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Dose-Response Study of Recombinant Factor VIII Manufactured Protein-Free (rAHF-PFM) in Patients With Hemophilia A

Primary Purpose

Hemophilia A

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Antihemophilic factor, recombinant, manufactured protein-free
Antihemophilic factor, recombinant, manufactured protein-free
Antihemophilic factor, recombinant, manufactured protein-free
Sponsored by
Baxalta now part of Shire
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hemophilia A

Eligibility Criteria

12 Years - 65 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: The subject has severe hemophilia A as defined by a baseline factor VIII activity <1% of normal; tested at screening. (A minimum washout period of 3 days is required before the blood sample can be drawn to determine baseline factor VIII levels.) The subject has a documented history of at least 150 exposure days to factor VIII concentrates (either plasma-derived or recombinant). The subject is within 12 to 65 years of age. The subject has a Karnofsky performance score >60. The subject is human immunodeficiency virus negative (HIV-) or HIV+ with CD4 count >=400 cells/mm3 (CD4 count determined at screening, if necessary). The subject or subject´s legally authorized representative has provided written informed consent. Exclusion Criteria: The subject has a known hypersensitivity to mouse or hamster proteins or to factor VIII concentrates. The subject has a history of factor VIII inhibitors with titer >=0.8 BU (Bethesda Assay) or >=0.4 BU (Nijmegen modification of the Bethesda Assay) any time prior to screening. The subject has a detectable factor VIII inhibitor at screening, >=0.4 BU (Nijmegen modification of the Bethesda Assay), in the Baxter central laboratory. The subject has severe chronic liver disease as evidenced by, but not limited to, any of the following: International Normalized Ratio (INR) >1.4, hypoalbuminemia, portal vein hypertension including presence of otherwise unexplained splenomegaly and history of esophageal varices. The subject has been diagnosed with an inherited or acquired hemostatic defect other than hemophilia A (e.g. qualitative platelet defect or von Willebrand´s Disease). The subject has participated in another investigational study within 30 days of enrollment. The subject´s clinical condition may require a major or moderate surgery (estimated blood loss >500 mL) during the period of participation in the study.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Low Dose

Medium Dose

High Dose

Arm Description

Outcomes

Primary Outcome Measures

Initial Recovery
Percent increase in factor VIII concentration per dose from pre- to post-infusion

Secondary Outcome Measures

Area Under the Curve/Dose
Area under the plasma factor VIII concentration versus time curve (AUC) estimated by linear trapezoidal method per dose.
Terminal Half-life
Computed from the regression slope in the terminal phase of the model (the slope is biphasic). Terminal half life is the time it takes for the plasma concentration or the amount of drug in the body to be reduced by 50%.
Area Under the Curve
AUC estimated by linear trapezoidal method. The linear trapezoidal method is a numerical method used to approximate the area under a curve.
Total Area Under the Curve
Total AUC with extrapolation using the slope of the β-phase
Total Area Under the Moment Curve
Total area under the first moment curve (AUMC) estimated by linear trapezoidal methods
Weight-adjusted Clearance
Computed as weight-adjusted dose divided by total AUC
Mean Residence Time
Computed as total AUMC divided by total AUC
Volume of Distribution at Steady State
Computed as weight-adjusted CL * Mean Residence Time
Maximum Plasma Concentration
Maximal factor VIII concentration after infusion
Pre-infusion Von Willebrand Factor Ristocetin Cofactor Activity (VWF:Rco)
Percentage of normal VWF:Rco activity. Normal is a lab standard consisting of a non-hemophilic population. Relationships between baseline VWF:Rco and pharmacokinetic parameters (initial recovery, total AUC/dose, and half-life) were evaluated statistically.
Pre-infusion Von Willebrand Factor Antigen (VWF:Ag)
Percentage of VWF:Ag. Relationships between baseline VWF:Ag and pharmacokinetic parameters (initial recovery, total AUC/dose, and half-life) were evaluated statistically.

Full Information

First Posted
February 9, 2006
Last Updated
May 28, 2021
Sponsor
Baxalta now part of Shire
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1. Study Identification

Unique Protocol Identification Number
NCT00289536
Brief Title
Dose-Response Study of Recombinant Factor VIII Manufactured Protein-Free (rAHF-PFM) in Patients With Hemophilia A
Official Title
Advate Antihemophilic Factor (Recombinant), Plasma/Albumin-Free Method (ADVATE rAHF-PFM): A Phase 4 Study to Determine the Pharmacokinetic Response of Patients Diagnosed With Severe Hemophilia A to Different Doses of ADVATE rAHF-PFM
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Completed
Study Start Date
February 2, 2006 (Actual)
Primary Completion Date
April 1, 2007 (Actual)
Study Completion Date
April 1, 2007 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Baxalta now part of Shire

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine the effect of 3 doses of ADVATE rAHF-PFM on initial recovery (% increase [IU/dL] per IU/kg infused) and major single-infusion pharmacokinetic parameters. The 3 doses are 15, 30, and 50 IU/kg. Prior to each infusion, subjects will not have received treatment with a factor VIII concentrate for at least 3 days. Blood samples will be drawn within 30 minutes pre-infusion and at 0.25, 0.5, 1, 3, 6, 9, 24, 28, 32 and 48 hours post-infusion. A washout period of at least 3 days, but no more than 30 days between the last blood draw and the next infusion will be observed. During participation, subjects will maintain their preexisting treatment regimens with ADVATE rAHF-PFM or other factor VIII concentrate. A secondary objective is to investigate the relationship between pharmacokinetic parameters at each dose level and the levels of von Willebrand factor ristocetin cofactor activity and von Willebrand factor antigen at baseline.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hemophilia A

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Crossover Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
38 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Low Dose
Arm Type
Experimental
Arm Title
Medium Dose
Arm Type
Experimental
Arm Title
High Dose
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
Antihemophilic factor, recombinant, manufactured protein-free
Intervention Description
15 IU/kg rAHF-PFM
Intervention Type
Biological
Intervention Name(s)
Antihemophilic factor, recombinant, manufactured protein-free
Intervention Description
30 IU/kg rAHF-PFM
Intervention Type
Biological
Intervention Name(s)
Antihemophilic factor, recombinant, manufactured protein-free
Intervention Description
50 IU/kg rAHF-PFM
Primary Outcome Measure Information:
Title
Initial Recovery
Description
Percent increase in factor VIII concentration per dose from pre- to post-infusion
Time Frame
Pharmacokinetic evaluations: 30 minutes pre-infusion to 30 minutes post-infusion
Secondary Outcome Measure Information:
Title
Area Under the Curve/Dose
Description
Area under the plasma factor VIII concentration versus time curve (AUC) estimated by linear trapezoidal method per dose.
Time Frame
Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion
Title
Terminal Half-life
Description
Computed from the regression slope in the terminal phase of the model (the slope is biphasic). Terminal half life is the time it takes for the plasma concentration or the amount of drug in the body to be reduced by 50%.
Time Frame
Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion
Title
Area Under the Curve
Description
AUC estimated by linear trapezoidal method. The linear trapezoidal method is a numerical method used to approximate the area under a curve.
Time Frame
Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion
Title
Total Area Under the Curve
Description
Total AUC with extrapolation using the slope of the β-phase
Time Frame
Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion
Title
Total Area Under the Moment Curve
Description
Total area under the first moment curve (AUMC) estimated by linear trapezoidal methods
Time Frame
Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion
Title
Weight-adjusted Clearance
Description
Computed as weight-adjusted dose divided by total AUC
Time Frame
Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion
Title
Mean Residence Time
Description
Computed as total AUMC divided by total AUC
Time Frame
Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion
Title
Volume of Distribution at Steady State
Description
Computed as weight-adjusted CL * Mean Residence Time
Time Frame
Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion
Title
Maximum Plasma Concentration
Description
Maximal factor VIII concentration after infusion
Time Frame
Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion
Title
Pre-infusion Von Willebrand Factor Ristocetin Cofactor Activity (VWF:Rco)
Description
Percentage of normal VWF:Rco activity. Normal is a lab standard consisting of a non-hemophilic population. Relationships between baseline VWF:Rco and pharmacokinetic parameters (initial recovery, total AUC/dose, and half-life) were evaluated statistically.
Time Frame
At baseline and before each pharmacokinetic evaluation
Title
Pre-infusion Von Willebrand Factor Antigen (VWF:Ag)
Description
Percentage of VWF:Ag. Relationships between baseline VWF:Ag and pharmacokinetic parameters (initial recovery, total AUC/dose, and half-life) were evaluated statistically.
Time Frame
At baseline and before each pharmacokinetic evaluation

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The subject has severe hemophilia A as defined by a baseline factor VIII activity <1% of normal; tested at screening. (A minimum washout period of 3 days is required before the blood sample can be drawn to determine baseline factor VIII levels.) The subject has a documented history of at least 150 exposure days to factor VIII concentrates (either plasma-derived or recombinant). The subject is within 12 to 65 years of age. The subject has a Karnofsky performance score >60. The subject is human immunodeficiency virus negative (HIV-) or HIV+ with CD4 count >=400 cells/mm3 (CD4 count determined at screening, if necessary). The subject or subject´s legally authorized representative has provided written informed consent. Exclusion Criteria: The subject has a known hypersensitivity to mouse or hamster proteins or to factor VIII concentrates. The subject has a history of factor VIII inhibitors with titer >=0.8 BU (Bethesda Assay) or >=0.4 BU (Nijmegen modification of the Bethesda Assay) any time prior to screening. The subject has a detectable factor VIII inhibitor at screening, >=0.4 BU (Nijmegen modification of the Bethesda Assay), in the Baxter central laboratory. The subject has severe chronic liver disease as evidenced by, but not limited to, any of the following: International Normalized Ratio (INR) >1.4, hypoalbuminemia, portal vein hypertension including presence of otherwise unexplained splenomegaly and history of esophageal varices. The subject has been diagnosed with an inherited or acquired hemostatic defect other than hemophilia A (e.g. qualitative platelet defect or von Willebrand´s Disease). The subject has participated in another investigational study within 30 days of enrollment. The subject´s clinical condition may require a major or moderate surgery (estimated blood loss >500 mL) during the period of participation in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Study Director
Organizational Affiliation
Takeda
Official's Role
Study Director
Facility Information:
City
Little Rock
State/Province
Arkansas
Country
United States
City
Los Angeles
State/Province
California
Country
United States
City
Peoria
State/Province
Illinois
Country
United States
City
Iowa City
State/Province
Iowa
Country
United States
City
New Brunswick
State/Province
New Jersey
Country
United States
City
Cincinnati
State/Province
Ohio
Country
United States
City
Oklahoma City
State/Province
Oklahoma
Country
United States
City
Houston
State/Province
Texas
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Dose-Response Study of Recombinant Factor VIII Manufactured Protein-Free (rAHF-PFM) in Patients With Hemophilia A

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