terminated

Administrative data

NCT number NCT02895945
Other study ID # 241502
Secondary ID 2015-005521-39
Status Terminated
Phase Phase 3
First received
Last updated
Start date December 22, 2016
Est. completion date January 22, 2021

Study information

Verified date October 2021
Source Takeda
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of this study is to evaluate the efficacy and safety of BAX 802 in males with congenital hemophilia A (CHA) with inhibitors who are undergoing major or minor elective surgical, dental, or other invasive procedures.


Recruitment information / eligibility

Status Terminated
Enrollment 8
Est. completion date January 22, 2021
Est. primary completion date January 22, 2021
Accepts healthy volunteers No
Gender Male
Age group 12 Years to 75 Years
Eligibility Inclusion Criteria 1. Participant requires a major or minor elective surgical, dental or other invasive procedure 2. Participant is male and = 12 to = 75 years old at the time of screening 3. Participant has provided signed informed consent (and assent for adolescent participants, as applicable) in accordance with local regulatory requirements 4. Participant has severe (factor VIII (FVIII) level < 1%) or moderately severe (FVIII level = 2%) congenital hemophilia A (CHA) with inhibitors to human factor VIII (hFVIII) of = 0.6 Bethesda units (BU), as tested at screening at the central laboratory 5. Participant is not currently receiving or has recently received (< 30 days) immune tolerance induction (ITI) therapy 6. Participant has a Karnofsky performance score of = 60 at screening 7. Participant is human immunodeficiency virus negative (HIV-); or HIV+ with stable disease and CD4+ count = 200 cells/mm^3 at screening 8. Participant is hepatitis C virus negative (HCV-) by antibody or polymerase chain reaction (PCR) testing; or HCV+ with chronic stable hepatitis disease. Positive serologies will be confirmed by PCR testing. 9. Participant is willing and able to comply with the requirements of the protocol. Exclusion Criteria 1. The participant requires emergency surgery 2. Severe chronic liver dysfunction or disease (e.g., = 5 × upper limit of normal [ULN] alanine aminotransferase [ALT], as confirmed by central laboratory at screening or a documented prothrombin time/international normalized ratio [PT/INR] > 1.5) 3. Clinically symptomatic renal disease (serum creatinine > 2.0 mg/dL), as confirmed by central laboratory at screening 4. Anti-porcine factor VIII (pFVIII) inhibitor > 10 BU prior to surgery 5. Platelet count < 100,000/µL at screening 6. Participant has another active coagulation disorder, other than hemophilia A, as per the medical history 7. Planned use of a-interferon with or without ribavirin for HCV infected patients or planned use of a protease inhibitor for HIV infected patients. Patients currently taking any of these medications for = 30 days are eligible 8. Known hypersensitivity to recombinant porcine factor VIII (rpFVIII), or hamster or murine proteins 9. Participant has an ongoing or recent (within 3 months of screening) thrombo-embolic disease, fibrinolysis or disseminated intravascular coagulation (DIC) 10. Participant has been exposed to an IP within 30 days prior to enrollment or is scheduled to participate in another clinical study involving an investigational product (IP) or investigational device during the course of this study 11. Participant is unable to tolerate quantity of blood to be drawn for protocol procedures 12. Participant is a family member or employee of the Investigator.

Study Design


Related Conditions & MeSH terms


Intervention

Biological:
Antihemophilic Factor (Recombinant), Porcine Sequence (BAX 802)
In case of major surgery, FVIII target level is =80% for major surgeries/ procedures and =50% for minor surgeries/ procedures.

Locations

Country Name City State
Bulgaria UMHAT 'Tsaritsa Yoanna - ISUL', EAD Sofia
Bulgaria UMHATEM 'N.I. Pirogov', EAD Sofia
Canada Hopital Maisonneuve-Rosemont d/b/a CIUSSS de l'Est-de-l'Île-de-Montréal Montréal Quebec
Germany Universitaetsklinikum Bonn AoeR Bonn
Germany Zentrum für Hämostaseologie, Universitätsklinikum Leipzig AöR Leipzig
Italy Presidio Ospedaliero di Castelfranco Veneto Castelfranco Veneto Treviso
Italy Azienda Ospedaliera Universitaria Careggi Firenze
Italy Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano
Italy Azienda Ospedaliera di Padova Padova
Netherlands UMC Utrecht Utrecht
Norway Oslo Universitetssykehus - Rikshospitalet Oslo
Poland Instytut Hematologii i Transfuzjologii-1-1Y7-1347 Warszawa
Russian Federation FSBI of Science "Kirov Scientific and Research Institute of Hematology and Blood Transfusion of FMBA. Kirov
South Africa Bleeding Disorders Unit and Clinical Haematology Service at Charlotte Maxeke JHB Academic Hospital Johannesburg
Spain Complejo Hospitalario Universitario A Coruña La Coruña
Spain Hospital Universitario La Paz Madrid
Spain Hospital Universitari i Politecnic La Fe Valencia Comunidad Valenciana
Turkey Ankara University Medical Faculty Ankara
Turkey Ege University Medical Faculty Izmir
Turkey Ege University Medical Faculty Izmir
Turkey Kocaeli University Medical Faculty Kocaeli
United States Case Western Reserve University Cleveland Ohio
United States Bleeding and Clotting Disorders Institute Peoria Illinois
United States Wake Forest University Baptist Medical Center Winston-Salem North Carolina

Sponsors (2)

Lead Sponsor Collaborator
Baxalta now part of Shire Baxalta Innovations GmbH, now part of Shire

Countries where clinical trial is conducted

United States,  Bulgaria,  Canada,  Germany,  Italy,  Netherlands,  Norway,  Poland,  Russian Federation,  South Africa,  Spain,  Turkey, 

Outcome

Type Measure Description Time frame Safety issue
Primary Percentage of Surgeries With a "Good" or "Excellent" Response as Measured by the Global Hemostatic Efficacy Assessment (GHEA) Score GHEA score consisted of 3 individual rating scales: (1) Intra-operative Efficacy Assessment Scale, (2) Post-operative Efficacy Assessment Scale, and (3) Overall Peri-operative Efficacy Assessment Scale. Scales 1 and 2 was performed by the operating surgeon on Day 1, and Scale 3 was performed by the investigator on Day 14. Each rating scale was based on 4 points scale ranging from: 3 (Excellent), 2 (Good), 1 (Fair), and 0 (None). Total score ranged from 0 to 9, where scores evaluated as: excellent (7 to 9), good (5 to 7), fair (3 to 4), and none (0 to 2). The scores of 3 individual ratings scales were added together to form a GHEA score. For a GHEA score of 7 to be rated "excellent" with no individual assessment scores less than (<) 2 and at least 1 assessment score equal to (=) 3; otherwise a score of 7 was rated "good". Percentage of Surgeries With a "Good" or "Excellent" response as measured by the GHEA score were reported. Day 1 up to discharge or Day 14 (whichever was earlier)
Secondary Actual Blood Loss, Estimated Volume of Expected Average Blood Loss and Expected Maximum Blood Loss During Intra-operative, Post-operative and Peri-operative Period Prior to the surgery, the surgeon/investigator predicted and compared the estimated volume (in milliliter [mL]) of the expected average blood loss and expected maximum blood loss for the planned surgical intervention in a comparable healthy individual with similar demographic characteristics; for intraoperative, postoperative, and overall perioperative time periods. Intra-operative defined as period from start of surgery to completion of surgical procedure. Post-operative defined as period from completion of surgical procedure till 24 hours post-surgery. Peri-operative defined as period from start of surgical procedure till discharge or 14 days post surgery (whichever was earlier). Actual blood loss, estimated volume of expected average blood loss and expected maximum blood loss during each operative period was reported. Intra-operative: up to completion of surgery (Day 1), Post-operative: at 24 hours post-surgery, and Peri-operative: at discharge or Day 14 (whichever was earlier)
Secondary Ratio of Actual Blood Loss and Estimated Volume of Expected Average Blood Loss During Intra-operative, Post-operative and Peri-operative Period Prior to the surgery, the surgeon/investigator predicted and compared the estimated volume (mL) of the expected average blood loss and expected maximum blood loss for the planned surgical intervention in a comparable healthy individual with similar demographic characteristics; for intraoperative, postoperative, and overall perioperative time periods. Intra-operative defined as period from start of surgery to completion of surgical procedure. Post-operative defined as period from completion of surgical procedure till 24 hours post-surgery. Peri-operative defined as period from start of surgical procedure till discharge or 14 days post surgery (whichever was earlier). Ratio of actual blood loss and estimated volume of expected average blood loss during each operative period was reported. Intra-operative: up to completion of surgery (Day 1), Post-operative: at 24 hours post-surgery, and Peri-operative: at discharge or Day 14 (whichever was earlier)
Secondary Ratio of Actual Blood Loss and Expected Maximum Blood Loss During Intra-operative, Post-operative and Peri-operative Period Prior to the surgery, the surgeon/investigator predicted and compared the estimated volume (mL) of the expected average blood loss and expected maximum blood loss for the planned surgical intervention in a comparable healthy individual with similar demographic characteristics; for intraoperative, postoperative, and overall perioperative time periods. Intra-operative defined as period from start of surgery to completion of surgical procedure. Post-operative defined as period from completion of surgical procedure till 24 hours post-surgery. Peri-operative defined as period from start of surgical procedure till discharge or 14 days post surgery (whichever was earlier). Ratio of actual blood loss and expected maximum blood loss during each operative period was reported. Intra-operative: up to completion of surgery (Day 1), Post-operative: at 24 hours post-surgery, and Peri-operative: at discharge or Day 14 (whichever was earlier)
Secondary Percentage of Major Surgeries With Good or Excellent Hemostatic Score Percentage of major surgeries with good or excellent hemostatic score was analyzed by GHEA score. It consisted of 3 individual ratings: (1) Intra-operative Efficacy Assessment Scale, (2) Post-operative Efficacy Assessment Scale, (3) Postoperative Efficacy Assessment Scale. Ratings 1 and 2 was performed by the operating surgeon on Day 1, and Rating 3 was performed by the investigator on Day 14. Each rating scale was based on 4 point scale ranging from: 3 (Excellent), 2 (Good), 1 (Fair), and 0 (None). The scores of each of the 3 individual ratings scales, was added together to form a GHEA score. Total score ranged from 0 to 9 where scores evaluated as excellent (7 to 9), good (5 to 7), fair (3 to 4), and none (0 to 2). Hemostatic efficacy success was defined as "excellent" or "good "outcome for >=70% of hemostatic efficacy assessments. Percentage of major surgeries with good or excellent hemostatic score were reported. Day 1 up to discharge or Day 14 (whichever was earlier)
Secondary Average Daily Weight-adjusted Dose of BAX 802 Per Participant During Pre-operative, Intra-operative and Post-operative Period Body-weight adjusted dose equals to amount infused/body-weight (kilogram [kg]), where amount infused as amount of drug infused (International Units [IU]) and body-weight as the last available body-weight (kg) prior to the infusion. Pre-operative defined as period prior to surgery. Intra-operative defined as period from start of surgery to completion of surgical procedure. Post-operative defined as period from completion of surgical procedure till discharge or 14 days post surgery (whichever was earlier). Average daily weight-adjusted dose of BAX 802 per participant during each operative period was reported. Pre-operative: before surgery, Intra-operative: up to completion of surgery (Day 1), Post-operative: from completion of surgical procedure till discharge or 14 days post surgery (whichever was earlier)
Secondary Total Weight-adjusted Dose of BAX 802 Per Participant During Pre-operative, Intra-operative and Post-operative Period Body-weight adjusted dose equals to amount infused/body-weight (kg), where amount infused as amount of drug infused (IU) and body-weight as the last available body-weight (kg) prior to the infusion. Pre-operative defined as period prior to surgery. Intra-operative defined as period from start of surgery to completion of surgical procedure. Post-operative defined as period from completion of surgical procedure till discharge or 14 days post surgery (whichever was earlier). Total weight-adjusted dose of BAX 802 per participant during each operative period was reported. Pre-operative: before surgery, Intra-operative: up to completion of surgery (Day 1), Post-operative: from completion of surgical procedure till discharge or 14 days post surgery (whichever was earlier)
Secondary Volume of Blood Products Transfused The volume (in mL) of blood products transfused from initiation of the intervention to discharge or Day 14 (whichever came earlier) was reported. From initiation of the surgery up to discharge or Day 14 (whichever came earlier)
Secondary Number of Participants With De Novo Inhibitors De novo inhibitor was defined as a post-baseline inhibitor titer to FVIII (hFVIII or porcine factor VIII [pFVIII])of >=0.6 Bethesda units per milliliter (BU/mL) given a baseline of <0.6 BU/mL. Number of participants with de novo inhibitors were reported. Baseline up end of study (EOS) (up to 44 months)
Secondary Number of Participants With Anamnestic Reactions An anamnestic reaction was defined as an increase from a measurable baseline (>0.6 BU/mL) in the inhibitor titer to FVIII (human or porcine) of >=10 BU/mL. Number of participants with anamnestic reactions were reported. Baseline up to EOS (up to 44 months)
Secondary Mean Change From Baseline up to EOS in Inhibitory and Binding Antibodies to pFVIII The assessment of inhibitory antibodies (immunoglobulin G [IgG] and immunoglobulin M [IgM]) to pFVIII was determined using Bethesda assay, and assessment of binding antibodies (IgG and IgM) to pFVIII was determined using validated enzyme-linked immunosorbent assays (ELISAs). Mean change from baseline in inhibitory and binding antibodies to pFVIII was reported. Baseline up to EOS (up to 44 months)
Secondary Mean Change From Baseline up to EOS in Inhibitory and Binding Antibodies to hFVIII The assessment of inhibitory antibodies (IgG and IgM) to hFVIII was determined using Bethesda assay, and assessment of binding antibodies (IgG and IgM) to hFVIII was determined using ELISA. Mean change from baseline in inhibitory and binding antibodies to hFVIII was reported. Baseline up to EOS (up to 44 months)
Secondary Number of Participants With Clinically Significant Change From Baseline in Binding Antibodies to Baby Hamster Kidney (BHK) Proteins The assessment of binding antibodies to BHK proteins was determined using ELISA. Clinical significance was judged by the investigator. Number of participants with clinically significant change from baseline in binding antibodies to BHK proteins were reported. Baseline up to EOS (up to 44 months)
Secondary Number of Participants With Thromboembolic Events Thromboembolism defined as formation in a blood vessel of a clot (thrombus) that breaks loose and carried by the blood stream to plug another vessel. Number of participants with thromboembolic events was reported. Baseline up to EOS (up to 44 months)
Secondary Number of Participants With Severe Allergic Reactions Number of participants with severe allergic reaction (example: anaphylaxis) after administration of study drug were reported. Baseline up to EOS (up to 44 months)
Secondary Number of Participants With Investigational Product (IP) Related Treatment-emergent Adverse Events (TEAEs) and Serious TEAEs An adverse event (AE) is any untoward medical occurrence in a clinical investigation participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. Serious AE was any untoward medical occurrence (whether considered to be related to study assigned treatment or not) that at any dose resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, resulted in a congenital abnormality/birth defect, or was an important medical event. TEAEs was defined as any adverse events (classified by preferred term) that had a start date on or after the first dose of study treatment or that had a start date before the date of first dose of study treatment, but increased in severity after the first dose of study treatment. TEAEs included both serious and non-serious TEAEs. Baseline up to EOS (up to 44 months)
Secondary Number of Participants With Clinically Significant Change From Baseline in Vital Sign Vital sign parameters included: temperature, pulse rate, respiration rate, systolic and diastolic blood pressure. Any changes in vital signs which were deemed clinically significant was judged by the investigator. Number of participants with clinically significant change from baseline in vital signs were reported. Baseline up to EOS (up to 44 months)
Secondary Number of Participants With Clinically Significant Change From Baseline in Clinical Laboratory Values Clinical laboratory assessment included hematology and clinical chemistry. Any changes in clinical laboratory results which were deemed clinically significant was judged by the investigator. Number of participants with clinical significant change from baseline in clinical laboratory values were reported. Baseline up to EOS (up to 44 months)
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