A Study of Icatibant in Patients With Acute Attacks of Hereditary Angioedema (FAST-3)
- Registration Number
- NCT00912093
- Lead Sponsor
- Shire
- Brief Summary
This study is being conducted to evaluate the efficacy and safety of icatibant compared to placebo in patients experiencing acute attacks of hereditary angioedema (HAE).
- Detailed Description
This Phase III study consisted of two parts: A controlled phase and an open label extension (OLE) phase.
The controlled phase describes the double blind part of the study and was intended to evaluate the efficacy and safety of icatibant compared with placebo for the first treated cutaneous and/or abdominal attack.
Patients with moderate to severe abdominal or cutaneous attacks were randomized to receive a single, blinded, subcutaneous injection of icatibant (30 mg) or placebo. After a protocol amendment, patients with mild to moderate laryngeal HAE attacks were also randomized to receive a single, blinded subcutaneous injection of icatibant (30 mg) or placebo in order to obtain blinded, controlled efficacy and safety data for this subset of subjects. Patients experiencing severe laryngeal attacks (post-amendment) or mild to severe laryngeal attacks (pre-amendment) were to receive open-label icatibant.
After treatment of the first attack in the controlled phase, patients were eligible to enter the OLE phase. In the OLE phase, patients who experienced angioedema attacks severe enough to warrant treatment were to be treated with s.c. icatibant as appropriate until the study was discontinued or the product was commercially available.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 98
Each patient must meet the following criteria to be enrolled in this study.
- The patient is ≥18 years old at the time of informed consent.
- The patient has a documented diagnosis of HAE type I or II. The diagnosis will be confirmed either by documented decreased C4 levels and/or immunogenic or functional C1-INH deficiency results (<50% of normal levels) consistent with HAE types I and II or by medical history.
- The current HAE attack must be in the cutaneous, abdominal and/or laryngeal (inclusive of laryngeal and pharyngeal) areas.
- Cutaneous or abdominal HAE attacks must be moderate to very severe as determined by investigator global assessment at pre-treatment assessments
- The patient must report at least 1 VAS score ≥ 30mm
- The patient commences treatment within 6 hours of the attack becoming at least mild (laryngeal) or moderate (non-laryngeal) in severity, but not more than 12 hours after the onset of the attack.
- Women of childbearing potential must have a negative urine pregnancy test and must use appropriate methods to prevent pregnancy during their participation in the study.
Patients who meet any of the following criteria will be excluded from the study.
- The patient has a diagnosis of angioedema other than HAE type I or II.
- The patient has received previous treatment with icatibant.
- The patient has participated in a clinical trial and has received treatment with another investigational medicinal product within the past 30 days.
- The patient has received treatment with any pain medication since the onset of the current angioedema attack.
- The patient has received replacement therapy (fresh frozen plasma [FFP], C1-INH products) less than 5 days (120 hours) from the onset of the current angioedema attack.
- The patient is receiving treatment with angiotensin converting enzyme (ACE) inhibitors.
- Evidence of coronary artery disease based on medical history or screening examination in particular unstable angina pectoris or severe coronary heart disease;
- The patient has a serious concomitant illness or condition that, in the opinion of the Investigator, would be a contraindication for participation in the trial.
- The patient is pregnant or breastfeeding.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Icatibant Icatibant Single subcutaneous injection of icatibant, 30 mg Placebo Placebo Single subcutaneous injection of matching placebo
- Primary Outcome Measures
Name Time Method Time to Onset of Symptom Relief for an Acute Attack, as Assessed by the Patient Up to 120 hours post-dose Time to onset of symptom relief was calculated from study drug administration to onset of symptom relief, where onset of symptom relief was defined as the earliest of 3 consecutive measurements in which there was a 50% reduction from pretreatment in composite VAS score. Composite VAS score comprised 3 symptoms, including skin swelling, skin pain, and abdominal pain, for cutaneous and abdominal attacks and 5 symptoms, including skin swelling, skin pain, abdominal pain, difficulty swallowing, and voice change, for laryngeal attacks. Subjects who did not achieve symptom relief within the observation period were censored at the last observation time.
- Secondary Outcome Measures
Name Time Method Time to Almost Complete Symptom Relief Up to 120 Hours post treatment Time to almost complete symptom relief was calculated from the time of study drug administration to almost complete symptom relief, where almost complete symptom relief was defined as the earliest of 3 consecutive non-missing measurements in which all VAS scores \<10 mm. Subjects who did not achieve almost complete symptom relief within the observation period were censored at the last observation time.
Time to Subject-Assessed Initial Symptom Improvement Up to 120 hours post-dose Time to initial symptom improvement was calculated from the time of study drug administration to initial symptom improvement as determined by the subject as the time they felt symptoms were starting to improve. Subjects who did not achieve initial symptom improvement within the observation period were censored at the last observation time.
Time to Investigator-Assessed Initial Symptom Improvement Up to 120 hours post-dose Time to initial symptom improvement was calculated from the time of study drug administration to initial symptom improvement as determined by the investigator as the time they felt symptoms were starting to improve. Subjects who did not achieve initial symptom improvement within the observation period were censored at the last observation time.
Time to Onset of Primary Symptom Relief Up to 120 hours post-dose Time to primary symptom relief was calculated from the time of study drug administration to the onset of primary symptom relief, where onset of primary symptom relief was determined using the subject-assessed VAS score for a single primary symptom (determined by edema location) and defined as the earliest of 3 consecutive non-missing measurements in which a pre-specified reduction from the pretreatment value was met. Subjects who did not achieve primary symptom relief within the observation period were censored at the last observation time.
Trial Locations
- Locations (64)
Children's Hospital of Pittsburgh (of UMPC)
🇺🇸Pittsburgh, Pennsylvania, United States
Rush University Medical Center
🇺🇸Chicago, Illinois, United States
Speciality Medical Clinic & Research Center
🇺🇸Stanford, California, United States
Research Institute of Deaconess Clinic
🇺🇸Evansville, Indiana, United States
University of Iowa Asthma Center/ Hospitals & Clinics
🇺🇸Iowa City, Iowa, United States
Asthma & Allergy Associates, PC
🇺🇸Colorado Springs, Colorado, United States
Montefiore Medical Center/Albert Einstein College of Medicine
🇺🇸Bronx, New York, United States
Mount Sinai School of Medicine
🇺🇸New York, New York, United States
Baker Allergy, Asthma & Dermatology Research Center LLC
🇺🇸Lake Oswego, Oregon, United States
UCLA - Clinical Immunology & Allergy
🇺🇸Los Angeles, California, United States
Allergy Diagnostic and Clinical Research Unit (ADCRU)
🇿🇦Cape Town, Mowbray, South Africa
Standford University
🇺🇸Stanford, California, United States
Optimed Research, LTD
🇺🇸Columbus, Ohio, United States
Institute for Asthman & Allergy, P.C.
🇺🇸Chevy Chase, Maryland, United States
Medical Associates of Brevard
🇺🇸Melbourne, Florida, United States
Winthrop University Hospital Clinical Trials Center
🇺🇸Mineola, New York, United States
Tulsa Allergy Clinic
🇺🇸Tulsa, Oklahoma, United States
Valley Clinical Research Center
🇺🇸Bethlehem, Pennsylvania, United States
Royal Adelaide Hospital
🇦🇺Adelaide, Australia
University of Texas Medical Branch (UTMB)
🇺🇸Galveston, Texas, United States
AARA Research Center
🇺🇸Dallas, Texas, United States
Dept of Medicine Immunology & Allergy Campbelltown Hospital
🇦🇺Campbelltown, New South Wales, Australia
Allergy & Asthma Research Centre
🇨🇦Ottawa, Ontario, Canada
Massachusetts General Hospital
🇺🇸Boston, Massachusetts, United States
Primary Care Associates of Alabaster
🇺🇸Alabaster, Alabama, United States
Medical Research of AZ A Division of Allergy & Immunology Assoc
🇺🇸Scottsdale, Arizona, United States
Allergy and Asthma Insititute of the Valley
🇺🇸Granada Hills, California, United States
The Asthma Center
🇺🇸Saint Louis, Missouri, United States
University of Reno Nevada School of Medicine
🇺🇸Reno, Nevada, United States
Allergy Partners of Western North Carolina
🇺🇸Asheville, North Carolina, United States
UAB Lung Health Center
🇺🇸Birmingham, Alabama, United States
University of Cincinnati Division of Immunology/Allergy
🇺🇸Cincinnati, Ohio, United States
Duke University Medical Center
🇺🇸Durham, North Carolina, United States
Texas A&M Health Science Center College of Medicine
🇺🇸Houston, Texas, United States
Allergy and Asthma Research Center, P.A.
🇺🇸San Antonio, Texas, United States
University of Utah
🇺🇸Salt Lake City, Utah, United States
The Chaim Sheba Medical Center
🇮🇱Tel Hashomer, Israel
Institute of Otolaryngology
🇺🇦Kyiv, Ukraine
STARx Research Center, LLC
🇺🇸Edison, New Jersey, United States
Royal Melbourne Hospital Department of Immunology
🇦🇺Parkville, Victoria, Australia
3rd Department of Internal Medicine Semmelweis University
🇭🇺Budapest, Hungary
Centre de recherché Appliquée en allergie de Québec
🇨🇦Quebec City, Quebec, Canada
Tel Aviv Medical Center
🇮🇱Tel Aviv, Israel
Autonomous Non Commercial Organization
🇷🇺St Petersburg, Saint Petersburg, Russian Federation
Vinnitsa Medical Academy Chair of Internal Disease
🇺🇦Vinnitsa, Ukraine
State Enterprise State Scientific Centre
🇷🇺Moscow, Russian Federation
Bnai-Zion Medical Center Division of Immunology & Allergy
🇮🇱Haifa, Israel
Medical Academy of Postgraduate Education
🇷🇺St Petersburg, Saint Petersburg, Russian Federation
Municipal Medical & Preventive Treatment Institution
🇷🇺Smolensk, Russian Federation
National Medical Academy for Postgraduate Education
🇺🇦Kyiv, Ukraine
University of California San Diego
🇺🇸La Jolla, California, United States
State Healthcare Institution of City of Moscow
🇷🇺Moscow, Russian Federation
LSUHSC Allergy & Immunology
🇺🇸Shreveport, Louisiana, United States
Spitalul Clinic Judetean Mures Sectia Medicina Interna
🇷🇴Targu Mures, Transylvania, Romania
Canberra Hospital Department of Immunology
🇦🇺Garran, Australian Capital Territory, Australia
State Educational Institution of Additional Profess. Edu. Moscow
🇷🇺Moscow, Russian Federation
Regional Clinical Center of Specialized Medical Treatment
🇷🇺Vladivostok, Russian Federation
Ivano-Frankivsk national Medical University
🇺🇦Ivano-Frankivsk, Ukraine
Penn State Hershey Medical Center
🇺🇸Hershey, Pennsylvania, United States
NACTRC
🇨🇦Edmonton, Alberta, Canada
Ukranian Medical Stomatological Academy Dept of Int Diseases
🇺🇦Poltava, Ukraine
Family Allergy and Asthma Center, PC
🇺🇸Atlanta, Georgia, United States
University of South Florida Division of Allergy and Immunology
🇺🇸Tampa, Florida, United States
Little Rock Allergy & Asthma Clinic, PA
🇺🇸Little Rock, Arkansas, United States