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Adjusted Fibrinogen Replacement Strategy (AdFIrst)

Primary Purpose

Bleeding Disorder, Hypofibrinogenemia; Acquired

Status
Recruiting
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
BT524
FFP/Cryo
Sponsored by
Biotest
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Bleeding Disorder focused on measuring Fibrinogen

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

At screening:

  1. Written informed consent
  2. Subjects scheduled for elective major spine surgery with expected major blood loss
  3. Male or female, aged ≥ 18 years
  4. No increased bleeding risk as assessed by standard coagulation tests and medical history

    Intra-operative:

  5. Intra-operative bleeding > 1,000 mL (total blood loss), resulting in a high risk for the need of FFP transfusion during surgery.

Exclusion Criteria:

  1. Pregnancy or unreliable contraceptive measures or lactation period (women only)
  2. Hypersensitivity to proteins of human origin or known hypersensitivity reactions to components of the Investigational Medicinal Products (IMP)
  3. Participation in another clinical study within 30 days before entering the study or during the study and/or previous participation in this study
  4. Treatment with any fibrinogen concentrate and/or fibrinogen-containing product within 30 days prior to infusion of BT524
  5. Employee or direct relative of an employee of the Contract Research Organization (CRO), the study site, or Biotest
  6. Inability or lacking motivation to participate in the study
  7. Medical condition, laboratory finding (e.g. clinically relevant biochemical or hematological findings outside the normal range), or physical exam finding that in the opinion of the investigator precludes participation
  8. Presence or history of venous/arterial thrombosis or TEE in the preceding 6 months -

Sites / Locations

  • Site 02
  • Site 01
  • Site 54Recruiting
  • Site 51Recruiting
  • Site 53
  • Site 52Recruiting
  • Site 15Recruiting
  • Site 11Recruiting
  • Site 12
  • Site 14Recruiting
  • Site 13
  • Site 21
  • Site 31
  • Site 32Recruiting
  • Site 33
  • Site34Recruiting
  • Site 41
  • Site 71Recruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

BT524

Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo)

Arm Description

Investigational Human Fibrinogen Concentrate

Standard of Care

Outcomes

Primary Outcome Measures

Intra-operative blood loss
Intra-operative blood loss as measured by amount of blood from blood suction unit and amount of blood from surgical cloths and compresses.

Secondary Outcome Measures

Correction of the fibrinogen level
Proportion (%) of subjects with successful correction of fibrinogen level
Transfusion requirements
Total amount of transfusion products
24 hours post-operative blood loss
Drainage volume
Subjects with rebleeds
Proportion (%) of subjects
Hospital length of stay
Days in hospital after surgery
In-Hospital mortality
Number of death during hospital stay
Adverse events
Number of adverse events
Virus status
Number of subjects with viral infection
Thrombosis and of thromboembolic events
Frequency and severity

Full Information

First Posted
December 19, 2017
Last Updated
March 28, 2022
Sponsor
Biotest
Collaborators
PRA Health Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT03444324
Brief Title
Adjusted Fibrinogen Replacement Strategy
Acronym
AdFIrst
Official Title
A Randomized, Active-controlled, Multicenter, Phase III Study Investigating Efficacy and Safety of Intra-operative Use of BT524 (Human Fibrinogen Concentrate) in Subjects Undergoing Major Spinal or Abdominal Surgery (AdFIrst)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2022
Overall Recruitment Status
Recruiting
Study Start Date
February 12, 2018 (Actual)
Primary Completion Date
December 2022 (Anticipated)
Study Completion Date
March 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Biotest
Collaborators
PRA Health Sciences

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to investigate efficacy and safety of fibrinogen concentrate BT524, when administered to patients with major blood loss during elective spine surgery.The study aims to demonstrate that BT524 is at least not worse than the comparator fresh frozen plasma in reducing intra-operative blood loss.
Detailed Description
Fibrinogen is the first coagulation factor to become critically reduced during intra-operative bleeding. Therefore, rapid fibrinogen supplementation to restore physiological plasma levels is an important component to achieve and maintain hemostasis in bleeding patients. In this study, patients with major blood loss during elective spine surgery will be randomized 1:1 to a single intravenous transfusion of the fibrinogen concentrate BT524 or to fibrinogen-containing fresh frozen plasma (FFP).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Bleeding Disorder, Hypofibrinogenemia; Acquired
Keywords
Fibrinogen

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
Patients are randomly assigned to treatment with BT524 or FFP/Crypo.
Masking
ParticipantCare ProviderInvestigator
Masking Description
Study 995 will be partially blinded; surgeon, surgical staff and subjects will be blinded to treatment allocation throughout the entire surgery. The IMP (BT524 or FFP/Cryo) will be administered by an unblinded anaesthesiologist.
Allocation
Randomized
Enrollment
200 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
BT524
Arm Type
Experimental
Arm Description
Investigational Human Fibrinogen Concentrate
Arm Title
Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo)
Arm Type
Active Comparator
Arm Description
Standard of Care
Intervention Type
Biological
Intervention Name(s)
BT524
Other Intervention Name(s)
Human Fibrinogen concentrate
Intervention Description
BT524 is administered intravenously, patient specific dosage calculated based on body weight and fibrinogen level.
Intervention Type
Biological
Intervention Name(s)
FFP/Cryo
Other Intervention Name(s)
Fresh Frozen Plasma
Intervention Description
FFP/Cryo is administered intravenously; dosage according to local standards in mL per kg body weight.
Primary Outcome Measure Information:
Title
Intra-operative blood loss
Description
Intra-operative blood loss as measured by amount of blood from blood suction unit and amount of blood from surgical cloths and compresses.
Time Frame
Decision to treat until end of surgery, expected average of 3 hours
Secondary Outcome Measure Information:
Title
Correction of the fibrinogen level
Description
Proportion (%) of subjects with successful correction of fibrinogen level
Time Frame
15 minutes after start of IMP administration
Title
Transfusion requirements
Description
Total amount of transfusion products
Time Frame
After end of IMP administration until end of surgery, expected average of 2 hours
Title
24 hours post-operative blood loss
Description
Drainage volume
Time Frame
1 day after surgery
Title
Subjects with rebleeds
Description
Proportion (%) of subjects
Time Frame
8 days after surgery
Title
Hospital length of stay
Description
Days in hospital after surgery
Time Frame
35 days after surgery
Title
In-Hospital mortality
Description
Number of death during hospital stay
Time Frame
35 days after surgery
Title
Adverse events
Description
Number of adverse events
Time Frame
35 days after surgery
Title
Virus status
Description
Number of subjects with viral infection
Time Frame
35 days after surgery
Title
Thrombosis and of thromboembolic events
Description
Frequency and severity
Time Frame
35 days after surgery

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: At screening: Written informed consent Subjects scheduled for elective major spine surgery with expected major blood loss Male or female, aged ≥ 18 years No increased bleeding risk as assessed by standard coagulation tests and medical history Intra-operative: Intra-operative bleeding > 1,000 mL (total blood loss), resulting in a high risk for the need of FFP transfusion during surgery. Exclusion Criteria: Pregnancy or unreliable contraceptive measures or lactation period (women only) Hypersensitivity to proteins of human origin or known hypersensitivity reactions to components of the Investigational Medicinal Products (IMP) Participation in another clinical study within 30 days before entering the study or during the study and/or previous participation in this study Treatment with any fibrinogen concentrate and/or fibrinogen-containing product within 30 days prior to infusion of BT524 Employee or direct relative of an employee of the Contract Research Organization (CRO), the study site, or Biotest Inability or lacking motivation to participate in the study Medical condition, laboratory finding (e.g. clinically relevant biochemical or hematological findings outside the normal range), or physical exam finding that in the opinion of the investigator precludes participation Presence or history of venous/arterial thrombosis or TEE in the preceding 6 months -
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Judith Wessels-Kranz, PhD
Phone
00496103801
Ext
6395
Email
judith.wessels-kranz@biotest.com
First Name & Middle Initial & Last Name or Official Title & Degree
Joachim Schütze, PhD
Phone
00496103801
Ext
5127
Email
joachim.schuetze@biotest.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Niels Rahe-Meyer, Prof.
Organizational Affiliation
Franziskus Hospital, Bielefeld
Official's Role
Principal Investigator
Facility Information:
Facility Name
Site 02
City
Jette
Country
Belgium
Individual Site Status
Completed
Facility Name
Site 01
City
Leuven
Country
Belgium
Individual Site Status
Completed
Facility Name
Site 54
City
Brno
Country
Czechia
Individual Site Status
Recruiting
Facility Name
Site 51
City
Prague
Country
Czechia
Individual Site Status
Recruiting
Facility Name
Site 53
City
Prague
Country
Czechia
Individual Site Status
Completed
Facility Name
Site 52
City
Usti Nad Labem
Country
Czechia
Individual Site Status
Recruiting
Facility Name
Site 15
City
Bielefeld
Country
Germany
Individual Site Status
Recruiting
Facility Name
Site 11
City
Bonn
Country
Germany
Individual Site Status
Recruiting
Facility Name
Site 12
City
Hannover
Country
Germany
Individual Site Status
Completed
Facility Name
Site 14
City
München
Country
Germany
Individual Site Status
Recruiting
Facility Name
Site 13
City
Münster
Country
Germany
Individual Site Status
Completed
Facility Name
Site 21
City
Warschau
Country
Poland
Individual Site Status
Completed
Facility Name
Site 31
City
Barcelona
Country
Spain
Individual Site Status
Completed
Facility Name
Site 32
City
Barcelona
Country
Spain
Individual Site Status
Recruiting
Facility Name
Site 33
City
Barcelona
Country
Spain
Individual Site Status
Completed
Facility Name
Site34
City
Barcelona
Country
Spain
Individual Site Status
Recruiting
Facility Name
Site 41
City
Liestal
Country
Switzerland
Individual Site Status
Completed
Facility Name
Site 71
City
Basingstoke
Country
United Kingdom
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

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Adjusted Fibrinogen Replacement Strategy

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