China ADVATE PTP Study
- Conditions
- Hemophilia A
- Interventions
- Biological: Octocog alfa (recombinant human coagulation factor VIII)
- Registration Number
- NCT02170402
- Lead Sponsor
- Baxalta now part of Shire
- Brief Summary
The purpose of this study is to assess efficacy, safety and pharmacokinetics of ADVATE in the treatment and prevention of bleeding episodes (BEs)
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Male
- Target Recruitment
- 82
- Ethnic Chinese
- is of any age
- has a documented diagnosis of severe or moderately severe hemophilia A (congenital FVIII deficiency: baseline Factor VIII (FVIII) ≤ 2%)
- has documented and verified >50 exposure days (EDs) to FVIII (recombinant or plasma derived)
- is receiving on-demand treatment with FVIII at the time of enrolment in this study
- has negative history of inhibitor development
- is HIV negative or HIV positive with stable disease and CD4+ count ≥ 200 cells per mm^3
- is negative for Hepatitis C virus (HCV); Or participant is HCV positive with chronic stable hepatitis as assessed by investigator
Main
- has prior history of hypersensitivity or anaphylaxis associated with receipt of FVIII
- is diagnosed with other bleeding disorder(s) other than hemophilia A, including but not limited to thrombocytopenia (platelet count < 100000 /mL)
- has been exposed to an investigational product (IP) within 30 days prior to the screening visit or is scheduled to participate in another clinical study involving an IP or investigational device during participation in the study
- is planned, or likely to have surgery during the study period
- has end-stage renal failure or evidence of a severe or uncontrolled systemic disease as judged by the investigator
- has active hepatic disease (alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels > 5 times the upper limit of normal)
- has clinical or laboratory evidence of severe liver impairment including (but not limited to) a recent & persistent international normalized ratio (INR) >1.4, and/or the presence of splenomegaly and/or significant spider angioma on physical exam, and/or a history of esophageal hemorrhage or documented esophageal varices
- is a family member of the investigator or site staff
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Previously Treated Patients (PTPs) Octocog alfa (recombinant human coagulation factor VIII) PTPs will participate sequentially with: Part 1: Pharmacokinetic parameters of ADVATE measured in subset of 24 participants, consisting of: * 12 adults (\>12 years of age) * 12 children (≤12 years of age) Part 2: On-demand treatment with ADVATE for 6 months Part 3: Prophylaxis regimen with ADVATE for 6 months
- Primary Outcome Measures
Name Time Method Percentage of reduction in annualized bleed rate (ABR) during prophylactic treatment compared to ABR during on demand treatment 12 months Computed as:
{\[median ABR on-demand - median ABR prophylaxis\]÷\[median ABR on-demand\]}\*100%
The ABR, will be assumed to have a negative binomial distribution. The 2 treatment regimens (on-demand and prophylaxis) will be compared in terms of mean ABR within a generalized linear model framework (with a logarithmic link function which is the default for the negative binomial distribution), accounting for the fixed effect of study arm and the follow-up time (in years) as an offset. Ratios between treatment means (95% CI) will be estimated within this model.
- Secondary Outcome Measures
Name Time Method Overall evaluation of efficacy on a four-point scale (Excellent-Good-Fair-Poor) 12 months Clearance (CL) Within 30 minutes prior to the start of the infusion through 48 hours post-infusion Computed as Dose/ AUC0-∞
Number of units per kg body weight of ADVATE required to resolve a bleeding episode (BE) 12 months Annualized bleeding episode rates (ABR) according to bleed type and bleed etiology summarized by treatment regimen 12 months Bleed types and etiologies summarized by treatment regimen (prophylaxis, on-demand) including:
* Joint bleeds
* Non-joint bleeds
* Spontaneous bleeds
* Traumatic bleeds
* Target joint bleedsInhibitor incidence 13 months Inhibitor incidence in:
1. Previously treated patients (PTPs) with previous 51-150 exposure days (EDs) to Factor VIII (FVIII)
2. PTPs with previous \>150 EDs to FVIIIAdverse events according to relatedness, seriousness, and severity 13 months Area under the plasma concentration/time curve from time 0 to infinity Within 30 minutes prior to the start of the infusion through 48 hours post-infusion Computed as AUC0-t + Ct/ λz, where t is the time of last quantifiable concentration, Ct is the last quantifiable concentration, and λz is the terminal rate constant
Elimination phase half-life Within 30 minutes prior to the start of the infusion through 48 hours post-infusion Computed as: ln2/ λz. λz will be estimated from the slope of natural log-linear fitting to latter quantifiable concentrations, with largest adjusted R\^2
Number of infusions of ADVATE required to resolve a bleeding episode (BE) 12 months Mean Residence Time (MRT) Within 30 minutes prior to the start of the infusion through 48 hours post-infusion Computed as AUMC0-∞ / AUC0-∞ - TI/2, where AUMC0-∞ will be determined in a similar manner as AUC0-∞ and TI represents infusion duration \[hour\]
Incremental Recovery (IR) at Cmax Within 30 minutes prior to the start of the infusion, and within 1 hour post-infusion Computed as: (Cmax - Cpre-infusion)/Dose, where Cmax will be determined as the highest concentration achieved within one hour after infusion
Volume of distribution at steady state (Vss) Within 30 minutes prior to the start of the infusion through 48 hours post-infusion Computed as: CL \* MRT
Trial Locations
- Locations (11)
Fujian Medical University Union Hospital
🇨🇳Fuzhou, Fujian, China
Cangzhou Central Hospital
🇨🇳Cangzhou, Hebei, China
Xiangya Hospital Central South University
🇨🇳Changsha, Hunan, China
Hospital of Blood Disease, Chinese Academy of Medical Sciences
🇨🇳Tianjin, China
Peking Union Medical College Hospital
🇨🇳Dongcheng, Beijing, China
Tongji Hospital of Tongji Medical College of Hongzhong Science and Techology University
🇨🇳Wuhan, Hubei, China
Tongji Hosp, Tongji Med. Col, Huazhong Univ. of Sci. & Tech/ Wuhan Union Hospital
🇨🇳Wuhan, Hubei, China
The First Affiliated Hospital of College of Medicine, Zhengjiang University
🇨🇳Hangzhou, Zhejiang, China
The First Affiliated Hospital of Soochow University
🇨🇳Suzhou, Jiangsu, China
Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
🇨🇳Shanghai, China
Beijing Children's Hospital Affiliated to Capital University of Medical Sciences
🇨🇳Beijing, China