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Clinical Trial Details — Status: Active, not recruiting

Administrative data

NCT number NCT03861273
Other study ID # C0371002
Secondary ID 2018-003086-3320
Status Active, not recruiting
Phase Phase 3
First received
Last updated
Start date July 29, 2019
Est. completion date September 5, 2030

Study information

Verified date May 2024
Source Pfizer
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This study will evaluate the efficacy and safety of PF-06838435 (a gene therapy drug) in adult male participants with moderately severe to severe hemophilia B (participants that have a Factor IX circulating activity of 2% or less). The gene therapy is designed to introduce genetic material into cells to compensate for missing or non-functioning Factor IX. Eligible study participants will have completed a minimum 6 months of routine Factor IX prophylaxis therapy during the lead in study (C0371004). Participants will be dosed once (intravenously) and will be evaluated over the course of 6 years. The main objective of the study will evaluate the annualized bleeding rate [ABR] for participants treated with gene therapy versus standard of care (SOC) therapy (FIX prophylaxis replacement regimen).


Recruitment information / eligibility

Status Active, not recruiting
Enrollment 51
Est. completion date September 5, 2030
Est. primary completion date November 16, 2022
Accepts healthy volunteers No
Gender Male
Age group 18 Years to 65 Years
Eligibility Inclusion Criteria - Males who completed 6 months of Factor IX prophylaxis therapy during the lead-in study (C0371004) prior to providing consent at the screening visit for this study. - Documented moderately severe to severe hemophilia B (Factor IX activity < =2%) - Previous experience with FIX therapy (=>50 documented exposure days to a FIX protein product) - Suspension of prophylaxis therapy for hemophilia B after administration of the study drug - Laboratory values (hemoglobin, platelets and creatinine) within study specified limits - Agree to contraception until components of the drug are eliminated from their body - Capable of giving signed informed consent Exclusion Criteria - Anti-AAVRh74var neutralizing antibodies (nAb) titer above the established threshold (ie, positive for nAb). - History of inhibitor to Factor IX or inhibitor detected during screening. Clinical signs or symptoms of decreased response to Factor IX - Hypersensitivity to Factor IX replacement product or IV immunoglobulin administration - History of chronic infection or other chronic disease - Any conditions associated with increased thromboembolic risk - Concurrent clinically significant major disease or condition unsuitable for participation and/or may interfere with the interpretation of study results - Laboratory values at screening visit that are abnormal or outside acceptable study limits - Current unstable liver or biliary disease - Currently on antiviral therapy for hepatitis B or C - Planned surgical procedure requiring Factor IX surgical prophylactic factor treatment 15 months from screening visit - Use of restricted therapies (e.g., blood products, acetylsalicylic acid [aspirin] or ibuprofen, other investigational therapy, and by-passing agents) - Previously dosed in a gene therapy research trial at any time or in an interventional clinical study within 12 weeks of screening visit - Active hepatitis B or C; hepatitis B surface antigen, hepatitis B virus deoxyribonucleic acid positivity, or hepatitis C virus ribonucleic acid positivity - Significant liver disease - Serological evidence of HIV1 or HIV2 infection with either CD4+ cell count <=200 mm3 and/or a viral load >20 copies/mL - Study and sponsor staff involved in the conduct of the study and their families - Unable to comply with study procedures - Sensitivity to heparin or heparin induced thrombocytopenia - Sensitivity to any of the study interventions, or components thereof, or drug or other allergy

Study Design


Related Conditions & MeSH terms


Intervention

Biological:
PF-06838435/ fidanacogene elaparvovec
Gene Therapy

Locations

Country Name City State
Australia Royal Adelaide Hospital Adelaide South Australia
Australia Royal Brisbane and Women's Hospital Brisbane Queensland
Australia Royal Prince Alfred Hospital Camperdown New South Wales
Australia The Alfred Hospital Melbourne Victoria
Australia Fiona Stanley Hospital Murdoch Western Australia
Brazil Centro de Hematologia e Hemoterapia - Hemocentro de Campinas - UNICAMP Campinas SÃO Paulo
Brazil Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti - HEMORIO Rio de Janeiro
Brazil Instituto Estadual de Hematologia Arthur de Siqueira Cavalcanti- HEMORIO Rio de Janeiro
Brazil Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo Sao Paulo SP
Brazil Centro Estadual de Hemoterapia e Hematologia Marcos Daniel Santos - Hemoes Vitoria Espirito Santo
Canada Juravinski Hospital - Hamilton Health Sciences Hamilton Ontario
Canada McMaster University Medical Centre - Hamilton Health Sciences Hamilton Ontario
Canada St. Michael's Hospital Toronto Ontario
France Hopital Cardiologique Louis Pradel - CRTH Bron
France Hopital Necker Paris
Germany Vivantes Klinikum Friedrichshain Berlin
Germany Vivantes Klinikum im Friedrichshain Berlin
Germany Universitätsklinikum Bonn Bonn
Germany Universitätsklinikum Bonn, Anstalt des öffentlichen Rechts Bonn
Germany Universität und Universitätsklinikum des Saarlandes Homburg/Saar
Greece General Hospital of Athens "LAIKO", 2nd Regional Blood Transfusion Center Athens
Japan Saitama Medical University Hospital Iruma-gun Saitama
Japan Nara Medical University Hospital Kashihara Nara
Japan Sapporo Tokushukai Hospital Sapporo Hokkaido
Japan National Center for Child Health and Development Setagaya-ku Tokyo
Korea, Republic of Kyung Hee University Hospital at Gangdong Seoul
Saudi Arabia King Faisal Specialist Hospital and Research Centre Riyadh
Sweden ApoEx AB Malmö
Sweden Skåne University Hospital, Department of Hematology, Oncology and Radiation Physics Malmö
Taiwan Changhua Christian Hospital Changhua
Taiwan Kaohsiung Medical University Chung-Ho Memorial Hospital Kaohsiung
Taiwan Taichung Veterans General Hospital Taichung
Taiwan Chung Shan Medical University Taichung City
Taiwan Chung Shan Medical University Hospital Taichung City
Taiwan National Taiwan University Hospital Taipei
Turkey Acibadem Adana Hospital Adana
Turkey Gaziantep University Sahinbey Training and Research Hospital Gaziantep
Turkey Istanbul University Oncology Institute Istanbul
Turkey Ege University Medical Faculty Hospital Izmir
United Kingdom Glasgow Royal Infirmary Glasgow
United Kingdom Guy's and St. Thomas' NHS Foundation Trust London
United Kingdom Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne
United Kingdom Newcastle upon Tyne Hospitals NHS FT Newcastle Upon Tyne Tyne & Wear
United Kingdom Newcastle upon Tyne Hospitals NHS FT Newcastle upon Tyne Tyne & Wear
United States Hemophilia and Thrombosis Center at the University of Colorado Anschutz Medical Campus Aurora Colorado
United States Indiana Hemophilia & Thrombosis Center, Inc. Indianapolis Indiana
United States Indiana Hemophilia and Thrombosis Center, Inc Indianapolis Indiana
United States St. Vincent Hospital & Health Care Center, Inc. Indianapolis Indiana
United States Madison Radiological Group Madison Mississippi
United States Mississippi Center for Advanced Medicine Madison Mississippi
United States Center for Human Phenomic Science Philadelphia Pennsylvania
United States Center for Human Phenomic Science CHPS Philadelphia Pennsylvania
United States Investigational Drug Service Philadelphia Pennsylvania
United States Penn Blood Disorder Center Philadelphia Pennsylvania
United States University of California, San Francisco - Clinical Research Center San Francisco California
United States University of California, San Francisco - Outpatient Hematology Clinic San Francisco California

Sponsors (1)

Lead Sponsor Collaborator
Pfizer

Countries where clinical trial is conducted

United States,  Australia,  Brazil,  Canada,  France,  Germany,  Greece,  Japan,  Korea, Republic of,  Saudi Arabia,  Sweden,  Taiwan,  Turkey,  United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Primary Annualized Bleeding Rate (ABR) for Total Bleeds (Treated and Untreated) From Week 12 to Month 15 ABR = number of total bleeding episodes on study during the given time period) *365.25/ (Date of last day - date of first day +1) in that time period. Surgical procedures were excluded from summary/analyses. Treated Bleed: An event necessitating administration of coagulation factor within 72 hours of signs or symptoms of bleeding (protocol definition, unless specifically referring to untreated bleed). Untreated Bleed: A bleeding event not necessitating administration of coagulation factor within 72 hours of signs or symptoms of bleeding. This outcome measure compared data collected from lead-in study C0371004 and from current study C0371002. Pre-infusion period = at least 6 months of prospectively collected data while receiving FIX prophylaxis replacement therapy in lead-in study C0371004 up to dosing in current study C0371002. Pre-infusion period: minimum of 6 months through first dose of current study, an average of 1.31 years (FIX Prophylaxis arm); Week 12 to Month 15 post infusion in current study (PF-06838435 arm)
Secondary ABR for Treated Bleeds From Week 12 to Month 15 ABR = number of total bleeding episodes on study during the given time period) *365.25/ (Date of last day - date of first day +1) in that time period. Surgical procedures were excluded from summary/analyses. Treated Bleed: An event necessitating administration of coagulation factor within 72 hours of signs or symptoms of bleeding (protocol definition, unless specifically referring to untreated bleed). This outcome measure compared data collected from lead-in study C0371004 and from current study C0371002. Pre-infusion period = at least 6 months of prospectively collected data while receiving FIX prophylaxis replacement therapy in lead-in study C0371004 up to dosing in current study C0371002. Pre-infusion period: minimum of 6 months through first dose of current study, an average of 1.31 years (FIX Prophylaxis arm); Week 12 to Month 15 post infusion in current study (PF-06838435 arm)
Secondary Annualized Infusion Rate (AIR) of Exogenous FIX From Week 12 to Month 15 AIR = number of exogenous infusions (for any reason) received during given time period *365.25/ (Date of last day - date of first day +1) in that time period. This outcome measure compared data collected from lead-in study C0371004 and from current study C0371002. Pre-infusion period = at least 6 months of prospectively collected data while receiving FIX prophylaxis replacement therapy in lead-in study C0371004 up to dosing in current study C0371002. Pre-infusion period: minimum of 6 months through first dose of current study, an average of 1.31 years (FIX Prophylaxis arm); Week 12 to Month 15 post infusion in current study (PF-06838435 arm)
Secondary Steady State Circulating Factor IX (FIX:C) From Week 12 to Month 15 The certified central clinical laboratory analyzed the sample by two one-stage assays and a chromogenic assay. The first one-stage assay was performed on BCSXP analyzer with Actin-FSL reagent. The second one-stage assay used the same analyzer but SynthAsil as reagent. Data reported in this Outcome Measure is the geometric mean of all assessments from week 12 to Month 15. Week 12 to Month 15
Secondary Circulating Factor IX (FIX:C) at Week 12, Week 24, Week 65 The certified central clinical laboratory analyzed the sample by two one-stage assays and a chromogenic assay. The first one-stage assay was performed on BCSXP analyzer with Actin-FSL reagent. The second one-stage assay used the same analyzer but SynthAsil as reagent. Week 12, Week 24, Week 65
Secondary Annualized Factor IX (FIX) Consumption From Week 12 to Month 15 Annualized FIX consumption was reported by International Units per kilogram (IU/kg). This outcome measure compared data collected from lead-in study C0371004 and from current study C0371002. Pre-infusion period = at least 6 months of prospectively collected data while receiving FIX prophylaxis replacement therapy in lead-in study C0371004 up to dosing in current study C0371002. Data reported in this Outcome Measure is average of all assessments from Week 12 to Month 15. Pre-infusion period: minimum of 6 months through first dose of current study, an average of 1.31 years (FIX Prophylaxis arm); Week 12 to Month 15 post infusion in current study (PF-06838435 arm)
Secondary ABR for Spontaneous Bleeds From Week 12 to Month 15 ABR = number of total bleeding episodes on study during the given time period) *365.25/ (Date of last day - date of first day +1) in that time period. Surgical procedures were excluded from summary/analyses. Surgical procedures were excluded from summary/analyses. Spontaneous Bleeds: Bleeding for no apparent/known reason particularly into the joints, muscles, and soft tissues. This outcome measure compared data collected from lead-in study C0371004 and from current study C0371002. Pre-infusion period = at least 6 months of prospectively collected data while receiving FIX prophylaxis replacement therapy in lead-in study C0371004 up to dosing in current study C0371002. Pre-infusion period: minimum of 6 months through first dose of current study, an average of 1.31 years (FIX Prophylaxis arm); Week 12 to Month 15 post infusion in current study (PF-06838435 arm)
Secondary ABR for Traumatic Bleeds From Week 12 to Month 15 ABR = number of total bleeding episodes on study during the given time period) *365.25/ (Date of last day - date of first day +1) in that time period. Surgical procedures were excluded from summary/analyses. Surgical procedures were excluded from summary/analyses. Traumatic Bleeds: Bleeding event occurring for an apparent/known reason. This outcome measure compared data collected from lead-in study C0371004 and from current study C0371002. Pre-infusion period = at least 6 months of prospectively collected data while receiving FIX prophylaxis replacement therapy in lead-in study C0371004 up to dosing in current study C0371002. Pre-infusion period: minimum of 6 months through first dose of current study, an average of 1.31 years (FIX Prophylaxis arm); Week 12 to Month 15 post infusion in current study (PF-06838435 arm)
Secondary ABR for Untreated Bleeds From Week 12 to Month 15 ABR = number of total bleeding episodes on study during the given time period) *365.25/ (Date of last day - date of first day +1) in that time period. Surgical procedures were excluded from summary/analyses. Surgical procedures were excluded from summary/analyses. Untreated Bleed: A bleeding event not necessitating administration of coagulation factor within 72 hours of signs or symptoms of bleeding. This outcome measure compared data collected from lead-in study C0371004 and from current study C0371002. Pre-infusion period = at least 6 months of prospectively collected data while receiving FIX prophylaxis replacement therapy in lead-in study C0371004 up to dosing in current study C0371002. Pre-infusion period: minimum of 6 months through first dose of current study, an average of 1.31 years (FIX Prophylaxis arm); Week 12 to Month 15 post infusion in current study (PF-06838435 arm)
Secondary Number of Target Joint Bleeds From Week 12 to Month 15 Target Joint: Defined as a major joint (e.g., hip, elbow, wrist, shoulder, knee, and ankle) into which repeated bleeds occurred (three or more spontaneous bleeds into a single joint within a consecutive 6-month period). A target joint was considered resolved when there were =<2 bleeds into the joint within a 12-month period. Joint Bleed: A bleeding episode characterized by rapid loss of range of motion as compared with baseline that was associated with any combination of the following: pain or an unusual sensation in the joint, palpable swelling, and warmth of the skin over the joint. This outcome measure compared data collected from lead-in study C0371004 and from current study C0371002. Pre-infusion period = at least 6 months of prospectively collected data while receiving FIX prophylaxis replacement therapy in lead-in study C0371004 up to dosing in current study C0371002. Pre-infusion period: minimum of 6 months through first dose of current study, an average of 1.31 years (FIX Prophylaxis arm); Week 12 to Month 15 post infusion in current study (PF-06838435 arm)
Secondary Percentage of the Participants Without Bleeds From Week 12 to Month 15 Percentage of participants without bleeds (total bleeds and treated bleeds) were summarized by type from Week 12 to Month 15. Week 12 to Month 15
Secondary Change From Baseline in Joint Health as Measured by the Hemophilia Joint Health Score (HJHS) Instrument at Month 12 A qualified healthcare professional assessed six joints (left ankle, right ankle, left elbow, right elbow, left knee, right knee) scored from 0 to 20 based on: duration of swelling, muscle atrophy, crepitus, flexion loss, extension loss, instability, joint pain, and strength. Gait was scored (0 to 4) based on walking, stairs, running, hopping on one leg. Total score = sum of scores from all joints + gait score ranged from 0 to 124, with the higher the number equating to more severe joint damage. Baseline, Month 12
Secondary Change From Baseline in Hemophilia Quality of Life (Haem A QoL) Physical Health Domain at Month 12 The Haem-A-QoL questionnaire contained 46 items with ten domains that assessed health in the following areas: Physical Health; Feelings; View of Self; Sports and Leisure; Work and School; Dealing with Haemophilia; Treatment; Future; Family Planning; and Partnership and Sexuality. The physical health domain was considered as the primary domain in this questionnaire, had a transformed score range from 0 to 100, with lower scores representing higher quality of life. In this Outcome Measure Physical Health domain scores of Haem A QoL are reported. Baseline, Month 12
Secondary Change From Baseline in Hemophilia Activities List (HAL) Complex Lower Extremity Activities Component Score at Month 12 The HAL was a multiple domain measure of the impact of hemophilia on functional abilities in adults. The 7 domains of this instrument contained 42 items in total, as follows: lying/sitting/kneeling/standing; lower (leg) functioning; upper (arm) functioning; transportation; self-care; household tasks; and sports/leisure. Selected items from five of the domains were used to create three components: upper extremity; basic lower extremity; and complex lower extremity activities. The component score of "complex lower extremity activities" was the most important in this questionnaire, had a transformed score range from 0 to 100, higher values indicated less functional limitations in performing tasks. Baseline, Month 12
Secondary Number of Participants With Treatment-Emergent Adverse Events (TEAEs) and Serious TEAEs Results would be posted at secondary completion date. Maximum up to 6 years (Week 312) after PF-06838435 infusion
Secondary Number of Participants With Adverse Events of Special Interest Results would be posted at secondary completion date. Maximum up to 6 years (Week 312) after PF-06838435 infusion
Secondary Number of Participants With Positive Neutralizing Antibody (nAb) to Adeno-associated Virus Vector (AAV) and Anti-Drug Antibody (ADA) Results would be posted at secondary completion date. Maximum up to 6 years (Week 312) after PF-06838435 infusion
Secondary ABR for Total Bleeds (Treated and Untreated) Through the Study Results would be posted at secondary completion date. Maximum up to 6 years (Week 312) after PF-06838435 infusion
Secondary ABR for Treated Bleeds Through the Study Results would be posted at secondary completion date. Maximum up to 6 years (Week 312) after PF-06838435 infusion
Secondary AIR of Exogenous Factor IX Through the Study Results would be posted at secondary completion date. Maximum up to 6 years (Week 312) after PF-06838435 infusion
Secondary FIX: C Level Through the Study Results would be posted at secondary completion date. Maximum up to 6 years (Week 312) after PF-06838435 infusion
Secondary Annualized Factor IX Consumption Through the Study Results would be posted at secondary completion date. Maximum up to 6 years (Week 312) after PF-06838435 infusion
Secondary ABR for Spontaneous and Traumatic, and Untreated Bleeds Through the Study Results would be posted at secondary completion date. Maximum up to 6 years (Week 312) after PF-06838435 infusion
Secondary Change From Baseline in Joint Health as Measured by the HJHS Instrument Through the Study Results would be posted at secondary completion date. Baseline, 6 years
Secondary Number of Target Joint Bleeds Through the Study Results would be posted at secondary completion date. Maximum up to 6 years (Week 312) after PF-06838435 infusion
Secondary Change From Baseline in Haem A QoL Physical Health Domain Through the Study Results would be posted at secondary completion date. Baseline, Maximum up to 6 years (Week 312) after PF-06838435 infusion
Secondary Change From Baseline in HAL Complex Lower Extremity Activities Component Score Through the Study Results would be posted at secondary completion date. Baseline, 6 years
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