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AOP2014 vs. BAT in Patients With Polycythemia Vera Who Previously Participated in the PROUD-PV Study.

Phase 3
Completed
Conditions
Polycythemia Vera
Interventions
Drug: Best available therapy (BAT)
Drug: Pegylated-Proline-interferon alpha-2b
Registration Number
NCT02218047
Lead Sponsor
AOP Orphan Pharmaceuticals AG
Brief Summary

Polycythemia Vera (PV) is a disease of bone marrow stem cells that manifests in a drastic increase of red blood cells and frequently also of white blood cells. The "thickening" of the blood in relation with a modified function of the cells has several consequences like increased blood pressure, pruritus of the skin, fatigue, disturbed blood circulation in the brain as well as fingers and toes and an increased risk of arterial and venous thrombosis (thrombosis is the formation of a blood clot in a vessel); like stroke, cardiac infarction, deep vein thrombosis in the legs. In case of a strong increase of platelets there is an additional risk of bleedings. As the disease progresses the size of spleen and liver increased in most cases and the bone marrow shows signs of fibrosis. In some cases of PV a progression at a later time point to a leukemia (increased formation of white blood cells) can occur.

The aim of this study is to show that the study drug AOP2014 (pegylated proline interferon alpha-2b) has the long term efficacy and safety in controlling the disease. A comparison arm is receiving best available therapy as selected by the investigator. Response to the treatment is measured by several blood parameters as well as size of the spleen.

Interferon-alpha has been shown to be effective in controlling the blood parameters by immunologically influencing the blood building cells. This can lead to a suppression of the disease-causing stem cells and help healthy stem cells to proliferate. Through this mechanism it is possible that Interferon-alpha can avoid long-term damaging effects of the disease.

Detailed Description

This is a Phase III, parallel-arm, open-label continuation of the PROUD-PV study performed in adults diagnosed with Polycythemia Vera (PV). Patients who received AOP2014 in the primary study, PROUD-PV will continue on AOP2014, patients who received HU in the PROUD-PV study will receive best available therapy as selected by the investigator. Only patients who completed PROUD-PV including the end of study visit will be enrolled into this continuation study.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
170
Inclusion Criteria
  1. Patients who completed the 12 months AOP2014 treatment arm of the PROUD-PV study and at the "end-of-treatment visit" (EoT) of the PROUD-PV study who fulfill at least one of the following criteria:

    • normalization of at least two out of three main blood parameters (Hct, PLTs and WBCs) if these parameters were moderately increased (Hct<50%, WBC<20 x 109/L, PLTs<600 x 109/L) at baseline of the PROUD-PV study, OR
    • >35% decrease of at least two out of three main blood parameters (Hct, PLTs and WBCs) if these parameters were massively increased (Hct>50%, WBCs>20 x 109/L, PLTs>600 x 109/L), at baseline of the PROUD-PV study, OR
    • normalization of spleen size, if spleen was enlarged at baseline of the PROUD-PV study, OR
    • otherwise a clear, medically verified benefit from treatment with AOP2014 (e.g. normalization of disease-related micro-vasculatory symptoms, substantial decrease of JAK2 allelic burden).
  2. Signed written ICF.

Exclusion criteria:

Withdrawal criteria, as specified in the PROUD-PV study, which mandate treatment discontinuation:

  1. Non-recovery from the AOP2014 related toxicities to the grade (usually, Grade I) which allows continuation of the treatment.
  2. HADS score of 11 or higher on either or both of the subscales, and /or development or worsening of the clinically significant depression or suicidal thoughts.
  3. Progressive and clinically significant increase of liver enzyme levels despite dose reduction, or if such increase is accompanied by increased bilirubin level, any signs or symptoms of a clinically significant autoimmune disease.
  4. Clinically significant development of a new ophthalmologic disorder, or worsening of a pre-existing one, during the study.
  5. Loss of efficacy of AOP2014 or any comparable situation where no further benefits of treatment continuation are expected by the investigator.

The main efficacy evaluation criterion will be disease response defined as Hct<45% without phlebotomy (at least 3 months since the last phlebotomy), PLTs<400 x 109/L, WBCs<10 x 109/L, and normal spleen size.

The main efficacy endpoint will be the maintenance rate of disease response at assessment visits (every three months).

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Best available therapy (BAT)Best available therapy (BAT)Best available therapy, as chosen by the investigator for patients who had been on HU in the 1 Year PROUD-PV study
Pegylated-Proline-interferon alpha-2bPegylated-Proline-interferon alpha-2bAOP2014 for those patients who had been on AOP2014 in the PROUD-PV study
Primary Outcome Measures
NameTimeMethod
Disease response at quarterly assessment visits3 years

The primary efficacy endpoint will be the rate of disease response at assessment visits (every 3 months).

The co-primary efficacy evaluation criterion will be (1) disease response defined as hematologic response: Hct\<45% without phlebotomy (at least 3 months since the last phlebotomy), PLTs\<400 x 109/L, WBCs\<10 x 109/L, and normal spleen size, and (2) disease response defined as hematologic response (Hct\<45% without phlebotomy (at least 3 months since the last phlebotomy), PLTs\<400 x 109/L, WBCs\<10 x 109/L), resolution and/or clinically improvement of disease-related signs (clinical significant splenomegaly) and disease-related symptoms (microvascular disturbances, pruritus, headache).

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (47)

University Hospital with Outpatient Clinic F.D. Roosevelt

πŸ‡ΈπŸ‡°

Banska Bystrica, Slovakia

Nicolaus Copernicus Municipal Specialist Hospital

πŸ‡΅πŸ‡±

Torun, Poland

Bucharest University Emergency Hospital

πŸ‡·πŸ‡΄

Bucharest, Romania

Elisabethinen Hospital Linz

πŸ‡¦πŸ‡Ή

Linz, Austria

University Hospital Innsbruck

πŸ‡¦πŸ‡Ή

Innsbruck, Austria

Specialized Hospital for Active Treatment of Hematological Diseases

πŸ‡§πŸ‡¬

Sofia, Bulgaria

LKH Graz

πŸ‡¦πŸ‡Ή

Graz, Austria

Hanusch Hospital

πŸ‡¦πŸ‡Ή

Vienna, Austria

Medical University Vienna

πŸ‡¦πŸ‡Ή

Vienna, Austria

Hospital Wels-Grieskirchen

πŸ‡¦πŸ‡Ή

Wels, Austria

University Hospital in Cracow

πŸ‡΅πŸ‡±

Krakow, Poland

Fryderyk Chopin Provincial Specialized Hospital

πŸ‡΅πŸ‡±

Rzeszow, Poland

University Hospital Carl Gustav Carus, Medical Clinic and Polyclinic I

πŸ‡©πŸ‡ͺ

Dresden, Germany

University of Szeged, Albert Szent-Gyorgyi Clinical Center, Koranyi fasor 6

πŸ‡­πŸ‡Ί

Szeged, Hungary

Independent Public Teaching Hospital No.1 in Lublin

πŸ‡΅πŸ‡±

Lublin, Poland

University of Debrecen

πŸ‡­πŸ‡Ί

Debrecen, Hungary

Kaposi Mor County Teaching Hospital

πŸ‡­πŸ‡Ί

Kaposvar, Hungary

St Istvan and St Laszlo Hospital of Budapest

πŸ‡­πŸ‡Ί

Budapest, Hungary

University Hospital Brno

πŸ‡¨πŸ‡Ώ

Brno, Czechia

Bekes County Pandy Kalman Hospital, 1st Department of Medicine, Hematology

πŸ‡­πŸ‡Ί

Gyula, Hungary

Samara Kalinin Regional Clinical Hospital

πŸ‡·πŸ‡Ί

Samara, Russian Federation

Komi Republican Oncology Center

πŸ‡·πŸ‡Ί

Syktyvkar, Russian Federation

Emergency Clinical County Hospital Brasov

πŸ‡·πŸ‡΄

Brasov, Romania

Tula Regional Clinical Hospital

πŸ‡·πŸ‡Ί

Tula, Russian Federation

Yaroslavl Regional Clinical Hospital

πŸ‡·πŸ‡Ί

Yaroslavl, Russian Federation

University Hospital Hradec Kralove

πŸ‡¨πŸ‡Ώ

Hradec Kralove, Czechia

University Hospital Kralovske Vinohrady

πŸ‡¨πŸ‡Ώ

Prague, Czechia

Aachen University Hospital, Medical Clinic IV

πŸ‡©πŸ‡ͺ

Aachen, Germany

Institute of Hematology and Transfusion Medicine

πŸ‡΅πŸ‡±

Warsaw, Poland

Coltea Clinical Hospital

πŸ‡·πŸ‡΄

Bucharest, Romania

Baranov Republican Hospital

πŸ‡·πŸ‡Ί

Petrozavodsk, Russian Federation

Saint Cyril and Metod University Hospital Bratislava

πŸ‡ΈπŸ‡°

Bratislava, Slovakia

Institute of Blood Pathology and Transfusion Medicine

πŸ‡ΊπŸ‡¦

Lviv, Ukraine

Hospital del Mar

πŸ‡ͺπŸ‡Έ

Barcelona, Spain

O.F. Herbachevskyi Regional Clinical Hospital

πŸ‡ΊπŸ‡¦

Zhytomyr, Ukraine

Salzburg Regional Hospital

πŸ‡¦πŸ‡Ή

Salzburg, Austria

Multiprofile Hospital for Active Treatment "Sveta Marina", Varna

πŸ‡§πŸ‡¬

Varna, Bulgaria

University Multiprofile Hospital for Active Treatment "Sveti Georgi", Plovdiv

πŸ‡§πŸ‡¬

Plovdiv, Bulgaria

Multiprofile Hospital for Active Treatment - Hristo Botev, Vratsa, First Department of Internal Medicine

πŸ‡§πŸ‡¬

Vratsa, Bulgaria

Institute Paoli-Calmettes

πŸ‡«πŸ‡·

Marseille, France

University Hospital Motol

πŸ‡¨πŸ‡Ώ

Prague, Czechia

Hospital Saint-Louis

πŸ‡«πŸ‡·

Paris, France

Clinical Research Center CIC

πŸ‡«πŸ‡·

Poitiers, France

Cherkasy Regional Oncology Center, Regional Treatment and Diagnostics Hematology Center

πŸ‡ΊπŸ‡¦

Cherkasy, Ukraine

Dnipropetrovsk City Multispecialty Clinical Hospital #4

πŸ‡ΊπŸ‡¦

Dnipropetrovsk, Ukraine

National Research Center for Radiation Medicine, Institute of Clinical Radiology

πŸ‡ΊπŸ‡¦

Kiev, Ukraine

University Hospital Bonn, Center for Internal Medicine, Medical Clinic and Outpatient Clinic III

πŸ‡©πŸ‡ͺ

Bonn, Germany

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