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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT01486927
Registration number
NCT01486927
Ethics application status
Date submitted
19/11/2011
Date registered
7/12/2011
Date last updated
9/08/2016
Titles & IDs
Public title
An Open-label Safety, Efficacy and Pharmacokinetic Study of a Recombinant FVIII Compared to Recombinant Human Antihemophilic FVIII in Patients With Severe Hemophilia A
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Scientific title
A Phase I/III Open-label, Multicenter, Crossover Safety, Efficacy and Pharmacokinetic Study of Recombinant Coagulation Factor VIII (rFVIII) Compared to Recombinant Human Antihaemophilic Factor VIII (rFVIII; INN: Octocog Alfa) in Subjects With Hemophilia A, and a Repeat PK, Safety and Efficacy Study
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Secondary ID [1]
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2011-002393-23
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Secondary ID [2]
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CSL627_1001
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Hemophilia A
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Condition category
Condition code
Blood
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Clotting disorders
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Human Genetics and Inherited Disorders
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Other human genetics and inherited disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Other - rVIII-SingleChain
Treatment: Other - Octocog alfa
Experimental: Recombinant Factor VIII (rFVIII) -
Treatment: Other: rVIII-SingleChain
In Part 1 of the study, subjects received a single intravenous infusion of 50 IU/kg recombinant, single-chain coagulation factor VIII (rVIII-SingleChain) preceded by a 4-day washout period. In Parts 2 and 3 of the study, subjects received repeat injections of rVIII-SingleChain either as an on-demand or prophylaxis regimen at a dose and frequency determined by their study doctor. Subjects participating in the Part 3 PK analyses received a single infusion of 50 IU/kg rVIII-SingleChain and a repeat dose of the same strength of rVIII-SingleChain after 3 to 6 months. Subjects from Parts 2 and 3 participating in the surgical substudy received an individualized dose regimen of rVIII-SingleChain, based on the type of surgery and the clinical status of the subject.
Treatment: Other: Octocog alfa
In Part 1 of the study, subjects received a single intravenous infusion of 50 IU/kg of octocog alfa preceded by a 4-day washout period. Octocog alfa is the international nonproprietary name (INN) for recombinant human coagulation factor VIII.
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Intervention code [1]
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Treatment: Other
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Treatment Success
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Assessment method [1]
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The investigator rated the efficacy of the treatment based on a 4-point rating scale "excellent, good, moderate or poor/no response". Efficacy ratings of "excellent" or "good" were considered treatment success for this end point; the percentage of bleeding events with a rating of excellent or good and the 95% confidence interval are presented. The denominator includes all treated bleeding events. The 95% confidence interval is based on a model to account for within-subject correlation.
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Timepoint [1]
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Up to 24 months
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Primary outcome [2]
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Inhibitor Formation to FVIII
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Assessment method [2]
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Number of subjects who develop inhibitors to FVIII
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Timepoint [2]
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Up to 24 months
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Primary outcome [3]
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Annualized Spontaneous Bleeding Rate
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Assessment method [3]
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The annualized spontaneous bleeding rate (AsBR) was derived for each subject as follows: 365.25\*(number of spontaneous bleeding episodes requiring treatment) / (observed treatment period of interest).
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Timepoint [3]
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Up to 24 months
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Primary outcome [4]
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Treatment Success During the Peri-operative Surgical Sub-study
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Assessment method [4]
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Subjects received rVIII-SingleChain before and during surgery based on the type of surgery and the clinical status of the subject. The investigator rated the efficacy of the treatment based on a 4-point surgical treatment rating scale of "excellent, good, moderate or poor/no response". Efficacy ratings of "excellent" or "good" were considered treatment success for this end point. The rate of success, defined as the percentage of surgeries with a rating of excellent or good for hemostatic efficacy on the surgical treatment scale is presented for the Surgical Population, based on the total number of surgeries (N=16) as denominator.
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Timepoint [4]
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From the start of surgery through the post-operative recovery (generally up to 14 days after surgery)
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Secondary outcome [1]
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AUC0-8 (Part 1)
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Assessment method [1]
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AUC0-8 (AUC from 0 extrapolated to infinity) of a single infusion of octocog alfa and rVIII-SingleChain without correction for subject's predose plasma FVIII activity. FVIII activity values for octocog alfa are dose-adjusted for chromogenic potency.
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Timepoint [1]
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Before infusion and at up to 10 time points within 72 hours of infusion
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Secondary outcome [2]
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Cmax (Part 1)
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Assessment method [2]
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Cmax of a single infusion of octocog alfa and rVIII-SingleChain with correction for subject's predose plasma FVIII activity. FVIII activity values for octocog alfa are dose-adjusted for chromogenic potency.
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Timepoint [2]
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Before infusion and at up to 10 time points within 72 hours of infusion
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Secondary outcome [3]
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Tmax (Part 1)
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Assessment method [3]
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Tmax = time of Cmax (with correction for subject's predose plasma FVIII activity) after a single infusion of octocog alfa and rVIII-SingleChain.
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Timepoint [3]
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Before infusion and at up to 10 time points within 72 hours of infusion
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Secondary outcome [4]
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Half-life (t1/2) (Part 1)
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Assessment method [4]
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Half-life (t1/2) of a single infusion of octocog alfa and rVIII-SingleChain without correction for subject's predose plasma FVIII activity.
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Timepoint [4]
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Before infusion and at up to 10 time points within 72 hours of infusion.
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Secondary outcome [5]
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Mean Residence Time (MRT) (Part 1)
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Assessment method [5]
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Mean residence time (MRT) of a single infusion of octocog alfa and rVIII-SingleChain without correction for subject's predose plasma FVIII activity.
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Timepoint [5]
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Before infusion and at up to 10 time points within 72 hours of infusion
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Secondary outcome [6]
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Clearance (Cl) (Part 1)
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Assessment method [6]
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Clearance (Cl) of a single infusion of octocog alfa and rVIII-SingleChain without correction for subject's predose plasma FVIII activity. FVIII activity values for octocog alfa are dose-adjusted for chromogenic potency.
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Timepoint [6]
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Before infusion and at up to 10 time points within 72 hours of infusion
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Secondary outcome [7]
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Volume of Distribution at Steady-state (Vss) (Part 1)
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Assessment method [7]
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Volume of distribution at steady-state (Vss) of a single infusion of octocog alfa and rVIII-SingleChain without correction for subject's predose plasma FVIII activity. FVIII activity values for octocog alfa are dose-adjusted for chromogenic potency.
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Timepoint [7]
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Before infusion and at up to 10 time points within 72 hours of infusion
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Secondary outcome [8]
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Incremental Recovery (Part 1)
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Assessment method [8]
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Incremental recovery of a single infusion of octocog alfa and rVIII-SingleChain with correction for subject's predose plasma FVIII activity. FVIII activity values for octocog alfa are dose-adjusted for chromogenic potency.
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Timepoint [8]
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At 30 minutes after infusion
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Secondary outcome [9]
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Annualized Bleeding Rate for Total Bleeds and Traumatic Bleeds
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Assessment method [9]
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The annualized bleeding rate was derived for each subject as follows: 365.25\*(number of bleeding episodes requiring treatment) / (observed treatment period of interest).
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Timepoint [9]
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Up to 24 months
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Secondary outcome [10]
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Proportion of Bleeding Episodes Requiring 1, 2, 3 or > 3 Infusions of rVIII-SingleChain to Achieve Hemostasis
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Assessment method [10]
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Percentage of bleeding episodes requiring 1, 2, 3 or \> 3 infusions of rVIII-SingleChain to achieve hemostasis. The denominator includes all treated bleeding episodes.
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Timepoint [10]
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During the study (up to 24 months; assessed at Months 1, 2, 3, 4, 5, 6, 9, 12, 15, 18, 21 and 24)
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Eligibility
Key inclusion criteria
* Diagnosis of severe hemophilia A defined as <1% FVIII:C documented in medical records.
* Males between 18 and 65 years of age (Parts 1 and 2).
* Males between 12 and 65 years of age (Part 3).
* Subjects who have received or are currently receiving FVIII products (plasma-derived and/or recombinant FVIII) and have had >150 exposure days (EDs) with a FVIII product
* Written informed consent for study participation obtained before undergoing any study specific procedures.
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Minimum age
12
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Maximum age
65
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Sex
Males
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Any history of or current FVIII inhibitors
* Any first order family history of FVIII inhibitors
* Use of an Investigational Medicinal Product within 30 days prior to the first rVIII-SingleChain administration.
* Administration of any cryoprecipitate, whole blood or plasma within 30 days prior to administration of rVIII-SingleChain or reference product.
* Known hypersensitivity (allergic reaction or anaphylaxis) to any FVIII product or hamster protein.
* Any known congenital or acquired coagulation disorder other than congenital FVIII deficiency.
* Platelet count < 100,000/µL at screening.
* Human immunodeficiency virus (HIV) positive subjects with a CD4 count < 200/mm3, in their medical history or at screening if available results are older than one year. (HIV positive subjects may participate in the study and antiviral therapy are permitted, at the discretion of the Investigator).
* Subject currently receiving IV immunomodulating agents such as immunoglobulin or chronic systemic corticosteroid treatment.
* Subject with serum aspartate aminotransferase (AST) or serum alanine aminotransferase (ALT) values > 5 times (x) the upper limit of normal (ULN) at Screening.
* Subjects with serum creatinine values > 2 x ULN at Screening.
* Evidence of thrombosis, including deep vein thrombosis, stroke, pulmonary embolism, myocardial infarction and arterial embolus within 3 months prior to Day 1.
* Experienced life-threatening bleeding episode or had major surgery or an orthopedic surgical procedure during the 3 months prior to Day 1.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
NA
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/02/2012
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/12/2014
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Sample size
Target
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Accrual to date
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Final
175
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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Study Site - Nedlands
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Recruitment hospital [2]
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Study Site - Perth
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Recruitment postcode(s) [1]
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WA 6009 - Nedlands
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Recruitment postcode(s) [2]
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WA 6000 - Perth
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Recruitment outside Australia
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United States of America
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California
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United States of America
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Colorado
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Connecticut
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Florida
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Wisconsin
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Austria
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Graz
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Vienna
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Berlin
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Germany
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Bonn
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Gießen
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Germany
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Torino
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Okayama
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Saitama
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Suginami-ku, Tokyo
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Tokyo
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Silesia
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Poland
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Gdansk
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Krakow
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Romania
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Bucharest
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Russian Federation
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Barnaul
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Russian Federation
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Kemerovo
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South Africa
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Cape Town
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Johannesburg
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Barcelona
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La Coruna
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Valencia
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Dnipropetrovsk
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Donetsk
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Ukraine
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Lviv
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United Kingdom
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London
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
CSL Behring
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
This is an open-label, non-randomized, efficacy, safety and pharmacokinetic (PK) study comparing octocog alfa and rVIII-SingleChain. The study consists of three parts, a PK period (Part 1), a continuation of dosing safety and efficacy period (Part 2) and a safety, efficacy, and repeat PK period (Part 3) and also includes a surgical sub-study for subjects enrolled in Parts 2 and 3.
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Trial website
https://clinicaltrials.gov/study/NCT01486927
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Trial related presentations / publications
Mahlangu J, Kuliczkowski K, Karim FA, Stasyshyn O, Kosinova MV, Lepatan LM, Skotnicki A, Boggio LN, Klamroth R, Oldenburg J, Hellmann A, Santagostino E, Baker RI, Fischer K, Gill JC, P'Ng S, Chowdary P, Escobar MA, Khayat CD, Rusen L, Bensen-Kennedy D, Blackman N, Limsakun T, Veldman A, St Ledger K, Pabinger I; AFFINITY Investigators. Efficacy and safety of rVIII-SingleChain: results of a phase 1/3 multicenter clinical trial in severe hemophilia A. Blood. 2016 Aug 4;128(5):630-7. doi: 10.1182/blood-2016-01-687434. Epub 2016 Jun 21.
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Public notes
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Contacts
Principal investigator
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Program Director
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Address
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CSL Behring
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT01486927
Download to PDF