MedPath

BAX 855 Continuation

Phase 3
Completed
Conditions
Hemophilia A
Interventions
Biological: BAX855
Registration Number
NCT01945593
Lead Sponsor
Baxalta now part of Shire
Brief Summary

To continue the evaluation of the safety and efficacy of BAX 855 for prophylaxis and treatment of bleeding episodes in adult and pediatric previously treated patients (PTPs) aged ≤ 75 years of age with severe hemophilia A.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
218
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Fixed BAX855 prophylaxisBAX85545-80 IU/kg twice weekly to once per week.
Pharmacokinetic (PK)-tailored BAX 855 prophylaxisBAX855PK-tailored prophylactic BAX855 regimen based on participant's individual PK profile to maintain a Factor VIII (FVIII) trough level
Primary Outcome Measures
NameTimeMethod
Annualized Bleed Rate (ABR) - Spontaneous BleedsBaseline through end of study (53 months)

The ABR was assessed based upon each individual bleeding episode. A bleeding episode was defined as subjective (pain consistent with a joint bleed) or objective evidence of bleeding which may or may not require treatment with FVIII. The ABR of spontaneous bleeds was reported separately for twice weekly, PK-t R, each of the every 5 days and every 7 days treatment regimens at the time of bleed.

Number of Participants With Inhibitory Antibodies to Factor VIII (FVIII)Baseline through end of study (53 months)

Inhibitory antibodies to Factor VIII were measured by the Nijmegen modification of the Bethesda assay. Inhibitors had to be confirmed by 2 separate assessments within a 2 to 4 week period from the central laboratory.

Secondary Outcome Measures
NameTimeMethod
Total Annualized Bleed Rate (ABR)Baseline through end of study (53 months)

The ABR was assessed based upon each individual bleeding episode. A bleeding episode was defined as subjective (pain consistent with a joint bleed) or objective evidence of bleeding which may or may not require treatment with FVIII. Bleeding occurring at multiple locations related to the same injury (e.g., knee and ankle bleed following a fall) was counted as a single bleeding episode. Total annualized bleed rate (spontaneous and traumatic bleeding episodes) was reported.

Overall Hemostatic Efficacy Rating of BAX 855 for Treatment of Breakthrough Bleeding EpisodesBaseline through end of study (53 months)

The participant or caregiver rated the overall treatment response at 24 (+/- 2) hours after the initiation of treatment using a 4-point efficacy rating scale as Excellent: Full relief of pain and cessation of objective signs of bleeding after a single infusion and no additional infusion is required for the control of bleeding; Good: Definite pain relief and/or improvement in signs of bleeding after a single infusion and possibly requires more than 1 infusion for complete resolution; Fair: Slight relief of pain and slight improvement in signs of bleeding after a single infusion and required more than 1 infusion for complete resolution and None: No improvement or condition worsens.

Change From Baseline in Pain SeverityBaseline, end of study (53 months)

Hemophilia symptom (haemo-SYM) questionnaire has two subscales: pain and bleed. It was used to asses the pain severity for participants \>=18 years of age as: pain because of swelling in my joints, climbing stairs, upon waking in the morning, active arthritis; constant pain, in my muscles, that needs medication; joint sensitivity to weather conditions; reduced range of joint movement, joint deformity, sleep disturbance because of pain or bleeds, blood in my urine, nose bleeds and assigned a score of 0=Absent, 1=very mild, 2=mild, 3=moderate, 4=severe and 5=very severe. The score was determined as (mean score/5)\*100 where mean score is the mean of the available results in the particular subscale. Higher scores on the Haemo-SYM indicate more severe symptoms. Therefore, negative change scores indicate that symptoms have improved. Here 'n' refers to the number of participants evaluable for this endpoint.

Change From Baseline in Respiratory RateBaseline, end of study (53 months)

Change in respiratory rate at pre-infusion and post-infusion at end of the study was reported. In the below table, FDR refers to fixed dose regimen, PK-tR refers to PK tailored regimen at the time of sampling.

Total Time Intervals Between Bleeding EpisodesBaseline through end of study (53 months)

The time interval between bleeding episodes was calculated based upon the date and time reported for each bleeding episode. A bleeding episode was defined as subjective (pain consistent with a joint bleed) or objective evidence of bleeding which may or may not require treatment with FVIII.

Average Dose of BAX 855 Per Prophylactic InfusionBaseline through end of study (53 months)

The average dose of BAX 855 per prophylactic infusion was reported.

Change From Baseline in Blood PressureBaseline, end of study (53 months)

Change in systolic and diastolic blood pressure at pre-infusion and post-infusion at end of the study were reported. In the below table, FDR refers to fixed dose regimen, PK-tR refers to PK tailored regimen at the time of sampling, SBP refers to systolic blood pressure, DBP refers to diastolic blood pressure.

Change From Baseline in Bleed SeverityBaseline, end of study (53 months)

Hemophilia symptom (haemo-SYM) questionnaire has two subscales: pain and bleed. It was used to asses the bleed severity for participants \>=18 years of age as: severity of spontaneous bleeding in my joints (unrelated to injury or activity), spontaneous bleeding in my muscles (unrelated to injury or activity), prolonged bleeding after injury in spite of treatment, intense pain because of bleeding event, joint pain due to active bleed and bleeding during personal hygiene routine, blood in my urine, nose bleeds and assigned a score of 0=Absent, 1=very mild, 2=mild, 3=moderate, 4=severe and 5=very severe. The score was determined as (mean score/5)\*100 where mean score is the mean of the available results in the particular subscale. Higher scores on the Haemo-SYM indicate more severe symptoms. Therefore, negative change scores indicate that symptoms have improved. Here 'n' refers to the number of participants evaluable for this endpoint.

Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)Baseline through end of study (53 months)

An AE was any unfavorable and unintended sign (eg, an abnormal laboratory finding), symptom (eg, rash, pain, discomfort, fever, dizziness, etc.), disease (eg, peritonitis, bacteremia, etc.), or outcome of death temporally associated with the use of an investigational product (IP), whether or not considered causally related to the IP. A serious adverse event (SAE) was defined as an untoward medical occurrence that at any dose met one or more of the following criteria: outcome was fatal/resulted in death; was life-threatening; required inpatient hospitalization or resulted in prolongation of an existing hospitalization; resulted in persistent or significant disability/incapacity; was a congenital anomaly/birth defect; was a medically important event.

BAX 855 Infusions Needed to Treat Bleeding EpisodesBaseline through end of study (53 months)

The BAX 855 infusions to treat each bleeding episode was determined by the participant, the participant's caregiver, and/or investigator, and was based upon the participant's response to treatment. A bleeding episode was defined as subjective (pain consistent with a joint bleed) or objective evidence of bleeding which may or may not require treatment with FVIII.

Change From Baseline in Body TemperatureBaseline, end of study (53 months)

Change in body temperature at pre-infusion and post-infusion at end of the study was reported. In the below table, FDR refers to fixed dose regimen, PK-tR refers to PK tailored regimen at the time of sampling.

Change From Baseline in Pulse RateBaseline, end of study (53 months)

Change in pulse rate at pre-infusion and post-infusion at end of the study was reported. In the below table, FDR refers to fixed dose regimen, PK-tR refers to PK tailored regimen at the time of sampling.

Change From Baseline in Patient Reported Outcomes: Health-related Quality of Life (HRQoL): Short Form-36 (SF-36)Baseline, end of study (53 months)

HRQoL in participants aged \>=14 years was measured using the SF-36 questionnaire. The questionnaire was divided into 8 domains and scored as: physical functioning (1=yes, limited a lot to 3=no, not limited at all), role-physical (1=all of the time to 5=none of the time), bodily pain (1=very severe to 6=none), general health (1=poor to 5=excellent), vitality (1=none of the time to 5=all of the time), social functioning (1=all of the time: to 5=none of the time), role emotional (1=all of the time to 5=none of the time) and mental health (1=all of the time to 5=none of the time). The score for each domain is then to be transformed to a 0-100 range as \[(actual raw score-lowest possible raw score)/possible raw score range\]\*100. Positive change scores indicate improved HRQoL. in the below table 'FDR' indicates fixed dose regimen, 'PK-tr' indicates pharmacokinetically tailored regimen and 'n' refers to the number of participants evaluable for this endpoint.

Number of Participants With Shifts in Clinical Chemistry Laboratory Assessments.Baseline through end of study (53 months)

The number of participants with clinically significant shifts from "normal" "abnormal clinically significant (CS)" and "abnormal not clinically significant (abnormal NCS)" at baseline to "normal" "abnormal clinically significant (CS) and abnormal clinically significant (NCS)" at completion were reported. In the below table, FDR refers to fixed dose regimen at the time of sampling, AlA refers to alanine aminotransferase, AP refers to alkaline phosphatase, AsA refers to aspartate aminotransferase.

Number of Participants With Shifts in Hematology Laboratory AssessmentsBaseline through end of study (53 months)

The number of participants with clinically significant shifts from "normal" "abnormal clinically significant (CS)" and "abnormal not clinically significant (abnormal NCS)" at baseline to "normal" "abnormal clinically significant (CS) and abnormal clinically significant (NCS)" at completion were reported. In the below table, FDR refers to fixed dose regimen, PK-tR refers to PK tailored regimen at the time of sampling, Leu refers to leukocytes, MCV refers to mean corpuscular volume, Lym/Leu refers to lymphocytes/leukocytes.

Number of Participants With Shifts in Lipid Panel AssessmentsBaseline through end of study (53 months)

The number of participants with clinically significant shifts from "normal" "abnormal clinically significant (CS)" and "abnormal not clinically significant (abnormal NCS)" at baseline to "normal" "abnormal clinically significant (CS) and abnormal clinically significant (NCS)" at completion were reported.. In the below table, HDL refers to high density lipoprotein, LDL refers to low density lipoprotein, VLDL refers to very low density lipoprotein.

Number of Participants With Binding AntibodiesBaseline through end of study (53 months)

Binding antibodies (IgG and IgM) against FVIII, polyethylene glycol (PEG) and PEGylated FVIII (PEG-FVIII) were analyzed using enzyme-linked immunosorbent assay (ELISA).

Number of Participants With Anti-Chinese Hamster Ovary (CHO) AntibodiesBaseline through end of study (53 months)

Testing for binding of anti-CHO protein antibodies was performed on citrate-anti-coagulated plasma using an ELISA employing polyclonal antihuman IgG antibodies.

Change From Baseline in Patient Reported Outcomes: Health-related Quality of Life (HRQoL): Pediatrics Quality of Life (PedsQL) QuestionnaireBaseline, end of study (53 months)

HRQoL in participants aged \<14 years was measured using the PedsQL. It capture data for the following domains: physical functioning, emotional functioning, social functioning, school functioning, psychosocial functioning, physical health and a total score. Each question of the PedsQL was scored as Never: 100, almost never: 75, sometimes: 50, often: 25, almost always: 0. The mean of the individual question scores was calculated. Lower scores on the PedsQL indicating worse HRQoL. Here, FDR refers to fixed dose regimen, PK-t R refers to PK-tailored regimen. Here 'n' refers to the number of participants evaluable for this endpoint. Here 'n' refers to the number of participants evaluable for this endpoint.

Trial Locations

Locations (89)

Universitatsklinik fur Innere Medizin I

🇦🇹

Vienna, Austria

University of Occupational and Environmental Health Hospital

🇯🇵

Kitakyushu-shi, Fukuoka-Ken, Japan

Ulsan University Hospital

🇰🇷

Ulsan, Korea, Republic of

Eulji University Hospital

🇰🇷

Daejeon, Korea, Republic of

Wojewodzki Szpital Specjalistyczny im.M.Kopernika w Lodzi

🇵🇱

Lodz, Poland

Hospital Regional Universitario de Malaga

🇪🇸

Malaga, Málaga, Spain

Sjukhusapoteket Malmo

🇸🇪

Malmo, Sweden

Taichung Veterans General Hospital

🇨🇳

Taichung, Taiwan

Tri-Service General Hospital

🇨🇳

Taipei, Taiwan

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

Cincinnati Children's Hospital Medical Center

🇺🇸

Cincinnati, Ohio, United States

Phoenix Childrens Hospital

🇺🇸

Phoenix, Arizona, United States

University of Oklahoma

🇺🇸

Oklahoma City, Oklahoma, United States

University of Utah

🇺🇸

Salt Lake City, Utah, United States

University of Colorado

🇺🇸

Aurora, Colorado, United States

North Shore-Long Island Jewish Health System

🇺🇸

New Hyde Park, New York, United States

New York - Presbyterian/Weill Cornell Medical Center

🇺🇸

New York, New York, United States

Cleveland Clinic Foundation

🇺🇸

Cleveland, Ohio, United States

Fremantle Hospital

🇦🇺

Fremantle, Western Australia, Australia

Royal Adelaide Hospital

🇦🇺

Adelaide, South Australia, Australia

Fakultni nemocnice v Motole

🇨🇿

Praha 5, Czechia

Fakultni nemocnice Brno

🇨🇿

Brno, Czechia

Fakultni nemocnice Olomouc

🇨🇿

Olomouc, Czechia

SHAT of Oncohaematology Diseases

🇧🇬

Sofia, Bulgaria

Vivantes Klinikum im Friedrichshain - Landsberger Allee

🇩🇪

Berlin, Germany

Gerinnungszentrum Rhein-Ruhr

🇩🇪

Duisburg, Nordrhein Westfalen, Germany

Universitaetsklinikum Hamburg-Eppendorf

🇩🇪

Hamburg, Germany

St. Marianna University School of Medicine Hospital

🇯🇵

Kawasaki-shi, Kanagawa-Ken, Japan

Pusan National University Hospital

🇰🇷

Busan, Korea, Republic of

Chonnam National University Hwasun Hospital

🇰🇷

Hwasun-gun, Jeollanam-do, Korea, Republic of

Kyung Hee University Hospital at Gangdong

🇰🇷

Seoul, Korea, Republic of

Children's Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos

🇱🇹

Vilnius, Lithuania

Penang General Hospital

🇲🇾

George Town, Penang, Malaysia

Vilnius University Hospital Santariskiu Clinics, Public Institution

🇱🇹

Vilnius, Lithuania

Hospital Umum Sarawak

🇲🇾

Kuching, Sarawak, Malaysia

Hospital Ampang

🇲🇾

Ampang, Selangor, Malaysia

Sanador SRL

🇷🇴

Bucuresti, Romania

LLC "Alba Dent"

🇷🇺

Kirov, Russian Federation

Hospital Universitari Son Espases

🇪🇸

Palma de Mallorca, Baleares, Spain

Complejo Hospitalario Universitario A Coruña

🇪🇸

A Coruña, La Coruña, Spain

Hospital Universitari i Politecnic La Fe

🇪🇸

Valencia, Spain

Hospital Universitario La Paz

🇪🇸

Madrid, Spain

Karolinska

🇸🇪

Stockholm, Sweden

Universitaetsspital Zuerich

🇨🇭

Zuerich, Switzerland

Ankara University Medical Faculty

🇹🇷

Ankara, Turkey

Akdeniz University Faculty of Medicine

🇹🇷

Antalya, Turkey

Istanbul University Cerrahpasa Medical Faculty

🇹🇷

Istanbul, Turkey

SI V.K.Gusak Emergency and Reconstructive Surgery Institute of NAMSU

🇺🇦

Donetsk, Ukraine

Bristol Royal Hospital for Children

🇬🇧

Bristol, Avon, United Kingdom

Royal Free Hospital

🇬🇧

London, Greater London, United Kingdom

Royal Manchester Children's Hospital

🇬🇧

Manchester, Greater Manchester, United Kingdom

Great Ormond Street Hospital for Children

🇬🇧

London, Greater London, United Kingdom

The Churchill Hospital

🇬🇧

Oxford, United Kingdom

University of Florida College of Medicine

🇺🇸

Gainesville, Florida, United States

Ann & Robert H. Lurie Children's Hospital of Chicago

🇺🇸

Chicago, Illinois, United States

Bleeding and Clotting Disorders Institute

🇺🇸

Peoria, Illinois, United States

Nationwide Children's Hospital

🇺🇸

Columbus, Ohio, United States

Penn State Hershey Cancer Center

🇺🇸

Hershey, Pennsylvania, United States

Puget Sound Blood Group

🇺🇸

Seattle, Washington, United States

MHAT 'Sv. Marina', EAD

🇧🇬

Varna, Bulgaria

University of Kentucky Medical Center

🇺🇸

Lexington, Kentucky, United States

Birmingham Children's Hospital

🇬🇧

Birmingham, West Midlands, United Kingdom

Werlhof-Institut GmbH

🇩🇪

Hannover, Niedersachsen, Germany

Nara Medical University Hospital

🇯🇵

Kashihara-shi, Nara-Ken, Japan

Tokyo Medical University Hospital

🇯🇵

Shinjuku-ku, Tokyo-To, Japan

Ogikubo Hospital

🇯🇵

Suginami City, Tokyo, Japan

Nagoya University Hospital

🇯🇵

Nagoya-shi, Aichi-Ken, Japan

Uniwersyteckie Centrum Kliniczne

🇵🇱

Gdansk, Poland

The Alfred Hospital

🇦🇺

Melbourne, Victoria, Australia

Chaim Sheba Medical Center

🇮🇱

Ramat-Gan, Israel

SI Institute of Blood Pathology and Transfusion Medicine of NAMSU

🇺🇦

Lviv, Ukraine

Hospital Sibu

🇲🇾

Sibu, Sarawak, Malaysia

UMHAT "Sv. Georgi", EAD

🇧🇬

Plovdiv, Bulgaria

Regional Clinical Hospital

🇷🇺

Krasnoyarsk, Russian Federation

Southampton General Hospital

🇬🇧

Southampton, Hampshire, United Kingdom

Landes-Frauen-und Kinderklinik Linz

🇦🇹

Linz, Austria

Rambam Health Care Campus

🇮🇱

Haifa, Israel

Hiroshima University Hospital

🇯🇵

Hiroshima-shi, Hiroshima-Ken, Japan

Pusat Darah Negara

🇲🇾

Kuala Lumpur, Malaysia

Hospital Pulau Pinang

🇲🇾

Pulau Pinang, Malaysia

Academisch Medisch Centrum

🇳🇱

Amsterdam, Netherlands

Leicester Royal Infirmary

🇬🇧

Leicester, Leicestershire, United Kingdom

Palmetto Health Richland

🇺🇸

Columbia, South Carolina, United States

University of Louisville

🇺🇸

Louisville, Kentucky, United States

Tulane University School of Medicine

🇺🇸

New Orleans, Louisiana, United States

Children's Mercy Hospitals & Clinics

🇺🇸

Kansas City, Missouri, United States

University of North Carolina at Chapel Hill

🇺🇸

Chapel Hill, North Carolina, United States

St Thomas' Hospital

🇬🇧

London, Greater London, United Kingdom

Prince of Wales Hospital

🇭🇰

Shatin, Hong Kong

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