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Study to Monitor Subcutaneous Human Immunoglobulin Administered at Modified Dosing Regimens in Patients With Primary Immunodeficiency Diseases

Primary Purpose

Primary Immune Deficiency Disorder

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
CUTAQUIG
Sponsored by
Octapharma
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Primary Immune Deficiency Disorder

Eligibility Criteria

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

Inclusion Criteria:

  1. Age ≥2 years and ≤75 years.
  2. Confirmed diagnosis of primary immunodeficiency (PI) disease as defined by the European Society for Immunodeficiencies and Pan American Group for Immunodeficiency and requiring immunoglobulin replacement therapy due to hypogammaglobulinaemia or agammaglobulinaemia. Note: The exact type of PI disease will be recorded.
  3. Established on a consistent or stable mg/kg dose of any SCIG treatment for a minimum of 3 months prior to Screening. Note: patients entering Cohort 3 must be on weekly SCIG infusions for a minimum of 12 weeks.
  4. Availability of the Immunoglobulin G (IgG) trough levels of 2 previous SCIG infusions within 1 year of Screening, with 1 trough level obtained within 3 months prior to enrollment, and maintenance of trough serum IgG levels

    ≥5.0 g/L in 2 previous infusions. Patients with no prior IgG trough level within 3 months prior to enrollment may use the Screening IgG trough level as their 2nd reading.

  5. Voluntarily given, fully informed signed informed consent. For patients under the legal age of consent, voluntarily given, fully-informed, signed informed consent will be provided by patient's parent or legal guardian, and assent will be provided by patient (per age-appropriate Institutional Review Board [IRB] requirements).
  6. Females of childbearing potential, who are not nursing and have no plans for pregnancy during the course of the study, have been using at least 1 acceptable form of birth control for a minimum of 30 days prior to the Screening visit and must agree to use at least 1 acceptable method of contraception for 30 days after the last dose of CUTAQUIG. Acceptable methods include: intrauterine device (IUD), hormonal contraception, male or female condom, spermicide gel, diaphragm, sponge, cervical cap, or abstinence.
  7. For female patients of child-bearing potential, a negative result in a urine pregnancy test conducted at the Screening visit.
  8. Willingness to comply with all aspects of the protocol, including blood sampling, for the duration of the study.

Exclusion Criteria:

  1. Evidence of active infection within 4 weeks of Screening or during the Screening Period.
  2. Current or clinically-significant history of any cardiovascular, respiratory, hepatic, renal, gastrointestinal, endocrine, neurological, immunological (excluding PI), hematologic, and/or psychiatric disorder(s), or a history of any other illness that, in the opinion of the Investigator, might confound the results of the study, or pose additional risk to the patient by participation in the study.
  3. Known history of adverse reactions to immunoglobulin A (IgA) in other products.
  4. Body mass index (BMI) >40 kg/m2 for patients entering Cohort 2 or Cohort 3. There are no BMI restrictions for Cohort 1.
  5. Ongoing history of hypersensitivity or persistent reactions to blood or plasma derived products, or any component of the investigational product (such as Polysorbate 80).
  6. Requirement of any routine premedication for IgG administration.
  7. History of malignancies of lymphoid cells and immunodeficiency with lymphoma.
  8. Severe liver function impairment (aspartate aminotransferase [AST] or alanine aminotransferase [ALT] >3 times above upper limit of normal).
  9. Known protein-losing enteropathies or clinically significant proteinuria.
  10. Presence of renal function impairment (creatine >120 μM/L or creatinine >1.35 mg/dL), or predisposition for acute renal failure (eg, any degree of preexisting renal insufficiency or routine treatment with known nephritic drugs).
  11. Treatment with oral or parenteral steroids for ≥30 days, or when given intermittently or as bolus at daily doses ≥0.15 mg/kg when taken within 30 days of Screening. Note: Short or intermittent courses of steroids (ie, a steroid burst) of >0.15 mg/kg/day is allowed for treatment of a short-term condition such as an asthma exacerbation.
  12. Treatment with immunosuppressive or immunomodulatory drugs (except Omalizumab).
  13. Use of HYQVIA (Immune Globulin Infusion 10% [Human] with Recombinant Human Hyaluronidase) within 3 months prior to first CUTAQUIG infusion.
  14. Live viral vaccination (such as measles, rubella, mumps, and varicella) within 2 months prior to first CUTAQUIG infusion.
  15. Exposure to blood or any blood product or derivative, other than subcutaneous IgG used for regular PI disease treatment, within 3 months before the first CUTAQUIG infusion.
  16. Treatment with any investigational medicinal product within 3 months prior to first CUTAQUIG infusion. Note: Patients participating in Study SCGAM-03 will be allowed to enter this study without the 3-month waiting period for an Investigational Product. Patients receiving another SCIG product within 3 months prior to the first CUTAQUIG infusion may be considered for enrollment after Sponsor approval.
  17. Presence of any condition that is likely to interfere with the evaluation of CUTAQUIG or satisfactory conduct of the trial.
  18. Known or suspected to abuse alcohol, drugs, psychotropic agents, or other chemicals within the past 12 months prior to first CUTAQUIG infusion.
  19. Known active or chronic hepatitis B, hepatitis C, or HIV infection. Past hepatitis B or hepatitis C infection that has been cured is allowed.

Sites / Locations

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

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Increased Volume Cohort - Cohort 1

Increased Infusion Rate Cohort - Cohort 2

Every Other Week Dosing Cohort - Cohort 3

Arm Description

Increased volume at each infusion site - patients will receive CUTAQUIG weekly and increase infusion volumes every 4 weeks

Increased infusion rate - patients will receive CUTAQUIG weekly and increase infusion rates every 4 weeks

Every other week dosing - patients will receive CUTAQUIG every other week at the equivalent of twice their body-weight dependent [mg/kg] weekly dose

Outcomes

Primary Outcome Measures

IgG Trough Levels
Change in individual total IgG trough levels from weekly infusions to every other week infusions
AEs
Occurrence of treatment-emergent AEs (TEAEs) throughout the entire Stabilization and Treatment Periods starting with the first infusion of investigational medicinal product (IMP)
Temporally Associated TEAEs During Treatment Period
Occurrence of TEAEs temporally associated with CUTAQUIG delivered during the Treatment Period
Temporally Associated TEAEs During Stabilization Period
Occurrence of TEAEs temporally associated with CUTAQUIG delivered during the Stabilization Period
TEAEs by speed of infusion
TEAEs by speed of infusion
Number of local infusion-site reactions
Patients will grade the overall perception of local reactions in their diaries after each infusion using a 4-point rating scale: 0=none, 1=mild, 2=moderate, 3=severe. Investigators will evaluate local reactions after infusion at every study visit, using a 4-point rating scale: 0=none, 1=mild, 2=moderate, 3=severe.
CBC
Complete blood count
WBC
White blood cells
Differential WBC Count
Measures amount of each type of white blood cell
Hematocrit
Changes in hematocrit
Hemoglobin
Changes in hemoglobin
Blood sodium
Changes in blood sodium
Blood potassium
Changes in blood potassium
Blood glucose
Changes in blood glucose
ALT
Changes in ALT
AST
Changes in AST
LDH
Changes in LDH
Total bilirubin
Changes in total bilirubin
Blood urea nitrogen
Changes in blood urea nitrogen
Creatinine
Changes in creatinine
Urine pH
Changes in urine pH
Urine glucose
Changes in urine glucose
Urine ketones
Changes in urine ketones
Urine leukocytes
Changes in urine leukocytes
Urine hemoglobin
Changes in urine hemoglobin

Secondary Outcome Measures

Quality of Life questionnaire - CHQ-PF50
CHQ-PF50 (Child Health Questionnaire Parent Form 50) from parent or guardian of patients <14 years of age. Likert-type scale with higher scores indicating better or more positive health states. Scores transformed to 0 - 100 scale.
Quality of Life questionnaire - SF-36
SF-36 (36-Item Short Form Survey) in patients ≥14 years of age SF-36: Likert-type scale with higher scores indicating better or more positive health states. Scores transformed to 0 - 100 scale.
IgG trough levels
Measurement of individual profiles of IgG trough levels over time (all cohorts)
Infectious Disease Occurrence
Monitoring for infectious disease occurrence
Infectious Disease Resolution
Monitoring for occurrences of infectious disease resolution
Antibiotic use
Monitoring for occurrences of antibiotic use
Serious bacterial infections
Occurrence of serious bacterial infections
Blood Pressure
Blood pressure including systolic and diastolic.
Pulse
Pulse
Body temperature
Body temperature
Respiratory rate
Respiratory rate

Full Information

First Posted
May 3, 2019
Last Updated
January 10, 2022
Sponsor
Octapharma
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1. Study Identification

Unique Protocol Identification Number
NCT03939533
Brief Title
Study to Monitor Subcutaneous Human Immunoglobulin Administered at Modified Dosing Regimens in Patients With Primary Immunodeficiency Diseases
Official Title
Clinical Phase 3 Study to Monitor the Safety, Tolerability, and Efficacy of Subcutaneous Human Immunoglobulin (CUTAQUIG®) Administered at Modified Dosing Regimens in Patients With Primary Immunodeficiency Diseases
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Completed
Study Start Date
October 17, 2019 (Actual)
Primary Completion Date
January 3, 2022 (Actual)
Study Completion Date
January 3, 2022 (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
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
CLINICAL PHASE 3 STUDY TO MONITOR THE SAFETY, TOLERABILITY, AND EFFICACY OF SUBCUTANEOUS HUMAN IMMUNOGLOBULIN (CUTAQUIG®) ADMINISTERED AT MODIFIED DOSING REGIMENS IN PATIENTS WITH PRIMARY IMMUNODEFICIENCY DISEASES

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Primary Immune Deficiency Disorder

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Increased Volume Cohort - Cohort 1
Arm Type
Experimental
Arm Description
Increased volume at each infusion site - patients will receive CUTAQUIG weekly and increase infusion volumes every 4 weeks
Arm Title
Increased Infusion Rate Cohort - Cohort 2
Arm Type
Experimental
Arm Description
Increased infusion rate - patients will receive CUTAQUIG weekly and increase infusion rates every 4 weeks
Arm Title
Every Other Week Dosing Cohort - Cohort 3
Arm Type
Experimental
Arm Description
Every other week dosing - patients will receive CUTAQUIG every other week at the equivalent of twice their body-weight dependent [mg/kg] weekly dose
Intervention Type
Drug
Intervention Name(s)
CUTAQUIG
Intervention Description
Human normal immunoglobulin
Primary Outcome Measure Information:
Title
IgG Trough Levels
Description
Change in individual total IgG trough levels from weekly infusions to every other week infusions
Time Frame
25 weeks
Title
AEs
Description
Occurrence of treatment-emergent AEs (TEAEs) throughout the entire Stabilization and Treatment Periods starting with the first infusion of investigational medicinal product (IMP)
Time Frame
25 weeks
Title
Temporally Associated TEAEs During Treatment Period
Description
Occurrence of TEAEs temporally associated with CUTAQUIG delivered during the Treatment Period
Time Frame
25 weeks
Title
Temporally Associated TEAEs During Stabilization Period
Description
Occurrence of TEAEs temporally associated with CUTAQUIG delivered during the Stabilization Period
Time Frame
25 weeks
Title
TEAEs by speed of infusion
Description
TEAEs by speed of infusion
Time Frame
25 weeks
Title
Number of local infusion-site reactions
Description
Patients will grade the overall perception of local reactions in their diaries after each infusion using a 4-point rating scale: 0=none, 1=mild, 2=moderate, 3=severe. Investigators will evaluate local reactions after infusion at every study visit, using a 4-point rating scale: 0=none, 1=mild, 2=moderate, 3=severe.
Time Frame
25 weeks
Title
CBC
Description
Complete blood count
Time Frame
25 weeks
Title
WBC
Description
White blood cells
Time Frame
25 weeks
Title
Differential WBC Count
Description
Measures amount of each type of white blood cell
Time Frame
25 weeks
Title
Hematocrit
Description
Changes in hematocrit
Time Frame
25 weeks
Title
Hemoglobin
Description
Changes in hemoglobin
Time Frame
25 weeks
Title
Blood sodium
Description
Changes in blood sodium
Time Frame
25 weeks
Title
Blood potassium
Description
Changes in blood potassium
Time Frame
25 weeks
Title
Blood glucose
Description
Changes in blood glucose
Time Frame
25 weeks
Title
ALT
Description
Changes in ALT
Time Frame
25 weeks
Title
AST
Description
Changes in AST
Time Frame
25 weeks
Title
LDH
Description
Changes in LDH
Time Frame
25 weeks
Title
Total bilirubin
Description
Changes in total bilirubin
Time Frame
25 weeks
Title
Blood urea nitrogen
Description
Changes in blood urea nitrogen
Time Frame
25 weeks
Title
Creatinine
Description
Changes in creatinine
Time Frame
25 weeks
Title
Urine pH
Description
Changes in urine pH
Time Frame
25 weeks
Title
Urine glucose
Description
Changes in urine glucose
Time Frame
25 weeks
Title
Urine ketones
Description
Changes in urine ketones
Time Frame
25 weeks
Title
Urine leukocytes
Description
Changes in urine leukocytes
Time Frame
25 weeks
Title
Urine hemoglobin
Description
Changes in urine hemoglobin
Time Frame
25 weeks
Secondary Outcome Measure Information:
Title
Quality of Life questionnaire - CHQ-PF50
Description
CHQ-PF50 (Child Health Questionnaire Parent Form 50) from parent or guardian of patients <14 years of age. Likert-type scale with higher scores indicating better or more positive health states. Scores transformed to 0 - 100 scale.
Time Frame
25 weeks
Title
Quality of Life questionnaire - SF-36
Description
SF-36 (36-Item Short Form Survey) in patients ≥14 years of age SF-36: Likert-type scale with higher scores indicating better or more positive health states. Scores transformed to 0 - 100 scale.
Time Frame
25 weeks
Title
IgG trough levels
Description
Measurement of individual profiles of IgG trough levels over time (all cohorts)
Time Frame
25 weeks
Title
Infectious Disease Occurrence
Description
Monitoring for infectious disease occurrence
Time Frame
25 weeks
Title
Infectious Disease Resolution
Description
Monitoring for occurrences of infectious disease resolution
Time Frame
25 weeks
Title
Antibiotic use
Description
Monitoring for occurrences of antibiotic use
Time Frame
25 weeks
Title
Serious bacterial infections
Description
Occurrence of serious bacterial infections
Time Frame
25 weeks
Title
Blood Pressure
Description
Blood pressure including systolic and diastolic.
Time Frame
25 weeks
Title
Pulse
Description
Pulse
Time Frame
25 weeks
Title
Body temperature
Description
Body temperature
Time Frame
25 weeks
Title
Respiratory rate
Description
Respiratory rate
Time Frame
25 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥2 years and ≤75 years. Confirmed diagnosis of primary immunodeficiency (PI) disease as defined by the European Society for Immunodeficiencies and Pan American Group for Immunodeficiency and requiring immunoglobulin replacement therapy due to hypogammaglobulinaemia or agammaglobulinaemia. Note: The exact type of PI disease will be recorded. Established on a consistent or stable mg/kg dose of any SCIG treatment for a minimum of 3 months prior to Screening. Note: patients entering Cohort 3 must be on weekly SCIG infusions for a minimum of 12 weeks. Availability of the Immunoglobulin G (IgG) trough levels of 2 previous SCIG infusions within 1 year of Screening, with 1 trough level obtained within 3 months prior to enrollment, and maintenance of trough serum IgG levels ≥5.0 g/L in 2 previous infusions. Patients with no prior IgG trough level within 3 months prior to enrollment may use the Screening IgG trough level as their 2nd reading. Voluntarily given, fully informed signed informed consent. For patients under the legal age of consent, voluntarily given, fully-informed, signed informed consent will be provided by patient's parent or legal guardian, and assent will be provided by patient (per age-appropriate Institutional Review Board [IRB] requirements). Females of childbearing potential, who are not nursing and have no plans for pregnancy during the course of the study, have been using at least 1 acceptable form of birth control for a minimum of 30 days prior to the Screening visit and must agree to use at least 1 acceptable method of contraception for 30 days after the last dose of CUTAQUIG. Acceptable methods include: intrauterine device (IUD), hormonal contraception, male or female condom, spermicide gel, diaphragm, sponge, cervical cap, or abstinence. For female patients of child-bearing potential, a negative result in a urine pregnancy test conducted at the Screening visit. Willingness to comply with all aspects of the protocol, including blood sampling, for the duration of the study. Exclusion Criteria: Evidence of active infection within 4 weeks of Screening or during the Screening Period. Current or clinically-significant history of any cardiovascular, respiratory, hepatic, renal, gastrointestinal, endocrine, neurological, immunological (excluding PI), hematologic, and/or psychiatric disorder(s), or a history of any other illness that, in the opinion of the Investigator, might confound the results of the study, or pose additional risk to the patient by participation in the study. Known history of adverse reactions to immunoglobulin A (IgA) in other products. Body mass index (BMI) >40 kg/m2 for patients entering Cohort 2 or Cohort 3. There are no BMI restrictions for Cohort 1. Ongoing history of hypersensitivity or persistent reactions to blood or plasma derived products, or any component of the investigational product (such as Polysorbate 80). Requirement of any routine premedication for IgG administration. History of malignancies of lymphoid cells and immunodeficiency with lymphoma. Severe liver function impairment (aspartate aminotransferase [AST] or alanine aminotransferase [ALT] >3 times above upper limit of normal). Known protein-losing enteropathies or clinically significant proteinuria. Presence of renal function impairment (creatine >120 μM/L or creatinine >1.35 mg/dL), or predisposition for acute renal failure (eg, any degree of preexisting renal insufficiency or routine treatment with known nephritic drugs). Treatment with oral or parenteral steroids for ≥30 days, or when given intermittently or as bolus at daily doses ≥0.15 mg/kg when taken within 30 days of Screening. Note: Short or intermittent courses of steroids (ie, a steroid burst) of >0.15 mg/kg/day is allowed for treatment of a short-term condition such as an asthma exacerbation. Treatment with immunosuppressive or immunomodulatory drugs (except Omalizumab). Use of HYQVIA (Immune Globulin Infusion 10% [Human] with Recombinant Human Hyaluronidase) within 3 months prior to first CUTAQUIG infusion. Live viral vaccination (such as measles, rubella, mumps, and varicella) within 2 months prior to first CUTAQUIG infusion. Exposure to blood or any blood product or derivative, other than subcutaneous IgG used for regular PI disease treatment, within 3 months before the first CUTAQUIG infusion. Treatment with any investigational medicinal product within 3 months prior to first CUTAQUIG infusion. Note: Patients participating in Study SCGAM-03 will be allowed to enter this study without the 3-month waiting period for an Investigational Product. Patients receiving another SCIG product within 3 months prior to the first CUTAQUIG infusion may be considered for enrollment after Sponsor approval. Presence of any condition that is likely to interfere with the evaluation of CUTAQUIG or satisfactory conduct of the trial. Known or suspected to abuse alcohol, drugs, psychotropic agents, or other chemicals within the past 12 months prior to first CUTAQUIG infusion. Known active or chronic hepatitis B, hepatitis C, or HIV infection. Past hepatitis B or hepatitis C infection that has been cured is allowed.
Facility Information:
Facility Name
Octapharma Research Site
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85251
Country
United States
Facility Name
Octapharma Research Site
City
Irvine
State/Province
California
ZIP/Postal Code
92697
Country
United States
Facility Name
Octapharma Research Site
City
Santa Barbara
State/Province
California
ZIP/Postal Code
93105
Country
United States
Facility Name
Octapharma Research Site
City
Centennial
State/Province
Colorado
ZIP/Postal Code
80112
Country
United States
Facility Name
Octapharma Research Site
City
North Palm Beach
State/Province
Florida
ZIP/Postal Code
33408
Country
United States
Facility Name
Octapharma Research Site
City
Saint Petersburg
State/Province
Florida
ZIP/Postal Code
33701
Country
United States
Facility Name
Octapharma Research Site
City
Albany
State/Province
Georgia
ZIP/Postal Code
31707
Country
United States
Facility Name
Octapharma Research Site
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40215
Country
United States
Facility Name
Octapharma Research Site
City
Chevy Chase
State/Province
Maryland
ZIP/Postal Code
20815
Country
United States
Facility Name
Octapharma Research Site
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63141
Country
United States
Facility Name
Octapharma Research Site
City
Papillion
State/Province
Nebraska
ZIP/Postal Code
68046
Country
United States
Facility Name
Octapharma Research Site
City
Asheville
State/Province
North Carolina
ZIP/Postal Code
28801
Country
United States
Facility Name
Octapharma Research Site
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45231
Country
United States
Facility Name
Octapharma Research Site
City
Mayfield
State/Province
Ohio
ZIP/Postal Code
44124
Country
United States
Facility Name
Octapharma Research Site
City
Toledo
State/Province
Ohio
ZIP/Postal Code
43617
Country
United States
Facility Name
Octapharma Research Site
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15241
Country
United States
Facility Name
Octapharma Research Site
City
Dallas
State/Province
Texas
ZIP/Postal Code
75225
Country
United States
Facility Name
Octapharma Research Site
City
Bellingham
State/Province
Washington
ZIP/Postal Code
98225
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Study to Monitor Subcutaneous Human Immunoglobulin Administered at Modified Dosing Regimens in Patients With Primary Immunodeficiency Diseases

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