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Efficacy, safety and pharmaco-economic assessment of secondary long term prophylaxis with highly purified, standardized, doubly virus inactivated FVIII/VWF concentrates in patients with severe, inherited VWD and frequent bleedings.

Phase 1
Conditions
Severe, inherited von Willebrand disease (VWD) and frequent bleedings
MedDRA version: 14.1 Level: PT Classification code 10047715 Term: Von Willebrand's disease System Organ Class: 10010331 - Congenital, familial and genetic disorders
Therapeutic area: Diseases [C] - Blood and lymphatic diseases [C15]
Registration Number
EUCTR2006-001383-23-GB
Lead Sponsor
Prof Flora Peyvandi, MD
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
Not specified
Target Recruitment
24
Inclusion Criteria

1. Documented unresponsiveness to DDAVP. All the patients, excluding type 3 and type 2B, should have been exposed to a documented infusion trial with DDAVP. Responsiveness to DDAVP is defined as an increase in plasma FVIII:C and VWF:RCo levels of at least three fold over baseline and in absolute reaching at least 30 IU/dl for both values and a BT of 12 minutes or less after 2 hours from administration of 0,3 mcg/kg of DDAVP
OR
contraindication to DDAVP (namely type 2B VWD patients or other patients who display significant side effects to DDAVP)

2. Frequent, spontaneous bleedings i.e. at least 5 episodes in whatever anatomical site in the last 12 months, severe enough to require treatment with FVIII/VWF concentrates

Prolonged or excess bleeding during menses will be allowed only when:
i. No other medication can control frequent bleeds
ii. Bleeding exceeds 10 consecutive days
OR
Recurrent spontaneous bleedings, severe enough to require treatment with FVIII/VWF concentrates of the following types:
-Epistaxes (at least 5 episodes in the last 12 months)
- Haemarthroses (at least 3 episodes at the same joint in the last 12 months)
-Gastrointestinal bleeding (at least 2 episodes in the last 12 months, with a drop = 2 g/dl of haemoglobin in 24-48 hours) due to unexplained reason or in association with underlying gastrointestinal angiodysplasia

3. Willingness to participate in the study, expressed by signed, written informed consent

Are the trial subjects under 18? yes
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range

Exclusion Criteria

1. a life expectancy < 1 year
2. presence of allo-antibodies to VWF or FVIII
3. acquired Von Willebrand’s syndrome (AVWS)
4. co-morbidity with other haemorrhagic diathesis, excluded those linked to VWD as the complication of treatment (for instance thrombocytopenia in Type 2B VWD)
5. advanced liver cirrhosis with:
- cirrhosis related coagulation abnormalities (thrombocytopenia, defined as platelet count < 50.000/mm3, INR >1,7, prolonged prothrombin time > 4 seconds versus normal)
- portal hypertension with history of variceal bleeding
6. pregnancy and lactation
7. any known need for invasive procedures or elective surgery scheduled in the following 3 months (recruitment in these cases should be postponed)
8. proven co-morbidity for other causes of gastrointestinal bleeding not related to the studied disease (as drug induced haemorrhagic gastropathy, upper GI tract ulcers or cancer, or operable conditions, e.g. haemorrhoids) with the exception of concomitant angiodysplasia which meets the inclusion criteria
9. gastrointestinal bleeding due to trauma, invasive diagnostic or surgical procedures
10. concomitant autoimmune anaemia and/or autoimmune thrombocytopenia

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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