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Phase 3 Study of Fibrinogen Concentrate (CSL511) in Subjects With Pseudomyxoma Peritonei Undergoing Cytoreductive Surgery

Phase 3
Recruiting
Conditions
Acquired Fibrinogen Deficiency
Interventions
Biological: CSL511 Fibrinogen concentrate (human)
Biological: Cryoprecipitate
Registration Number
NCT06617897
Lead Sponsor
CSL Behring
Brief Summary

This study is a phase 3, prospective, single center, randomized, open label, controlled, parallel arm, interventional study to investigate the efficacy and safety of CSL511, in participants undergoing cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) for pseudomyxoma peritonei (PMP) with predicted intraoperative blood loss of greater than or equal to (\>=) 2 liter (L). Eligible participants will be randomized in a 1:1 ratio to 1 of 2 treatment arms, to receive CSL511 or cryoprecipitate.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
90
Inclusion Criteria
  • Aged >= 18 years at the time of providing written informed consent.
  • Diagnosis of PMP requiring CRS with HIPEC.
  • Bleeding risk: Predicted intraoperative blood loss of >=2L, assessed within 60 and 100 mins after start of study surgery (assessment made before 2 L of blood is lost)
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Exclusion Criteria
  • Confirmed or suspected congenital or acquired coagulation disorder or a prothrombotic disorder
  • Myocardial infarction, acute coronary syndrome, or stroke within 2 months before study surgery.
  • Known history of chronic hepatitis.
  • Clopidogrel or ticagrelor administration within 5 days before study surgery.
  • Prasugrel administration within 7 days before study surgery.
  • Oral factor Xa inhibitor administration within 2 days before study surgery.
  • Glycoprotein IIb / IIIa antagonist administration within 24 hours before study surgery.
  • Oral direct thrombin inhibitor administration within 3 days before study surgery.
  • Vitamin K antagonists within 5 days before study surgery.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
CSL511CSL511 Fibrinogen concentrate (human)-
CryoprecipitateCryoprecipitate-
Primary Outcome Measures
NameTimeMethod
Percentage of participants with overall hemostatic successDuring surgery to 24 hours after surgery

Overall hemostatic success will be assessed by an independent data monitoring and efficacy adjudication committee (IDMEAC). The IDMEAC will assess the overall efficacy based on a composite of intraoperative and postoperative hemostasis using a 4-point scale, where ratings correspond to excellent or good (hemostatic success) or moderate or none (hemostatic failure).

Secondary Outcome Measures
NameTimeMethod
Coagulation parameter profileUp to 8 days after surgery

The following coagulation parameter profiles will be assessed: thrombin generation marker, protein C and S, antithrombin and alpha 2-antiplasmin.

Coagulation factor profileUp to 8 days after surgery

The following coagulation factor profiles will be assessed: fibrinogen, factor VIII (FVIII):C, von Willebrand ristocetin cofactor (VWF:Rco) and factor XIII (FXIII).

Duration of mechanical ventilationUp to 30 days after surgery
Duration of intensive care unit (ICU) stayUp to 30 days after surgery
Duration of hospital stayUp to 30 days after surgery
Number of participants with treatment-emergent (TE): adverse events (AEs), serious AEs (SAEs), and AEs of special interest (AESIs)Up to 30 days after IV infusion

The TE AESIs include thromboembolic events, viral transmission/seroconversion, and anaphylaxis and severe hypersensitivity/severe allergic reactions.

Number of participants with intraoperative hemostatic efficacyDuring surgery

Intraoperative hemostatic efficacy will be assessed by the surgeon and anesthesiologist using an objective 4-point hemostatic efficacy scale, where ratings correspond to excellent or good (hemostatic success) or moderate or none (hemostatic failure).

Number of participants with postoperative hemostatic efficacyUp to 24 hours after surgery

Postoperative hemostatic efficacy will be assessed by a hematologist using an objective 4-point hemostatic efficacy scale, where ratings correspond to excellent or good (hemostatic success) or moderate or none (hemostatic failure).

Plasma fibrinogen concentrationDuring surgery, at the end of surgery and up to 24 hours after start of surgery
Mean total dose of fibrinogen administeredDuring surgery, at the end of surgery and up to 24 hours after start of surgery
Number of doses of fibrinogen administeredDuring surgery, at the end of surgery and up to 72 hours after start of surgery
Duration of surgeryDuring surgery
Intraoperative blood lossDuring surgery
Intraoperative requirements for blood productsDuring surgery

Blood products include fresh frozen plasma, red blood cells, and platelets.

Postoperative blood lossUp to 48 hours after start of surgery
Postoperative requirements for blood productsUp to 9 days after surgery

Blood products include fresh frozen plasma, red blood cells, and platelets.

Number of participants with reoperation (for bleeding)Up to 30 days after surgery
Number of participants with reoperation (for reasons other than bleeding)Up to 30 days after surgery
21-day mortalityUp to 21 days after surgery
In-hospital mortalityUp to 30 days after surgery
Time between placing the investigational product (IP) order to administrationDuring surgery

The following time to event parameters will be assessed: time between when IP is ordered and when IP is ready to administer in the operating room and time between when IP is ordered and start of IP administration.

Prothrombin time and activated partial thromboplastin timeUp to 8 days after surgery

Trial Locations

Locations (1)

Basingstoke and North Hampshire Hospital

🇬🇧

Basingstoke, United Kingdom

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