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Octaplas Pediatric Plasma Replacement Trial

Primary Purpose

Liver Surgery, Liver Dysfunction, Coagulopathy

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
octaplas
Sponsored by
Octapharma
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Liver Surgery focused on measuring Pediatric, patients, replacement, coagulation factors, plasma, s/d plasma, Octaplas, plasma replacement

Eligibility Criteria

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

Inclusion Criteria:

  1. Patient requiring liver or cardiac surgery and/or patient with liver dysfunction associated with coagulopathy in whom replacement of multiple coagulation factors is required.
  2. Voluntarily given, written and signed informed consent by the patient's legal representative(s) or guardian(s). Children deemed old enough by the Investigator/institution to understand the risks and benefits of the study should also be made aware of the risks/benefits of the study and provide written assent.
  3. Male or female patient ≤ 16 years of age.

Exclusion Criteria:

  1. Patient with known homozygous congenital deficiency of protein S.
  2. Patient has a history of hypersensitivity reaction to blood or plasma-derived products or to any excipient of the investigational product.
  3. Patient has an already known IgA (Immunoglobulin A) deficiency with documented antibodies against IgA.
  4. Patient has a congenital factor deficiency or platelet disorder requiring plasma treatment.
  5. Patient is currently participating in another study investigating a new drug product or another interventional clinical study that may impact coagulation factors or has participated during the last three (3) months.
  6. Patient received FFP (Fresh Frozen Plasma), FP24 (Plasma frozen within 24 hours of collection) or any other plasma product other than Octaplas within the last 72 hours (cryoprecipitate and albumin are not exclusionary) prior to first Octaplas infusion.
  7. Patient is on ECMO (Extracorporeal Membrane Oxygenation) when plasma is ordered by the treating physician for the first infusion episode.
  8. Patient is pregnant.
  9. Patient is predicted to require massive blood transfusion defined as more than 40 mL per kilogram of all blood products in a 24-hour period
  10. Patient is receiving plasma exchange, therapeutic plasma exchange (TPE) or plasmapheresis.
  11. Patient is a premature neonate defined as less than 37 weeks gestation.
  12. Cardiac surgery patients who develop the need for plasma replacement greater than 72 hours after the end of the associated cardiac surgery and do not have coagulopathy due to hepatic dysfunction.

Sites / Locations

  • Octapharma Research Site
  • Octapharma Research Site
  • Octapharma Research Site
  • Octapharma Research Site

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Octaplas

Arm Description

Qualified patients will receive Octaplas as per protocol.

Outcomes

Primary Outcome Measures

Number of Participants With Adverse Drug Reactions (e.g., Allergic Reactions, TEs, TEEs (Thromboembolic Events) and Hyperfibrinolytic Events)
Monitoring of Clinically Significant Changes in White Blood Cells
Assesses Pre- and Post-infusion for Infusion Episode 1
Monitoring of Clinically Significant Changes in Red Blood Cells
Assesses Pre- and Post-infusion for Infusion Episode 1
Monitoring of Clinically Significant Changes in Hemoglobin
Assesses Pre- and Post-infusion for Infusion Episode 1
Monitoring of Clinically Significant Changes in Hematocrit
Assesses Pre- and Post-infusion for Infusion Episode 1
Monitoring of Clinically Significant Changes in Mean Corpuscular Volume (MCV)
Assesses Pre- and Post-infusion for Infusion Episode 1
Monitoring of Clinically Significant Changes in Mean Corpuscular Hemoglobin (MCH)
Assesses Pre- and Post-infusion for Infusion Episode 1
Monitoring of Clinically Significant Changes in Mean Corpuscular Hemoglobin Concentration (MCHC)
Assesses Pre- and Post-infusion for Infusion Episode 1
Monitoring of Clinically Significant Changes in Red Cell Distribution Width (RDW)
Assesses Pre- and Post-infusion for Infusion Episode 1
Monitoring of Clinically Significant Changes in Platelets
Assesses Pre- and Post-infusion for Infusion Episode 1

Secondary Outcome Measures

Number of Participants With Clinically Significant Changes in Hemostatic Parameters as Measured by the Following: International Normalized Ratio (INR)
This hemostatic parameter is figured out in the lab and helps to diagnose a bleeding disorder or excessive clotting disorder. The change of INR before and after 1st Octaplas infusion was scrutinized by analyzing the shifts between the classifications given below.
Number of Participants With Clinically Significant Changes in Hemostatic Parameters as Measured by the Following: Prothrombin Time (PT)
This hemostatic parameter is figured out in the lab and measures the time it takes for your blood to clot (the higher the PT the longer it takes your blood to clot). The change of PT before and after 1st Octaplas infusion was scrutinized by analyzing the shifts between the classifications given below.
Number of Participants With Clinically Significant Changes in Hemostatic Parameters as Measured by the Following: Thromboelastography (TEG) or Thromboelastometry (ROTEM).
TEG and ROTEM are methods of testing the efficiency of blood coagulation. The results were compared by looking at potential trends from TEG and ROTEM between pre-infusion vs post-infusion time points.
Number of Participants With Clinically Significant Changes in Hemostatic Parameters as Measured by the Following: Activated Partial Thromboplastin Time (aPTT)
aPTT measures the length of time (in seconds) that it takes for clotting to occur in a test cube. The higher the number of seconds the longer it takes the blood to clot. The changes between pre - and post infusion were analyzed
Volume (Dose in mL/kg) of Octaplas Used Per Infusion Episode for Each Patient.
Normal infusion: Replacement of multiple clotting factors Bypass priming: Limit hemodilution and reduce transfusion requirements Bypass warming up: Rewarm patients suffering from hypothermia during the surgery process
Medically Significant Changes in Blood Pressure
Medically Significant Changes in Heart Rate
Medically Significant Changes in Respiratory Rate
Medically Significant Changes in Oxygen Saturation
Medically Significant Changes in Body Temperature
Count of Investigator's Assessment of Overall Safety Observed for Patients by Category (Assessed to Have Overall Safety of 'Excellent', Assessed to Have Overall Safety of 'Moderate', Assessed to Have Overall Safety of 'Poor')

Full Information

First Posted
January 21, 2014
Last Updated
June 9, 2020
Sponsor
Octapharma
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1. Study Identification

Unique Protocol Identification Number
NCT02050841
Brief Title
Octaplas Pediatric Plasma Replacement Trial
Official Title
An Open-label, Multicenter, Post-Marketing Requirement (PMR) Study to Investigate the Safety, Tolerability and Efficacy of Octaplas in the Management of Pediatric Patients Who Require Replacement of Multiple Coagulation Factors.
Study Type
Interventional

2. Study Status

Record Verification Date
June 2020
Overall Recruitment Status
Completed
Study Start Date
December 2014 (undefined)
Primary Completion Date
December 4, 2017 (Actual)
Study Completion Date
December 4, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Octapharma

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to investigate the safety, tolerability and efficacy of octaplas in pediatric patients who require replacement of multiple coagulation factors. Replacement of multiple coagulation factors in pediatric patients with acquired deficiencies due to liver disease and/or in pediatric patients requiring cardiac surgery or liver surgery.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Liver Surgery, Liver Dysfunction, Coagulopathy, Cardiac Surgery
Keywords
Pediatric, patients, replacement, coagulation factors, plasma, s/d plasma, Octaplas, plasma replacement

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Octaplas
Arm Type
Experimental
Arm Description
Qualified patients will receive Octaplas as per protocol.
Intervention Type
Biological
Intervention Name(s)
octaplas
Intervention Description
Octaplas S/D Plasma
Primary Outcome Measure Information:
Title
Number of Participants With Adverse Drug Reactions (e.g., Allergic Reactions, TEs, TEEs (Thromboembolic Events) and Hyperfibrinolytic Events)
Time Frame
up to 6 days
Title
Monitoring of Clinically Significant Changes in White Blood Cells
Description
Assesses Pre- and Post-infusion for Infusion Episode 1
Time Frame
up to 6 days
Title
Monitoring of Clinically Significant Changes in Red Blood Cells
Description
Assesses Pre- and Post-infusion for Infusion Episode 1
Time Frame
up to 6 days
Title
Monitoring of Clinically Significant Changes in Hemoglobin
Description
Assesses Pre- and Post-infusion for Infusion Episode 1
Time Frame
up to 6 days
Title
Monitoring of Clinically Significant Changes in Hematocrit
Description
Assesses Pre- and Post-infusion for Infusion Episode 1
Time Frame
up to 6 days
Title
Monitoring of Clinically Significant Changes in Mean Corpuscular Volume (MCV)
Description
Assesses Pre- and Post-infusion for Infusion Episode 1
Time Frame
up to 6 days
Title
Monitoring of Clinically Significant Changes in Mean Corpuscular Hemoglobin (MCH)
Description
Assesses Pre- and Post-infusion for Infusion Episode 1
Time Frame
up to 6 days
Title
Monitoring of Clinically Significant Changes in Mean Corpuscular Hemoglobin Concentration (MCHC)
Description
Assesses Pre- and Post-infusion for Infusion Episode 1
Time Frame
up to 6 days
Title
Monitoring of Clinically Significant Changes in Red Cell Distribution Width (RDW)
Description
Assesses Pre- and Post-infusion for Infusion Episode 1
Time Frame
up to 6 days
Title
Monitoring of Clinically Significant Changes in Platelets
Description
Assesses Pre- and Post-infusion for Infusion Episode 1
Time Frame
up to 6 days
Secondary Outcome Measure Information:
Title
Number of Participants With Clinically Significant Changes in Hemostatic Parameters as Measured by the Following: International Normalized Ratio (INR)
Description
This hemostatic parameter is figured out in the lab and helps to diagnose a bleeding disorder or excessive clotting disorder. The change of INR before and after 1st Octaplas infusion was scrutinized by analyzing the shifts between the classifications given below.
Time Frame
up to 6 days
Title
Number of Participants With Clinically Significant Changes in Hemostatic Parameters as Measured by the Following: Prothrombin Time (PT)
Description
This hemostatic parameter is figured out in the lab and measures the time it takes for your blood to clot (the higher the PT the longer it takes your blood to clot). The change of PT before and after 1st Octaplas infusion was scrutinized by analyzing the shifts between the classifications given below.
Time Frame
up to 6 days
Title
Number of Participants With Clinically Significant Changes in Hemostatic Parameters as Measured by the Following: Thromboelastography (TEG) or Thromboelastometry (ROTEM).
Description
TEG and ROTEM are methods of testing the efficiency of blood coagulation. The results were compared by looking at potential trends from TEG and ROTEM between pre-infusion vs post-infusion time points.
Time Frame
up to 6 days
Title
Number of Participants With Clinically Significant Changes in Hemostatic Parameters as Measured by the Following: Activated Partial Thromboplastin Time (aPTT)
Description
aPTT measures the length of time (in seconds) that it takes for clotting to occur in a test cube. The higher the number of seconds the longer it takes the blood to clot. The changes between pre - and post infusion were analyzed
Time Frame
up to 6 days
Title
Volume (Dose in mL/kg) of Octaplas Used Per Infusion Episode for Each Patient.
Description
Normal infusion: Replacement of multiple clotting factors Bypass priming: Limit hemodilution and reduce transfusion requirements Bypass warming up: Rewarm patients suffering from hypothermia during the surgery process
Time Frame
up to 6 days
Title
Medically Significant Changes in Blood Pressure
Time Frame
up to 6 days
Title
Medically Significant Changes in Heart Rate
Time Frame
up to 6 days
Title
Medically Significant Changes in Respiratory Rate
Time Frame
up to 6 days
Title
Medically Significant Changes in Oxygen Saturation
Time Frame
up to 6 days
Title
Medically Significant Changes in Body Temperature
Time Frame
up to 6 days
Title
Count of Investigator's Assessment of Overall Safety Observed for Patients by Category (Assessed to Have Overall Safety of 'Excellent', Assessed to Have Overall Safety of 'Moderate', Assessed to Have Overall Safety of 'Poor')
Time Frame
up to 6 days

10. Eligibility

Sex
All
Maximum Age & Unit of Time
16 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient requiring liver or cardiac surgery and/or patient with liver dysfunction associated with coagulopathy in whom replacement of multiple coagulation factors is required. Voluntarily given, written and signed informed consent by the patient's legal representative(s) or guardian(s). Children deemed old enough by the Investigator/institution to understand the risks and benefits of the study should also be made aware of the risks/benefits of the study and provide written assent. Male or female patient ≤ 16 years of age. Exclusion Criteria: Patient with known homozygous congenital deficiency of protein S. Patient has a history of hypersensitivity reaction to blood or plasma-derived products or to any excipient of the investigational product. Patient has an already known IgA (Immunoglobulin A) deficiency with documented antibodies against IgA. Patient has a congenital factor deficiency or platelet disorder requiring plasma treatment. Patient is currently participating in another study investigating a new drug product or another interventional clinical study that may impact coagulation factors or has participated during the last three (3) months. Patient received FFP (Fresh Frozen Plasma), FP24 (Plasma frozen within 24 hours of collection) or any other plasma product other than Octaplas within the last 72 hours (cryoprecipitate and albumin are not exclusionary) prior to first Octaplas infusion. Patient is on ECMO (Extracorporeal Membrane Oxygenation) when plasma is ordered by the treating physician for the first infusion episode. Patient is pregnant. Patient is predicted to require massive blood transfusion defined as more than 40 mL per kilogram of all blood products in a 24-hour period Patient is receiving plasma exchange, therapeutic plasma exchange (TPE) or plasmapheresis. Patient is a premature neonate defined as less than 37 weeks gestation. Cardiac surgery patients who develop the need for plasma replacement greater than 72 hours after the end of the associated cardiac surgery and do not have coagulopathy due to hepatic dysfunction.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Wolfgang Frenzel
Organizational Affiliation
International Medical Director
Official's Role
Study Director
Facility Information:
Facility Name
Octapharma Research Site
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35233
Country
United States
Facility Name
Octapharma Research Site
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Octapharma Research Site
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States
Facility Name
Octapharma Research Site
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
33042916
Citation
Spinella PC, Borasino S, Alten J. Solvent/Detergent-Treated Plasma in the Management of Pediatric Patients Who Require Replacement of Multiple Coagulation Factors: An Open-Label, Multicenter, Post-marketing Study. Front Pediatr. 2020 Sep 17;8:572. doi: 10.3389/fped.2020.00572. eCollection 2020.
Results Reference
derived

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Octaplas Pediatric Plasma Replacement Trial

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