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A Study to Find Out How Safe and Effective Gammaplex® is in Young People With Primary Immunodeficiency

Primary Purpose

Primary Immune Deficiency Disorders, Common Variable Immunodeficiency, X-linked Agammaglobulinemia

Status
Completed
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
Gammaplex
Sponsored by
Bio Products Laboratory
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Primary Immune Deficiency Disorders focused on measuring Primary Immune Deficiency Disorders, Common Variable Immunodeficiency, X-linked agammaglobulinemia, Hyper-IgM syndrome, Wiskott-Aldrich Syndrome, Immunoglobulins, Bacterial Infections

Eligibility Criteria

2 Years - 16 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • The subject is between the ages of or is equal to 2 and 16 years of age, of either sex, belonging to any ethnic group, and above a minimum weight of 10 kg. This weight is based on the amount of blood required for testing.
  • The subject has a primary immunodeficiency disease, which has as a significant component of hypogammaglobulinemia and/or antibody deficiency (e.g. common variable immunodeficiency, X-linked and autosomal forms of agammaglobulinemia, hyper-IgM syndrome, Wiskott-Aldrich Syndrome). NB Isolated deficiency of a single IgG subclass, or of specific antibodies without hypogammaglobulinemia per se, does not qualify for inclusion.
  • Subjects already receiving IGIV replacement therapy require the following before their first infusion of Gammaplex:
  • Documented IGIV dose(s) and treatment intervals for the last 2 consecutive routine IGIV treatments (one of which can be the screening visit result). The previous doses should also meet the following conditions before study entry: Have not changed by ± 50% of the mean dose for at least 3 months; be between 300 and 800 mg/kg/infusion; be given every 21-28 days, inclusive; be a licensed or investigational product (Phase III or IIIb).
  • Documented previous IgG trough levels for the last 2 consecutive routine IGIV treatments for the last 2 consecutive routine IGIV treatments: Maintained at least 300 mg/dL above baseline serum IgG levels (defined as before initiation of any gamma globulin treatment for that subject); must be more than/equal to 600 mg/dL.
  • If a subject is a female of child-bearing potential, she must have a negative result on an HCG-based pregnancy test.
  • If a subject is a female who is or becomes sexually active, she must practice contraception by using a method of proven reliability for the duration of the study.
  • The subject is willing to comply with all aspects of the protocol, including blood sampling, for the duration of the study.
  • The subject, if old enough (generally 6 years to 16), has signed a Child Assent Form and the subject's parent or legal guardian has signed the Informed Consent Form, both approved by the IEC/IRB.

Exclusion Criteria:

  • Has not been treated with IGIV (treatment naive subject)
  • The subject has a history of any severe anaphylactic reaction to blood or any blood-derived product.
  • The subject is known to be intolerant to any component of Gammaplex, such as sorbitol (i.e. intolerance to fructose).
  • The subject has selective IgA deficiency, history of reaction to products containing IgA, or has a history of antibodies to IgA.
  • Subjects who have completed the study and subjects who have withdrawn cannot participate in the study for a second time.
  • The subject is currently receiving, or has received, any investigational agent, other than an immune serum globulin (ISG) preparation that is being evaluated in a Phase III or IIIb study, within the prior 3 months.
  • The subject has been exposed to blood or any blood product or derivative within the last 6 months, other than a commercially available IGIV or other forms of commercially available and licensed ISG. If an unlicensed ISG product that is in Phase III or IIIb has been given, the subject cannot be infused with Gammaplex until 20 days after the last dose was given.
  • The subject is pregnant or is nursing.
  • The subject, at screening, has levels greater than 2.5 times the upper limit of normal as defined at the central laboratory of any of the following: (Alanine transaminase (ALT); Aspartate transaminase (AST) Lactate dehydrogenase (LDH)).
  • The subject has a severe renal impairment (defined as serum creatinine greater than 2 times the upper limit of normal or BUN greater than 2.5 times the upper limit of normal for the range of the laboratory doing the analysis); the subject is on dialysis; the subject has a history of acute renal failure.
  • The subject is known to abuse alcohol, opiates, psychotropic agents, or other chemicals or drugs, or has done so within the past 12 months.
  • The subject has a history of DVT, or thrombotic complications of IGIV therapy.
  • The subject suffers from any acute or chronic medical condition (e.g. renal disease or predisposing conditions for renal disease, or protein losing state) that, in the opinion of the investigator, may interfere with the conduct of the study.
  • The subject has an acquired medical condition, such as, chronic or recurrent neutropenia (ANC < 1000 x 109/L) or AIDS known to cause secondary immune deficiency, or is post or recovering from hematopoietic stem cell transplantation.
  • The subject is receiving the following medication: Systemic long-term corticosteroids (i.e. not intermittent or burst, daily, >1 mg of prednisone equivalent/kg/day).
  • The subject is receiving Immunosuppressive or Immunomodulatory drugs.
  • The subject has non-controlled arterial hypertension.
  • The subject has anemia (hemoglobin <10 g/dL) at screening.

Sites / Locations

  • Department of Medicine, University of California
  • Children's Hospital Los Angeles
  • IMMUNOe International Reseach Centers
  • Family Allergy & Asthma Center, PC
  • Rush University Medical Center
  • Children's Hospital of Pittsburgh of UPMC
  • Allergy, Asthma & Immunology Clinic, P.A
  • Children's Hospital of Richmond, VA
  • Hospital de Niňos Roberto del Río
  • Safra Children's Hospital, Sheba Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Gammaplex

Arm Description

Outcomes

Primary Outcome Measures

Adverse Events
Number of subjects with serious, acute, bacterial infections as a measure of efficacy

Secondary Outcome Measures

Therapeutic Efficacy
Number and proportion of subjects who maintain trough IgG levels at least as high as the average of the 2 previous trough levels before the first Gammaplex infusion
Therapeutic Efficacy
Number of days off school
Therapeutic Efficacy
Number of days in hospital
Therapeutic Efficacy
Visits to physicians and/or emergency room
Therapeutic Efficacy
Number of days on therapeutic antibiotics

Full Information

First Posted
January 27, 2011
Last Updated
December 15, 2014
Sponsor
Bio Products Laboratory
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1. Study Identification

Unique Protocol Identification Number
NCT01289847
Brief Title
A Study to Find Out How Safe and Effective Gammaplex® is in Young People With Primary Immunodeficiency
Official Title
A Phase IV, Multicenter, Open-Label Study to Evaluate the Efficacy, Safety and Pharmacokinetics of Gammaplex in Primary Immunodeficiency Diseases (PID) in Children and Adolescents
Study Type
Interventional

2. Study Status

Record Verification Date
December 2014
Overall Recruitment Status
Completed
Study Start Date
March 2011 (undefined)
Primary Completion Date
April 2014 (Actual)
Study Completion Date
April 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Bio Products Laboratory

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The main objective is to determine the efficacy of Gammaplex by measuring the number of serious acute bacterial infections during treatment with Gammaplex over a 12 month period. The secondary objectives are to assess the safety and tolerability of Gammaplex and to compare the data collected from adult subjects with PID from the GMX01 study

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Primary Immune Deficiency Disorders, Common Variable Immunodeficiency, X-linked Agammaglobulinemia, Hyper-IgM Syndrome, Wiskott-Aldrich Syndrome
Keywords
Primary Immune Deficiency Disorders, Common Variable Immunodeficiency, X-linked agammaglobulinemia, Hyper-IgM syndrome, Wiskott-Aldrich Syndrome, Immunoglobulins, Bacterial Infections

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
25 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Gammaplex
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
Gammaplex
Intervention Description
GAMMAPLEX 5g/100 mL, dose is 300-800 mg/kg/infusion every 21 or 28 days, intravenously. The total duration of treatment with GAMMAPLEX will be 12 months with a 3 month follow-up.
Primary Outcome Measure Information:
Title
Adverse Events
Description
Number of subjects with serious, acute, bacterial infections as a measure of efficacy
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Therapeutic Efficacy
Description
Number and proportion of subjects who maintain trough IgG levels at least as high as the average of the 2 previous trough levels before the first Gammaplex infusion
Time Frame
From week 15 onwards
Title
Therapeutic Efficacy
Description
Number of days off school
Time Frame
12 months
Title
Therapeutic Efficacy
Description
Number of days in hospital
Time Frame
12 months
Title
Therapeutic Efficacy
Description
Visits to physicians and/or emergency room
Time Frame
12 months
Title
Therapeutic Efficacy
Description
Number of days on therapeutic antibiotics
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
16 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The subject is between the ages of or is equal to 2 and 16 years of age, of either sex, belonging to any ethnic group, and above a minimum weight of 10 kg. This weight is based on the amount of blood required for testing. The subject has a primary immunodeficiency disease, which has as a significant component of hypogammaglobulinemia and/or antibody deficiency (e.g. common variable immunodeficiency, X-linked and autosomal forms of agammaglobulinemia, hyper-IgM syndrome, Wiskott-Aldrich Syndrome). NB Isolated deficiency of a single IgG subclass, or of specific antibodies without hypogammaglobulinemia per se, does not qualify for inclusion. Subjects already receiving IGIV replacement therapy require the following before their first infusion of Gammaplex: Documented IGIV dose(s) and treatment intervals for the last 2 consecutive routine IGIV treatments (one of which can be the screening visit result). The previous doses should also meet the following conditions before study entry: Have not changed by ± 50% of the mean dose for at least 3 months; be between 300 and 800 mg/kg/infusion; be given every 21-28 days, inclusive; be a licensed or investigational product (Phase III or IIIb). Documented previous IgG trough levels for the last 2 consecutive routine IGIV treatments for the last 2 consecutive routine IGIV treatments: Maintained at least 300 mg/dL above baseline serum IgG levels (defined as before initiation of any gamma globulin treatment for that subject); must be more than/equal to 600 mg/dL. If a subject is a female of child-bearing potential, she must have a negative result on an HCG-based pregnancy test. If a subject is a female who is or becomes sexually active, she must practice contraception by using a method of proven reliability for the duration of the study. The subject is willing to comply with all aspects of the protocol, including blood sampling, for the duration of the study. The subject, if old enough (generally 6 years to 16), has signed a Child Assent Form and the subject's parent or legal guardian has signed the Informed Consent Form, both approved by the IEC/IRB. Exclusion Criteria: Has not been treated with IGIV (treatment naive subject) The subject has a history of any severe anaphylactic reaction to blood or any blood-derived product. The subject is known to be intolerant to any component of Gammaplex, such as sorbitol (i.e. intolerance to fructose). The subject has selective IgA deficiency, history of reaction to products containing IgA, or has a history of antibodies to IgA. Subjects who have completed the study and subjects who have withdrawn cannot participate in the study for a second time. The subject is currently receiving, or has received, any investigational agent, other than an immune serum globulin (ISG) preparation that is being evaluated in a Phase III or IIIb study, within the prior 3 months. The subject has been exposed to blood or any blood product or derivative within the last 6 months, other than a commercially available IGIV or other forms of commercially available and licensed ISG. If an unlicensed ISG product that is in Phase III or IIIb has been given, the subject cannot be infused with Gammaplex until 20 days after the last dose was given. The subject is pregnant or is nursing. The subject, at screening, has levels greater than 2.5 times the upper limit of normal as defined at the central laboratory of any of the following: (Alanine transaminase (ALT); Aspartate transaminase (AST) Lactate dehydrogenase (LDH)). The subject has a severe renal impairment (defined as serum creatinine greater than 2 times the upper limit of normal or BUN greater than 2.5 times the upper limit of normal for the range of the laboratory doing the analysis); the subject is on dialysis; the subject has a history of acute renal failure. The subject is known to abuse alcohol, opiates, psychotropic agents, or other chemicals or drugs, or has done so within the past 12 months. The subject has a history of DVT, or thrombotic complications of IGIV therapy. The subject suffers from any acute or chronic medical condition (e.g. renal disease or predisposing conditions for renal disease, or protein losing state) that, in the opinion of the investigator, may interfere with the conduct of the study. The subject has an acquired medical condition, such as, chronic or recurrent neutropenia (ANC < 1000 x 109/L) or AIDS known to cause secondary immune deficiency, or is post or recovering from hematopoietic stem cell transplantation. The subject is receiving the following medication: Systemic long-term corticosteroids (i.e. not intermittent or burst, daily, >1 mg of prednisone equivalent/kg/day). The subject is receiving Immunosuppressive or Immunomodulatory drugs. The subject has non-controlled arterial hypertension. The subject has anemia (hemoglobin <10 g/dL) at screening.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tim J. Aldwinckle, MD
Organizational Affiliation
Medical Director
Official's Role
Study Director
Facility Information:
Facility Name
Department of Medicine, University of California
City
Irvine
State/Province
California
ZIP/Postal Code
92697.
Country
United States
Facility Name
Children's Hospital Los Angeles
City
Los Angeles
State/Province
California
ZIP/Postal Code
90027
Country
United States
Facility Name
IMMUNOe International Reseach Centers
City
Centennial
State/Province
Colorado
ZIP/Postal Code
80112
Country
United States
Facility Name
Family Allergy & Asthma Center, PC
City
Atlanta,
State/Province
Georgia
ZIP/Postal Code
30342
Country
United States
Facility Name
Rush University Medical Center
City
Chicago,
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
Children's Hospital of Pittsburgh of UPMC
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15224
Country
United States
Facility Name
Allergy, Asthma & Immunology Clinic, P.A
City
Irving
State/Province
Texas
ZIP/Postal Code
75063
Country
United States
Facility Name
Children's Hospital of Richmond, VA
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23219
Country
United States
Facility Name
Hospital de Niňos Roberto del Río
City
Santiago
ZIP/Postal Code
8380418
Country
Chile
Facility Name
Safra Children's Hospital, Sheba Medical Center
City
Tel-Hashomer
ZIP/Postal Code
52621
Country
Israel

12. IPD Sharing Statement

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A Study to Find Out How Safe and Effective Gammaplex® is in Young People With Primary Immunodeficiency

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