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Study to Evaluate Safety and Pharmacokinetics of BIVIGAM® in Primary Immune Deficiency Subjects Aged 2 to 16

Phase 4
Completed
Conditions
Humoral Immune Response
Interventions
Biological: Bivigam
Registration Number
NCT03164967
Lead Sponsor
ADMA Biologics, Inc.
Brief Summary

This study is part of the BIVIGAM® post marketing requirement (PMR). It is being conducted in subjects aged 2-16 with primary immune deficiency disorders associated with defects in humoral immunity to generate additional data on these populations, and more specifically safety and pharmacokinetic (PK) assessments.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
16
Inclusion Criteria
  • Written informed consent/Assent
  • Male or female between 2 and 16 years, inclusive, at time of Signing Informed Consent/Assent
  • Have a confirmed and documented clinical diagnosis of Primary Immune Deficiency Disorder, including hypogammaglobulinemia or agammaglobulinemia.
  • Have received IGIV therapy which was maintained at a steady dose (± 25% of the mean dose) for at least 3 months prior to study entry, and have maintained a trough IgG level at least 500mg/dL prior to receiving BIVIGAM®.
  • Subjects and/or parents/legal guardians must be able to understand and adhere to the study visit schedule and all other protocol requirements.
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Exclusion Criteria
  • Known intolerance to immunoglobulins or comparable substances (e.g. vaccination reaction).
  • Known intolerance to proteins of human origin or known allergic reactions to components of the study product(s).
  • Any previous randomization/participation in this clinical study must be discussed with and approved by the medical director (or designee).
  • Inability or lacking motivation to participate in the study.
  • Medical condition, laboratory finding, or physical exam finding (specify, e.g., vital signs outside of specific range that precludes participation. Per lab results at the Screening visit through Baseline.
  • Confirmed Screening visit laboratory results ˃2.5 X ULN as defined for pediatric populations for any of the following: ALT (alanine aminotransferase/SGPT), AST (aspartate aminotransferase/SGOT), LDH (lactate dehydrogenase), BUN (blood urea nitrogen), Serum creatinine
  • Has selective IgA deficiency or demonstrated antibodies to IgA.
  • History of thrombotic complications of IGIV therapy or history of (deep vein thrombosis)DVT.
  • Current use of daily corticosteroids (>10 mg of prednisone equivalent/day),immunosuppressants or immunomodulators are not allowed unless approved in advance by the medical monitor. Intermittent use of corticosteroids during the study is allowed if medically necessary.
  • Positive diagnosis of hepatitis B or hepatitis C.
  • Positive human immunodeficiency virus (HIV) test.
  • Subject has had a serious bacterial infection (SBI) within the last 3 months.
  • Subject has an active infection and is receiving antibiotic therapy for the treatment of this infection at the time of Screening. Note: if the subject is deemed a Screen Failure due to a nonserious active infection requiring antibiotic therapy, the subject may be rescreened 3 or 4 weeks (depending on drug administration schedule) after the initial screening.
  • Subject has a history of thrombotic events (including deep vein thrombosis, myocardial infarction, cerebrovascular accident and pulmonary embolism) within 6 months before 1st IGIV dose or has preexisting risk factors for thrombotic events.
  • Acquired medical condition known to cause secondary immune deficiency such as chronic lymphacitic leukemia, lymphoma or multiple lymphoma.
  • Subjects with protein-losing enteropathies, hypoalbuminaemia.
  • Females taking oral contraceptives.
  • Pregnancy or unreliable contraceptive measures or lactation period (females of childbearing potential (female capable of becoming pregnant) only. Males capable of reproduction must agree to a double barrier method of contraception during their study participation.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Active DrugBivigamAll subjects will receive Bivigam based on their prior dosing to be adjusted as clinically necessary.
Primary Outcome Measures
NameTimeMethod
Infusion Site ReactionsUp to approximately 7 months

Incidence reactions occuring at the infusion site

Serious Adverse EventsUp to approximately 7 months

Incidence of serious adverse events

Temporally Associated Adverse EventsDuring each infusion (During or within 1 hour, 24 hours and 72 hours of completion of an infusion)

Incidence of adverse events (During or within 1 hour, 24 hours and 72 hours of completion of an infusion)

Related Serious Adverse EventsUp to approximately 7 months

Incidence of related serious adverse events

Treatment Emergent Adverse EventsUp to approximately 7 months

Incidence of treatment emergent adverse events

Temporally Associated Infusion Adverse EventsUp to approximately 7 months

Incidence of adverse events which have a causal relationship with infusion treatment

Non-treatment Emergent Adverse EventsUp to approximately 7 months

Incidence of adverse events which do not have a causal relationship with study treatment

Adverse ReactionsUp to approximately 7 months

Number and incidence of adverse reactions plus suspected adverse reactions combined

Related Adverse ReactionsUp to approximately 7 months

Incidence of adverse infusion related reactions

Temporally Associated Adverse Events Following InfusionsUp to 72 hours after each infusion through study completion, up tp approximately 7 months

Incidence of adverse events

Number of Temporally Associated Adverse EventsUp to 72 hours of completion of an infusion

Mean number of temporally associated per infusion

Related Treatment Emergent Averse EventsWithin 72 hours of infusion

Incidence of adverse events that first appear, or that worsen relative to the pre-treatment state, which occur during and within 72 hours of treatment administration

Vital SignsBefore and after each administration of study drug through study completion, up to approximately 7 months

Change in vital signs

Secondary Outcome Measures
NameTimeMethod
Serious Bacterial InfectionsUp to approximately 7 months

Incidence of Serious Bacterial Infections

IgG subclassesPrior to first and last infusion, up tp approximately 7 months

Levels of subclasses 1- 4 before infusion

CmaxAt prior to, at end of infusion, and 6 hours, 24 hours, 7 days, and 4 days, 21 days and 28 days (if still enrolled) after final infusion, up tp approximately 7 months

Pharmacokinetic measure at 5th or 7th infusion

Other InfectionsUp to approximately 7 months

Incidence of infections other than Serious Bacterial Infections

Resolution of InfectionsUp to approximately 7 months

Time to resolution of Infections in days

Missed DaysUp to approximately 7 months

Number of days missed of school or work due to infections and treatment

HospitalizationsUp to approximately 7 months

Number of hospitalizations due to infections

Total IgG TroughAt each visit through study completion, up tp approximately 7 months

Levels taken before any infusion

FeverUp to approximately 7 months

Episodes of Fever

TmaxAt prior to, at end of infusion, and 6 hours, 24 hours, 7 days, and 4 days, 21 days and 28 days (if still enrolled) after final infusion, up tp approximately 7 months

Pharmacokinetic measure at 5th or 7th infusion

AUC(0-∞)At prior to, at end of infusion, and 6 hours, 24 hours, 7 days, and 4 days, 21 days and 28 days (if still enrolled) after infusion

Pharmacokinetic measure at 5th or 7th infusion

InfectionsUp to approximately 7 months

Number of infections of any kind, serious and non-serious

Total IgG PostAt each infusion through study completion, up tp approximately 7 months

End of infusion level of Total IgG

AUC(0-ʈ)At prior to, at end of infusion, and 6 hours, 24 hours, 7 days, and 4 days, 21 days and 28 days (if still enrolled) after final infusion, up tp approximately 7 months

Pharmacokinetic measure at 5th or 7th infusion

Terminal phase elimination half-life (ʈ½)At prior to, at end of infusion, and 6 hours, 24 hours, 7 days, and 4 days, 21 days and 28 days (if still enrolled) after final infusion, up tp approximately 7 months

Pharmacokinetic measure at 5th or 7th infusion

AntibodiesAt prior to, at end of infusion, and 6 hours, 24 hours, 7 days, and 4 days, 21 days and 28 days (if still enrolled) after final infusion, up tp approximately 7 months

Levels of specific antibodies (antipneumococcal capsular polysaccharide, antihaemophilus influenza B

First Serious Bacterial InfectionUp to approximately 7 months

Time to first Serious Bacterial Infections in days

Terminal phase elimination rate (λZ)At prior to, at end of infusion, and 6 hours, 24 hours, 7 days, and 4 days, 21 days and 28 days (if still enrolled) after final infusion, up tp approximately 7 months

Pharmacokinetic measure at 5th or 7th infusion

Trial Locations

Locations (8)

IMMUNOe Research Centers

🇺🇸

Centennial, Colorado, United States

Ohio Clinical Research Associates

🇺🇸

Mayfield Heights, Ohio, United States

Allergy Associates of the Palm Beaches

🇺🇸

North Palm Beach, Florida, United States

USF Health, Pediatric Allergy, Immunology & Rheumatology

🇺🇸

Saint Petersburg, Florida, United States

Duke University Medical Center

🇺🇸

Durham, Florida, United States

Oklahoma Institute of Allergy and Asthma Clinical Research

🇺🇸

Oklahoma City, Oklahoma, United States

Discovery Clinical Trials

🇺🇸

Dallas, Texas, United States

Lysosomal Rare Disorders Research & Treatment Center

🇺🇸

Fairfax, Virginia, United States

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