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Clinical Trials/NCT02974855
NCT02974855
Completed
Phase 2

A MULTICENTER, OPEN-LABEL, MULTIPLE ASCENDING DOSE STUDY TO EVALUATE THE SAFETY, TOLERABILITY, PHARMACOKINETICS, PHARMACODYNAMICS, AND EFFICACY OF SUBCUTANEOUS OR INTRAVENOUS PF-06741086 IN SUBJECTS WITH SEVERE HEMOPHILIA

Pfizer10 sites in 6 countries27 target enrollmentMarch 8, 2017

Overview

Phase
Phase 2
Intervention
Not specified
Conditions
Hemophilia A or B
Sponsor
Pfizer
Enrollment
27
Locations
10
Primary Endpoint
Number of Participants Discontinued From Study Due to TEAEs
Status
Completed
Last Updated
6 years ago

Overview

Brief Summary

This study is designed to evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics and efficacy of multiple subcutaneous and/or intravenous doses of PF-06741086 in subjects with severe hemophilia.

Registry
clinicaltrials.gov
Start Date
March 8, 2017
End Date
December 3, 2018
Last Updated
6 years ago
Study Type
Interventional
Study Design
Sequential
Sex
Male

Investigators

Sponsor
Pfizer
Responsible Party
Sponsor

Eligibility Criteria

Inclusion Criteria

  • Severe hemophilia A or B (Factor VIII or Factor IX activity ≤ 1%), including patients with inhibitors to Factor VIII or Factor IX
  • Episodic (on-demand) treatment regimen prior to screening
  • At least 6 acute bleeding episodes during the 6-month period prior to screening

Exclusion Criteria

  • Known coronary artery, thrombotic, or ischemic disease
  • Currently receiving treatment for acute bleeding episodes with APCC and cannot substitute treatment with rFVIIa

Outcomes

Primary Outcomes

Number of Participants Discontinued From Study Due to TEAEs

Time Frame: Study Day 1 to Day 113 Visit

An AE was any untoward medical occurrence in a clinical investigation participant administered a product; the event did not need to have a causal relationship with the treatment. TEAEs were AEs occurred following the start of treatment or AEs increasing in severity during treatment. Treatment-related TEAEs were determined by the investigator.

Number of Participants With Abnormal Laboratory Findings-Hematology

Time Frame: Baseline to Study Day 113 Visit

Hematology evaluation included: hemoglobin, hematocrit, erythrocytes, platelets, leukocytes, lymphocytes, neutrophils, basophils, eosinophils and monocytes. Predefined criteria for hemoglobin and hematocrit: \<0.8\*lower limit of normal (LLN) or \<0.8\*Baseline(Baseline \<1.0\*LLN); for platelets: \<100,000\*10\^3/mm\^3 or \<= 0.77\*Baseline (Baseline \<1.0\*LLN).

Change From Baseline for Fibrinogen by Dose Cohort

Time Frame: Baseline, Study Day 8, 15, 22, 29, 57, 85 and 113.

Fibrinogen is a protein, specifically a clotting factor (factor I), that is essential for proper blood clot formation. Blood samples were obtained to evaluate the amount of fibrinogen.

Number of Participants With Infusion and Injection Site Reactions

Time Frame: Baseline to Study Day 113 Visit

Infusion and injection site reactions included: injection site bruising, injection site erythema, injection site haemorrhage, injection site induration, injection site pain, injection site pruritus, injection site swelling and injection site warmth. Grade of severity was defined as follows: Mild: Transient or mild discomfort (\< 48 hours); no medical intervention/therapy required. Moderate: Mild to moderate limitation in activity - some assistance may be needed; no or minimal medical intervention/therapy required. Severe: Marked limitation in activity, some assistance usually required; medical intervention/therapy required, hospitalizations possible.

Number of Participants With Abnormal Laboratory Findings-Clinical Chemistry

Time Frame: Baseline to Study Day 113

Clinical chemistry evaluation included bilirubin, direct and indirect bilirubin, aspartate aminotransferase, alanine aminotransferase, gamma glutamyl transferase, alkaline phosphatase, protein, albumin, urea nitrogen, creatinine, urate, triglycerides, sodium, potassium, chloride, calcium, bicarbonate, glucose, creatine kinase, troponin I, cholesterol and fibrinogen.

Number of Participants With Abnormal Laboratory Findings-Urinalysis

Time Frame: Baseline to Study Day 113 Visit

Urinalysis included: pH, urine glucose, ketones, urine protein, urine hemoglobin, urobilinogen, urine bilirubin, nitrite, leukocyte esterase, urine erythrocytes, urine leukocytes and bacteria.

Change From Baseline for Antithrombin III by Dose Cohort

Time Frame: Baseline, Study Day 8, 15, 22 and 29.

Antithrombin (AT) is a protein produced by the liver that helps regulate blood clot formation (i.e., a naturally-occurring mild blood thinner). Blood samples were collected to measure the activity (function) and the amount (quantity) of antithrombin in an individual's blood is used to evaluate the person for excessive blood clotting.

Change From Baseline for Troponin I by Dose Cohort

Time Frame: Baseline, Study Day 8, 15, 22, 29, 57 and 85.

Blood samples were collected to measure the level of cardiac-specific troponin I in the blood to help detect heart injury.

Number of Participants With Vital Signs Data Meeting Pre-specified Criteria

Time Frame: Baseline to Study Day 113 Visit

Criteria for potentially clinically important findings in vital signs data were defined as: 1) supine systolic blood pressure (BP): value \<90 mm Hg or change \>=30 mm Hg increase; 2) Supine diastolic BP: value \<50 mm Hg or change \>=20 mm Hg increase; 3) Supine pulse rate: value \<40 beats/min or \>120 beats/min.

Number of Participants With Treatment Emergent Adverse Events (TEAEs)

Time Frame: Study Day 1 to Day 113 Visit

An adverse event (AE) was any untoward medical occurrence in a clinical investigation participant administered a product; the event did not need to have a causal relationship with the treatment. A serious adverse event (SAE) was any untoward medical occurrence at any dose that resulted in death; was life threatening; required inpatient hospitalization or prolongation of existing hospitalization; resulted in persistent or significant disability/incapacity; resulted in congenital anomaly/birth defect. AEs included both SAEs and non-serious AEs. TEAEs were AEs occurred following the start of treatment or AEs increasing in severity during treatment. Severe TEAEs were TEAEs that interfered significantly with participants' usual function. Treatment-related TEAEs were determined by the investigator.

Change From Baseline for Globulin by Dose Cohort

Time Frame: Baseline, Study Day 8, 15, 22, 29, 57, 85 and 113.

Blood samples were obtained to determine globulin level in serum, total globulin was derived as total protein other than albumin.

Number of Participants With Electrocardiogram (ECG) Change Meeting Pre-specified Criteria

Time Frame: Baseline to Study Day 29 Visit.

Criteria for potentially clinically important changes in ECG were defined as: PR interval baseline \>200 msec and increase of \>=25%; PR interval baseline \<=200 msec and increase of \>=50%; QRS interval increase of \>=50%. Only the number of participants meeting pre-defined criteria was reported below.

Number of Participants With Clinically Significant Changes in Physical Examination Findings

Time Frame: Baseline to Study Day 113 Visit

Physical examination included head, ears, eyes, nose, mouth, skin, heart and lung examinations, lymph nodes, gastrointestinal, musculoskeletal, and neurological systems. Clinical significance was judged by the investigator.

Change From Baseline for Prothrombin International Normalized Ratio (PT/INR) by Dose Cohort

Time Frame: Baseline, Study Day 8, 15, 22, 29, 57, 85 and 113.

Blood samples were obtained to evaluate this ratio. The prothrombin time (PT) is a test that helps evaluate your ability to appropriately form blood clots. The international normalized ratio (INR) is a calculation based on results of a PT that is used to monitor individuals who are being treated with the blood-thinning medication (anticoagulant) warfarin (Coumadin®).

Change From Baseline for Activated Partial Thromboplastin Time (aPTT) by Dose Cohort

Time Frame: Baseline, Study Day 8, 15, 22, 29, 57, 85 and 113.

The activated partial thromboplastin time (aPTT) is a screening test that helps evaluate a person's ability to appropriately form blood clots. It measures the number of seconds it takes for a clot to form in a sample of blood after substances (reagents) are added. Blood sample were obtained to evaluate aPTT.

Secondary Outcomes

  • Area Under the Concentration-time Profile From Time Zero to the Time of the Last Quantifiable Concentration (AUClast) of PF-06741086(Pre-dose on Day 1, 24 and 96 hours post Day 1 dosing)
  • Change From Baseline in Total Tissue Factor Pathway Inhibitor (TFPI)(Baseline, Study Day 2, 4, 8, 15, 22, 29, 30, 33, 57, 85 and 113)
  • Time to Reach Maximum Plasma Concentration (Tmax) of PF-06741086(Pre-dose on Day 1, 24 and 96 hours post Day 1 dosing, pre-dose on Day 29, 24 and 96 hours post Day 29 dosing)
  • Maximum Plasma Concentration (Cmax) of PF-06741086(Pre-dose on Day 1, 24 and 96 hours post Day 1 dosing, pre-dose on Day 29, 24 and 96 hours post Day 29 dosing)
  • Lowest Concentration Observed During the Dosing Interval (Cmin) of PF-06741086(Pre-dose on Day 1, 24 and 96 hours post Day 1 dosing, pre-dose on Day 29, 24 and 96 hours post Day 29 dosing)
  • Change From Baseline in Endogenous Thrombin Generation (TGA) Potential(Baseline, Study Day 2, 4, 8, 15, 22, 29, 30, 33, 57, 85 and 113)
  • Change From Baseline in D-Dimer(Baseline, Study Day 2, 4, 8, 15, 22, 29, 30, 33, 57, 85 and 113)
  • Number of Participants Who Tested Positive for Anti-PF-06741086 Antibody (ADA)(Baseline up to Study Day 113)
  • Area Under the Serum Concentration-time Curve Over the Dosing Interval Tau (AUCtau) of PF-06741086(Pre-dose on Day 29, 24 and 96 hours post Day 29 dosing)
  • Plasma PF-06741086 Concentrations(pre-dose on Study Day 1, 24hours (h), 72h post Study Day 1 dosing, pre-dose on Study Day 8, 15 and 22, pre-dose on Study Day 29, 24h, 96h post Study Day 29 dosing, pre-dose on Study Day 57, 168h, 840h post Study Day 57 dosing)
  • Annualized Bleeding Rate (ABR)(Pre-treatment: within 6 months prior to study enrollment; On-study: Day 1 to 9 days after the last dose (Day 78))
  • Apparent Clearance After Oral Dose (CL/F) of PF-06741086(Pre-dose on Day 29, 24 and 96 hours post Day 29 dosing)
  • Change From Baseline in Thrombin Generation (TGA) Peak(Baseline, Study Day 2, 4, 8, 15, 22, 29, 30, 33, 57, 85 and 113)
  • Change From Baseline in Prothrombin Fragments 1 + 2(Baseline, Study Day 2, 4, 8, 15, 22, 29, 30, 33, 57, 85 and 113)
  • Change From Baseline in Thrombin Generation (TGA) Lag Time(Baseline, Study Day 2, 4, 8, 15, 22, 29, 30, 33, 57, 85 and 113)
  • Change From Baseline in Dilute Prothrombin Time(Baseline, Study Day 2, 4, 8, 15, 22, 29, 30, 33, 57, 85 and 113)
  • Number of Participants Who Tested Positive for Neutralizing Antibody (NAb)(Baseline up to Study Day 113)

Study Sites (10)

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