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Pharmacokinetics, Efficacy, and Safety Study of RI-002 (IGIV) in Subjects With Primary Immunodeficiency Diseases (PIDD)

Primary Purpose

Primary Immune Deficiency Disorder

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
RI-002
Sponsored by
ADMA Biologics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Primary Immune Deficiency Disorder focused on measuring PIDD, PID, humoral immunity, antibody deficiency

Eligibility Criteria

2 Years - 75 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

To be eligible to participate in this study, the subjects must meet the following criteria:

  1. Signed a written informed consent or a specific assent form for minors.
  2. Have a diagnosis of primary immunodeficiency disease.
  3. Be ≥ 2 years and ≤ 75 years.
  4. Have body weight ≥ 12 kg at screening.
  5. Have been receiving IGIV at a dose that has not been changed by >50% of the mean dose on a mg/kg basis for at least 3 months prior to study entry and have maintained a trough serum Immunoglobulin G (IgG) level ≥ 500 mg/dL on the previous 2 assessments prior to receiving RI 002. The trough level must be at least 300 mg/dL above the pre-treatment serum IgG level.
  6. For female subjects, be of non-childbearing potential or have a negative pregnancy test prior to study start and be deemed not at risk of becoming pregnant by adherence to a reliable contraceptive method for the duration of the study.

Exclusion Criteria:

Subjects must be excluded if they meet any of the following criteria:

  1. Have a known hypersensitivity to immunoglobulin or any excipient in RI-002.
  2. Have a history of a severe anaphylactic or anaphylactoid reaction to blood or any blood-derived product.
  3. Have a specific Immunoglobulin A (IgA) deficiency, history of allergic reaction to products containing IgA or has demonstrable antibodies to IgA.
  4. Have uncompensated hemodynamically significant congenital or other heart disease.
  5. Have a medical condition that is known to cause secondary immune deficiency.
  6. Have a significant T-cell deficiency or deficiency of granulocyte number or function.
  7. Have significant renal impairment or have a history of acute renal failure.
  8. Have abnormal liver function.
  9. Be receiving chronic anti-coagulation therapy.
  10. Have a history of deep vein thrombosis (DVT), thrombotic or thrombo-embolic event, or are at increased risk for thrombotic events.
  11. Current daily use of the following medications:

    • corticosteroids (> 7.5 mg (or equivalent dose on a mg/kg basis) of prednisone equivalent per day for > 30 days)
    • immunomodulatory drugs
    • immunosuppressive drugs (excluding topical pimecrolimus (Elidel) and tacrolimus (Protopic))
  12. Administration of a hyperimmune or specialty high titer immunoglobulin product.
  13. Have uncontrollable arterial hypertension.
  14. Have a history of hemolysis or positive Coombs test while undergoing treatment with IGIV therapy.
  15. Be morbidly obese as indicated by a Body Mass Index (BMI) ≥ 40
  16. Have received any blood product (other than Immunoglobulin G) within 3 months prior to screening.
  17. Have received any Respiratory Syncytial Virus (RSV) specific products, including palivizumab (Synagis®) within 3 months prior to screening.
  18. Have abused alcohol, opiates, psychotropic agents, or other chemicals or drugs within the past 12 months.
  19. Have any condition or abnormal laboratory assessment judged by the investigator to preclude participation in the study.
  20. Are currently pregnant or nursing.
  21. Have hepatitis A, B, or C.

Sites / Locations

  • IMMUNOe Health Centers
  • Allergy Associates of the Palm Beaches, P.A.
  • Family Allergy Center, PC
  • The South Bend Clinic, LLP
  • Asthma & Immunology Associates
  • Mount Sinai School of Medicine
  • Dallas Immunology Research
  • AARA Research Center
  • Baylor Texas Children's Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

RI-002 Treatment

Arm Description

Drug: RI-002 Dose: 300-800 mg/kg infusion Frequency: Once every 3 to 4 Weeks

Outcomes

Primary Outcome Measures

Number of Serious Bacterial Infections (SBIs) Per Subject Per Year (FDA Guidance for Industry (2008))
The primary objective of this study was to demonstrate that RI-002 (IGIV) reduces the frequency of serious bacterial infections (SBIs), as defined by the Diagnostic Criteria for Serious Infection Types guideline, in subjects with primary humoral immunodeficiency.

Secondary Outcome Measures

Incidence of All Infections (Serious and Non-serious)
Number of Days Lost From Work/School/Daycare and Usual Activities Due to Infections and Their Treatment - Combined Days Lost
Number of Days Lost From Work/School/Daycare and Usual Activities Due to Infections and Their Treatment - Per Subject-Year
Number of Unscheduled Visits to Physician/ER Due to Infections - Total Number of Visits
Number of Unscheduled Visits to Physician/ER Due to Infections - Per Subject-Year
Time to Resolution of Infections - Duration Per Infection
Time to Resolution of Infections - Infection Days Per Subject
Number of Hospitalizations Due to Infections
Number of Hospitalizations Due to Infections - Per Subject-Year
Days of Hospitalization Due to Infections
Days of Hospitalization Due to Infections - Per Subject-Year
Number of Days of Antibiotic Therapy (Prophylaxis and Treatment of Infection)
Summary of the days of antibiotic therapy in the study for prophylaxis, as treatment for infections, and combined
Number of Days of Antibiotic Therapy (Prophylaxis and Treatment of Infection) - Per Subject-Year
Summary of the days of antibiotic therapy in the study for prophylaxis, as treatment for infections, and combined, per subject-year of treatment with RI-002
Correlation Between Trough Level of RI-002 and Serious and Non-serious Infections
The relationship between trough IgG concentrations and the number of infections of any kind/seriousness was evaluated using Pearson linear correlation coefficients using forward analysis (outcomes after infusion) and backward analysis (outcomes prior to infusion; outcomes post last infusion were excluded)
Trough Total IgG and Specific Antibody Levels - IgG
Summary of trough total IgG concentration prior to specified infusion
Trough Total IgG and Specific Antibody Levels - Haemophilus Influenzae Type B
Summary of trough antibody concentrations prior to specified infusion for Haemophilus influenzae type B
Trough Total IgG and Specific Antibody Levels - Respiratory Syncytial Virus (RSV)
Summary of trough antibody concentrations prior to specified infusion for Respiratory Syncytial Virus (RSV)
Trough Total IgG and Specific Antibody Levels - Tetanus
Summary of trough antibody concentrations prior to specified infusion for Tetanus
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 1
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 1
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 3
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 3
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 4
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 4
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 5
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 5
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 6B
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 6B
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 7F
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 7F
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 9V
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 9V
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 14
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 14
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 18C
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 18C
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 19A
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 19A
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 19F
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 19F
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 23F
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 23F

Full Information

First Posted
March 6, 2013
Last Updated
August 10, 2016
Sponsor
ADMA Biologics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01814800
Brief Title
Pharmacokinetics, Efficacy, and Safety Study of RI-002 (IGIV) in Subjects With Primary Immunodeficiency Diseases (PIDD)
Official Title
An Open Label, Multicenter, Study to Evaluate the Pharmacokinetics, Efficacy and Safety of RI-002 (IGIV) in Subjects With Primary Immunodeficiency Diseases (PIDD)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2016
Overall Recruitment Status
Completed
Study Start Date
February 2014 (undefined)
Primary Completion Date
December 2014 (Actual)
Study Completion Date
January 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
ADMA Biologics, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a Phase III, multicenter, open-label study of RI-002 administered as an intravenous infusion of RI-002 (IGIV) every 21 or 28 days in approximately 60 subjects with Primary Immunodeficiency Diseases (PIDD).
Detailed Description
Primary immunodeficiency diseases (PIDDs) are genetically determined disorders of the immune system resulting in greatly enhanced susceptibility to infectious disease, autoimmunity and malignancy. As most subjects with PIDDs present with infections, the differential diagnosis and initial investigations for an underlying immune defect are typically guided by the clinical presentation. In subjects with PIDDs, individual infections are not necessarily more severe than those that occur in a normal host. Rather, the clinical features suggestive of an immune defect may be the recurring and/or chronic nature of infections with common pathogens that may result in end organ damage, such as bronchiectasis. Several immune globulin products have already been approved by the FDA.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Primary Immune Deficiency Disorder
Keywords
PIDD, PID, humoral immunity, antibody deficiency

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
RI-002 Treatment
Arm Type
Experimental
Arm Description
Drug: RI-002 Dose: 300-800 mg/kg infusion Frequency: Once every 3 to 4 Weeks
Intervention Type
Biological
Intervention Name(s)
RI-002
Other Intervention Name(s)
Immune Globulin (Human)
Intervention Description
Immune Globulin Intravenous (IGIV)
Primary Outcome Measure Information:
Title
Number of Serious Bacterial Infections (SBIs) Per Subject Per Year (FDA Guidance for Industry (2008))
Description
The primary objective of this study was to demonstrate that RI-002 (IGIV) reduces the frequency of serious bacterial infections (SBIs), as defined by the Diagnostic Criteria for Serious Infection Types guideline, in subjects with primary humoral immunodeficiency.
Time Frame
One year
Secondary Outcome Measure Information:
Title
Incidence of All Infections (Serious and Non-serious)
Time Frame
Up to 1 Year
Title
Number of Days Lost From Work/School/Daycare and Usual Activities Due to Infections and Their Treatment - Combined Days Lost
Time Frame
Up to 1 year
Title
Number of Days Lost From Work/School/Daycare and Usual Activities Due to Infections and Their Treatment - Per Subject-Year
Time Frame
Up to 1 year
Title
Number of Unscheduled Visits to Physician/ER Due to Infections - Total Number of Visits
Time Frame
Up to 1 year
Title
Number of Unscheduled Visits to Physician/ER Due to Infections - Per Subject-Year
Time Frame
Up to 1 year
Title
Time to Resolution of Infections - Duration Per Infection
Time Frame
Up to 1 year
Title
Time to Resolution of Infections - Infection Days Per Subject
Time Frame
Up to 1 year
Title
Number of Hospitalizations Due to Infections
Time Frame
Up to 1 year
Title
Number of Hospitalizations Due to Infections - Per Subject-Year
Time Frame
Up to 1 year
Title
Days of Hospitalization Due to Infections
Time Frame
Up to 1 year
Title
Days of Hospitalization Due to Infections - Per Subject-Year
Time Frame
Up to 1 year
Title
Number of Days of Antibiotic Therapy (Prophylaxis and Treatment of Infection)
Description
Summary of the days of antibiotic therapy in the study for prophylaxis, as treatment for infections, and combined
Time Frame
Up to 1 year
Title
Number of Days of Antibiotic Therapy (Prophylaxis and Treatment of Infection) - Per Subject-Year
Description
Summary of the days of antibiotic therapy in the study for prophylaxis, as treatment for infections, and combined, per subject-year of treatment with RI-002
Time Frame
Up to 1 year
Title
Correlation Between Trough Level of RI-002 and Serious and Non-serious Infections
Description
The relationship between trough IgG concentrations and the number of infections of any kind/seriousness was evaluated using Pearson linear correlation coefficients using forward analysis (outcomes after infusion) and backward analysis (outcomes prior to infusion; outcomes post last infusion were excluded)
Time Frame
Up to 1 year
Title
Trough Total IgG and Specific Antibody Levels - IgG
Description
Summary of trough total IgG concentration prior to specified infusion
Time Frame
Up to 1 year
Title
Trough Total IgG and Specific Antibody Levels - Haemophilus Influenzae Type B
Description
Summary of trough antibody concentrations prior to specified infusion for Haemophilus influenzae type B
Time Frame
Up to 1 year
Title
Trough Total IgG and Specific Antibody Levels - Respiratory Syncytial Virus (RSV)
Description
Summary of trough antibody concentrations prior to specified infusion for Respiratory Syncytial Virus (RSV)
Time Frame
Up to 1 year
Title
Trough Total IgG and Specific Antibody Levels - Tetanus
Description
Summary of trough antibody concentrations prior to specified infusion for Tetanus
Time Frame
Up to 1 year
Title
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 1
Description
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 1
Time Frame
Up to 1 year
Title
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 3
Description
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 3
Time Frame
Up to 1 year
Title
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 4
Description
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 4
Time Frame
Up to 1 year
Title
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 5
Description
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 5
Time Frame
Up to 1 year
Title
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 6B
Description
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 6B
Time Frame
Up to 1 year
Title
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 7F
Description
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 7F
Time Frame
Up to 1 year
Title
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 9V
Description
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 9V
Time Frame
Up to 1 year
Title
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 14
Description
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 14
Time Frame
Up to 1 year
Title
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 18C
Description
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 18C
Time Frame
Up to 1 year
Title
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 19A
Description
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 19A
Time Frame
Up to 1 year
Title
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 19F
Description
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 19F
Time Frame
Up to 1 year
Title
Trough Total IgG and Specific Antibody Levels - Streptococcus Pneumoniae, Serotype 23F
Description
Summary of trough antibody concentrations prior to specified infusion for Streptococcus Pneumoniae, Serotype 23F
Time Frame
Up to 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: To be eligible to participate in this study, the subjects must meet the following criteria: Signed a written informed consent or a specific assent form for minors. Have a diagnosis of primary immunodeficiency disease. Be ≥ 2 years and ≤ 75 years. Have body weight ≥ 12 kg at screening. Have been receiving IGIV at a dose that has not been changed by >50% of the mean dose on a mg/kg basis for at least 3 months prior to study entry and have maintained a trough serum Immunoglobulin G (IgG) level ≥ 500 mg/dL on the previous 2 assessments prior to receiving RI 002. The trough level must be at least 300 mg/dL above the pre-treatment serum IgG level. For female subjects, be of non-childbearing potential or have a negative pregnancy test prior to study start and be deemed not at risk of becoming pregnant by adherence to a reliable contraceptive method for the duration of the study. Exclusion Criteria: Subjects must be excluded if they meet any of the following criteria: Have a known hypersensitivity to immunoglobulin or any excipient in RI-002. Have a history of a severe anaphylactic or anaphylactoid reaction to blood or any blood-derived product. Have a specific Immunoglobulin A (IgA) deficiency, history of allergic reaction to products containing IgA or has demonstrable antibodies to IgA. Have uncompensated hemodynamically significant congenital or other heart disease. Have a medical condition that is known to cause secondary immune deficiency. Have a significant T-cell deficiency or deficiency of granulocyte number or function. Have significant renal impairment or have a history of acute renal failure. Have abnormal liver function. Be receiving chronic anti-coagulation therapy. Have a history of deep vein thrombosis (DVT), thrombotic or thrombo-embolic event, or are at increased risk for thrombotic events. Current daily use of the following medications: corticosteroids (> 7.5 mg (or equivalent dose on a mg/kg basis) of prednisone equivalent per day for > 30 days) immunomodulatory drugs immunosuppressive drugs (excluding topical pimecrolimus (Elidel) and tacrolimus (Protopic)) Administration of a hyperimmune or specialty high titer immunoglobulin product. Have uncontrollable arterial hypertension. Have a history of hemolysis or positive Coombs test while undergoing treatment with IGIV therapy. Be morbidly obese as indicated by a Body Mass Index (BMI) ≥ 40 Have received any blood product (other than Immunoglobulin G) within 3 months prior to screening. Have received any Respiratory Syncytial Virus (RSV) specific products, including palivizumab (Synagis®) within 3 months prior to screening. Have abused alcohol, opiates, psychotropic agents, or other chemicals or drugs within the past 12 months. Have any condition or abnormal laboratory assessment judged by the investigator to preclude participation in the study. Are currently pregnant or nursing. Have hepatitis A, B, or C.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James Mond, M.D., Ph.D.
Organizational Affiliation
ADMA Biologics, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
IMMUNOe Health Centers
City
Cenntennial
State/Province
Colorado
ZIP/Postal Code
80112
Country
United States
Facility Name
Allergy Associates of the Palm Beaches, P.A.
City
North Palm Beach
State/Province
Florida
ZIP/Postal Code
33408
Country
United States
Facility Name
Family Allergy Center, PC
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30342
Country
United States
Facility Name
The South Bend Clinic, LLP
City
South Bend
State/Province
Indiana
ZIP/Postal Code
46617
Country
United States
Facility Name
Asthma & Immunology Associates
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68124
Country
United States
Facility Name
Mount Sinai School of Medicine
City
NY
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
Dallas Immunology Research
City
Dallas
State/Province
Texas
ZIP/Postal Code
75230
Country
United States
Facility Name
AARA Research Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75231
Country
United States
Facility Name
Baylor Texas Children's Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Pharmacokinetics, Efficacy, and Safety Study of RI-002 (IGIV) in Subjects With Primary Immunodeficiency Diseases (PIDD)

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