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Safety and Pharmacokinetics Study of Anthrax Immune Globulin Intravenous (AIGIV)

Primary Purpose

Anthrax

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
AIGIV 3.5 mg/kg
Gamunex 90 mg/kg
AIGIV 7.0 mg/kg
Gamunex 180 mg/kg
AIGIV 14.0 mg/kg
Gamunex 360 mg/kg
Sponsored by
Emergent BioSolutions
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Anthrax focused on measuring Anthrax, Human Anthrax Immune Globulin Intravenous, Safety, Pharmacokinetics

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Between 18 and 65 years of age, inclusive.
  • Have a minimal weight of 110 lbs and a body mass index (BMI) between 17 and 35.
  • In good health.
  • For pre-menopausal female subjects, using acceptable methods of birth control.
  • Willing and capable of complying with all aspects of the protocol through completion of the program period.
  • No blood donation in the preceding 8 weeks; willing to not donate whole blood or plasma during the clinical trial; and willing to not donate whole blood or plasma for up to one year following the last infusion.
  • Has read and signed an informed consent form.
  • Adequate venous access and can receive intravenous infusion.

Exclusion Criteria:

  • Previously intolerant of immune globulin or blood product preparations or known immunodeficiency.
  • Previous treatment with immune globulin products or blood products within three months of study.
  • Previous receipt of anthrax vaccine, known exposure to anthrax organisms, or previously enlisted in the military.
  • Receipt of any live vaccine within three months or inactivated vaccine within 2 weeks prior to study; plans to receive any vaccine at any time during the study.
  • Participation in any investigational clinical trial within one month prior to study.
  • Positive serology for human immunodeficiency virus (HIV), hepatitis B virus, or hepatitis C virus.
  • Receipt of chemotherapy, radiation therapy, immunosuppressive therapy, or high-dose corticosteroid therapy within five years of study.
  • Use of prohibited medications as defined in the protocol.
  • History of drug or alcohol abuse within 1 year of study.
  • History of IgA deficiency.
  • Pregnancy.
  • Positive Coombs test at screening.
  • Males with a hemoglobin value less than 13.2 gm/dL and females less than 10.9 gm/dL.
  • Absolute eosinophil counts greater than 600 cells/mm3 or Absolute lymphocyte counts less than 1000 cells/mm3.
  • Aspartate aminotransferase (AST) >55 U/L or alanine aminotransferase (ALT) >60 U/L.
  • Hyperglycemia with random blood glucose >141 mg/dL, fasting blood glucose >112 mg/dL, or urine glucose >50 mg/dL; or hypoglycemia with a blood glucose <65 mg/dL.
  • BUN >25 mg/dL or creatinine, for males >1.4 mg/dL and, for females >1.2 mg/dL.
  • Creatinine clearance <80 mL/min.
  • Urine protein >15 mg/dL for males and non-menstruating females, or >30 mg/dL for menstruating females.
  • Febrile illness within three days prior to infusion.
  • History of significant medical or psychiatric condition or abnormal laboratory tests indicating possible underlying medical condition.
  • An opinion of the investigator that a condition exists that would preclude compliance with protocol-specified procedures.
  • Absolute neutrophil count is less than 3000 cells/mm3 as defined by the central lab (screening) or local lab (pre-infusion) for cohort B. Absolute neutrophil count is less than 2500 cells/mm3 as defined by the central lab (screening) or local lab (pre-infusion) for cohort C.
  • White blood cell counts are less than 3500 cells/mm3 as defined by the central lab (screening) or local lab (pre-infusion) for cohorts B and C.
  • History of a severe or anaphylactic reaction to quinolone or penicillin antibiotics.

Sites / Locations

  • SNBL Clinical Pharmacology Center Inc.

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Other

Experimental

Other

Experimental

Other

Arm Label

AIGIV 3.5 mg/kg (Cohort A)

Gamunex 90 mg/kg (Cohort A)

AIGIV 7.0 mg/kg (Cohort B)

Gamunex 180 mg/kg (Cohort B)

AIGIV 14.0 mg/kg (Cohort C)

Gamunex 360 mg/kg (Cohort C)

Arm Description

AIGIV containing 3.5 mg/kg anti-PA IgG as a single intravenous infusion.

Gamunex 90 mg/kg total IgG as a single intravenous infusion.

AIGIV containing 7.0 mg/kg anti-PA IgG as a single intravenous infusion.

Gamunex 180 mg/kg total IgG as a single intravenous infusion.

AIGIV containing 14.0 mg/kg anti-PA IgG as a single intravenous infusion.

Gamunex 360 mg/kg total IgG as a single intravenous infusion.

Outcomes

Primary Outcome Measures

Number of Participants Reporting Adverse Events (AEs)
Any untoward medical occurrence reported to or observed by the principal investigator (PI), including as identified from other safety assessments (eg, vital signs, clinical laboratory testing, electrocardiogram).

Secondary Outcome Measures

Maximum Plasma Titer/Concentration of TNA (Toxin Neutralizing Antibody) (Cmax)
Blood samples for TNA analysis collected at pre-infusion; 5 minutes postinfusion; 8, 24, and 48 hours postinfusion; and Days 3, 5, 10, 14, 21, 30, 45, 60, and 90 postinfusion. Assay results are reported as the 50% neutralization factor, TNA NF50: the ED50 of the test sample (ie, effective dilution of test sample that neutralized 50% of toxin) divided by the ED50 of the reference standard.
Time of Cmax
Blood samples for TNA analysis collected at pre-infusion; 5 minutes postinfusion; 8, 24, and 48 hours postinfusion; and Days 3, 5, 10, 14, 21, 30, 45, 60, and 90 postinfusion.
Area Under the Curve to the Last Time With a Measurable TNA Titer (AUC[0-t])
Blood samples for TNA analysis collected at pre-infusion; 5 minutes postinfusion; 8, 24, and 48 hours postinfusion; and Days 3, 5, 10, 14, 21, 30, 45, 60, and 90 postinfusion.
Area Under the Curve to Infinity (AUC[0-inf])
Blood samples for TNA analysis collected at pre-infusion; 5 minutes postinfusion; 8, 24, and 48 hours postinfusion; and Days 3, 5, 10, 14, 21, 30, 45, 60, and 90 postinfusion.
Elimination Rate Constant
Blood samples for TNA analysis collected at pre-infusion; 5 minutes postinfusion; 8, 24, and 48 hours postinfusion; and Days 3, 5, 10, 14, 21, 30, 45, 60, and 90 postinfusion.
Elimination Half-life (t½)
Blood samples for TNA analysis collected at pre-infusion; 5 minutes postinfusion; 8, 24, and 48 hours postinfusion; and Days 3, 5, 10, 14, 21, 30, 45, 60, and 90 postinfusion.
Mean Residence Time (MRT)
Blood samples for TNA analysis collected at pre-infusion; 5 minutes postinfusion; 8, 24, and 48 hours postinfusion; and Days 3, 5, 10, 14, 21, 30, 45, 60, and 90 postinfusion.

Full Information

First Posted
February 13, 2009
Last Updated
July 16, 2019
Sponsor
Emergent BioSolutions
Collaborators
National Institutes of Health (NIH)
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1. Study Identification

Unique Protocol Identification Number
NCT00845650
Brief Title
Safety and Pharmacokinetics Study of Anthrax Immune Globulin Intravenous (AIGIV)
Official Title
A Randomized, Double-Blind, Dose-Escalation Study Evaluating Pharmacokinetics and Safety of Anthrax Immune Globulin Intravenous (AIGIV)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2019
Overall Recruitment Status
Completed
Study Start Date
February 2009 (undefined)
Primary Completion Date
October 2010 (Actual)
Study Completion Date
October 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Emergent BioSolutions
Collaborators
National Institutes of Health (NIH)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to: evaluate the safety profile of a single intravenous administration of AIGIV (containing either 3.5 mg/kg, 7.0 mg/kg or 14.0 mg/kg anti-PA IgG) as compared with either 90 mg/kg, 180 mg/kg or 360 mg/kg total IgG, GAMUNEX® (immune globulin intravenous (human) 10% caprylate/chromatography purified). GAMUNEX is a trademark of Talecris Biotherapeutics. evaluate the pharmacokinetic (PK) profile of a single intravenous administration of AIGIV (containing either 3.5 mg/kg, 7.0 mg/kg or 14.0 mg/kg anti-PA IgG) as measured by lethal toxin neutralizing antibody (TNA).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Anthrax
Keywords
Anthrax, Human Anthrax Immune Globulin Intravenous, Safety, Pharmacokinetics

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
129 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AIGIV 3.5 mg/kg (Cohort A)
Arm Type
Experimental
Arm Description
AIGIV containing 3.5 mg/kg anti-PA IgG as a single intravenous infusion.
Arm Title
Gamunex 90 mg/kg (Cohort A)
Arm Type
Other
Arm Description
Gamunex 90 mg/kg total IgG as a single intravenous infusion.
Arm Title
AIGIV 7.0 mg/kg (Cohort B)
Arm Type
Experimental
Arm Description
AIGIV containing 7.0 mg/kg anti-PA IgG as a single intravenous infusion.
Arm Title
Gamunex 180 mg/kg (Cohort B)
Arm Type
Other
Arm Description
Gamunex 180 mg/kg total IgG as a single intravenous infusion.
Arm Title
AIGIV 14.0 mg/kg (Cohort C)
Arm Type
Experimental
Arm Description
AIGIV containing 14.0 mg/kg anti-PA IgG as a single intravenous infusion.
Arm Title
Gamunex 360 mg/kg (Cohort C)
Arm Type
Other
Arm Description
Gamunex 360 mg/kg total IgG as a single intravenous infusion.
Intervention Type
Biological
Intervention Name(s)
AIGIV 3.5 mg/kg
Intervention Description
AIGIV containing 3.5 mg/kg anti-PA IgG as a single intravenous infusion.
Intervention Type
Biological
Intervention Name(s)
Gamunex 90 mg/kg
Other Intervention Name(s)
human immune globulin intravenous
Intervention Description
Gamunex 90 mg/kg total IgG as a single intravenous infusion.
Intervention Type
Biological
Intervention Name(s)
AIGIV 7.0 mg/kg
Intervention Description
AIGIV containing 7.0 mg/kg anti-PA IgG as a single intravenous infusion.
Intervention Type
Biological
Intervention Name(s)
Gamunex 180 mg/kg
Intervention Description
Gamunex 180 mg/kg total IgG as a single intravenous infusion.
Intervention Type
Biological
Intervention Name(s)
AIGIV 14.0 mg/kg
Intervention Description
AIGIV containing 14.0 mg/kg anti-PA IgG as a single intravenous infusion.
Intervention Type
Biological
Intervention Name(s)
Gamunex 360 mg/kg
Intervention Description
Gamunex 360 mg/kg total IgG as a single intravenous infusion.
Primary Outcome Measure Information:
Title
Number of Participants Reporting Adverse Events (AEs)
Description
Any untoward medical occurrence reported to or observed by the principal investigator (PI), including as identified from other safety assessments (eg, vital signs, clinical laboratory testing, electrocardiogram).
Time Frame
From the time of infusion through Day 90.
Secondary Outcome Measure Information:
Title
Maximum Plasma Titer/Concentration of TNA (Toxin Neutralizing Antibody) (Cmax)
Description
Blood samples for TNA analysis collected at pre-infusion; 5 minutes postinfusion; 8, 24, and 48 hours postinfusion; and Days 3, 5, 10, 14, 21, 30, 45, 60, and 90 postinfusion. Assay results are reported as the 50% neutralization factor, TNA NF50: the ED50 of the test sample (ie, effective dilution of test sample that neutralized 50% of toxin) divided by the ED50 of the reference standard.
Time Frame
From the time of infusion through Day 90 postinfusion.
Title
Time of Cmax
Description
Blood samples for TNA analysis collected at pre-infusion; 5 minutes postinfusion; 8, 24, and 48 hours postinfusion; and Days 3, 5, 10, 14, 21, 30, 45, 60, and 90 postinfusion.
Time Frame
From the time of infusion through Day 90 postinfusion.
Title
Area Under the Curve to the Last Time With a Measurable TNA Titer (AUC[0-t])
Description
Blood samples for TNA analysis collected at pre-infusion; 5 minutes postinfusion; 8, 24, and 48 hours postinfusion; and Days 3, 5, 10, 14, 21, 30, 45, 60, and 90 postinfusion.
Time Frame
From the time of infusion through Day 90 postinfusion.
Title
Area Under the Curve to Infinity (AUC[0-inf])
Description
Blood samples for TNA analysis collected at pre-infusion; 5 minutes postinfusion; 8, 24, and 48 hours postinfusion; and Days 3, 5, 10, 14, 21, 30, 45, 60, and 90 postinfusion.
Time Frame
From the time of infusion through Day 90 postinfusion.
Title
Elimination Rate Constant
Description
Blood samples for TNA analysis collected at pre-infusion; 5 minutes postinfusion; 8, 24, and 48 hours postinfusion; and Days 3, 5, 10, 14, 21, 30, 45, 60, and 90 postinfusion.
Time Frame
From the time of infusion through Day 90 postinfusion.
Title
Elimination Half-life (t½)
Description
Blood samples for TNA analysis collected at pre-infusion; 5 minutes postinfusion; 8, 24, and 48 hours postinfusion; and Days 3, 5, 10, 14, 21, 30, 45, 60, and 90 postinfusion.
Time Frame
From the time of infusion through Day 90 postinfusion.
Title
Mean Residence Time (MRT)
Description
Blood samples for TNA analysis collected at pre-infusion; 5 minutes postinfusion; 8, 24, and 48 hours postinfusion; and Days 3, 5, 10, 14, 21, 30, 45, 60, and 90 postinfusion.
Time Frame
From the time of infusion through Day 90 postinfusion.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Between 18 and 65 years of age, inclusive. Have a minimal weight of 110 lbs and a body mass index (BMI) between 17 and 35. In good health. For pre-menopausal female subjects, using acceptable methods of birth control. Willing and capable of complying with all aspects of the protocol through completion of the program period. No blood donation in the preceding 8 weeks; willing to not donate whole blood or plasma during the clinical trial; and willing to not donate whole blood or plasma for up to one year following the last infusion. Has read and signed an informed consent form. Adequate venous access and can receive intravenous infusion. Exclusion Criteria: Previously intolerant of immune globulin or blood product preparations or known immunodeficiency. Previous treatment with immune globulin products or blood products within three months of study. Previous receipt of anthrax vaccine, known exposure to anthrax organisms, or previously enlisted in the military. Receipt of any live vaccine within three months or inactivated vaccine within 2 weeks prior to study; plans to receive any vaccine at any time during the study. Participation in any investigational clinical trial within one month prior to study. Positive serology for human immunodeficiency virus (HIV), hepatitis B virus, or hepatitis C virus. Receipt of chemotherapy, radiation therapy, immunosuppressive therapy, or high-dose corticosteroid therapy within five years of study. Use of prohibited medications as defined in the protocol. History of drug or alcohol abuse within 1 year of study. History of IgA deficiency. Pregnancy. Positive Coombs test at screening. Males with a hemoglobin value less than 13.2 gm/dL and females less than 10.9 gm/dL. Absolute eosinophil counts greater than 600 cells/mm3 or Absolute lymphocyte counts less than 1000 cells/mm3. Aspartate aminotransferase (AST) >55 U/L or alanine aminotransferase (ALT) >60 U/L. Hyperglycemia with random blood glucose >141 mg/dL, fasting blood glucose >112 mg/dL, or urine glucose >50 mg/dL; or hypoglycemia with a blood glucose <65 mg/dL. BUN >25 mg/dL or creatinine, for males >1.4 mg/dL and, for females >1.2 mg/dL. Creatinine clearance <80 mL/min. Urine protein >15 mg/dL for males and non-menstruating females, or >30 mg/dL for menstruating females. Febrile illness within three days prior to infusion. History of significant medical or psychiatric condition or abnormal laboratory tests indicating possible underlying medical condition. An opinion of the investigator that a condition exists that would preclude compliance with protocol-specified procedures. Absolute neutrophil count is less than 3000 cells/mm3 as defined by the central lab (screening) or local lab (pre-infusion) for cohort B. Absolute neutrophil count is less than 2500 cells/mm3 as defined by the central lab (screening) or local lab (pre-infusion) for cohort C. White blood cell counts are less than 3500 cells/mm3 as defined by the central lab (screening) or local lab (pre-infusion) for cohorts B and C. History of a severe or anaphylactic reaction to quinolone or penicillin antibiotics.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mohamed Al-Ibrahim, MD
Organizational Affiliation
SNBL Clinical Pharmacology Center Inc, Baltimore, MD
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Robert J Hopkins, MD, MPH & TM
Organizational Affiliation
Emergent Product Development Gaithersburg
Official's Role
Study Director
Facility Information:
Facility Name
SNBL Clinical Pharmacology Center Inc.
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
23979731
Citation
Mytle N, Hopkins RJ, Malkevich NV, Basu S, Meister GT, Sanford DC, Comer JE, Van Zandt KE, Al-Ibrahim M, Kramer WG, Howard C, Daczkowski N, Chakrabarti AC, Ionin B, Nabors GS, Skiadopoulos MH. Evaluation of intravenous anthrax immune globulin for treatment of inhalation anthrax. Antimicrob Agents Chemother. 2013 Nov;57(11):5684-92. doi: 10.1128/AAC.00458-13. Epub 2013 Aug 26.
Results Reference
derived
Links:
URL
http://www.emergentbiosolutions.com/
Description
Sponsor website

Learn more about this trial

Safety and Pharmacokinetics Study of Anthrax Immune Globulin Intravenous (AIGIV)

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