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Phase 1 Dose Escalation, Single Dose Study to Assess Safety and Pharmacokinetics of BAX930 in Hereditary Thrombotic Thrombocytopenic Purpura (TTP)

Primary Purpose

Hereditary Thrombotic Thrombocytopenic Purpura (TTP)

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Recombinant ADAMTS13
Sponsored by
Baxalta now part of Shire
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hereditary Thrombotic Thrombocytopenic Purpura (TTP)

Eligibility Criteria

12 Years - 65 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Subject is between 12 and 65 years of age, inclusive. (The first 2 subjects in any cohort will be ≥ 18 years of age.)
  • Subject and/or legally authorized representative has provided written informed consent.
  • Subject has a documented diagnosis of severe hereditary ADAMTS13 deficiency, defined as 1) confirmed by genetic testing, documented in patient history or at screening, and 2) ADAMTS13 activity < 6%, documented in patient history or at screening. NOTE: In patients receiving prophylactic therapy with fresh frozen plasma (FFP) or other ADAMTS13 containing products, the levels of plasma ADAMTS13 activity may exceed 6% at screening.
  • Cryoprecipitate, FFP, or other ADAMTS13 containing products interfering with ADAMTS13 PK have to be paused at least 10 days prior to infusion of the investigational product.
  • The subject is not displaying any severe TTP symptoms at screening. Patients presenting with minor, but stable laboratory abnormalities (LDH not higher than 3 times the upper limit of normal; platelet count not lower than 100,000 per μl) at screening may be enrolled.
  • Subjects ≥18 years of age have a Karnofsky score ≥ 60%, and subjects < 18 years of age have a Lansky score ≥ 70%.
  • Subject is hepatitis C virus negative (HCV-) as confirmed by antibody or polymerase chain reaction (PCR) testing; HCV positive (HCV+) subjects are eligible for inclusion if their disease is chronic but stable.
  • If female of childbearing potential, subject presents with a negative serum pregnancy test and agrees to employ adequate birth control measures for the duration of the study.
  • Subject is willing and able to comply with the requirements of the protocol.

Exclusion Criteria:

  • Subject has been diagnosed with any other TTP-like disorder (for example, microangiopathic hemolytic anemia), including acquired TTP.
  • Subject has known hypersensitivity to hamster proteins or other components of the investigational product.
  • Subject has a medical history or presence of a functional neutralizing ADAMTS13 inhibitor at screening.
  • Subject has a medical history of immunological disorders, excluding seasonal allergic rhinitis/conjunctivitis/mild asthma, food allergies or animal allergies.
  • Subject has a medical history of hematological disorders, in particular systemic lupus erythematosus, amyloidosis, antiphospholipid antibody syndrome, vasculitis, other hemolytic anemia, disseminated intravascular coagulation, and systemic scleroderma.
  • Subject has a history of significant neurological events, such as major stroke, indicating that a relapse might have severe consequences, as judged by the investigator.
  • Subject is HIV positive with an absolute CD4 count < 200/mm3.
  • Subject has been diagnosed with a cardiovascular disease [New York Heart Association (NYHA) classes 3-4].
  • Subject is scheduled to undergo elective surgery during study participation.
  • Subject has been diagnosed with severe liver disease, as evidenced by, but not limited to, any of the following: serum ALT 3 times the upper limit of normal, international normalized ratio (INR) > 1.5, hypoalbuminemia, portal vein hypertension (e.g. presence of otherwise unexplained splenomegaly, history of esophageal varices).
  • Subject has been diagnosed with severe glomerular disease, with gross proteinuria and a serum creatinine level ≥ 2.5 mg/dL.
  • Subject has been treated with an immunomodulatory drug, in case of corticoids with an equivalent to hydrocortisone greater than 10 mg /day, excluding topical treatment (e.g. ointments, nasal spray), within 30 days prior to enrollment.
  • Subject has a history of drug and/or alcohol abuse within the last 6 months prior to study enrollment.
  • Subject has a life expectancy of less than 3 months.
  • Subject is identified by the investigator as being unable or unwilling to cooperate with study procedures.
  • Subject is a family member or employee of the investigator.
  • Subject suffers from a mental condition rendering him/her unable to understand the nature, scope and possible consequences of the study and/or evidence of an uncooperative attitude.
  • If female, subject is pregnant or lactating at the time of study enrollment.
  • Subject has participated in another clinical study involving an investigational product or device within 30 days prior to study enrollment.
  • Subject is scheduled to participate in another clinical study involving an investigational product or device during the course of this study.

Sites / Locations

  • Ohio State University Medical Center
  • Oregon Health & Science University
  • The Methodist Hospital Research Institute
  • General Hospital Vienna (Allgemeines Krankenhaus der Stadt Wien)
  • Universitätsklinikum Hamburg-Eppendorf
  • Universitätsklinikum Jena
  • • Tokyo Medical and Dental University Hospital, Faculty of Medicine
  • Hyogo College of Medicine Hospital, Department of Hematology
  • Institute of Hematology and Transfusion Medicine
  • Inselspital - Universitaetsspital Bern
  • University College London Hospital NHS Foundation Trust

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Recombinant ADAMTS13

Arm Description

The study is comprised of 3 dose cohorts and two dose escalation steps [Cohort 1: 3 subjects; Cohort 2: 3 subjects; Cohort 3: 8 subjects]. Subjects will be enrolled and dosed sequentially. Subjects will be recruited to the next dose level only after short-term safety has been demonstrated and reviewed by an independent Data Monitoring Committee (DMC) at the preceding dose level. The first 2 subjects in any cohort will be ≥ 18 years of age. The effects of the investigational product on vital signs, hematology, and clinical chemistry parameters (up to 96 ± 2 hrs blood sampling timepoint) will determine short-term safety. The DMC will recommend whether to proceed with the study or in case of a safety concern recommend remedial actions and/or to discontinue the study. Subject participation will continue until 28 ± 3 days after infusion of the investigational product. Subject participation in one Dose Cohort (1-3) is expected to be approximately 6-8 weeks.

Outcomes

Primary Outcome Measures

Occurrence of adverse events (serious and non-serious), including the incidence of binding and inhibitory antibody formation

Secondary Outcome Measures

Pharmacokinetic [PK] parameter 'incremental recovery [IR]'
Will be evaluated after single infusions of rADAMTS13 in Dose Cohorts 1, 2 and 3
PK parameter 'maximum concentration following infusion [Cmax]'
Will be evaluated after single infusions of rADAMTS13 in Dose Cohorts 1, 2 and 3
PK parameter 'minimum time to reach Cmax [T max]'
Will be evaluated after single infusions of rADAMTS13 in Dose Cohorts 1, 2 and 3
PK parameter 'terminal or disposition half-life [T1/2]'
Will be evaluated after single infusions of rADAMTS13 in Dose Cohorts 1, 2 and 3
PK parameter 'mean residence time [MRT]'
Will be evaluated after single infusions of rADAMTS13 in Dose Cohorts 1, 2 and 3
PK parameter 'systemic clearance [Cl]'
Will be evaluated after single infusions of rADAMTS13 in Dose Cohorts 1, 2 and 3
PK parameter 'area under the plasma/time curve [AUC]'
Will be evaluated after single infusions of rADAMTS13 in Dose Cohorts 1, 2 and 3
PK parameter 'steady state volume of distribution [Vss]'
Will be evaluated after single infusions of rADAMTS13 in Dose Cohorts 1, 2 and 3
Plasma von Willebrand factor: Ristocetin cofactor activity [VWF:RCo], von Willebrand factor antigen [VWF:Ag] and VWF structure analysis
Will be evaluated after single infusions of rADAMTS13 in Dose Cohorts 1, 2 and 3

Full Information

First Posted
August 12, 2014
Last Updated
May 3, 2021
Sponsor
Baxalta now part of Shire
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1. Study Identification

Unique Protocol Identification Number
NCT02216084
Brief Title
Phase 1 Dose Escalation, Single Dose Study to Assess Safety and Pharmacokinetics of BAX930 in Hereditary Thrombotic Thrombocytopenic Purpura (TTP)
Official Title
BAX930 (rADAMTS13): A Phase 1 Prospective, Uncontrolled, Open-Label, Multicenter, Dose-Escalation Study Evaluating the Safety and Pharmacokinetics in Hereditary Thrombotic Thrombocytopenic Purpura (TTP)
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Completed
Study Start Date
September 30, 2014 (Actual)
Primary Completion Date
February 22, 2016 (Actual)
Study Completion Date
February 22, 2016 (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 purpose of this Phase 1, prospective, uncontrolled, open-label, multicenter, dose-escalation study is to evaluate the safety, including immunogenicity, and pharmacokinetics of BAX930 (rADAMTS13) in a total of 14 evaluable subjects diagnosed with severe hereditary thrombotic thrombocytopenic purpura (TTP) (plasma ADAMTS13 activity <6%) who are assigned to one of three dose cohorts.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hereditary Thrombotic Thrombocytopenic Purpura (TTP)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
16 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Recombinant ADAMTS13
Arm Type
Experimental
Arm Description
The study is comprised of 3 dose cohorts and two dose escalation steps [Cohort 1: 3 subjects; Cohort 2: 3 subjects; Cohort 3: 8 subjects]. Subjects will be enrolled and dosed sequentially. Subjects will be recruited to the next dose level only after short-term safety has been demonstrated and reviewed by an independent Data Monitoring Committee (DMC) at the preceding dose level. The first 2 subjects in any cohort will be ≥ 18 years of age. The effects of the investigational product on vital signs, hematology, and clinical chemistry parameters (up to 96 ± 2 hrs blood sampling timepoint) will determine short-term safety. The DMC will recommend whether to proceed with the study or in case of a safety concern recommend remedial actions and/or to discontinue the study. Subject participation will continue until 28 ± 3 days after infusion of the investigational product. Subject participation in one Dose Cohort (1-3) is expected to be approximately 6-8 weeks.
Intervention Type
Drug
Intervention Name(s)
Recombinant ADAMTS13
Intervention Description
rADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) is a lyophilized formulation for intravenous injection. The lyophilized rADAMTS13 is reconstituted with sterile water for injection. Subjects will receive an intravenous injection with rADAMTS13 at a dose of either 5 U/kg bodyweight (Cohort 1), or 20 U/kg bodyweight (Cohort 2), or 40 U/kg bodyweight (Cohort 3).
Primary Outcome Measure Information:
Title
Occurrence of adverse events (serious and non-serious), including the incidence of binding and inhibitory antibody formation
Time Frame
Up to 28 (± 3) days after investigational product infusion
Secondary Outcome Measure Information:
Title
Pharmacokinetic [PK] parameter 'incremental recovery [IR]'
Description
Will be evaluated after single infusions of rADAMTS13 in Dose Cohorts 1, 2 and 3
Time Frame
Within 1 hour pre-infusion and up to 288 (± 4) hours post-infusion
Title
PK parameter 'maximum concentration following infusion [Cmax]'
Description
Will be evaluated after single infusions of rADAMTS13 in Dose Cohorts 1, 2 and 3
Time Frame
Within 1 hour pre-infusion and up to 288 (± 4) hours post-infusion
Title
PK parameter 'minimum time to reach Cmax [T max]'
Description
Will be evaluated after single infusions of rADAMTS13 in Dose Cohorts 1, 2 and 3
Time Frame
Within 1 hour pre-infusion and up to 288 (± 4) hours post-infusion
Title
PK parameter 'terminal or disposition half-life [T1/2]'
Description
Will be evaluated after single infusions of rADAMTS13 in Dose Cohorts 1, 2 and 3
Time Frame
Within 1 hour pre-infusion and up to 288 (± 4) hours post-infusion
Title
PK parameter 'mean residence time [MRT]'
Description
Will be evaluated after single infusions of rADAMTS13 in Dose Cohorts 1, 2 and 3
Time Frame
Within 1 hour pre-infusion and up to 288 (± 4) hours post-infusion
Title
PK parameter 'systemic clearance [Cl]'
Description
Will be evaluated after single infusions of rADAMTS13 in Dose Cohorts 1, 2 and 3
Time Frame
Within 1 hour pre-infusion and up to 288 (± 4) hours post-infusion
Title
PK parameter 'area under the plasma/time curve [AUC]'
Description
Will be evaluated after single infusions of rADAMTS13 in Dose Cohorts 1, 2 and 3
Time Frame
Within 1 hour pre-infusion and up to 288 (± 4) hours post-infusion
Title
PK parameter 'steady state volume of distribution [Vss]'
Description
Will be evaluated after single infusions of rADAMTS13 in Dose Cohorts 1, 2 and 3
Time Frame
Within 1 hour pre-infusion and up to 288 (± 4) hours post-infusion
Title
Plasma von Willebrand factor: Ristocetin cofactor activity [VWF:RCo], von Willebrand factor antigen [VWF:Ag] and VWF structure analysis
Description
Will be evaluated after single infusions of rADAMTS13 in Dose Cohorts 1, 2 and 3
Time Frame
Within 1 hour pre-infusion and up to 288 (± 4) hours post-infusion

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is between 12 and 65 years of age, inclusive. (The first 2 subjects in any cohort will be ≥ 18 years of age.) Subject and/or legally authorized representative has provided written informed consent. Subject has a documented diagnosis of severe hereditary ADAMTS13 deficiency, defined as 1) confirmed by genetic testing, documented in patient history or at screening, and 2) ADAMTS13 activity < 6%, documented in patient history or at screening. NOTE: In patients receiving prophylactic therapy with fresh frozen plasma (FFP) or other ADAMTS13 containing products, the levels of plasma ADAMTS13 activity may exceed 6% at screening. Cryoprecipitate, FFP, or other ADAMTS13 containing products interfering with ADAMTS13 PK have to be paused at least 10 days prior to infusion of the investigational product. The subject is not displaying any severe TTP symptoms at screening. Patients presenting with minor, but stable laboratory abnormalities (LDH not higher than 3 times the upper limit of normal; platelet count not lower than 100,000 per μl) at screening may be enrolled. Subjects ≥18 years of age have a Karnofsky score ≥ 60%, and subjects < 18 years of age have a Lansky score ≥ 70%. Subject is hepatitis C virus negative (HCV-) as confirmed by antibody or polymerase chain reaction (PCR) testing; HCV positive (HCV+) subjects are eligible for inclusion if their disease is chronic but stable. If female of childbearing potential, subject presents with a negative serum pregnancy test and agrees to employ adequate birth control measures for the duration of the study. Subject is willing and able to comply with the requirements of the protocol. Exclusion Criteria: Subject has been diagnosed with any other TTP-like disorder (for example, microangiopathic hemolytic anemia), including acquired TTP. Subject has known hypersensitivity to hamster proteins or other components of the investigational product. Subject has a medical history or presence of a functional neutralizing ADAMTS13 inhibitor at screening. Subject has a medical history of immunological disorders, excluding seasonal allergic rhinitis/conjunctivitis/mild asthma, food allergies or animal allergies. Subject has a medical history of hematological disorders, in particular systemic lupus erythematosus, amyloidosis, antiphospholipid antibody syndrome, vasculitis, other hemolytic anemia, disseminated intravascular coagulation, and systemic scleroderma. Subject has a history of significant neurological events, such as major stroke, indicating that a relapse might have severe consequences, as judged by the investigator. Subject is HIV positive with an absolute CD4 count < 200/mm3. Subject has been diagnosed with a cardiovascular disease [New York Heart Association (NYHA) classes 3-4]. Subject is scheduled to undergo elective surgery during study participation. Subject has been diagnosed with severe liver disease, as evidenced by, but not limited to, any of the following: serum ALT 3 times the upper limit of normal, international normalized ratio (INR) > 1.5, hypoalbuminemia, portal vein hypertension (e.g. presence of otherwise unexplained splenomegaly, history of esophageal varices). Subject has been diagnosed with severe glomerular disease, with gross proteinuria and a serum creatinine level ≥ 2.5 mg/dL. Subject has been treated with an immunomodulatory drug, in case of corticoids with an equivalent to hydrocortisone greater than 10 mg /day, excluding topical treatment (e.g. ointments, nasal spray), within 30 days prior to enrollment. Subject has a history of drug and/or alcohol abuse within the last 6 months prior to study enrollment. Subject has a life expectancy of less than 3 months. Subject is identified by the investigator as being unable or unwilling to cooperate with study procedures. Subject is a family member or employee of the investigator. Subject suffers from a mental condition rendering him/her unable to understand the nature, scope and possible consequences of the study and/or evidence of an uncooperative attitude. If female, subject is pregnant or lactating at the time of study enrollment. Subject has participated in another clinical study involving an investigational product or device within 30 days prior to study enrollment. Subject is scheduled to participate in another clinical study involving an investigational product or device during the course of this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Study Director
Organizational Affiliation
Takeda
Official's Role
Study Director
Facility Information:
Facility Name
Ohio State University Medical Center
City
Dublin
State/Province
Ohio
ZIP/Postal Code
43017
Country
United States
Facility Name
Oregon Health & Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
The Methodist Hospital Research Institute
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
General Hospital Vienna (Allgemeines Krankenhaus der Stadt Wien)
City
Vienna
ZIP/Postal Code
1090
Country
Austria
Facility Name
Universitätsklinikum Hamburg-Eppendorf
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Facility Name
Universitätsklinikum Jena
City
Jena
ZIP/Postal Code
07743
Country
Germany
Facility Name
• Tokyo Medical and Dental University Hospital, Faculty of Medicine
City
Bunkyo-ku, Tokyo
ZIP/Postal Code
113-8519
Country
Japan
Facility Name
Hyogo College of Medicine Hospital, Department of Hematology
City
Nishinomiya-shi
ZIP/Postal Code
663-8501
Country
Japan
Facility Name
Institute of Hematology and Transfusion Medicine
City
Warsaw
ZIP/Postal Code
02776
Country
Poland
Facility Name
Inselspital - Universitaetsspital Bern
City
Bern
ZIP/Postal Code
3010
Country
Switzerland
Facility Name
University College London Hospital NHS Foundation Trust
City
London
ZIP/Postal Code
NW1 2BU
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
28912376
Citation
Scully M, Knobl P, Kentouche K, Rice L, Windyga J, Schneppenheim R, Kremer Hovinga JA, Kajiwara M, Fujimura Y, Maggiore C, Doralt J, Hibbard C, Martell L, Ewenstein B. Recombinant ADAMTS-13: first-in-human pharmacokinetics and safety in congenital thrombotic thrombocytopenic purpura. Blood. 2017 Nov 9;130(19):2055-2063. doi: 10.1182/blood-2017-06-788026. Epub 2017 Sep 14.
Results Reference
derived

Learn more about this trial

Phase 1 Dose Escalation, Single Dose Study to Assess Safety and Pharmacokinetics of BAX930 in Hereditary Thrombotic Thrombocytopenic Purpura (TTP)

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