Pharmacokinetic Study of ADVATE 3000 IU in Previously Treated Patients With Severe Hemophilia A
Primary Purpose
Hemophilia A
Status
Completed
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
Octocog alfa (recombinant human coagulation factor VIII) [ADVATE]
Sponsored by
About this trial
This is an interventional treatment trial for Hemophilia A
Eligibility Criteria
Inclusion Criteria:
- Participant is 18 to 65 years old, at the time of screening
- Participant has provided signed informed consent
- Participant has severe hemophilia A, defined by a baseline FVIII level < 1% of normal, as tested at screening at the central laboratory
- Participant's weight is between 55-65 kg
- Participant was previously treated with FVIII concentrate(s) for a minimum of 150 exposure days prior to study entry
- If Participant is HIV positive, he must be immunocompetent as determined with a CD4 count ≥ 200 cells/mm³ (CD4 count at screening)
- Participant is willing and able to comply with the requirements of the protocol
Exclusion Criteria:
- Participant has a detectable FVIII inhibitor at screening, with a titer ≥ 0.4 Bethesda unit (BU) (Nijmegen modification of the Bethesda Assay) measured at the central laboratory
- Participant has a history of FVIII inhibitors with a titer ≥ 0.4 BU (by Nijmegen assay) or ≥ 0.5 BU (by Bethesda Assay) at any time prior to screening
- Participant has undergone a surgery within 21 days prior to screening or within 6 weeks prior to the anticipated first pharmacokinetics(PK) infusion
- Participant has an abnormal renal function (serum creatinine > 1.5 mg/dL)
- Participant has active hepatic disease (alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels >5 times the upper limit of normal)
- Participant 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
- Participant has clinical and/or laboratory evidence of abnormal hemostasis from causes other than hemophilia A (eg, late-stage chronic liver disease, immune thrombocytopenia purpura)
- Participant is currently receiving, or is scheduled to receive during the course of the clinical study, an immunomodulating drug other than anti-retroviral chemotherapy (eg, alfa-interferon, or corticosteroid agents at a dose equivalent to hydrocortisone greater than 10 mg/day)
- Participant has a known hypersensitivity to mouse or hamster proteins
- Participant has participated in another clinical study involving an investigational product or investigational device within 30 days prior to enrollment or is scheduled to participate in another clinical study involving an investigational product or investigational device during the course of this clinical study
- Participant is identified by the investigator as being unable or unwilling to cooperate with study procedures
- Participant is a member of the team conducting this clinical study or is in a dependent relationship with one of the study team members. Dependent relationships include close relatives (ie, children, partner/spouse, siblings, or parents) as well as employees of the investigator or site personnel conducting the clinical study.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Active Comparator
Arm Label
1
2
Arm Description
One infusion using a 3000 IU potency vial of Advate dissolved and administered in 5 mL diluent followed by a second infusion of two 1500 IU potency vials of Advate dissolved in 5 mL diluent each (administered in 10 mL diluent in total)
One infusion of two 1500 IU potency vials of Advate dissolved in 5 mL diluent each (administered in 10 mL diluent in total) followed by a second infusion of one 3000 IU potency vial of Advate dissolved and administered in 5 mL diluent
Outcomes
Primary Outcome Measures
Area Under the Plasma Concentration Versus Time Curve From 0 to 48 Hours (AUC 0-48h). Chromogenic Assay
Computed using the linear trapezoidal method.
Area Under the Plasma Concentration Versus Time Curve From 0 to 48 Hours (AUC 0-48h). One-stage Activated Partial Thromboplastin Time (aPTT) Assay
Computed using the linear trapezoidal method.
Secondary Outcome Measures
Area Under the Plasma Concentration Versus Time Curve From 0 to Infinity (AUC 0-infinity). Chromogenic Assay
The total area under the plasma concentration versus time curve when the concentration is extrapolated to zero using the slope of the β-phase of the model.
Area Under the Plasma Concentration Versus Time Curve From 0 to Infinity (AUC 0-infinity). One-stage aPTT Assay
The total area under the plasma concentration versus time curve when the concentration is extrapolated to zero using the slope of the β-phase of the model.
Incremental Recovery at Cmax - Chromogenic Assay
Determined as the highest Factor VIII (FVIII) activity achieved post-infusion
Incremental Recovery at Cmax - One-stage aPTT Assay
Determined as the highest FVIII activity achieved post-infusion
Incremental Recovery at 30 Minutes- Chromogenic Assay
Change in factor VIII concentration from pre-infusion to 30 minutes post-infusion
Incremental Recovery at 30 Minutes- One-stage aPTT Assay
Change in factor VIII concentration from pre-infusion to 30 minutes post-infusion
Elimination Phase Half-life- Chromogenic Assay
calculated as log_e2/λ, where λ is the regression slope in the terminal phase of the least absolute deviations regression model
Elimination Phase Half-life- One-stage aPTT Assay
calculated as log_e2/λ, where λ is the regression slope in the terminal phase of the least absolute deviations regression model
FVIII Clearance- Chromogenic Assay
computed as the dose divided by total AUC
FVIII Clearance- One-stage aPTT Assay
Computed as the dose divided by total AUC
Mean Residence Time (MRT)- Chromogenic Assay
Computed as total area under the first moment curve (Total AUMC) divided by the total area under the concentration versus time curve (Total AUC)
Mean Residence Time (MRT)- One-stage aPTT Assay
Computed as total area under the first moment curve (Total AUMC) divided by the total area under the concentration versus time curve (Total AUC)
Volume of Distribution at Steady State- Chromogenic Assay
computed as Clearance (CL) * Mean residence time (MRT)
Volume of Distribution at Steady State- One-stage aPTT Assay
computed as CL * MRT
Factor VIII (FVIII) Maximum Plasma Concentration (C-max)- Chromogenic Assay
Determined as the highest FVIII activity achieved post-infusion.
Factor VIII (FVIII) Maximum Plasma Concentration (C-max)- One-stage aPTT Assay
Determined as the highest FVIII activity achieved post-infusion.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00916032
Brief Title
Pharmacokinetic Study of ADVATE 3000 IU in Previously Treated Patients With Severe Hemophilia A
Official Title
Pharmacokinetic Comparison of 3000 IU Advate (rAHF-PFM) (Using One 3000 IU Potency Vial) With 3000 IU Advate (rAHF PFM) (Using Two 1500 IU Potency Vials) in Previously Treated Patients With Severe Hemophilia A: a Phase 4, Open-label, Prospective, Randomized, Controlled, Crossover, Multiple Center Study
Study Type
Interventional
2. Study Status
Record Verification Date
April 2021
Overall Recruitment Status
Completed
Study Start Date
June 29, 2009 (Actual)
Primary Completion Date
April 1, 2010 (Actual)
Study Completion Date
April 1, 2010 (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 objective of this clinical study is to compare the pharmacokinetic parameters of 3000 IU Advate using one 3000 IU potency vial dissolved in 5 mL diluent with that of 3000 IU Advate using two vials of 1500 IU potency dissolved in 5 mL diluent each (administered in 10 mL diluent in total) in previously treated patients with severe hemophilia A (factor VIII level < 1%).
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
29 (Actual)
8. Arms, Groups, and Interventions
Arm Title
1
Arm Type
Active Comparator
Arm Description
One infusion using a 3000 IU potency vial of Advate dissolved and administered in 5 mL diluent followed by a second infusion of two 1500 IU potency vials of Advate dissolved in 5 mL diluent each (administered in 10 mL diluent in total)
Arm Title
2
Arm Type
Active Comparator
Arm Description
One infusion of two 1500 IU potency vials of Advate dissolved in 5 mL diluent each (administered in 10 mL diluent in total) followed by a second infusion of one 3000 IU potency vial of Advate dissolved and administered in 5 mL diluent
Intervention Type
Biological
Intervention Name(s)
Octocog alfa (recombinant human coagulation factor VIII) [ADVATE]
Other Intervention Name(s)
ADVATE, Antihemophilic Factor (Recombinant)- Plasma/albumin free method (rAHF-PFM)
Intervention Description
Participants will receive 3000 IU Advate using one 3000 IU potency vial dissolved in 5 mL diluent followed by two 1500 IU potency vials dissolved in 5 mL diluent each (administered in 10 mL diluent in total) or the alternate sequence
Primary Outcome Measure Information:
Title
Area Under the Plasma Concentration Versus Time Curve From 0 to 48 Hours (AUC 0-48h). Chromogenic Assay
Description
Computed using the linear trapezoidal method.
Time Frame
Within 30 minutes prior to the start of the infusion; and after the end of the infusion at 15, 30 minutes, and 1, 3, 6, 9, 24, 28, 32, and 48 hours.
Title
Area Under the Plasma Concentration Versus Time Curve From 0 to 48 Hours (AUC 0-48h). One-stage Activated Partial Thromboplastin Time (aPTT) Assay
Description
Computed using the linear trapezoidal method.
Time Frame
Within 30 minutes prior to the start of the infusion; and after the end of the infusion at 15, 30 minutes, and 1, 3, 6, 9, 24, 28, 32, and 48 hours.
Secondary Outcome Measure Information:
Title
Area Under the Plasma Concentration Versus Time Curve From 0 to Infinity (AUC 0-infinity). Chromogenic Assay
Description
The total area under the plasma concentration versus time curve when the concentration is extrapolated to zero using the slope of the β-phase of the model.
Time Frame
Within 30 minutes prior to the start of the infusion; and after the end of the infusion at 15, 30 minutes, and 1, 3, 6, 9, 24, 28, 32, and 48 hours.
Title
Area Under the Plasma Concentration Versus Time Curve From 0 to Infinity (AUC 0-infinity). One-stage aPTT Assay
Description
The total area under the plasma concentration versus time curve when the concentration is extrapolated to zero using the slope of the β-phase of the model.
Time Frame
Within 30 minutes prior to the start of the infusion; and after the end of the infusion at 15, 30 minutes, and 1, 3, 6, 9, 24, 28, 32, and 48 hours.
Title
Incremental Recovery at Cmax - Chromogenic Assay
Description
Determined as the highest Factor VIII (FVIII) activity achieved post-infusion
Time Frame
Within 30 minutes prior to the start of the infusion; and after the end of the infusion at 15, 30 minutes, and 1, 3 hours.
Title
Incremental Recovery at Cmax - One-stage aPTT Assay
Description
Determined as the highest FVIII activity achieved post-infusion
Time Frame
Within 30 minutes prior to the start of the infusion; and after the end of the infusion at 15, 30 minutes, and 1, 3 hours.
Title
Incremental Recovery at 30 Minutes- Chromogenic Assay
Description
Change in factor VIII concentration from pre-infusion to 30 minutes post-infusion
Time Frame
30 minutes pre-infusion and 30 minutes post-infusion
Title
Incremental Recovery at 30 Minutes- One-stage aPTT Assay
Description
Change in factor VIII concentration from pre-infusion to 30 minutes post-infusion
Time Frame
30 minutes pre-infusion and 30 minutes post-infusion
Title
Elimination Phase Half-life- Chromogenic Assay
Description
calculated as log_e2/λ, where λ is the regression slope in the terminal phase of the least absolute deviations regression model
Time Frame
Within 30 minutes prior to the start of the infusion; and after the end of the infusion at 15, 30 minutes, and 1, 3, 6, 9, 24, 28, 32, and 48 hours.
Title
Elimination Phase Half-life- One-stage aPTT Assay
Description
calculated as log_e2/λ, where λ is the regression slope in the terminal phase of the least absolute deviations regression model
Time Frame
Within 30 minutes prior to the start of the infusion; and after the end of the infusion at 15, 30 minutes, and 1, 3, 6, 9, 24, 28, 32, and 48 hours.
Title
FVIII Clearance- Chromogenic Assay
Description
computed as the dose divided by total AUC
Time Frame
Within 30 minutes prior to the start of the infusion; and after the end of the infusion at 15, 30 minutes, and 1, 3, 6, 9, 24, 28, 32, and 48 hours.
Title
FVIII Clearance- One-stage aPTT Assay
Description
Computed as the dose divided by total AUC
Time Frame
Within 30 minutes prior to the start of the infusion; and after the end of the infusion at 15, 30 minutes, and 1, 3, 6, 9, 24, 28, 32, and 48 hours.
Title
Mean Residence Time (MRT)- Chromogenic Assay
Description
Computed as total area under the first moment curve (Total AUMC) divided by the total area under the concentration versus time curve (Total AUC)
Time Frame
Within 30 minutes prior to the start of the infusion; and after the end of the infusion at 15, 30 minutes, and 1, 3, 6, 9, 24, 28, 32, and 48 hours.
Title
Mean Residence Time (MRT)- One-stage aPTT Assay
Description
Computed as total area under the first moment curve (Total AUMC) divided by the total area under the concentration versus time curve (Total AUC)
Time Frame
Within 30 minutes prior to the start of the infusion; and after the end of the infusion at 15, 30 minutes, and 1, 3, 6, 9, 24, 28, 32, and 48 hours.
Title
Volume of Distribution at Steady State- Chromogenic Assay
Description
computed as Clearance (CL) * Mean residence time (MRT)
Time Frame
Within 30 minutes prior to the start of the infusion; and after the end of the infusion at 15, 30 minutes, and 1, 3, 6, 9, 24, 28, 32, and 48 hours.
Title
Volume of Distribution at Steady State- One-stage aPTT Assay
Description
computed as CL * MRT
Time Frame
Within 30 minutes prior to the start of the infusion; and after the end of the infusion at 15, 30 minutes, and 1, 3, 6, 9, 24, 28, 32, and 48 hours.
Title
Factor VIII (FVIII) Maximum Plasma Concentration (C-max)- Chromogenic Assay
Description
Determined as the highest FVIII activity achieved post-infusion.
Time Frame
Within 30 minutes prior to the start of the infusion; and after the end of the infusion at 15, 30 minutes, and 1, 3, 6, 9, 24, 28, 32, and 48 hours.
Title
Factor VIII (FVIII) Maximum Plasma Concentration (C-max)- One-stage aPTT Assay
Description
Determined as the highest FVIII activity achieved post-infusion.
Time Frame
Within 30 minutes prior to the start of the infusion; and after the end of the infusion at 15, 30 minutes, and 1, 3, 6, 9, 24, 28, 32, and 48 hours.
10. Eligibility
Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Participant is 18 to 65 years old, at the time of screening
Participant has provided signed informed consent
Participant has severe hemophilia A, defined by a baseline FVIII level < 1% of normal, as tested at screening at the central laboratory
Participant's weight is between 55-65 kg
Participant was previously treated with FVIII concentrate(s) for a minimum of 150 exposure days prior to study entry
If Participant is HIV positive, he must be immunocompetent as determined with a CD4 count ≥ 200 cells/mm³ (CD4 count at screening)
Participant is willing and able to comply with the requirements of the protocol
Exclusion Criteria:
Participant has a detectable FVIII inhibitor at screening, with a titer ≥ 0.4 Bethesda unit (BU) (Nijmegen modification of the Bethesda Assay) measured at the central laboratory
Participant has a history of FVIII inhibitors with a titer ≥ 0.4 BU (by Nijmegen assay) or ≥ 0.5 BU (by Bethesda Assay) at any time prior to screening
Participant has undergone a surgery within 21 days prior to screening or within 6 weeks prior to the anticipated first pharmacokinetics(PK) infusion
Participant has an abnormal renal function (serum creatinine > 1.5 mg/dL)
Participant has active hepatic disease (alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels >5 times the upper limit of normal)
Participant 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
Participant has clinical and/or laboratory evidence of abnormal hemostasis from causes other than hemophilia A (eg, late-stage chronic liver disease, immune thrombocytopenia purpura)
Participant is currently receiving, or is scheduled to receive during the course of the clinical study, an immunomodulating drug other than anti-retroviral chemotherapy (eg, alfa-interferon, or corticosteroid agents at a dose equivalent to hydrocortisone greater than 10 mg/day)
Participant has a known hypersensitivity to mouse or hamster proteins
Participant has participated in another clinical study involving an investigational product or investigational device within 30 days prior to enrollment or is scheduled to participate in another clinical study involving an investigational product or investigational device during the course of this clinical study
Participant is identified by the investigator as being unable or unwilling to cooperate with study procedures
Participant is a member of the team conducting this clinical study or is in a dependent relationship with one of the study team members. Dependent relationships include close relatives (ie, children, partner/spouse, siblings, or parents) as well as employees of the investigator or site personnel conducting the clinical study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Study Director
Organizational Affiliation
Takeda
Official's Role
Study Director
Facility Information:
City
Sofia
ZIP/Postal Code
1233
Country
Bulgaria
City
Kirov
Country
Russian Federation
City
Moscow
ZIP/Postal Code
125167
Country
Russian Federation
City
St. Petersburg
ZIP/Postal Code
195213
Country
Russian Federation
12. IPD Sharing Statement
Learn more about this trial
Pharmacokinetic Study of ADVATE 3000 IU in Previously Treated Patients With Severe Hemophilia A
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