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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT01736475
Other study ID # 261201
Secondary ID 2012-003599-38
Status Completed
Phase Phase 2/Phase 3
First received
Last updated
Start date January 31, 2013
Est. completion date July 17, 2014

Study information

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

Clinical Trial Summary

To assess efficacy and safety, including immunogenicity of BAX 855 administered as prophylaxis and as on-demand therapy in adult and adolescent (12-65 years) previously treated patients (PTPs) with severe hemophilia A To determine the pharmacokinetic (PK) parameters of BAX 855.


Recruitment information / eligibility

Status Completed
Enrollment 159
Est. completion date July 17, 2014
Est. primary completion date July 17, 2014
Accepts healthy volunteers No
Gender Male
Age group 12 Years to 65 Years
Eligibility Main Inclusion Criteria: - Participant and/or legal representative has/have voluntarily provided signed informed consent - Participant is 12 to 65 years old at the time of screening - Participant is male with severe hemophilia A (Factor VIII (FVIII) clotting activity < 1%) as confirmed by central laboratory at screening after the appropriate washout period or a documented FVIII clotting activity <1% - Participant has been previously treated with plasma-derived FVIII concentrates or recombinant FVIII for =150 documented exposure days (EDs) - Participant is currently receiving prophylaxis or on-demand therapy with FVIII - Participant is willing and able to comply with the requirements of the protocol Main Exclusion Criteria: - Participant has detectable FVIII inhibitory antibodies (= 0.6 Bethesda Units (BU) using the Nijmegen modification of the Bethesda assay) as confirmed by central laboratory at screening - Participant has history of FVIII inhibitory antibodies (= 0.4 BU using the Nijmegen modification of the Bethesda assay or = 0.6 BU using the Bethesda assay) at any time prior to screening - Participant has been diagnosed with an inherited or acquired hemostatic defect other than hemophilia A (eg, qualitative platelet defect or von Willebrand's disease).

Study Design


Related Conditions & MeSH terms


Intervention

Biological:
Antihemophilic Factor (Recombinant) - Plasma/Albumin Free Method
Pharmacokinetic (PK) evaluation of ADVATE
PEGylated Recombinant Factor VIII
Pharmacokinetic (PK) evaluation of BAX 855
PEGylated Recombinant Factor VIII
Prophylaxis treatment
PEGylated Recombinant Factor VIII
On-demand treatment

Locations

Country Name City State
Australia Royal Adelaide Hospital Adelaide South Australia
Australia The Alfred Hospital Clayton Victoria
Australia Fremantle Hospital Fremantle Western Australia
Australia Hollywood Specialist Centre Nedlands Western Australia
Austria Landes-Frauen-und Kinderklinik Linz Linz
Austria AKH - Medizinische Universität Wien Vienna
Bulgaria SHAT of Oncohaematology Diseases Sofia
Czechia Fakultni nemocnice Brno Brno
Czechia Fakultni nemocnice Olomouc Olomouc
Czechia Fakultni nemocnice v Motole Praha 5
Germany Vivantes Klinikum im Friedrichshain - Landsberger Allee Berlin
Germany Gerinnungszentrum Rhein-Ruhr Duisburg Nordrhein Westfalen
Germany Universitaetsklinikum Hamburg-Eppendorf Hamburg
Germany Werlhof-Institut MVZ Hannover
Israel Rambam Health Care Campus Haifa
Israel Chaim Sheba Medical Center Tel Aviv
Japan Hiroshima University Hospital Hiroshima-shi Hiroshima-Ken
Japan Nara Medical University Hospital Kashihara-shi Nara-Ken
Japan St. Marianna University School of Medicine Hospital Kawasaki-shi Kanagawa-Ken
Japan University of Occupational and Environmental Health Hospital Kitakyushu-shi Fukuoka-Ken
Japan Nagoya University Hospital Nagoya-shi Aichi-Ken
Japan Hyogo College of Medicine Hospital Nishinomiya-shi Hyogo-Ken
Japan Tokyo Medical University Hospital Shinjuku-ku Tokyo-To
Japan Ogikubo Hospital Suginami-ku Tokyo-To
Korea, Republic of Pusan National University Hospital Busan
Korea, Republic of Eulji University Hospital Daejeon
Korea, Republic of Chonnam National University Hwasun Hospital Hwasun Jeollanam-do
Korea, Republic of Kyung hee University Hospital at Gangdong Seoul
Korea, Republic of Ulsan University Hospital Ulsan
Lithuania Children's Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos Vilnius
Lithuania Vilnius University Hospital Santariskiu Clinics, Public Institution Vilnius
Malaysia Hospital Pulau Pinang George Town Pulau Pinang
Malaysia Hospital Tengku Ampuan Rahimah Klang Selangor
Malaysia Pusat Darah Negara Kuala Lumpur
Netherlands Academisch Medisch Centrum Amsterdam
Poland Uniwersyteckie Centrum Kliniczne Gdansk
Poland Wojewodzki Szpital Specjalistyczny im.M.Kopernika w Lodzi Lodz
Romania Sanador SRL Bucuresti
Spain Complejo Hospitalario Universitario A Coruña A Coruña La Coruña
Spain Hospital Regional Universitario de Malaga Malaga Málaga
Spain Hospital Universitari Son Espases Palma de Mallorca Baleares
Spain Hospital Universitari i Politecnic La Fe Valencia
Sweden Skånes Universitetssjukhus, Malmö Malmö
Sweden Karolinska Universitetssjukhuset, Solna Stockholm
Switzerland Universitatsspital Zurich Zurich
Taiwan Tri-Service General Hospital Taipei
Ukraine SI V.K.Gusak Emergency and Reconstructive Surgery Institute of NAMSU Center of IT Donetsk
Ukraine SI Institute of Blood Pathology and Transfusion Medicine of NAMSU Lviv
United Kingdom Bristol Royal Hospital for Children Bristol Avon
United Kingdom Leicester Royal Infirmary Leicester Leicestershire
United Kingdom Royal Free Hospital London Greater London
United Kingdom St Thomas' Hospital London Greater London
United Kingdom Manchester Royal Infirmary Manchester Greater Manchester
United Kingdom Royal Manchester Children's Hospital Manchester Greater Manchester
United Kingdom Churchill Hospital Oxford Oxfordshire
United States Children's Healthcare of Atlanta Atlanta Georgia
United States University of Colorado Aurora Colorado
United States University of North Carolina Chapel Hill Chapel Hill North Carolina
United States Cincinnati Children's Hospital Medical Center Cincinnati Ohio
United States The Cleveland Clinic Foundation Cleveland Ohio
United States Palmetto Health Columbia South Carolina
United States Duke University Medical Center Durham North Carolina
United States University of Florida, College of Medicine Gainesville Florida
United States Penn State Milton S. Hershey Medical Center Hershey Pennsylvania
United States Children's Mercy Hospitals & Clinics Kansas City Missouri
United States University of Kentucky Medical Center Lexington Kentucky
United States University of Louisville Hospital Louisville Kentucky
United States Tulane University Medical School New Orleans Louisiana
United States Weill Cornell Medical College-New York Presbyterian Hospital New York New York
United States Bleeding and Clotting Disorders Institute Peoria Illinois
United States University of Utah Health Sciences Center Salt Lake City Utah
United States Puget Sound Blood Group Seattle Washington

Sponsors (1)

Lead Sponsor Collaborator
Baxalta now part of Shire

Countries where clinical trial is conducted

United States,  Australia,  Austria,  Bulgaria,  Czechia,  Germany,  Israel,  Japan,  Korea, Republic of,  Lithuania,  Malaysia,  Netherlands,  Poland,  Romania,  Spain,  Sweden,  Switzerland,  Taiwan,  Ukraine,  United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Primary Annualized Bleeding Rate (ABR) Comparisons between prophylactic and on-demand treatment were based on ABR estimates from a negative binomial regression model, taking into account the treatment regimen, target joints and age at screening, and duration of the observation period for efficacy. 9 months
Secondary Rate of Success of BAX 855 for Treatment of Bleeding Episodes Success in the control of bleeding was defined as a rating of excellent or good using the Efficacy Rating Scale for Treatment of Bleeding Episodes measured 24 hours after initiation of treatment for the bleeding episode. EXCELLENT: Full relief of pain and cessation of objective signs of bleeding (eg, swelling, tenderness, and decreased range of motion in the case of musculoskeletal hemorrhage) after a single infusion. No additional infusion is required for the control of bleeding. Administration of further infusions to maintain hemostasis would not affect this scoring. GOOD: Definite pain relief and/or improvement in signs of bleeding after a single infusion. Possibly requires more than 1 infusion for complete resolution. FAIR: Probable and/or slight relief of pain and slight improvement in signs of bleeding after a single infusion. Required more than 1 infusion for complete resolution. NONE: No improvement or condition worsens. At least 50 exposure days or 6 months (±2 weeks), whichever occurs last, for the prophylaxis arm and 6 months (± 2 weeks) for the on-demand arm.
Secondary Average Number of BAX 855 Infusions Needed for the Treatment of Bleeding Episodes From first exposure to BAX 855 until the end of the study, [at least 50 exposure days or 6 months (±2 weeks), whichever occurs last, for the prophylaxis arm; and 6 months (± 2 weeks) for the on-demand arm].
Secondary Number of Participants With =1, 2, 3, 4, 5, 6, or >6 Month Time Intervals Between Bleeding Episodes or no Bleeding Episodes Interval between Bleeds in months was calculated as: Observation period for efficacy (in days)/(number of bleeds)*(12/365.2425) From first exposure to BAX 855 until the end of the study, [at least 50 exposure days or 6 months (±2 weeks), whichever occurs last, for the prophylaxis arm; and 6 months (± 2 weeks) for the on-demand arm].
Secondary Weight-adjusted Consumption of BAX 855 - Per Prophylactic Infusion and Pharmacokinetic (PK) Infusion Prophylactic Infusion: =50 exposure days or 6 months (±2 weeks), whichever occurs last. PK Infusion: PK #1 Pre-infusion within 30 minutes; Post-infusion 10 min, and 0.5, 1, 3, 6, 24, 32, 48, 56 hours (h). PK #2 also at Post-infusion 96h
Secondary Weight-adjusted Consumption of BAX 855 - Per Treatment of Bleeding Episode (BE) and Per BE for Maintenance of Hemostasis Infusions per bleeding episode for maintenance of hemostasis only includes infusions following the resolution of a bleed to maintain hemostasis. Treatment of Bleeding Episode (BE): Minor/Moderate BE every 12 to 24 hours until bleeding is resolved; Major BE every 8 to 12 hours until bleeding is resolved. Per BE for Maintenance of Hemostasis: within 48 hours after bleeding episode resolution.
Secondary Percentage of Participants With Adverse Events Adverse Events (AEs) and Serious Adverse Events (SAEs) From first exposure to BAX 855 until the end of the study, [at least 50 exposure days or 6 months (±2 weeks), whichever occurs last, for the prophylaxis arm; and 6 months (± 2 weeks) for the on-demand arm].
Secondary Immunogenicity - Number of Participants With Positive Inhibitory Antibodies to FVIII, Binding Antibodies to FVIII, PEG-VIII, PEG and Anti-CHO Antibodies at Study Completion/Termination Number of participants who received BAX855, with immunogenicity data from study completion/termination visit. FVIII = factor VIII; PEG-VIII = polyethylene glycol-factor VIII; Anti-CHO = Anti-Chinese hamster ovary From first exposure to BAX 855 until the end of the study, [at least 50 exposure days or 6 months (±2 weeks), whichever occurs last, for the prophylaxis arm; and 6 months (± 2 weeks) for the on-demand arm].
Secondary Patient Reported Outcomes: Haemo-SYM Questionnaire, Change in Score From Baseline to End of Study The HAEMO-SYM has two subscales: pain and bleeds. HAEMO-SYM subscale scores are calculated by taking the mean of the items in each subscale and transforming them to a 0 (none or absent) to 100 (very severe) scale. Given that higher scores indicate more severe symptoms on the Haemo-SYM and that the change scores were calculated as the value at study completion minus the value at baseline, a negative change score indicates an improvement (reduction in symptoms). Conversely, a positive change score indicates worsening symptoms. Baseline; and end of study visit [at least 50 exposure days or 6 months (±2 weeks), whichever occurs last, for the prophylaxis arm and 6 months (± 2 weeks) for the on-demand arm].
Secondary Patient Reported Outcomes - Short Form (SF)-36, Change From Baseline to End of Study Change from Baseline to End of Study for SF-36 Questionnaire is provided. Scores for individual SF-36 categories range from 0 to 100 with higher scores representing better health. Given that higher scores indicate better health-related quality of life (HRQoL) and that the change scores were calculated as the value at study completion minus the value at baseline, a negative change score indicates a worsening of HRQoL. Baseline; and end of study visit [at least 50 exposure days or 6 months (±2 weeks), whichever occurs last, for the prophylaxis arm and 6 months (± 2 weeks) for the on-demand arm]
Secondary Pharmacokinetics (Pk) - Plasma Half-life (One-stage Clotting Assay) Terminal half-life calculated as log_e2/?z where ?z is the terminal elimination rate constant. Participants in the pharmacokinetic full analysis set (PKFAS) analysis set received an initial infusion of ADVATE for pharmacokinetic analysis (PK-1) followed by a washout period and an infusion of BAX 855 for a second pharmacokinetic analysis (PK-2). After at least 50 EDs of BAX 855, participants in the PK subgroup received another infusion of BAX 855 for pharmacokinetic analysis (PK-3). Within 30 minutes prior to start of infusion; and post-infusion at 10, 30 minutes, and 1, 3, 6, 9, 24, 32, 48, 56, 72 (PK2 and PK3 only), and 96 hours (PK2 and PK3 only).
Secondary Pharmacokinetics (Pk) - Mean Residence Time (One-stage Clotting Assay) The mean residence time (MRT) w as calculated as total area under the moment curve divided by the total area under the curve starting from the begin of infusion (or the end of infusion if start time is not available). Participants in the pharmacokinetic full analysis set (PKFAS) analysis set received an initial infusion of ADVATE for pharmacokinetic analysis (PK-1) followed by a washout period and an infusion of BAX 855 for a second pharmacokinetic analysis (PK-2). After at least 50 EDs of BAX 855, participants in the PK subgroup received another infusion of BAX 855 for pharmacokinetic analysis (PK-3). Within 30 minutes prior to start of infusion; and post-infusion at 10, 30 minutes, and 1, 3, 6, 9, 24, 32, 48, 56, 72 (PK2 and PK3 only), and 96 hours (PK2 and PK3 only).
Secondary Pharmacokinetics (Pk) - Total Body Clearance (One-stage Clotting Assay) Clearance in dL/(kg.h) will be calculated as the dose in IU/kg divided by the total area under the curve starting from the begin of infusion (or the end of infusion if start time is not available). Participants in the pharmacokinetic full analysis set (PKFAS) analysis set received an initial infusion of ADVATE for pharmacokinetic analysis (PK-1) followed by a washout period and an infusion of BAX 855 for a second pharmacokinetic analysis (PK-2). After at least 50 EDs of BAX 855, participants in the PK subgroup received another infusion of BAX 855 for pharmacokinetic analysis (PK-3). Within 30 minutes prior to start of infusion; and post-infusion at 10, 30 minutes, and 1, 3, 6, 9, 24, 32, 48, 56, 72 (PK2 and PK3 only), and 96 hours (PK2 and PK3 only).
Secondary Pharmacokinetics (Pk) - Incremental Recovery Over Time (One-stage Clotting Assay) Incremental recovery (IR) in (IU/dL)/ (IU/kg) calculated as: IR = (Cmax- (C pre-infusion)) / (Dose/kg), where C =concentration. Participants in the pharmacokinetic full analysis set (PKFAS) analysis set received an initial infusion of ADVATE for pharmacokinetic analysis (PK-1) followed by a washout period and an infusion of BAX 855 for a second pharmacokinetic analysis (PK-2). After at least 50 EDs of BAX 855, participants in the PK subgroup received another infusion of BAX 855 for pharmacokinetic analysis (PK-3). Within 30 minutes prior to start of infusion; and post-infusion at 10, 30 minutes, and 1, 3, 6, 9, 24, 32, 48, 56, 72 (PK2 and PK3 only), and 96 hours (PK2 and PK3 only).
Secondary Pharmacokinetics (Pk) - Area Under the Concentration Versus Time Curve From 0 to Infinity (AUC0-8) (One-stage Clotting Assay) Calculated by WinNonlin NCA (Model 201, calculation method: Linear Trapezoidal Linear/Log Interpolation). Participants in the pharmacokinetic full analysis set (PKFAS) analysis set received an initial infusion of ADVATE for pharmacokinetic analysis (PK-1) followed by a washout period and an infusion of BAX 855 for a second pharmacokinetic analysis (PK-2). After at least 50 EDs of BAX 855, participants in the PK subgroup received another infusion of BAX 855 for pharmacokinetic analysis (PK-3). Within 30 minutes prior to start of infusion; and post-infusion at 10, 30 minutes, and 1, 3, 6, 9, 24, 32, 48, 56, 72 (PK2 and PK3 only), and 96 hours (PK2 and PK3 only).
Secondary Pharmacokinetics (Pk) - Apparent Volume of Distribution at Steady State (Vss) (One-stage Clotting Assay) The apparent volume of distribution at steady state (Vss) will be calculated as: Vss = Clearance * Mean Residence Time. Participants in the pharmacokinetic full analysis set (PKFAS) analysis set received an initial infusion of ADVATE for pharmacokinetic analysis (PK-1) followed by a washout period and an infusion of BAX 855 for a second pharmacokinetic analysis (PK-2). After at least 50 EDs of BAX 855, participants in the PK subgroup received another infusion of BAX 855 for pharmacokinetic analysis (PK-3). Within 30 minutes prior to start of infusion; and post-infusion at 10, 30 minutes, and 1, 3, 6, 9, 24, 32, 48, 56, 72 (PK2 and PK3 only), and 96 hours (PK2 and PK3 only).
Secondary Pharmacokinetics (Pk) - Maximum Plasma Concentration (Cmax) (One-stage Clotting Assay) Participants in the pharmacokinetic full analysis set (PKFAS) analysis set received an initial infusion of ADVATE for pharmacokinetic analysis (PK-1) followed by a washout period and an infusion of BAX 855 for a second pharmacokinetic analysis (PK-2). After at least 50 EDs of BAX 855, participants in the PK subgroup received another infusion of BAX 855 for pharmacokinetic analysis (PK-3). Within 30 minutes prior to start of infusion; and post-infusion at 10, 30 minutes, and 1, 3, 6, 9, 24, 32, 48, 56, 72 (PK2 and PK3 only), and 96 hours (PK2 and PK3 only).
Secondary Pharmacokinetics (Pk) -Time to Maximum Concentration in Plasma (Tmax) (One-stage Clotting Assay) Tmax in hours will be defined as the time to reach Cmax. Participants in the pharmacokinetic full analysis set (PKFAS) analysis set received an initial infusion of ADVATE for pharmacokinetic analysis (PK-1) followed by a washout period and an infusion of BAX 855 for a second pharmacokinetic analysis (PK-2). After at least 50 EDs of BAX 855, participants in the PK subgroup received another infusion of BAX 855 for pharmacokinetic analysis (PK-3). Within 30 minutes prior to start of infusion; and post-infusion at 10, 30 minutes, and 1, 3, 6, 9, 24, 32, 48, 56, 72 (PK2 and PK3 only), and 96 hours (PK2 and PK3 only).
Secondary Change in Vital Signs From Screening - Temperature Screening, week 2, week 4, exposure day 10-15, month 3, study completion/termination
Secondary Change in Vital Signs From Screening - Pulse Rate Screening, week 2, week 4, exposure day 10-15, month 3, study completion/termination
Secondary Change in Vital Signs From Screening - Respiratory Rate Screening, week 2, week 4, exposure day 10-15, month 3, study completion/termination
Secondary Changes in Vital Signs From Screening - Blood Pressure Systolic Blood Pressure (SBP) Diastolic Blood Pressure (DBP) Screening, week 2, week 4, exposure day 10-15, month 3, study completion/termination
Secondary Changes in Clinical Chemistry Laboratory Assessments From Screening - Albumin and Protein Screening, week 2, week 4, month 3, study completion/termination
Secondary Changes in Clinical Chemistry Laboratory Assessments From Screening - Alkaline Phosphatase, Alanine Aminotransferase, Aspartate Aminotransferase Alkaline Phosphatase (Alk Phos); Alanine Aminotransferase (Ala Amino); Aspartate Aminotransferase (Asp Amino) Screening, week 2, week 4, month 3, study completion/termination
Secondary Changes in Clinical Chemistry Laboratory Assessments From Screening - Bicarbonate, Chloride, Glucose, Potassium, Sodium, Blood Urea Nitrogen (BUN) Screening, week 2, week 4, month 3, study completion/termination
Secondary Changes in Clinical Chemistry Laboratory Assessments From Screening - Creatinine, and Bilirubin Screening, week 2, week 4, month 3, study completion/termination
Secondary Changes in Hematology Laboratory Assessments From Screening - Basophils, Eosinophils, Lymphocytes, Monocytes, Neutrophils, Platelets, and Leukocytes Screening, week 2, week 4, month 3, study completion/termination
Secondary Changes in Hematology Laboratory Assessments From Screening - Hematocrit Screening, week 2, week 4, month 3, study completion/termination
Secondary Changes in Hematology Laboratory Assessments From Screening - Hemoglobin Screening, week 2, week 4, month 3, study completion/termination
Secondary Changes in Hematology Laboratory Assessments From Screening - Erythrocytes Screening, week 2, week 4, month 3, study completion/termination
Secondary Changes in Lipid Panel Assessments From Screening - Cholesterol; High Density Lipoprotein (HDL); Low Density Lipoprotein (LDL); Triglycerides; and Very Low Density Lipoprotein (VLDL) Screening, week 2, week 4, month 3, study completion/termination
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