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Study of TAK-672 in Participants With Acquired Hemophilia A

Primary Purpose

Acquired Hemophilia A

Status
Completed
Phase
Phase 2
Locations
Japan
Study Type
Interventional
Intervention
TAK-672
Sponsored by
Takeda
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acquired Hemophilia A

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female Japanese participants of >=18 years of age.
  2. Participants who (or their legally authorized representatives) have provided his/her written informed consent form prior to any study-related procedures and study product administration.
  3. Participants with a diagnosis of AHA based on clinical evaluation and supportive local laboratory testing as shown below:

    • Presentation with spontaneous bleeding without anatomical cause and without prior known bleeding disorder.
    • Prolonged activated partial thromboplastin time (aPTT) without explanation.
    • Abnormal aPTT cross mixing test consistent with FVIII inhibitors
    • Confirmation of a low FVIII:C.
    • Positive FVIII inhibitor (>=0.6 BU) as measured either in the local or central laboratory
  4. Participants with a severe bleeding episode which the investigator finds necessary to treat and whose severe bleeding episode meets at least 1 of the following criteria:

    • Bleeds that pose a threat to a vital organ that could threaten life (e.g. intracranial bleed, or any site that could obstruct the airway).
    • Bleeds that pose a threat to a vital organ where life is not threatened but the organ function could be impaired (e.g., intraspinal bleed threatening the spinal cord and/or nerve conduction; a continual bleed into the kidney or bladder that could result in an obstructive uropathy, testicular bleed, bleed in and around the eye).
    • Bleeds requiring a blood transfusion to maintain the Hgb level at above-life or organ threatening levels (e.g. post-surgical, gastro-intestinal, retro-peritoneal, and thigh bleeds).
    • Intramuscular bleeds where muscle viability and/or neurovascular integrity is significantly compromised or at risk of being compromised.
    • Intra-articular bleeds impacting a major joint associated with severe pain, swelling and severe loss of joint mobility (reduced >70%) or where a bleed could result in joint destruction (e.g. in and around the femoral head).
  5. Participants who are taking anti-thrombotics (including anti-platelet agents and anticoagulantswith confirmatory laboratory testing documenting specific FVIII inhibitor titer and with 3 half-lives of the agent have elapsed since the last dose.
  6. Participants with expected life expectancies of at least 90 days prior to the onset of the hemorrhagic episode.
  7. Participants of reproductive age who have agreed to use acceptable methods of contraception and if female, undergo pregnancy testing as part of the screening process.
  8. Participant who are able to willing and able to comply with the requirements of the protocol.

Exclusion Criteria:

  1. Participants with an established reason for bleeding that is not correctable even with hemostatic therapy.
  2. Participants presenting a bleeding episode that is assessed likely to resolve on its own, even if left untreated.
  3. Participants with a known major sensitivity (anaphylactoid reactions) to therapeutic products of porcine or hamster origin; examples include therapeutics of porcine origin (e.g. previously marketed porcine FVIII, Hyate: C) and recombinant therapeutics prepared from hamster cells (e.g. Humira, Advate, and Enbrel).
  4. Participants with the use of hemophilia medication: prior to the administration of TAK-672 under one of the following conditions: (1) use of "recombinant activated factor VII (rFVI)Ia " within 3 hours prior to TAK-672 administration (2) use of " activated prothrombin complex concentrate (aPCC)" within 6 hours prior to TAK-672 administration or (3) use of " plasma-derived FX/FVIIa complex concentrate (pd-FX/FVIIa) " within 8 hours prior to TAK-672 administration.
  5. Participants with an anticipated need for treatment or device during the study that may interfere with the evaluation of the safety or efficacy of TAK-672, or whose safety or efficacy may be affected by TAK-672.
  6. Participants who are currently pregnant or breastfeeding, or planning to become pregnant or father a child during the study
  7. Participants who have participated in another clinical study and has been exposed to an investigational product or device within 30 days prior to the study enrollment.
  8. Participants who are scheduled to participate in another non-observational (interventional) clinical study involving an investigational product or device during the course of the study.
  9. Participants who are unable to or unwilling to comply with the study design, protocol requirements, and/or the follow-up procedures.
  10. Participants whose majority of age are under legal protection.
  11. Participants who are an immediate family member, study site employee, or are in a dependent relationship with a study site employee who is involved in the conduct of this study (e.g. spouse, parent, child, sibling) or may consent under duress.
  12. Participants who are judged by the investigator as being ineligible for any other reason.

Sites / Locations

  • Gunma University Hospital
  • Nagoya University Hospital
  • Nara Medical University Hospital
  • Uonuma Kikan Hospital
  • Jichi Medical University Hospital
  • Tokyo Saiseikai Central Hospital
  • Chiba University Hospital
  • Fukushima Medical University Hospital
  • Yamagata University Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

TAK-672

Arm Description

TAK-672 will be administered at an initial dose of 200 U/kg with intravenous infusion at a rate of 1-2 mL/min. Subsequent doses will be determined based on the post-infusion factor VIII activity (FVIII:C) achieved after the most recent dose given, the target FVIII:C, and pFVIII inhibitor titer (when available)

Outcomes

Primary Outcome Measures

Percentage of Severe Bleeding Episodes with Demonstrated Response to TAK-672 Therapy at 24 Hours after the Initiation of Treatment
Percentage of severe bleeding episodes with demonstrated response to TAK-672 therapy at 24 hours after the initiation of treatment will be assessed by using a well-defined 4-point ordinal scale - A 'positive response' is defined as 'effective' (bleeding stopped with clinical control and FVIII:C levels of 50% or higher ) or 'partially effective' (bleeding reduced with clinical stabilization and FVIII:C levels of 20% or higher) control of bleeding, as determined by the investigator using a 4-point rating scale (effective - partially effective - poorly effective - not effective). 'Poorly effective' is defined as 'bleeding slightly reduced or unchanged and FVIII:C levels of less than 50%'. 'Not effective' is defined as 'bleeding worsening and FVIII:C levels of less than 50%'.

Secondary Outcome Measures

The Overall Percentage of Severe Bleeding Episodes Successfully Controlled with TAK-672 Therapy, as Assessed by the Investigator
Treatment success is defined as control of qualifying bleeding episode at the time of final treatment dosing. A severe bleeding episode is considered 'successfully controlled' if the investigator has checked 'completed TAK-672 therapy as treatment success' on the electronic case report form (eCRF).
The Percentage of Bleeding Episodes Responsive to TAK-672 Therapy at Designated Assessment Time Points after the Initiation of Therapy, as Assessed by the Investigator
A 'positive response' is defined as 'effective' (bleeding stopped with clinical control and FVIII:C levels of 50% or higher ) or 'partially effective' (bleeding reduced with clinical stabilization and FVIII:C levels of 20% or higher) control of bleeding, as determined by the investigator using a 4-point rating scale (effective - partially effective - poorly effective - not effective). 'Poorly effective' is defined as 'bleeding slightly reduced or unchanged and FVIII:C levels of less than 50%'. 'Not effective' is defined as 'bleeding worsening and FVIII:C levels of less than 50%'.
Frequency of Infusions of TAK-672 Required to Successfully Control Qualifying Bleeding Episodes
'Frequency of infusions' will be calculated as the 'average number of infusions per day'. 'Qualifying bleeding episode' is defined as the 'initial, severe bleeding episode'
Total Dose of Infusions of TAK-672 Required to Successfully Control Qualifying Bleeding Episodes.
'Qualifying bleeding episode' is defined as the 'initial, severe bleeding episode'.
Total Number of Infusions of TAK-672 Required to Successfully Control Qualifying Bleeding Episodes
'Qualifying bleeding episode' is defined as the 'initial, severe bleeding episode'. A severe bleeding episode is considered 'successfully controlled' if the investigator had checked 'completed TAK-672 therapy as treatment success' on the eCRF.
Correlation between Response to TAK-672 Therapy at Specified Time Points and Eventual Control of Severe Bleeding Episodes
Correlation among the Pre-infusion Anti-TAK-672 Antibody Titers and the Eventual Control of the Bleeding Episode
Correlation among the Total Dose of TAK-672 and the Eventual Control of the Bleeding Episode
Correlation between the Response at 24 Hours and the Eventual Control of the Bleeding Episode
Anti-hFVIII Inhibitor Level
Anti-pFVIII Inhibitor Level
Terminal Half-life (t1/2) for TAK-672
Clearance (CL) for TAK-672
Volume of Distribution (Vd) for TAK-672
Area Under the Concentration-Time Curve (AUC) for TAK-672
Maximum Drug Concentration (Cmax) per Dose (Cmax/Dose) for TAK-672
Duration Period from Initial Dose of TAK-672 until Completion of Hemostasis Control
Total Dose from Initial Dose of TAK-672 until Completion of Hemostasis Control
Number of new qualified severe bleeding episodes

Full Information

First Posted
October 5, 2020
Last Updated
December 27, 2022
Sponsor
Takeda
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1. Study Identification

Unique Protocol Identification Number
NCT04580407
Brief Title
Study of TAK-672 in Participants With Acquired Hemophilia A
Official Title
A Phase 2/3, Open-Label, Non-controlled Study to Evaluate the Efficacy and Safety of B-Domain Deleted Recombinant Porcine Factor VIII (rpFVIII, TAK-672), in the Treatment of Serious Bleeding Episode in Japanese Subjects With Acquired Hemophilia A (AHA)
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Completed
Study Start Date
November 9, 2021 (Actual)
Primary Completion Date
November 29, 2022 (Actual)
Study Completion Date
November 29, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Takeda

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
The main aims of the study are to learn if TAK-672 can control bleeds in participants with acquired hemophilia A and if the participants have side effects from TAK-672. Acquired hemophilia A is when people's immune system attacks specific proteins, known as clotting factors, in their bodies. This is different from hemophilia A, which is a condition people are born with. At the first visit, the study doctor will check who can take part. For those who can take part, participants will visit the clinic or hospital when they get their next bleed. They will receive TAK-672 slowly through a vein. This is called an infusion. They might need extra infusions of TAK-672 to control the bleed. After their bleed is controlled, participants will regularly visit the clinic for a check-up and to treat any further bleeds. This will happen until all participants have received their last dose of TAK-672 to control their 1st bleed. After this, all participants will visit the clinic 90 days later for a final check-up.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acquired Hemophilia A

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
5 (Actual)

8. Arms, Groups, and Interventions

Arm Title
TAK-672
Arm Type
Experimental
Arm Description
TAK-672 will be administered at an initial dose of 200 U/kg with intravenous infusion at a rate of 1-2 mL/min. Subsequent doses will be determined based on the post-infusion factor VIII activity (FVIII:C) achieved after the most recent dose given, the target FVIII:C, and pFVIII inhibitor titer (when available)
Intervention Type
Biological
Intervention Name(s)
TAK-672
Other Intervention Name(s)
rpFVIII, TAK-672, Obizur
Intervention Description
B-Domain Deleted Recombinant Porcine Factor VIII
Primary Outcome Measure Information:
Title
Percentage of Severe Bleeding Episodes with Demonstrated Response to TAK-672 Therapy at 24 Hours after the Initiation of Treatment
Description
Percentage of severe bleeding episodes with demonstrated response to TAK-672 therapy at 24 hours after the initiation of treatment will be assessed by using a well-defined 4-point ordinal scale - A 'positive response' is defined as 'effective' (bleeding stopped with clinical control and FVIII:C levels of 50% or higher ) or 'partially effective' (bleeding reduced with clinical stabilization and FVIII:C levels of 20% or higher) control of bleeding, as determined by the investigator using a 4-point rating scale (effective - partially effective - poorly effective - not effective). 'Poorly effective' is defined as 'bleeding slightly reduced or unchanged and FVIII:C levels of less than 50%'. 'Not effective' is defined as 'bleeding worsening and FVIII:C levels of less than 50%'.
Time Frame
24 hours after the initiation of treatment
Secondary Outcome Measure Information:
Title
The Overall Percentage of Severe Bleeding Episodes Successfully Controlled with TAK-672 Therapy, as Assessed by the Investigator
Description
Treatment success is defined as control of qualifying bleeding episode at the time of final treatment dosing. A severe bleeding episode is considered 'successfully controlled' if the investigator has checked 'completed TAK-672 therapy as treatment success' on the electronic case report form (eCRF).
Time Frame
Up to 1 year (90 days after final treatment dosing)
Title
The Percentage of Bleeding Episodes Responsive to TAK-672 Therapy at Designated Assessment Time Points after the Initiation of Therapy, as Assessed by the Investigator
Description
A 'positive response' is defined as 'effective' (bleeding stopped with clinical control and FVIII:C levels of 50% or higher ) or 'partially effective' (bleeding reduced with clinical stabilization and FVIII:C levels of 20% or higher) control of bleeding, as determined by the investigator using a 4-point rating scale (effective - partially effective - poorly effective - not effective). 'Poorly effective' is defined as 'bleeding slightly reduced or unchanged and FVIII:C levels of less than 50%'. 'Not effective' is defined as 'bleeding worsening and FVIII:C levels of less than 50%'.
Time Frame
Up to 1 year (90 days after final treatment dosing)
Title
Frequency of Infusions of TAK-672 Required to Successfully Control Qualifying Bleeding Episodes
Description
'Frequency of infusions' will be calculated as the 'average number of infusions per day'. 'Qualifying bleeding episode' is defined as the 'initial, severe bleeding episode'
Time Frame
Time of successful control of qualifying bleeding episode (varied from participant to participant)
Title
Total Dose of Infusions of TAK-672 Required to Successfully Control Qualifying Bleeding Episodes.
Description
'Qualifying bleeding episode' is defined as the 'initial, severe bleeding episode'.
Time Frame
Time of successful control of qualifying bleeding episode (varied from participant to participant)
Title
Total Number of Infusions of TAK-672 Required to Successfully Control Qualifying Bleeding Episodes
Description
'Qualifying bleeding episode' is defined as the 'initial, severe bleeding episode'. A severe bleeding episode is considered 'successfully controlled' if the investigator had checked 'completed TAK-672 therapy as treatment success' on the eCRF.
Time Frame
Time of successful control of qualifying bleeding episode (varied from participant to participant)
Title
Correlation between Response to TAK-672 Therapy at Specified Time Points and Eventual Control of Severe Bleeding Episodes
Time Frame
Up to 1 year (90 days after final treatment dosing)
Title
Correlation among the Pre-infusion Anti-TAK-672 Antibody Titers and the Eventual Control of the Bleeding Episode
Time Frame
Up to 1 year (90 days after final treatment dosing)
Title
Correlation among the Total Dose of TAK-672 and the Eventual Control of the Bleeding Episode
Time Frame
Up to 1 year (90 days after final treatment dosing)
Title
Correlation between the Response at 24 Hours and the Eventual Control of the Bleeding Episode
Time Frame
Up to 1 year (90 days after final treatment dosing)
Title
Anti-hFVIII Inhibitor Level
Time Frame
Up to 1 year (90 days after final treatment dosing)
Title
Anti-pFVIII Inhibitor Level
Time Frame
Up to 1 year (90 days after final treatment dosing)
Title
Terminal Half-life (t1/2) for TAK-672
Time Frame
Pre-dose and at multiple time points (up to 24 hours) post-dose
Title
Clearance (CL) for TAK-672
Time Frame
Pre-dose and at multiple time points (up to 24 hours) post-dose
Title
Volume of Distribution (Vd) for TAK-672
Time Frame
Pre-dose and at multiple time points (up to 24 hours) post-dose
Title
Area Under the Concentration-Time Curve (AUC) for TAK-672
Time Frame
Pre-dose and at multiple time points (up to 24 hours) post-dose
Title
Maximum Drug Concentration (Cmax) per Dose (Cmax/Dose) for TAK-672
Time Frame
Pre-dose and at multiple time points (up to 24 hours) post-dose
Title
Duration Period from Initial Dose of TAK-672 until Completion of Hemostasis Control
Time Frame
Time of completion of hemostasis control (varied from participant to participant)
Title
Total Dose from Initial Dose of TAK-672 until Completion of Hemostasis Control
Time Frame
Time of completion of hemostasis control (varied from participant to participant)
Title
Number of new qualified severe bleeding episodes
Time Frame
Up to 1 year (90 days after final treatment dosing)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female Japanese participants of >=18 years of age. Participants who (or their legally authorized representatives) have provided his/her written informed consent form prior to any study-related procedures and study product administration. Participants with a diagnosis of AHA based on clinical evaluation and supportive local laboratory testing as shown below: Presentation with spontaneous bleeding without anatomical cause and without prior known bleeding disorder. Prolonged activated partial thromboplastin time (aPTT) without explanation. Abnormal aPTT cross mixing test consistent with FVIII inhibitors Confirmation of a low FVIII:C. Positive FVIII inhibitor (>=0.6 BU) as measured either in the local or central laboratory Participants with a severe bleeding episode which the investigator finds necessary to treat and whose severe bleeding episode meets at least 1 of the following criteria: Bleeds that pose a threat to a vital organ that could threaten life (e.g. intracranial bleed, or any site that could obstruct the airway). Bleeds that pose a threat to a vital organ where life is not threatened but the organ function could be impaired (e.g., intraspinal bleed threatening the spinal cord and/or nerve conduction; a continual bleed into the kidney or bladder that could result in an obstructive uropathy, testicular bleed, bleed in and around the eye). Bleeds requiring a blood transfusion to maintain the Hgb level at above-life or organ threatening levels (e.g. post-surgical, gastro-intestinal, retro-peritoneal, and thigh bleeds). Intramuscular bleeds where muscle viability and/or neurovascular integrity is significantly compromised or at risk of being compromised. Intra-articular bleeds impacting a major joint associated with severe pain, swelling and severe loss of joint mobility (reduced >70%) or where a bleed could result in joint destruction (e.g. in and around the femoral head). Participants who are taking anti-thrombotics (including anti-platelet agents and anticoagulantswith confirmatory laboratory testing documenting specific FVIII inhibitor titer and with 3 half-lives of the agent have elapsed since the last dose. Participants with expected life expectancies of at least 90 days prior to the onset of the hemorrhagic episode. Participants of reproductive age who have agreed to use acceptable methods of contraception and if female, undergo pregnancy testing as part of the screening process. Participant who are able to willing and able to comply with the requirements of the protocol. Exclusion Criteria: Participants with an established reason for bleeding that is not correctable even with hemostatic therapy. Participants presenting a bleeding episode that is assessed likely to resolve on its own, even if left untreated. Participants with a known major sensitivity (anaphylactoid reactions) to therapeutic products of porcine or hamster origin; examples include therapeutics of porcine origin (e.g. previously marketed porcine FVIII, Hyate: C) and recombinant therapeutics prepared from hamster cells (e.g. Humira, Advate, and Enbrel). Participants with the use of hemophilia medication: prior to the administration of TAK-672 under one of the following conditions: (1) use of "recombinant activated factor VII (rFVI)Ia " within 3 hours prior to TAK-672 administration (2) use of " activated prothrombin complex concentrate (aPCC)" within 6 hours prior to TAK-672 administration or (3) use of " plasma-derived FX/FVIIa complex concentrate (pd-FX/FVIIa) " within 8 hours prior to TAK-672 administration. Participants with an anticipated need for treatment or device during the study that may interfere with the evaluation of the safety or efficacy of TAK-672, or whose safety or efficacy may be affected by TAK-672. Participants who are currently pregnant or breastfeeding, or planning to become pregnant or father a child during the study Participants who have participated in another clinical study and has been exposed to an investigational product or device within 30 days prior to the study enrollment. Participants who are scheduled to participate in another non-observational (interventional) clinical study involving an investigational product or device during the course of the study. Participants who are unable to or unwilling to comply with the study design, protocol requirements, and/or the follow-up procedures. Participants whose majority of age are under legal protection. Participants who are an immediate family member, study site employee, or are in a dependent relationship with a study site employee who is involved in the conduct of this study (e.g. spouse, parent, child, sibling) or may consent under duress. Participants who are judged by the investigator as being ineligible for any other reason.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Study Director
Organizational Affiliation
Takeda
Official's Role
Study Director
Facility Information:
Facility Name
Gunma University Hospital
City
Maebashi
State/Province
Gunma
Country
Japan
Facility Name
Nagoya University Hospital
City
Aichi
State/Province
Nagoya
Country
Japan
Facility Name
Nara Medical University Hospital
City
Kashihara-shi
State/Province
Nara
Country
Japan
Facility Name
Uonuma Kikan Hospital
City
Minamiuonuma
State/Province
Niigata
Country
Japan
Facility Name
Jichi Medical University Hospital
City
Shimotsuke
State/Province
Tochigi
Country
Japan
Facility Name
Tokyo Saiseikai Central Hospital
City
Mita
State/Province
Tokyo
Country
Japan
Facility Name
Chiba University Hospital
City
Chiba
Country
Japan
Facility Name
Fukushima Medical University Hospital
City
Fukushima
Country
Japan
Facility Name
Yamagata University Hospital
City
Yamagata
Country
Japan

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
De-identified individual participant data from this particular study will not be shared as there is a reasonable likelihood that individual patients could be re-identified (due to the limited number of study participants/study sites.
Links:
URL
https://clinicaltrials.takeda.com/study-detail/5f9464b2296beb001e63bf9f
Description
To obtain more information on the study, click here/on this link

Learn more about this trial

Study of TAK-672 in Participants With Acquired Hemophilia A

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