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A Study of Fitusiran (ALN-AT3SC) in Severe Hemophilia A and B Patients Without Inhibitors

Primary Purpose

Hemophilia A, Hemophilia B

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
fitusiran
factor concentrates
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, Coagulants, Fitusiran

Eligibility Criteria

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

Inclusion Criteria:

  • Males, >=12 years of age.
  • Severe hemophilia A or B without inhibitors.

    • Severity confirmed by a central laboratory where FVIII level was less than (<) 1 percent (%) or Factor IX (FIX) level was less than or equal to (<=) 2% at Screening.
    • On-demand use of factor concentrate to manage bleeding episodes for at least the last 6 months prior to Screening, and meet each of the following criterion:

      • Nijmegen modified Bethesda assay inhibitor titer of <0.6 Bethesda units per milliliter (BU/mL) at Screening.
      • No use of Bypassing agents to treat bleeding episodes for at least the last 6 months prior to Screening.
      • No history of immune tolerance induction therapy within the last 3 years prior to Screening.
  • A minimum of 6 bleeding episodes requiring factor concentrate treatment within the last 6 months prior to Screening.
  • Willing and complied 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, i.e., Von Willebrand's disease, additional factor deficiencies, or platelet disorders.
  • 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 (GalNAc).
  • 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 judgment.

Sites / Locations

  • Investigational Site Number 0140
  • Investigational Site Number 128
  • Investigational Site Number 103
  • Investigational Site Number 102
  • Investigational Site Number 119
  • Investigational Site Number 125
  • Investigational Site Number 111
  • Investigational Site Number 110
  • Investigational Site Number 6101
  • Investigational Site Number 6103
  • Investigational Site Number 6104
  • Investigational Site Number 8604
  • Investigational Site Number 8602
  • Investigational Site Number 8605
  • Investigational Site Number 8603
  • Investigational Site Number 8601
  • Investigational Site Number 4501
  • Investigational Site Number 3303
  • Investigational Site Number 3305
  • Investigational Site Number 3301
  • Investigational Site Number 4904
  • Investigational Site Number 4905
  • Investigational Site Number 4906
  • Investigational Site Number 3602
  • Investigational Site Number 9102
  • Investigational Site Number 9104
  • Investigational Site Number 9106
  • Investigational Site Number 9109
  • Investigational Site Number 9108
  • Investigational Site Number 9111
  • Investigational Site Number 9103
  • Investigational Site Number 9105
  • Investigational Site Number 9701
  • Investigational Site Number 3904
  • Investigational Site Number 8105
  • Investigational Site Number 8104
  • Investigational Site Number 8201
  • Investigational Site Number 8202
  • Investigational Site Number 8204
  • Investigational Site Number 6004
  • Investigational Site Number 6002
  • Investigational Site Number 6003
  • Investigational Site Number 2701
  • Investigational Site Number 2702
  • Investigational Site Number 3402
  • Investigational Site Number 8807
  • Investigational Site Number 8805
  • Investigational Site Number 8804
  • Investigational Site Number 8801
  • Investigational Site Number 8808
  • Investigational Site Number 9002
  • Investigational Site Number 9004
  • Investigational Site Number 9008
  • Investigational Site Number 9005
  • Investigational Site Number 9003
  • Investigational Site Number 9009
  • Investigational Site Number 9006
  • Investigational Site Number 8001
  • Investigational Site Number 8003
  • Investigational Site Number 8002
  • Investigational Site Number 8005
  • Investigational Site Number 4402
  • Investigational Site Number 4407
  • Investigational Site Number 4401

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Factor On-demand

Fitusiran 80 mg Prophylaxis

Arm Description

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

Participants received open-label fitusiran 80 milligram (mg) administered subcutaneously (SC) as prophylaxis once monthly from Day 1 up to a total of 9 months. Participants received on-demand factor concentrates (per investigator's discretion and within bleeding dosing guidelines) for the treatment of breakthrough bleeding episodes.

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 by-passing agents (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) presents 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 <=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 presents observed results (i.e., descriptive statistics values based on the data 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 <=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 presents 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 <=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 presents observed results (i.e., descriptive statistics values based on data collected during TP).
Estimated Annualized Spontaneous Bleeding Rate for Treated Bleeds During the 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 <=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 presents 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 the bleed, within which any symptoms of bleeding at the same location or injections <=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 presents 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) increasing 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) increasing 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 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). Scoring for each item was based on a 5-point Likert scale (1= never, 2= rarely, 3= sometimes, 4= often, and 5=all the time), and higher scores represented greater impairment. 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 (better health outcome) to 100 (worst health outcome), 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). Scoring for each item was based on a 5-point Likert scale (1= never, 2= rarely, 3= sometimes, 4= often, and 5=all the time), and higher scores represent greater impairment. Raw score for each domain were transformed to a scale ranged between 0 and 100, where lower scores denoted better health. Haem-A-QoL total score was average of all domain scores and ranged from 0 (better health outcome) to 100 (worst health outcome), where lower scores denoted better physical health.
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 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 <=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 presents 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 factor 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
NCT03417245
Brief Title
A Study of Fitusiran (ALN-AT3SC) in Severe Hemophilia A and B Patients Without Inhibitors
Official Title
ATLAS-A/B: A Phase 3 Study to Evaluate the Efficacy and Safety of Fitusiran in Patients With Hemophilia A or B, Without 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
March 1, 2018 (Actual)
Primary Completion Date
January 26, 2021 (Actual)
Study Completion Date
July 14, 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
Primary Objective: -To evaluate the efficacy of fitusiran compared to on-demand treatment with factor concentrates, as determined by the frequency of bleeding episodes. Secondary Objectives: To evaluate the efficacy of fitusiran compared to on-demand treatment with factor concentrates, as determined by: The frequency of spontaneous bleeding episodes. The frequency of joint bleeding episodes. Health-related quality of life (HRQOL) in participants >=17 years of age. To determine the frequency of bleeding episodes during the onset period. To determine the safety and tolerability of fitusiran.
Detailed Description
The duration of treatment with fitusiran was 9 months. The estimated total time on study, inclusive of screening, was up to 11 months for all participants in the factor on-demand arm and for participants in the fitusiran arm who enrolled in the extension study (LTE15174). The estimated total time on the study was up to 17 months for participants in the fitusiran treatment arm 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. Participants who completed the study will be eligible for an open-label extension study LTE15174 (NCT03754790).

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, Coagulants, Fitusiran

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Factor On-demand
Arm Type
Experimental
Arm Description
Participants received on-demand factor concentrates (as needed, for episodic bleeding episodes, and not on a regular regimen intended to prevent spontaneous bleeding) per Investigator discretion for the treatment of breakthrough bleeding episodes from Day 1 up to a total of 9 months.
Arm Title
Fitusiran 80 mg Prophylaxis
Arm Type
Experimental
Arm Description
Participants received open-label fitusiran 80 milligram (mg) administered subcutaneously (SC) as prophylaxis once monthly from Day 1 up to a total of 9 months. Participants received on-demand factor concentrates (per investigator's discretion and within bleeding dosing guidelines) for the treatment of breakthrough bleeding episodes.
Intervention Type
Drug
Intervention Name(s)
fitusiran
Intervention Description
by SC injection
Intervention Type
Drug
Intervention Name(s)
factor concentrates
Intervention Description
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 by-passing agents (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) presents 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 <=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 presents observed results (i.e., descriptive statistics values based on the 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
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 <=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 presents 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 <=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 presents 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 the 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 <=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 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 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 the bleed, within which any symptoms of bleeding at the same location or injections <=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 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
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) increasing 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) increasing 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 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). Scoring for each item was based on a 5-point Likert scale (1= never, 2= rarely, 3= sometimes, 4= often, and 5=all the time), and higher scores represented greater impairment. 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 (better health outcome) to 100 (worst health outcome), 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). Scoring for each item was based on a 5-point Likert scale (1= never, 2= rarely, 3= sometimes, 4= often, and 5=all the time), and higher scores represent greater impairment. Raw score for each domain were transformed to a scale ranged between 0 and 100, where lower scores denoted better health. Haem-A-QoL total score was average of all domain scores and ranged from 0 (better health outcome) to 100 (worst health outcome), where lower scores denoted better physical health.
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 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 <=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 presents 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 factor 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-month follow-up)

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males, >=12 years of age. Severe hemophilia A or B without inhibitors. Severity confirmed by a central laboratory where FVIII level was less than (<) 1 percent (%) or Factor IX (FIX) level was less than or equal to (<=) 2% at Screening. On-demand use of factor concentrate to manage bleeding episodes for at least the last 6 months prior to Screening, and meet each of the following criterion: Nijmegen modified Bethesda assay inhibitor titer of <0.6 Bethesda units per milliliter (BU/mL) at Screening. No use of Bypassing agents to treat bleeding episodes for at least the last 6 months prior to Screening. No history of immune tolerance induction therapy within the last 3 years prior to Screening. A minimum of 6 bleeding episodes requiring factor concentrate treatment within the last 6 months prior to Screening. Willing and complied 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, i.e., Von Willebrand's disease, additional factor deficiencies, or platelet disorders. 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 (GalNAc). 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 judgment.
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 0140
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72202
Country
United States
Facility Name
Investigational Site Number 128
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32610
Country
United States
Facility Name
Investigational Site Number 103
City
Tampa
State/Province
Florida
ZIP/Postal Code
33607
Country
United States
Facility Name
Investigational Site Number 102
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612-3833
Country
United States
Facility Name
Investigational Site Number 119
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70112
Country
United States
Facility Name
Investigational Site Number 125
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Facility Name
Investigational Site Number 111
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89135
Country
United States
Facility Name
Investigational Site Number 110
City
Akron
State/Province
Ohio
ZIP/Postal Code
44308
Country
United States
Facility Name
Investigational Site Number 6101
City
Camperdown
ZIP/Postal Code
2050
Country
Australia
Facility Name
Investigational Site Number 6103
City
Murdoch
ZIP/Postal Code
6961
Country
Australia
Facility Name
Investigational Site Number 6104
City
Prahran
ZIP/Postal Code
3181
Country
Australia
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
89147
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 4501
City
Copenhagen
ZIP/Postal Code
2100
Country
Denmark
Facility Name
Investigational Site Number 3303
City
Lyon
ZIP/Postal Code
69677
Country
France
Facility Name
Investigational Site Number 3305
City
Paris
ZIP/Postal Code
75015
Country
France
Facility Name
Investigational Site Number 3301
City
Rouen
ZIP/Postal Code
76038
Country
France
Facility Name
Investigational Site Number 4904
City
Berlin
ZIP/Postal Code
10249
Country
Germany
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 3602
City
Budapest
ZIP/Postal Code
1134
Country
Hungary
Facility Name
Investigational Site Number 9102
City
Bangalore
ZIP/Postal Code
560034
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 9109
City
Mumbai
ZIP/Postal Code
400012
Country
India
Facility Name
Investigational Site Number 9108
City
Mumbai
ZIP/Postal Code
400022
Country
India
Facility Name
Investigational Site Number 9111
City
Mumbai
Country
India
Facility Name
Investigational Site Number 9103
City
Pune
ZIP/Postal Code
411001
Country
India
Facility Name
Investigational Site Number 9105
City
Vellore
ZIP/Postal Code
632004
Country
India
Facility Name
Investigational Site Number 9701
City
Ramat-Gan
ZIP/Postal Code
52621
Country
Israel
Facility Name
Investigational Site Number 3904
City
Padova
ZIP/Postal Code
35128
Country
Italy
Facility Name
Investigational Site Number 8105
City
Isehara
Country
Japan
Facility Name
Investigational Site Number 8104
City
Saitama
Country
Japan
Facility Name
Investigational Site Number 8201
City
Busan
ZIP/Postal Code
602-739
Country
Korea, Republic of
Facility Name
Investigational Site Number 8202
City
Daejeon
ZIP/Postal Code
35233
Country
Korea, Republic of
Facility Name
Investigational Site Number 8204
City
Seoul
ZIP/Postal Code
3722
Country
Korea, Republic of
Facility Name
Investigational Site Number 6004
City
Ampang
ZIP/Postal Code
68000
Country
Malaysia
Facility Name
Investigational Site Number 6002
City
Johor Bahru
ZIP/Postal Code
80100
Country
Malaysia
Facility Name
Investigational Site Number 6003
City
Kota Kinabalu
ZIP/Postal Code
88586
Country
Malaysia
Facility Name
Investigational Site Number 2701
City
Parktown
ZIP/Postal Code
2193
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 8807
City
Taichung
ZIP/Postal Code
40447
Country
Taiwan
Facility Name
Investigational Site Number 8805
City
Taichung
ZIP/Postal Code
40705
Country
Taiwan
Facility Name
Investigational Site Number 8804
City
Taipei
ZIP/Postal Code
100
Country
Taiwan
Facility Name
Investigational Site Number 8801
City
Taipei
ZIP/Postal Code
110
Country
Taiwan
Facility Name
Investigational Site Number 8808
City
Taoyuan
ZIP/Postal Code
33305
Country
Taiwan
Facility Name
Investigational Site Number 9002
City
Adana
ZIP/Postal Code
?01130
Country
Turkey
Facility Name
Investigational Site Number 9004
City
Antalya
ZIP/Postal Code
07059
Country
Turkey
Facility Name
Investigational Site Number 9008
City
Gaziantep
ZIP/Postal Code
27100
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
TR-35100
Country
Turkey
Facility Name
Investigational Site Number 9009
City
Kayseri
ZIP/Postal Code
38039
Country
Turkey
Facility Name
Investigational Site Number 9006
City
Samsun
ZIP/Postal Code
55200
Country
Turkey
Facility Name
Investigational Site Number 8001
City
Kyiv
ZIP/Postal Code
04060
Country
Ukraine
Facility Name
Investigational Site Number 8003
City
Kyiv
ZIP/Postal Code
?01135
Country
Ukraine
Facility Name
Investigational Site Number 8002
City
Lviv
ZIP/Postal Code
79044
Country
Ukraine
Facility Name
Investigational Site Number 8005
City
Mykolaiv
ZIP/Postal Code
54058
Country
Ukraine
Facility Name
Investigational Site Number 4402
City
Glasgow
ZIP/Postal Code
G4 0SF
Country
United Kingdom
Facility Name
Investigational Site Number 4407
City
London
ZIP/Postal Code
E1 2ES
Country
United Kingdom
Facility Name
Investigational Site Number 4401
City
London
ZIP/Postal Code
SE1 9RT
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
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 Without Inhibitors

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