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Recombinant Human Antithrombin (rhAT) in Patients With Hereditary Antithrombin Deficiency Undergoing Surgery or Delivery

Primary Purpose

Antithrombin III Deficiency

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Recombinant human antithrombin (rhAT)
Sponsored by
rEVO Biologics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Antithrombin III Deficiency focused on measuring Antithrombin Deficiency, Congenital or Hereditary, Antithrombin III Deficiency, ATIII, Hereditary Antithrombin Deficiency (HD)

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Have hereditary antithrombin deficiency (HD) with a personal history of venous thromboembolic events. Have a history of HD that includes 2 or more plasma AT activity values ≤ 60%. Be scheduled to have an elective procedure(s) known to be associated with a high risk for occurrence for DVT. This will include non-pregnant surgical patients or pregnant patients scheduled for caesarean section or delivery induction. Be at least 18 years of age, not exceeding 80 years of age. Have signed an informed consent form. Have a negative serum pregnancy test at screening and a negative urine pregnancy test at baseline. This applies only to female non-pregnant surgical patients of childbearing potential. Are able to comply with the requirements of the study protocol. In addition, hospitalized pregnant HD patients in active labor and eligible HD patients previously treated with rhAT were allowed entry into the study. Exclusion Criteria: Patients who have a diagnosis of another hereditary thrombophilic disorder (e.g. activated protein C(APC) resistance/Factor V Leiden, Protein S or C deficiency, prothrombin gene mutation (G20210A), or acquired (lupus anticoagulant) thrombophilic disorder). Patients who have a baseline bilateral ultrasound positive for acute DVT or baseline diagnostic testing (if required) that is positive for a thromboembolic event other than acute DVT. Patients who have a known allergy to goats or goat products. Patients who have participated in a study employing a different investigational drug within 30 days of the start of their participation in the current trial. Patients using fondaparinux sodium or the oral thrombin inhibitor, ximelagatran, or are expected to be treated with fondaparinux sodium or ximelagatran during the study period (up to 7 days after stop of treatment).

Sites / Locations

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Recombinant Human Antithrombin (rhAT) Infusion

Arm Description

Intravenous infusion of rhAT.

Outcomes

Primary Outcome Measures

Incidence of Thromboembolic Events Acute Deep Venous Thrombosis (DVT) and/or Thromboembolic Events Other Than Acute Deep Venous Thrombosis (DVT)
To assess the incidence of thromboembolic events acute deep venous thrombosis (DVT) and/or thromboembolic events other than acute deep venous thrombosis (DVT) by clinical signs and symptoms of venous thromboembolism (VTE), confirmed by diagnostic assessments.

Secondary Outcome Measures

Full Information

First Posted
May 10, 2005
Last Updated
August 10, 2012
Sponsor
rEVO Biologics
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1. Study Identification

Unique Protocol Identification Number
NCT00110513
Brief Title
Recombinant Human Antithrombin (rhAT) in Patients With Hereditary Antithrombin Deficiency Undergoing Surgery or Delivery
Official Title
A Multicenter, Multinational Study to Assess the Safety and Efficacy of Antithrombin Alfa in Hereditary Antithrombin (AT) Deficient Patients in High-Risk Situations for Thrombosis
Study Type
Interventional

2. Study Status

Record Verification Date
August 2012
Overall Recruitment Status
Completed
Study Start Date
April 2005 (undefined)
Primary Completion Date
May 2008 (Actual)
Study Completion Date
July 2008 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
rEVO Biologics

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Patients with hereditary antithrombin deficiency are at increased risk of venous thrombosis and pulmonary embolism, particularly during certain high risk procedures. The trial focused on patients with confirmed hereditary antithrombin deficiency who were undergoing a surgical procedure or induced/spontaneous labor and delivery, and/or caesarean section. The study assessed the incidence of thromboembolic events following prophylactic intravenous administration of recombinant human antithrombin (rhAT) to patients with hereditary antithrombin (AT) deficiency in situations usually associated with a high risk for thromboembolic events.
Detailed Description
GTC Biotherapeutics established clinical trial sites in Europe, Canada, Australia, Austria and Canada. GTC Biotherapeutics provided an international clinical team to support site registration requirements once a patient was identified for treatment. GTC Biotherapeutics also provided consultation to help evaluate patient eligibility. In September 2006, GTC Biotherapeutics modified exclusion criteria 1 (below) to allow for the participation of previously excluded patients with the hereditary thrombophilic disorders Factor V Leiden and prothrombin gene mutation (G20210A).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Antithrombin III Deficiency
Keywords
Antithrombin Deficiency, Congenital or Hereditary, Antithrombin III Deficiency, ATIII, Hereditary Antithrombin Deficiency (HD)

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
18 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Recombinant Human Antithrombin (rhAT) Infusion
Arm Type
Experimental
Arm Description
Intravenous infusion of rhAT.
Intervention Type
Biological
Intervention Name(s)
Recombinant human antithrombin (rhAT)
Other Intervention Name(s)
Recombinant human antithrombin (Tradename: ATryn)
Intervention Description
Up to 24 hours prior to the scheduled elective surgical procedure, caesarean section, or delivery induction, each patient will receive an initial intravenous loading dose followed by a continuous intravenous infusion of recombinant human antithrombin (rhAT) that will target and maintain an AT activity that is > 80% and < 120% of normal. The dosing objective for all study patients is maintenance of the AT activity at > 80% and < 120% of normal during the high-risk period for thromboembolic events. Dosing and dose adjustments will be based on the results of AT activity determinations performed prior to and during treatment.
Primary Outcome Measure Information:
Title
Incidence of Thromboembolic Events Acute Deep Venous Thrombosis (DVT) and/or Thromboembolic Events Other Than Acute Deep Venous Thrombosis (DVT)
Description
To assess the incidence of thromboembolic events acute deep venous thrombosis (DVT) and/or thromboembolic events other than acute deep venous thrombosis (DVT) by clinical signs and symptoms of venous thromboembolism (VTE), confirmed by diagnostic assessments.
Time Frame
During treatment and follow up period of 7 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Have hereditary antithrombin deficiency (HD) with a personal history of venous thromboembolic events. Have a history of HD that includes 2 or more plasma AT activity values ≤ 60%. Be scheduled to have an elective procedure(s) known to be associated with a high risk for occurrence for DVT. This will include non-pregnant surgical patients or pregnant patients scheduled for caesarean section or delivery induction. Be at least 18 years of age, not exceeding 80 years of age. Have signed an informed consent form. Have a negative serum pregnancy test at screening and a negative urine pregnancy test at baseline. This applies only to female non-pregnant surgical patients of childbearing potential. Are able to comply with the requirements of the study protocol. In addition, hospitalized pregnant HD patients in active labor and eligible HD patients previously treated with rhAT were allowed entry into the study. Exclusion Criteria: Patients who have a diagnosis of another hereditary thrombophilic disorder (e.g. activated protein C(APC) resistance/Factor V Leiden, Protein S or C deficiency, prothrombin gene mutation (G20210A), or acquired (lupus anticoagulant) thrombophilic disorder). Patients who have a baseline bilateral ultrasound positive for acute DVT or baseline diagnostic testing (if required) that is positive for a thromboembolic event other than acute DVT. Patients who have a known allergy to goats or goat products. Patients who have participated in a study employing a different investigational drug within 30 days of the start of their participation in the current trial. Patients using fondaparinux sodium or the oral thrombin inhibitor, ximelagatran, or are expected to be treated with fondaparinux sodium or ximelagatran during the study period (up to 7 days after stop of treatment).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert C Tait, MD
Organizational Affiliation
Glasgow Royal Infirmary
Official's Role
Principal Investigator
Facility Information:
City
New Haven
State/Province
Connecticut
Country
United States
City
St Louis
State/Province
Missouri
Country
United States
City
New York
State/Province
New York
Country
United States
City
North Gosford
Country
Australia
City
Vienna
Country
Austria
City
Ottawa
State/Province
Ontario
Country
Canada
City
Vancouver
Country
Canada
City
Montpellier
Country
France
City
Berlin
Country
Germany
City
Alessandria
Country
Italy
City
Exeter
State/Province
Devon
Country
United Kingdom
City
Chichester
State/Province
West Sussex
Country
United Kingdom
City
Cambridge
Country
United Kingdom
City
Glasgow
Country
United Kingdom
City
London
Country
United Kingdom
City
Nottingham
Country
United Kingdom
City
Plymouth
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
24335249
Citation
DeJongh J, Frieling J, Lowry S, Drenth HJ. Pharmacokinetics of recombinant human antithrombin in delivery and surgery patients with hereditary antithrombin deficiency. Clin Appl Thromb Hemost. 2014 May;20(4):355-64. doi: 10.1177/1076029613516188. Epub 2013 Dec 11.
Results Reference
derived

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Recombinant Human Antithrombin (rhAT) in Patients With Hereditary Antithrombin Deficiency Undergoing Surgery or Delivery

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