Study of Next-Generation Recombinant Factor IX Variant in Adult Subjects With Hemophilia B
Primary Purpose
Hemophilia B
Status
Completed
Phase
Phase 2
Locations
South Africa
Study Type
Interventional
Intervention
Coagulation Factor IX variant
Coagulation Factor IX variant
Sponsored by
About this trial
This is an interventional treatment trial for Hemophilia B
Eligibility Criteria
Inclusion Criteria:
- Confirmed diagnosis of severe (<2%) congenital hemophilia B.
- Male, age 18 or older.
- Agreement to use highly effective birth control throughout the study.
- Affirmation of informed consent with signature confirmation before any trial-related activities.
- Stated willingness to comply with all study procedures and availability for the duration of the study.
Exclusion Criteria:
- History or a family history of FIX inhibitors.
- Positive antibody to FIX detected by central laboratory at screening.
- Previous participation in and subsequent treatment in a clinical trial within the previous 30 days or 3-half-lives, whichever is longer, or absence of clinical effect.
- Have a coagulation disorder other than congenital hemophilia B.
- Factor IX gene mutation 128G>A.
- Significant contraindication to participation.
Sites / Locations
- Haemophilia Comprehensive Care Centre
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
Intravenous Dose
Subcutaneous Dosing
Arm Description
Coagulation Factor IX variant, 50 IU/kg by intravenous route
Coagulation Factor IX variant, 100 IU/kg by subcutaneous route
Outcomes
Primary Outcome Measures
Number of Subjects Who Achieved FIX Level ≥12%
Subjects who achieved a FIX activity level ≥12% during the treatment period in the PK Population
Secondary Outcome Measures
FIX Activity Levels (Actual and Change From Baseline) in All Subjects
FIX Activity Levels measured by percent activity.
Baseline was defined as the lowest assessment before the first administration of study drug. Maximum change from baseline was calculated as the maximum of the changes from baseline over all visits during treatment period. FIX activity level below the limit of quantification (BLQ) were set to zero. In case of retest, the average of the different test results were considered for the summary analyses.
1 subject received a higher IV dose than allowed per protocol (150 IU/kg) at Day 1 thus this subject's values at Day 1 (SC Dose), Day 2, & Day 3 were excluded from this analysis & the total number of participants was lowered by 1 at these timepoints. Additionally, mean (standard deviation) for the maximum change from baseline in the FIX activity level (%) during SC dosing was calculated by excluding actual values at Day 1 IV dose, Day 1 SC dose, Day 2 & Day 3 for all 6 subjects.
Pharmacokinetic (PK) Analysis - AUC
Summary of Pharmacokinetic Parameters - AUC Infinity Observation and AUC to Last Non-zero Concentration
PK Analysis - Clearance
Summary of PK Parameters - Clearance
PK Analysis - Maximum Concentration During SC Dosing
Summary of PK Parameters - Maximum Concentration during SC dosing
PK Analysis - Half-Life and Residence Time
Summary of PK Parameters - Half-Life-1(alpha), Half-Life-1(beta), and Mean Residence Time
PK Analysis - Volume of Distribution at Steady-State Observed
Summary of PK Parameters - Volume of Distribution at Steady-State Observed
Occurrence of Clinical Thrombotic Event
Rate of occurrence of clinical thrombotic event not attributable to another cause
Occurrence of an Antibody Response
Rate of occurrence of an antibody response to CB2679d and cross-reactive with wild-type recombinant coagulation FIX
Thrombogenicity Assessment - Fibrinogen
Evaluation of the levels of thrombogenicity markers of a subcutaneous regimen of CB2679d
Thrombogenicity Assessment - D-Dimer
Evaluation of the levels of thrombogenicity markers of a subcutaneous regimen of CB2679d
Thrombogenicity Assessment - Prothrombin Fragments 1 + 2
Evaluation of the levels of thrombogenicity markers of a subcutaneous regimen of CB2679d
Thrombogenicity Assessment - Thrombin/Antithrombin
Evaluation of the levels of thrombogenicity markers of a subcutaneous regimen of CB2679d
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03995784
Brief Title
Study of Next-Generation Recombinant Factor IX Variant in Adult Subjects With Hemophilia B
Official Title
Phase 2b Study to Evaluate the Pharmacokinetics, Pharmacodynamics, Efficacy and Safety of a Subcutaneous Prophylaxis Treatment Regimen of CB2679d, in Adult Subjects With Hemophilia B
Study Type
Interventional
2. Study Status
Record Verification Date
August 2021
Overall Recruitment Status
Completed
Study Start Date
June 18, 2019 (Actual)
Primary Completion Date
February 28, 2020 (Actual)
Study Completion Date
April 30, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Catalyst Biosciences
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
Phase 2b, single-center, open-label study designed to evaluate the pharmacokinetics, pharmacodynamics, efficacy and safety of subcutaneous (SC) prophylaxis treatment regimens with CB2679d in 6 adult, male subjects with severe congenital hemophilia B.
Detailed Description
Single-center, open-label Phase 2b study will evaluate the PK, PD, efficacy and safety parameters of SC prophylaxis treatment regimens with CB2679d in adult subjects with hemophilia B. The study will enroll and dose subcutaneously, a total of 6 adult male subjects with severe congenital hemophilia B.
During the Treatment Period, the subject will receive an IV dose of 50 IU/kg followed 35 ± 5 minutes later by a SC dose of 100 IU/kg. Daily SC doses of 100 IU/kg will be administered until Day 28 (28 total SC doses). On Day 1, PK, PD, and safety assessments will be done at pre-IV dose and repeated 35 (± 5) minutes later prior to the SC dose. Subsequent PK, PD and safety assessments will be performed pre-dose on days 2, 3, 7, 14, 21 and 28.
During the Washout Period, PK, PD, and safety assessments will be done on Days 29, 30, 31, 32 and 33. Daily FIX activity levels will be measured, unless FIX activity level is known to be < 5%, as measured by local laboratory.
An End of Study visit will occur 30 days (± 2 days) after the last dose of study drug.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hemophilia B
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
6 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Intravenous Dose
Arm Type
Experimental
Arm Description
Coagulation Factor IX variant, 50 IU/kg by intravenous route
Arm Title
Subcutaneous Dosing
Arm Type
Experimental
Arm Description
Coagulation Factor IX variant, 100 IU/kg by subcutaneous route
Intervention Type
Biological
Intervention Name(s)
Coagulation Factor IX variant
Intervention Description
Single intravenous injection of CB2679d/Dalcinonacog alfa
Intervention Type
Biological
Intervention Name(s)
Coagulation Factor IX variant
Intervention Description
Daily subcutaneous injections of CB2679d/Dalcinonacog alfa for 28 days
Primary Outcome Measure Information:
Title
Number of Subjects Who Achieved FIX Level ≥12%
Description
Subjects who achieved a FIX activity level ≥12% during the treatment period in the PK Population
Time Frame
Days 7, 14, 21, 28, 29
Secondary Outcome Measure Information:
Title
FIX Activity Levels (Actual and Change From Baseline) in All Subjects
Description
FIX Activity Levels measured by percent activity.
Baseline was defined as the lowest assessment before the first administration of study drug. Maximum change from baseline was calculated as the maximum of the changes from baseline over all visits during treatment period. FIX activity level below the limit of quantification (BLQ) were set to zero. In case of retest, the average of the different test results were considered for the summary analyses.
1 subject received a higher IV dose than allowed per protocol (150 IU/kg) at Day 1 thus this subject's values at Day 1 (SC Dose), Day 2, & Day 3 were excluded from this analysis & the total number of participants was lowered by 1 at these timepoints. Additionally, mean (standard deviation) for the maximum change from baseline in the FIX activity level (%) during SC dosing was calculated by excluding actual values at Day 1 IV dose, Day 1 SC dose, Day 2 & Day 3 for all 6 subjects.
Time Frame
Screening, Day 1 (IV Pre-dose, SC Dose), Day 2, 3, 7, 14, 21, 28, 29, 30, 31, 32, 33, and End of Study. End of Study is the average of each subject's last recorded assessment (between Days 29 to 33).
Title
Pharmacokinetic (PK) Analysis - AUC
Description
Summary of Pharmacokinetic Parameters - AUC Infinity Observation and AUC to Last Non-zero Concentration
Time Frame
From date of first dose of CB2679d until date of first occurrence of clinical event, assessed up to treatment Day 28. PK sampling was conducted on Day 1 (IV pre-dose -5 min, SC 30 min post IV dose, hour 7 +/- 1 hour) and Day 2 (hour 24 +/- 1 hour).
Title
PK Analysis - Clearance
Description
Summary of PK Parameters - Clearance
Time Frame
From date of first dose of CB2679d until date of first occurrence of clinical event, assessed up to treatment Day 28. PK sampling was conducted on Day 1 (IV pre-dose -5 min, SC 30 min post IV dose, hour 7 +/- 1 hour) and Day 2 (hour 24 +/- 1 hour).
Title
PK Analysis - Maximum Concentration During SC Dosing
Description
Summary of PK Parameters - Maximum Concentration during SC dosing
Time Frame
From date of first dose of CB2679d until date of first occurrence of clinical event, assessed up to treatment Day 28. PK sampling was conducted on Day 1 (IV pre-dose -5 min, SC 30 min post IV dose, hour 7 +/- 1 hour) and Day 2 (hour 24 +/- 1 hour).
Title
PK Analysis - Half-Life and Residence Time
Description
Summary of PK Parameters - Half-Life-1(alpha), Half-Life-1(beta), and Mean Residence Time
Time Frame
From date of first dose of CB2679d until date of first occurrence of clinical event, assessed up to treatment Day 28. PK sampling was conducted on Day 1 (IV pre-dose -5 min, SC 30 min post IV dose, hour 7 +/- 1 hour) and Day 2 (hour 24 +/- 1 hour).
Title
PK Analysis - Volume of Distribution at Steady-State Observed
Description
Summary of PK Parameters - Volume of Distribution at Steady-State Observed
Time Frame
From date of first dose of CB2679d until date of first occurrence of clinical event, assessed up to treatment Day 28. PK sampling was conducted on Day 1 (IV pre-dose -5 min, SC 30 min post IV dose, hour 7 +/- 1 hour) and Day 2 (hour 24 +/- 1 hour).
Title
Occurrence of Clinical Thrombotic Event
Description
Rate of occurrence of clinical thrombotic event not attributable to another cause
Time Frame
From date of first dose of CB2679d until date of first occurrence of clinical event, assessed up to treatment Day 28
Title
Occurrence of an Antibody Response
Description
Rate of occurrence of an antibody response to CB2679d and cross-reactive with wild-type recombinant coagulation FIX
Time Frame
From date of first dose of CB2679d until date of first occurrence of clinical event, assessed up to treatment Day 28
Title
Thrombogenicity Assessment - Fibrinogen
Description
Evaluation of the levels of thrombogenicity markers of a subcutaneous regimen of CB2679d
Time Frame
Screening, Day 1 (IV Pre-dose, SC Dose), Day 2, 3, 7, 14, 21, 28, 29, 30, 31, 32, 33, and End of Study. End of Study is the average of each subject's last recorded assessment (between Days 29 to 33).
Title
Thrombogenicity Assessment - D-Dimer
Description
Evaluation of the levels of thrombogenicity markers of a subcutaneous regimen of CB2679d
Time Frame
Screening, Day 1 (IV Pre-dose, SC Dose), Day 2, 3, 7, 14, 21, 28, 29, 30, 31, 32, 33, and End of Study. End of Study is the average of each subject's last recorded assessment (between Days 29 to 33).
Title
Thrombogenicity Assessment - Prothrombin Fragments 1 + 2
Description
Evaluation of the levels of thrombogenicity markers of a subcutaneous regimen of CB2679d
Time Frame
Screening, Day 1 (IV Pre-dose, SC Dose), Day 2, 3, 7, 14, 21, 28, 29, 30, 31, 32, 33, and End of Study. End of Study is the average of each subject's last recorded assessment (between Days 29 to 33).
Title
Thrombogenicity Assessment - Thrombin/Antithrombin
Description
Evaluation of the levels of thrombogenicity markers of a subcutaneous regimen of CB2679d
Time Frame
Screening, Day 1 (IV Pre-dose, SC Dose), Day 2, 3, 7, 14, 21, 28, 29, 30, 31, 32, 33, and End of Study. End of Study is the average of each subject's last recorded assessment (between Days 29 to 33).
10. Eligibility
Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Confirmed diagnosis of severe (<2%) congenital hemophilia B.
Male, age 18 or older.
Agreement to use highly effective birth control throughout the study.
Affirmation of informed consent with signature confirmation before any trial-related activities.
Stated willingness to comply with all study procedures and availability for the duration of the study.
Exclusion Criteria:
History or a family history of FIX inhibitors.
Positive antibody to FIX detected by central laboratory at screening.
Previous participation in and subsequent treatment in a clinical trial within the previous 30 days or 3-half-lives, whichever is longer, or absence of clinical effect.
Have a coagulation disorder other than congenital hemophilia B.
Factor IX gene mutation 128G>A.
Significant contraindication to participation.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Howard Levy, MD, PhD, MMM
Organizational Affiliation
Catalyst Biosciences
Official's Role
Study Director
Facility Information:
Facility Name
Haemophilia Comprehensive Care Centre
City
Johannesburg
Country
South Africa
12. IPD Sharing Statement
Plan to Share IPD
No
IPD Sharing Plan Description
This is a single-center, open label study so the investigator will have full access to all study subject data.
Learn more about this trial
Study of Next-Generation Recombinant Factor IX Variant in Adult Subjects With Hemophilia B
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