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A Study of Fitusiran (ALN-AT3SC) in Severe Hemophilia A and B Patients With Inhibitors (ATLAS-INH)

Primary Purpose

Hemophilia A, Hemophilia B

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
fitusiran
Bypassing agents
Sponsored by
Genzyme, a Sanofi Company
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hemophilia A focused on measuring RNAi therapeutic, Hemophilia A, Hemophilia B, Hemophilia A, Severe, Hemophilia B, Severe, Blood Coagulation Disorders, Inherited, Blood Coagulation Disorders, Hematologic Diseases, Coagulation Protein Disorders, Hemorrhagic Disorders, Genetic Diseases, Inborn, Genetic Diseases, X-Linked, Factor VIII, Factor IX, Inhibitor, Bypassing agents, Coagulants, Fitusiran

Eligibility Criteria

12 Years - undefined (Child, Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Males, greater than or equal to (>=) 12 years of age.
  • Severe hemophilia A or B with inhibitors.

    • (Severity confirmed by a central laboratory where coagulation factor VIII (FVIII) level was less than (<)1% or factor IX (FIX) level was less than or equal to [<=]2% at Screening; Inhibitors defined as inhibitor titer of >=0.6 Bethesda units per milliliter [BU/mL] or as evidenced by medical records).
  • A minimum of 6 bleeding episodes requiring BPA treatment within the last 6 months prior to screening.
  • Willing and able to comply with the study requirements and to provide written informed consent and assent.

Exclusion Criteria:

  • Known co-existing bleeding disorders other than hemophilia A or B.
  • Antithrombin (AT) activity <60% at Screening.
  • Co-existing thrombophilic disorder.
  • Clinically significant liver disease.
  • Active hepatitis C virus infection.
  • HIV positive with a cluster of differentiation-4 count of <200 cells/microliter.
  • History of arterial or venous thromboembolism.
  • Inadequate renal function.
  • History of multiple drug allergies or history of allergic reaction to an oligonucleotide or N-Acetylgalactosamine.
  • History of intolerance to SC injection(s).
  • Any other conditions or comorbidities that would make the participant unsuitable for enrollment or could interfere with participation in or completion of the study, per Investigator judgement.

Sites / Locations

  • Investigational Site Number 0117
  • Investigational Site Number 0139
  • Investigational Site Number 0135
  • Investigational Site Number 0137
  • Investigational Site Number 0128
  • Investigational Site Number 0115
  • Investigational Site Number 0105
  • Investigational Site Number 0103
  • Investigational Site Number 0119
  • Investigational Site Number 0136
  • Investigational Site Number 0111
  • Investigational Site Number 0104
  • Investigational Site Number 6101
  • Investigational Site Number 6104
  • Investigational Site Number 1102
  • Investigational Site Number 8604
  • Investigational Site Number 8602
  • Investigational Site Number 8605
  • Investigational Site Number 8603
  • Investigational Site Number 8601
  • Investigational Site Number 3303
  • Investigational Site Number 3301
  • Investigational Site Number 4905
  • Investigational Site Number 4906
  • Investigational Site Number 9102
  • Investigational Site Number 9108
  • Investigational Site Number 9104
  • Investigational Site Number 9106
  • Investigational Site Number 9103
  • Investigational Site Number 9111
  • Investigational Site Number 9105
  • Investigational Site Number 3901
  • Investigational Site Number 3904
  • Investigational Site Number 8110
  • Investigational Site Number 8103
  • Investigational Site Number 8202
  • Investigational Site Number 8203
  • Investigational Site Number 8204
  • Investigational Site Number 6003
  • Investigational Site Number 6004
  • Investigational Site Number 2701
  • Investigational Site Number 2703
  • Investigational Site Number 2702
  • Investigational Site Number 3402
  • Investigational Site Number 8803
  • Investigational Site Number 8801
  • Investigational Site Number 8804
  • Investigational Site Number 8805
  • Investigational Site Number 9002
  • Investigational Site Number 9004
  • Investigational Site Number 9001
  • Investigational Site Number 9005
  • Investigational Site Number 9003
  • Investigational Site Number 9006
  • Investigational Site Number 8003
  • Investigational Site Number 8001
  • Investigational Site Number 8002
  • Investigational Site Number 4407

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Bypassing Agents (BPA) On-demand

Fitusiran 80 mg Prophylaxis

Arm Description

Participants received On-demand BPAs (use of these agents, as needed, for episodic bleeding episodes, and not on a regular regimen intended to prevent spontaneous bleeding) per Investigator discretion from Day 1 for treatment of breakthrough bleeding episodes, up to a total of 9 months.

Participants received Fitusiran 80 mg subcutaneously (SC) as prophylaxis once monthly from Day 1, along with the on-demand BPAs (per investigator's discretion and within bleeding dosing guidelines) for treatment of breakthrough bleeding episodes, up to a total of 9 months.

Outcomes

Primary Outcome Measures

Estimated Annualized Bleeding Rate (ABR) for Treated Bleeds During the Efficacy Period
ABR for a participant during efficacy period (EP) was defined as annualized number of bleeding episodes during EP annualized to a 1-year interval of time. Treated Bleeding episode: any occurrence of hemorrhage that required administration of BPA or factor. It started from first sign of a bleed and ended no more than 72 hours after last treatment for bleed, within which any symptoms of bleeding at same location or injections less than or equal to 72 hours apart were considered the same bleeding episode. EP was defined as time duration starting from Day 29 when antithrombin (AT) lowering capacity of fitusiran had achieved therapeutic target range to the earliest of (Day 246 or last day of bleeding follow up) (maximum duration of EP: from Day 29 to Day 246). This outcome measure (OM) represents estimated results (i.e., results received by applying negative binomial [NB] regression model on data collected during EP).
Observed Annualized Bleeding Rate (ABR) for Treated Bleeds During the Efficacy Period
ABR for a participant during EP was defined as annualized number of bleeding episodes during EP annualized to a 1-year interval of time. ABR= number of bleeding episodes during EP divided by total number of days during EP*365.25. A bleeding episode was defined as any occurrence of hemorrhage that required administration of BPA or factor. It started from the first sign of a bleed and ended no more than 72 hours after the last treatment for the bleed, within which any symptoms of bleeding at the same location or injections less than or equal to 72 hours apart were considered the same bleeding episode. EP was defined as time duration starting from Day 29 when the AT lowering capacity of fitusiran had achieved therapeutic target range to the earliest of (Day 246 or the last day of bleeding follow up) (maximum duration of EP: from Day 29 to Day 246). This OM represents observed results (i.e., descriptive statistics values based on the data which was collected during EP).

Secondary Outcome Measures

Estimated Annualized Bleeding Rate (ABR) for Treated Bleeds During the Treatment Period
ABR for a participant during treatment period (TP) was defined as annualized number of bleeding episodes during TP annualized to a 1-year interval of time. Bleeding episode: any occurrence of hemorrhage that required administration of BPA or factor. It started from first sign of a bleed and ended no more than 72 hours after last treatment for bleed, within which any symptoms of bleeding at same location or injections less than or equal to 72 hours apart were considered the same bleeding episode. TP was sum of onset period (first 28 days after first dose of fitusiran) and EP (starting on Day 29 when AT lowering capacity of fitusiran had achieved therapeutic target range to earliest of [Day 246 or last day of bleeding follow up])(maximum duration of TP: from Day 1 to Day 246). This OM represents estimated results (i.e., results received by applying NB regression model on data collected during TP).
Observed Annualized Bleeding Rate (ABR) for Treated Bleeds During the Treatment Period
ABR for a participant during TP was defined as annualized number of bleeding episodes during TP annualized to a 1-year interval of time. ABR= number of bleeding episodes during TP divided by total number of days during TP*365.25. Bleeding episode: any occurrence of hemorrhage that required administration of BPA or factor. It started from the first sign of a bleed and ended no more than 72 hours after last treatment for bleed, within which any symptoms of bleeding at the same location or injections less than or equal to 72 hours apart were considered the same bleeding episode. TP was sum of onset period (first 28 days after the first dose of fitusiran) and EP (starting on Day 29 when AT lowering capacity of fitusiran had achieved therapeutic target range to the earliest of [Day 246 or the last day of bleeding follow up]) (maximum duration of TP: from Day 1 to Day 246). This OM represents observed results (i.e., descriptive statistics values based on data collected during TP).
Estimated Annualized Spontaneous Bleeding Rate for Treated Bleeds During Efficacy Period
Annualized spontaneous bleeding rate for a participant during EP was defined as annualized number of spontaneous bleeding episodes during EP annualized to a 1-year interval of time. Spontaneous bleeding episode was bleeding event that occurred for no apparent or known reason, particularly into joints, muscles, and soft tissues. It started from first sign of a bleed and ended no more than 72 hours after last treatment for the bleed, within which any symptoms of bleeding at the same location or injections less than or equal to 72 hours apart were considered the same bleeding episode. EP was defined as time duration starting from Day 29 when AT lowering capacity of fitusiran had achieved therapeutic target range to the earliest of (Day 246 or last day of bleeding follow up) (maximum duration of EP: from Day 29 to Day 246). This OM represents estimated results (i.e., results received by applying NB regression model on data collected during EP).
Observed Annualized Spontaneous Bleeding Rate for Treated Bleeds During the Efficacy Period
ABR for participant during EP was defined as annualized number of spontaneous bleeding episodes during EP annualized to a 1-year interval of time. ABR=number of treated spontaneous bleeding episodes during EP divided by total number of days during EP*365.25. Spontaneous bleeding episode was bleeding event that occurred for no apparent or known reason, into joints, muscles, and soft tissues. It started from the first sign of a bleed and ended no more than 72 hours after the last treatment for bleed, within which any symptoms of bleeding at the same location or injections less than or equal to 72 hours apart were considered the same bleeding episode. EP: time duration starting from Day 29 when the AT lowering capacity of fitusiran had achieved therapeutic target range to earliest of (Day 246 or the last day of bleeding follow up) (maximum duration of EP: from Day 29 to Day 246). This OM represents observed results (i.e., descriptive statistics values based on data collected during EP).
Estimated Annualized Joint Bleeding Rate for Treated Bleeds During the Efficacy Period
Annualized joint bleeding rate for a participant during EP was defined as annualized number of bleeding episodes during EP annualized to a 1-year interval of time. Joint bleeding episode was characterized by an unusual sensation in the joint ("aura") in combination with 1) increasing swelling or warmth over the skin, joint, 2) increased pain, or 3) progressive loss of range of motion or difficulty in using the limb as compared with Baseline. It started from first sign of a bleed and ended no more than 72 hours after last treatment for the bleed. EP was defined as time duration starting from Day 29 when the AT lowering capacity of fitusiran had achieved therapeutic target range to the earliest of (Day 246 or the last day of bleeding follow up) (maximum duration of EP: from Day 29 to Day 246). This OM presents estimated results (i.e., results received by applying NB regression model on data collected during EP).
Observed Annualized Joint Bleeding Rate for Treated Bleeds During the Efficacy Period
Annualized joint bleeding rate for participant during EP was defined as annualized number of joint bleeding episodes during EP annualized to 1-year interval of time. ABR= number of treated joint bleeding episodes during EP divided by total number of days during EP*365.25. A joint bleeding episode was characterized by an unusual sensation in joint ("aura") in combination with 1) increasing swelling or warmth over skin, joint, 2) increased pain, or 3) progressive loss of range of motion or difficulty in using limb as compared with Baseline. It started from first sign of a bleed and ended no more than 72 hours after the last treatment for the bleed. EP: time duration starting from Day 29 when the AT lowering capacity of fitusiran had achieved therapeutic target range to the earliest of (Day 246 or last day of bleeding follow up) (maximum duration of EP: from Day 29 to Day 246). This OM presents observed results (i.e., descriptive statistics values based on data collected during EP).
Health-related Quality of Life (HRQOL): Change From Baseline in Haemophilia Quality of Life Questionnaire for Adults (Haem-A-QOL) Physical Health Domain Score at Month 9
Haem-A-QoL: participant-reported questionnaire designed for adult participants (>=17 years of age) with hemophilia; and consisted of 46 items comprising 10 domains (physical health, feelings, view of yourself, sports and leisure, work and school, dealing with hemophilia, treatment, future, family planning, partnership and sexuality). Items were rated along five response options: never, rarely, sometimes, often, or all the time. Change from baseline in physical Health domain score was reported in this outcome measure. Raw score for physical health domain were transformed to a scale ranged from 0 to 100, where lower scores denoted better physical health.
Health-related Quality of Life (HRQOL): Change From Baseline in Haem-A-QOL Total Score at Month 9
Haem-A-QoL: participant-reported questionnaire designed for adult participants (>=17 years of age) with hemophilia; and consisted of 46 items comprising 10 domains (physical health, feelings, view of yourself, sports and leisure, work and school, dealing with hemophilia, treatment, future, family planning, partnership and sexuality). Items were rated along five response options: never, rarely, sometimes, often, or all the time. Raw score for each domain were transformed to a scale ranged from 0 to 100, where lower scores denoted better health. Haem-A-QoL Total Score was average of all domain scores and ranged from 0 to 100, where lower scores denoted better quality of life.
Estimated Annualized Bleeding Rate (ABR) for Treated Bleeds During the Onset Period
ABR was annualized number of bleeding episodes during onset period per participant annualized to a 1-year interval of time. A treated bleeding episode was defined as any occurrence of hemorrhage that may required administration of BPA or factor. It started from the first sign of a bleed and ended no more than 72 hours after the last treatment for the bleed, within which any symptoms of bleeding at the same location or injections less than or equal to 72 hours apart were considered the same bleeding episode. The onset period was defined as time interval from Day 1 to the earlier of Day 28 or the last day of bleeding follow up. This OM represents estimated results (i.e., results received by applying NB regression model on data collected during onset period).
Number of Participants With Treatment Emergent Adverse Events (TEAEs) and Treatment-Emergent Serious Adverse Events (TESAEs)
An adverse Event (AE) was defined as any untoward medical occurrence in a participant who received study drug which did not necessarily have a causal relationship with the treatment. Treatment emergent AEs were defined as any AE with onset date after first dose of fitusiran in the fitusiran prophylaxis arm or after Day 1 visit in the BPA on-demand arm. A Serious AE (SAE) was defined as any untoward medical occurrence that at any dose: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability or incapacity, was a congenital anomaly or birth defect, or was a medically important event.

Full Information

First Posted
January 25, 2018
Last Updated
March 15, 2022
Sponsor
Genzyme, a Sanofi Company
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1. Study Identification

Unique Protocol Identification Number
NCT03417102
Brief Title
A Study of Fitusiran (ALN-AT3SC) in Severe Hemophilia A and B Patients With Inhibitors
Acronym
ATLAS-INH
Official Title
ATLAS-INH: A Phase 3 Study to Evaluate the Efficacy and Safety of Fitusiran in Patients With Hemophilia A or B, With Inhibitory Antibodies to Factor VIII or IX
Study Type
Interventional

2. Study Status

Record Verification Date
March 2022
Overall Recruitment Status
Completed
Study Start Date
February 14, 2018 (Actual)
Primary Completion Date
November 25, 2020 (Actual)
Study Completion Date
June 23, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Genzyme, a Sanofi Company

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study was to determine the frequency of bleeding episodes in participants receiving fitusiran as prophylactic treatment of hemophilia compared to participants who were assigned to continue with their regular medication. In addition, the study assessed safety, quality of life, pharmacodynamics (PD), and pharmacokinetics (PK).
Detailed Description
The duration of treatment with fitusiran was 9 months. The estimated total time on study, inclusive of screening, for each participant was up to 11 months for all participants who enroll in the extension study and participants in the on-demand arm who did not enroll in the extension study. The estimated total time on study was up to 17 months in fitusiran treatment arm participants who did not enroll in the extension study due to the requirement for up to an additional 6 months of follow-up monitoring for antithrombin levels.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hemophilia A, Hemophilia B
Keywords
RNAi therapeutic, Hemophilia A, Hemophilia B, Hemophilia A, Severe, Hemophilia B, Severe, Blood Coagulation Disorders, Inherited, Blood Coagulation Disorders, Hematologic Diseases, Coagulation Protein Disorders, Hemorrhagic Disorders, Genetic Diseases, Inborn, Genetic Diseases, X-Linked, Factor VIII, Factor IX, Inhibitor, Bypassing agents, Coagulants, Fitusiran

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
60 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Bypassing Agents (BPA) On-demand
Arm Type
Active Comparator
Arm Description
Participants received On-demand BPAs (use of these agents, as needed, for episodic bleeding episodes, and not on a regular regimen intended to prevent spontaneous bleeding) per Investigator discretion from Day 1 for treatment of breakthrough bleeding episodes, up to a total of 9 months.
Arm Title
Fitusiran 80 mg Prophylaxis
Arm Type
Experimental
Arm Description
Participants received Fitusiran 80 mg subcutaneously (SC) as prophylaxis once monthly from Day 1, along with the on-demand BPAs (per investigator's discretion and within bleeding dosing guidelines) for treatment of breakthrough bleeding episodes, up to a total of 9 months.
Intervention Type
Drug
Intervention Name(s)
fitusiran
Intervention Description
solution for injection; by subcutaneous (SC) injection
Intervention Type
Drug
Intervention Name(s)
Bypassing agents
Intervention Description
solution for injection; by intravenous (IV) injection
Primary Outcome Measure Information:
Title
Estimated Annualized Bleeding Rate (ABR) for Treated Bleeds During the Efficacy Period
Description
ABR for a participant during efficacy period (EP) was defined as annualized number of bleeding episodes during EP annualized to a 1-year interval of time. Treated Bleeding episode: any occurrence of hemorrhage that required administration of BPA or factor. It started from first sign of a bleed and ended no more than 72 hours after last treatment for bleed, within which any symptoms of bleeding at same location or injections less than or equal to 72 hours apart were considered the same bleeding episode. EP was defined as time duration starting from Day 29 when antithrombin (AT) lowering capacity of fitusiran had achieved therapeutic target range to the earliest of (Day 246 or last day of bleeding follow up) (maximum duration of EP: from Day 29 to Day 246). This outcome measure (OM) represents estimated results (i.e., results received by applying negative binomial [NB] regression model on data collected during EP).
Time Frame
From Day 29 up to Day 246 or up to the last day of bleeding follow up (any day up to Day 246), whichever was the earliest
Title
Observed Annualized Bleeding Rate (ABR) for Treated Bleeds During the Efficacy Period
Description
ABR for a participant during EP was defined as annualized number of bleeding episodes during EP annualized to a 1-year interval of time. ABR= number of bleeding episodes during EP divided by total number of days during EP*365.25. A bleeding episode was defined as any occurrence of hemorrhage that required administration of BPA or factor. It started from the first sign of a bleed and ended no more than 72 hours after the last treatment for the bleed, within which any symptoms of bleeding at the same location or injections less than or equal to 72 hours apart were considered the same bleeding episode. EP was defined as time duration starting from Day 29 when the AT lowering capacity of fitusiran had achieved therapeutic target range to the earliest of (Day 246 or the last day of bleeding follow up) (maximum duration of EP: from Day 29 to Day 246). This OM represents observed results (i.e., descriptive statistics values based on the data which was collected during EP).
Time Frame
From Day 29 up to Day 246 or up to the last day of bleeding follow up (any day up to Day 246), whichever was the earliest
Secondary Outcome Measure Information:
Title
Estimated Annualized Bleeding Rate (ABR) for Treated Bleeds During the Treatment Period
Description
ABR for a participant during treatment period (TP) was defined as annualized number of bleeding episodes during TP annualized to a 1-year interval of time. Bleeding episode: any occurrence of hemorrhage that required administration of BPA or factor. It started from first sign of a bleed and ended no more than 72 hours after last treatment for bleed, within which any symptoms of bleeding at same location or injections less than or equal to 72 hours apart were considered the same bleeding episode. TP was sum of onset period (first 28 days after first dose of fitusiran) and EP (starting on Day 29 when AT lowering capacity of fitusiran had achieved therapeutic target range to earliest of [Day 246 or last day of bleeding follow up])(maximum duration of TP: from Day 1 to Day 246). This OM represents estimated results (i.e., results received by applying NB regression model on data collected during TP).
Time Frame
From Day 1 up to Day 246 or up to the last day of bleeding follow up (any day up to Day 246), whichever was the earliest
Title
Observed Annualized Bleeding Rate (ABR) for Treated Bleeds During the Treatment Period
Description
ABR for a participant during TP was defined as annualized number of bleeding episodes during TP annualized to a 1-year interval of time. ABR= number of bleeding episodes during TP divided by total number of days during TP*365.25. Bleeding episode: any occurrence of hemorrhage that required administration of BPA or factor. It started from the first sign of a bleed and ended no more than 72 hours after last treatment for bleed, within which any symptoms of bleeding at the same location or injections less than or equal to 72 hours apart were considered the same bleeding episode. TP was sum of onset period (first 28 days after the first dose of fitusiran) and EP (starting on Day 29 when AT lowering capacity of fitusiran had achieved therapeutic target range to the earliest of [Day 246 or the last day of bleeding follow up]) (maximum duration of TP: from Day 1 to Day 246). This OM represents observed results (i.e., descriptive statistics values based on data collected during TP).
Time Frame
From Day 1 up to Day 246 or up to the last day of bleeding follow up (any day up to Day 246), whichever was the earliest
Title
Estimated Annualized Spontaneous Bleeding Rate for Treated Bleeds During Efficacy Period
Description
Annualized spontaneous bleeding rate for a participant during EP was defined as annualized number of spontaneous bleeding episodes during EP annualized to a 1-year interval of time. Spontaneous bleeding episode was bleeding event that occurred for no apparent or known reason, particularly into joints, muscles, and soft tissues. It started from first sign of a bleed and ended no more than 72 hours after last treatment for the bleed, within which any symptoms of bleeding at the same location or injections less than or equal to 72 hours apart were considered the same bleeding episode. EP was defined as time duration starting from Day 29 when AT lowering capacity of fitusiran had achieved therapeutic target range to the earliest of (Day 246 or last day of bleeding follow up) (maximum duration of EP: from Day 29 to Day 246). This OM represents estimated results (i.e., results received by applying NB regression model on data collected during EP).
Time Frame
From Day 29 up to Day 246 or up to the last day of bleeding follow up (any day up to Day 246), whichever was the earliest
Title
Observed Annualized Spontaneous Bleeding Rate for Treated Bleeds During the Efficacy Period
Description
ABR for participant during EP was defined as annualized number of spontaneous bleeding episodes during EP annualized to a 1-year interval of time. ABR=number of treated spontaneous bleeding episodes during EP divided by total number of days during EP*365.25. Spontaneous bleeding episode was bleeding event that occurred for no apparent or known reason, into joints, muscles, and soft tissues. It started from the first sign of a bleed and ended no more than 72 hours after the last treatment for bleed, within which any symptoms of bleeding at the same location or injections less than or equal to 72 hours apart were considered the same bleeding episode. EP: time duration starting from Day 29 when the AT lowering capacity of fitusiran had achieved therapeutic target range to earliest of (Day 246 or the last day of bleeding follow up) (maximum duration of EP: from Day 29 to Day 246). This OM represents observed results (i.e., descriptive statistics values based on data collected during EP).
Time Frame
From Day 29 up to Day 246 or up to the last day of bleeding follow up (any day up to Day 246), whichever was the earliest
Title
Estimated Annualized Joint Bleeding Rate for Treated Bleeds During the Efficacy Period
Description
Annualized joint bleeding rate for a participant during EP was defined as annualized number of bleeding episodes during EP annualized to a 1-year interval of time. Joint bleeding episode was characterized by an unusual sensation in the joint ("aura") in combination with 1) increasing swelling or warmth over the skin, joint, 2) increased pain, or 3) progressive loss of range of motion or difficulty in using the limb as compared with Baseline. It started from first sign of a bleed and ended no more than 72 hours after last treatment for the bleed. EP was defined as time duration starting from Day 29 when the AT lowering capacity of fitusiran had achieved therapeutic target range to the earliest of (Day 246 or the last day of bleeding follow up) (maximum duration of EP: from Day 29 to Day 246). This OM presents estimated results (i.e., results received by applying NB regression model on data collected during EP).
Time Frame
From Day 29 up to Day 246 or up to the last day of bleeding follow up (any day up to Day 246), whichever was the earliest
Title
Observed Annualized Joint Bleeding Rate for Treated Bleeds During the Efficacy Period
Description
Annualized joint bleeding rate for participant during EP was defined as annualized number of joint bleeding episodes during EP annualized to 1-year interval of time. ABR= number of treated joint bleeding episodes during EP divided by total number of days during EP*365.25. A joint bleeding episode was characterized by an unusual sensation in joint ("aura") in combination with 1) increasing swelling or warmth over skin, joint, 2) increased pain, or 3) progressive loss of range of motion or difficulty in using limb as compared with Baseline. It started from first sign of a bleed and ended no more than 72 hours after the last treatment for the bleed. EP: time duration starting from Day 29 when the AT lowering capacity of fitusiran had achieved therapeutic target range to the earliest of (Day 246 or last day of bleeding follow up) (maximum duration of EP: from Day 29 to Day 246). This OM presents observed results (i.e., descriptive statistics values based on data collected during EP).
Time Frame
From Day 29 up to Day 246 or up to the last day of bleeding follow up (any day up to Day 246), whichever was the earliest
Title
Health-related Quality of Life (HRQOL): Change From Baseline in Haemophilia Quality of Life Questionnaire for Adults (Haem-A-QOL) Physical Health Domain Score at Month 9
Description
Haem-A-QoL: participant-reported questionnaire designed for adult participants (>=17 years of age) with hemophilia; and consisted of 46 items comprising 10 domains (physical health, feelings, view of yourself, sports and leisure, work and school, dealing with hemophilia, treatment, future, family planning, partnership and sexuality). Items were rated along five response options: never, rarely, sometimes, often, or all the time. Change from baseline in physical Health domain score was reported in this outcome measure. Raw score for physical health domain were transformed to a scale ranged from 0 to 100, where lower scores denoted better physical health.
Time Frame
Baseline (Day 1), Month 9
Title
Health-related Quality of Life (HRQOL): Change From Baseline in Haem-A-QOL Total Score at Month 9
Description
Haem-A-QoL: participant-reported questionnaire designed for adult participants (>=17 years of age) with hemophilia; and consisted of 46 items comprising 10 domains (physical health, feelings, view of yourself, sports and leisure, work and school, dealing with hemophilia, treatment, future, family planning, partnership and sexuality). Items were rated along five response options: never, rarely, sometimes, often, or all the time. Raw score for each domain were transformed to a scale ranged from 0 to 100, where lower scores denoted better health. Haem-A-QoL Total Score was average of all domain scores and ranged from 0 to 100, where lower scores denoted better quality of life.
Time Frame
Baseline (Day 1), Month 9
Title
Estimated Annualized Bleeding Rate (ABR) for Treated Bleeds During the Onset Period
Description
ABR was annualized number of bleeding episodes during onset period per participant annualized to a 1-year interval of time. A treated bleeding episode was defined as any occurrence of hemorrhage that may required administration of BPA or factor. It started from the first sign of a bleed and ended no more than 72 hours after the last treatment for the bleed, within which any symptoms of bleeding at the same location or injections less than or equal to 72 hours apart were considered the same bleeding episode. The onset period was defined as time interval from Day 1 to the earlier of Day 28 or the last day of bleeding follow up. This OM represents estimated results (i.e., results received by applying NB regression model on data collected during onset period).
Time Frame
From Day 1 up to Day 28 or up to the last day of bleeding follow up (any day up to Day 28), whichever was the earliest
Title
Number of Participants With Treatment Emergent Adverse Events (TEAEs) and Treatment-Emergent Serious Adverse Events (TESAEs)
Description
An adverse Event (AE) was defined as any untoward medical occurrence in a participant who received study drug which did not necessarily have a causal relationship with the treatment. Treatment emergent AEs were defined as any AE with onset date after first dose of fitusiran in the fitusiran prophylaxis arm or after Day 1 visit in the BPA on-demand arm. A Serious AE (SAE) was defined as any untoward medical occurrence that at any dose: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability or incapacity, was a congenital anomaly or birth defect, or was a medically important event.
Time Frame
From Baseline (Day 1) up to 15 months (i.e. 9 months treatment period + 6-months follow-up)

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males, greater than or equal to (>=) 12 years of age. Severe hemophilia A or B with inhibitors. (Severity confirmed by a central laboratory where coagulation factor VIII (FVIII) level was less than (<)1% or factor IX (FIX) level was less than or equal to [<=]2% at Screening; Inhibitors defined as inhibitor titer of >=0.6 Bethesda units per milliliter [BU/mL] or as evidenced by medical records). A minimum of 6 bleeding episodes requiring BPA treatment within the last 6 months prior to screening. Willing and able to comply with the study requirements and to provide written informed consent and assent. Exclusion Criteria: Known co-existing bleeding disorders other than hemophilia A or B. Antithrombin (AT) activity <60% at Screening. Co-existing thrombophilic disorder. Clinically significant liver disease. Active hepatitis C virus infection. HIV positive with a cluster of differentiation-4 count of <200 cells/microliter. History of arterial or venous thromboembolism. Inadequate renal function. History of multiple drug allergies or history of allergic reaction to an oligonucleotide or N-Acetylgalactosamine. History of intolerance to SC injection(s). Any other conditions or comorbidities that would make the participant unsuitable for enrollment or could interfere with participation in or completion of the study, per Investigator judgement.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Sciences & Operations, MD
Organizational Affiliation
Sanofi
Official's Role
Study Director
Facility Information:
Facility Name
Investigational Site Number 0117
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85016
Country
United States
Facility Name
Investigational Site Number 0139
City
Los Angeles
State/Province
California
ZIP/Postal Code
90027
Country
United States
Facility Name
Investigational Site Number 0135
City
Orange
State/Province
California
ZIP/Postal Code
92868
Country
United States
Facility Name
Investigational Site Number 0137
City
San Diego
State/Province
California
ZIP/Postal Code
92123
Country
United States
Facility Name
Investigational Site Number 0128
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32610
Country
United States
Facility Name
Investigational Site Number 0115
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32207
Country
United States
Facility Name
Investigational Site Number 0105
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Investigational Site Number 0103
City
Tampa
State/Province
Florida
ZIP/Postal Code
33607
Country
United States
Facility Name
Investigational Site Number 0119
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70112
Country
United States
Facility Name
Investigational Site Number 0136
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21205
Country
United States
Facility Name
Investigational Site Number 0111
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89135
Country
United States
Facility Name
Investigational Site Number 0104
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104-5127
Country
United States
Facility Name
Investigational Site Number 6101
City
Camperdown
ZIP/Postal Code
2050
Country
Australia
Facility Name
Investigational Site Number 6104
City
Clayton
ZIP/Postal Code
3168
Country
Australia
Facility Name
Investigational Site Number 1102
City
Montreal
ZIP/Postal Code
H1T 2M4
Country
Canada
Facility Name
Investigational Site Number 8604
City
Beijing
ZIP/Postal Code
100045
Country
China
Facility Name
Investigational Site Number 8602
City
Guangzhou
ZIP/Postal Code
510515
Country
China
Facility Name
Investigational Site Number 8605
City
Hangzhou
ZIP/Postal Code
310003
Country
China
Facility Name
Investigational Site Number 8603
City
Shanghai
ZIP/Postal Code
200025
Country
China
Facility Name
Investigational Site Number 8601
City
Tianjin
ZIP/Postal Code
300020
Country
China
Facility Name
Investigational Site Number 3303
City
Lyon
ZIP/Postal Code
69677
Country
France
Facility Name
Investigational Site Number 3301
City
Rouen
ZIP/Postal Code
76038
Country
France
Facility Name
Investigational Site Number 4905
City
Frankfurt Am Main
ZIP/Postal Code
60590
Country
Germany
Facility Name
Investigational Site Number 4906
City
Leipzig
ZIP/Postal Code
4103
Country
Germany
Facility Name
Investigational Site Number 9102
City
Bangalore
ZIP/Postal Code
560034
Country
India
Facility Name
Investigational Site Number 9108
City
India
Country
India
Facility Name
Investigational Site Number 9104
City
Jaipur
ZIP/Postal Code
302017
Country
India
Facility Name
Investigational Site Number 9106
City
Lucknow
ZIP/Postal Code
226003
Country
India
Facility Name
Investigational Site Number 9103
City
Pune
ZIP/Postal Code
411001
Country
India
Facility Name
Investigational Site Number 9111
City
Pune
ZIP/Postal Code
411004
Country
India
Facility Name
Investigational Site Number 9105
City
Vellore
ZIP/Postal Code
632004
Country
India
Facility Name
Investigational Site Number 3901
City
Florence
ZIP/Postal Code
50134
Country
Italy
Facility Name
Investigational Site Number 3904
City
Padua
ZIP/Postal Code
35128
Country
Italy
Facility Name
Investigational Site Number 8110
City
Japan
Country
Japan
Facility Name
Investigational Site Number 8103
City
Kita Kyushu-Shi
Country
Japan
Facility Name
Investigational Site Number 8202
City
Daejeon
ZIP/Postal Code
35233
Country
Korea, Republic of
Facility Name
Investigational Site Number 8203
City
Seoul
ZIP/Postal Code
3722
Country
Korea, Republic of
Facility Name
Investigational Site Number 8204
City
Seoul
Country
Korea, Republic of
Facility Name
Investigational Site Number 6003
City
Kota Kinabalu
ZIP/Postal Code
88586
Country
Malaysia
Facility Name
Investigational Site Number 6004
City
Malaysia
Country
Malaysia
Facility Name
Investigational Site Number 2701
City
Parktown
ZIP/Postal Code
2193
Country
South Africa
Facility Name
Investigational Site Number 2703
City
Polokwane
ZIP/Postal Code
699
Country
South Africa
Facility Name
Investigational Site Number 2702
City
Port Elizabeth
ZIP/Postal Code
6001
Country
South Africa
Facility Name
Investigational Site Number 3402
City
Madrid
ZIP/Postal Code
28046
Country
Spain
Facility Name
Investigational Site Number 8803
City
Changhua
ZIP/Postal Code
500
Country
Taiwan
Facility Name
Investigational Site Number 8801
City
Taipei
ZIP/Postal Code
110
Country
Taiwan
Facility Name
Investigational Site Number 8804
City
Taiwan
Country
Taiwan
Facility Name
Investigational Site Number 8805
City
Taiwan
Country
Taiwan
Facility Name
Investigational Site Number 9002
City
Adana
ZIP/Postal Code
?01130
Country
Turkey
Facility Name
Investigational Site Number 9004
City
Akdeniz
ZIP/Postal Code
07059
Country
Turkey
Facility Name
Investigational Site Number 9001
City
Ankara
ZIP/Postal Code
06100
Country
Turkey
Facility Name
Investigational Site Number 9005
City
Istanbul
ZIP/Postal Code
34093
Country
Turkey
Facility Name
Investigational Site Number 9003
City
Izmir
ZIP/Postal Code
35100
Country
Turkey
Facility Name
Investigational Site Number 9006
City
Turkey
Country
Turkey
Facility Name
Investigational Site Number 8003
City
Kyiv
ZIP/Postal Code
01135
Country
Ukraine
Facility Name
Investigational Site Number 8001
City
Kyiv
ZIP/Postal Code
04060
Country
Ukraine
Facility Name
Investigational Site Number 8002
City
Lviv
ZIP/Postal Code
79044
Country
Ukraine
Facility Name
Investigational Site Number 4407
City
London
ZIP/Postal Code
E1 2ES
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org
Citations:
PubMed Identifier
35114155
Citation
The Lancet Haematology. The role of conferences in tackling inequalities. Lancet Haematol. 2022 Feb;9(2):e81. doi: 10.1016/S2352-3026(22)00008-4. No abstract available.
Results Reference
derived
PubMed Identifier
34922648
Citation
Del Pozo Martin Y. 2021 ASH annual meeting. Lancet Haematol. 2022 Feb;9(2):e92-e93. doi: 10.1016/S2352-3026(21)00384-7. Epub 2021 Dec 16. No abstract available.
Results Reference
derived

Learn more about this trial

A Study of Fitusiran (ALN-AT3SC) in Severe Hemophilia A and B Patients With Inhibitors

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