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BAX 326 Pediatric Study

Primary Purpose

Hemophilia B

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
BAX326
Sponsored by
Baxalta now part of Shire
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hemophilia B

Eligibility Criteria

undefined - 12 Years (Child)All SexesDoes not accept healthy volunteers

Main Inclusion Criteria:

  • Participant and/or legal representative has/have voluntarily provided signed informed consent
  • Participant has severe (FIX level < 1%) or moderately severe (FIX level ≤ 2%) hemophilia B
  • Participant is < 12 years old at the time of screening
  • Participant has no evidence of a history of FIX inhibitors (based on the participant's medical records)
  • Participant is immunocompetent as evidenced by a CD4 count ≥ 200 cells/mm^3

Main Exclusion Criteria:

  • Participant has a detectable FIX inhibitor at screening, with a titer ≥ 0.6 Bethesda Unit (BU)
  • Participant has a history of allergic reaction, e.g. anaphylaxis, following exposure to FIX concentrate(s)
  • Participant has evidence of an ongoing or recent thrombotic disease
  • Participant has an inherited or acquired hemostatic defect other than hemophilia B

Sites / Locations

  • LNJP Maulana Azad Medical College & Associated Hospitals
  • University Pediatric Hospital
  • Stanislaw Popowski Provincial Specialist Pediatric Hospital
  • Professor Tadeusz Sokolowski Independent Public Teaching Hospital of the Pomeranian Medical University in Szczecin
  • S.C. Sanador SRL
  • Louis Turcanu Emergency Children's Hospital
  • Regional Clinical Hospital
  • Pediatric Regional Clinical Hospital, Hematology Department
  • Republican Center for Hemophilia Treatment
  • State Institution "Institute of Blood Pathology and Transfusion Medicine of the Academy of Medical Sciences of Ukraine"
  • Manchester Children´s Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

BAX326 < 6 years of age

BAX326 6 to <12 years of age

Arm Description

Outcomes

Primary Outcome Measures

Adverse Events (AEs) Possibly or Probably Related to BAX326

Secondary Outcome Measures

Pharmacokinetics (PK): Total Area Under the Plasma Concentration Versus Time Curve From 0 to 72 Hours Post-infusion Per Dose (AUC 0-72h/Dose)
Pharmacokinetics (PK): Total Area Under the Plasma Concentration Versus Time Curve From 0 to Infinity Post-infusion Per Dose (Total AUC/Dose)
Pharmacokinetics (PK): Mean Residence Time (MRT)
Computed as total area under the first moment curve (total AUMC) divided by the total area under the concentration versus time curve (total AUC)
Pharmacokinetics (PK): Factor IX (FIX) Clearance (CL)
Computed as the dose divided by total Area under the curve (AUC)
Pharmacokinetics (PK): Incremental Recovery (IR)
The rise in FIX activity in IU/dL per unit dose administered in IU/kg. Calculated as follows: (FIX activity at post-infusion minus FIX activity at pre-infusion) divided by weight-adjusted dose
Pharmacokinetics (PK): Elimination Phase Half-life (T 1/2)
Calculated as log_e2/λ, where λ is the regression slope in the terminal phase of the least absolute deviations regression model
Pharmacokinetics (PK): Volume of Distribution at Steady State (Vss)
Computed as Clearance (CL) * Mean residence time (MRT)
Pharmacokinetics (PK): Incremental Recovery (IR) Over Time
IR calculated as follows: (FIX activity at post-infusion minus FIX activity at pre-infusion) divided by weight-adjusted dose. IR is determined at baseline (PK analysis), Week 5, Week 13 and Week 26 timepoints. Number of participants contributing data (N) for this outcome measure is included in the category title in the order: pediatric participants > 6 years of age; pediatric participants 6 to <12 years of age; pharmacokinetic Full Analysis Set (PKFAS).
Hemostatic Efficacy: Treatment of Bleeding Episodes: Number of Infusions Per Bleeding Episode
Hemostatic Efficacy: Treatment of Bleeding Episodes: Overall Hemostatic Efficacy Rating at Resolution of Bleed
Rating Scale for Treatment of bleeding episodes (4-point ordinal scale): - Excellent: Full relief of pain and cessation of objective signs of bleeding (eg, swelling, tenderness, and decreased range of motion in the case of musculoskeletal hemorrhage) after a single infusion. No additional infusion required for the control of bleeding. Administration of further infusions to maintain hemostasis did not affect this scoring. - Good: Definite pain relief and/or improvement in signs of bleeding after a single infusion. Possibly requires more than 1 infusion for complete resolution. - Fair: Probable and/or slight relief of pain and slight improvement in signs of bleeding after single infusion. Required more than 1 infusion for complete resolution. - None: No improvement or condition worsens.
Hemostatic Efficacy: Prophylaxis: Annualized Bleeding Rate (ABR)
The annualized bleeding rate (ABR) during prophylaxis was calculated only for participants who had adequate treatment time for bleeding rate assessment (i.e., more than 3 months of prophylaxis treatment). The observation period for prophylaxis was to be the time between the first and the last prophylactic infusions. The treatment period for surgery was to be excluded from the bleed rate calculation. ABR calculated as (Number of bleeding episodes/observed treatment period in days) * 365.25.
Consumption of BAX326: Number of Infusions Per Month
Consumption of BAX326: Number of Infusions Per Year
Consumption of BAX326: Weight-adjusted Consumption Per Month
Consumption of BAX326: Weight-adjusted Consumption Per Year (Annualized)
Consumption of BAX326: Weight-adjusted Consumption Per Event
Event includes prophylactic infusions of study product and infusions of study product for treatment of bleeding episodes (BEs).
Safety and Immunogenicity: Number of Participants Who Developed Inhibitory Antibodies to Factor IX (FIX)
Safety and Immunogenicity: Number of Participants Who Developed Total Binding Antibodies to Factor IX (FIX)
If more than 2-dilution increase as compared to pre-study level at screening and titers verified for specificity in the confirmatory assay. AB=antibodies in category for outcome measure data.
Safety: Number of Participants With Severe Allergic Reactions, e.g. Anaphylaxis
Safety: Number of Participants With Thrombotic Events
Safety: Number of Participants With Clinically Significant Changes in Routine Laboratory Parameters (Haematology and Clinical Chemistry), and Vital Signs
Categories consist of Clinically Significant (CS) changes in haemaotology parameters, clinical chemistry parameters and vital signs. Abbreviations in categories; Clin=clinical; params=parameters
Safety: Number of Participants Who Developed Antibodies to Chinese Hamster Ovary (CHO) Proteins and Recombinant Furin (rFurin)
If more than 2-dilution increase as compared to pre-study level at screening and titers verified for specificity in the confirmatory assay.
Health-related Quality of Life (HRQoL): PedsQL™ Change From Baseline in Total Score
For this study, the PedsQL™ questionnaires for participants 2 to 7 years of age (parent-proxy versions for age groups 2-4 years and 5-7 years) and PedsQL™ Child version for participants 8 to 12 years of age were used. The Peds-QL is a generic Health-Related Quality of Life (HR QoL) instrument designed specifically for a pediatric population. It captures the following domains: general health/activities, feelings/emotional, social functioning, school functioning. A 5-point score is used for each domain: from 0 (never) to 4 (almost always). Items are reversed scored and linearly transformed to a 0-100 scale as follows: 0=100, 1=75, 2=50, 3=25, 4=0 so that higher scores indicate better quality of life (QoL). The total score is the mean (average) of all scores from the 4 domains. The change from baseline in total score is reported- a positive score indicates a better QoL compared to baseline and a negative score indicates a poorer QoL compared to baseline.
Health-related Quality of Life (HRQoL): Haemo-QoL, Change From Baseline in Total Score
The Haemo-QoL is a quality of life (QoL) assessment instrument for children and adolescents with haemophilia. As a hemophilia-specific instrument, this measure assesses very specific aspects of dealing with hemophilia. For the Haemo-QoL, higher scores indicate a worse quality of life. Scores on a scale range between 0 and 100.
Health Resource Use: Number of Hospitalizations
The number of hospitalizations per participant. Number of participants contributing data (N) for this outcome measure is included in the category title in the order: pediatric participants < 6 years of age; pediatric participants 6 to <12 years of age; Full Analysis Set.
Health Resource Use: Length of Hospitalization
The length of hospitalization per participant. Number of participants contributing data (N) for this outcome measure is included in the category title in the order: pediatric participants < 6 years of age; pediatric participants 6 to <12 years of age; Full Analysis Set.
Health Resource Use: Unscheduled Doctor's Office Visits
The number of unscheduled doctor's Office visits per participant. Number of participants contributing data (N) for this outcome measure is included in the category title in the order: pediatric participants < 6 years of age; pediatric participants 6 to <12 years of age; Full Analysis Set.
Health Resource Use: Emergency Room Visits
The number of Emergency Room visits per participant. Number of participants contributing data (N) for this outcome measure is included in the category title in the order: pediatric participants < 6 years of age; pediatric participants 6 to <12 years of age; Full Analysis Set.
Health Resource Use: Days Lost From School
The number of days lost from school per participant. Number of participants contributing data (N) for this outcome measure is included in the category title in the order: pediatric participants < 6 years of age; pediatric participants 6 to <12 years of age; Full Analysis Set.

Full Information

First Posted
December 6, 2011
Last Updated
April 30, 2021
Sponsor
Baxalta now part of Shire
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1. Study Identification

Unique Protocol Identification Number
NCT01488994
Brief Title
BAX 326 Pediatric Study
Official Title
BAX 326 (Recombinant Factor IX): A Phase 2/3 Prospective, Uncontrolled, Multicenter Study Evaluating Pharmacokinetics, Efficacy, Safety, and Immunogenicity in Previously Treated Pediatric Patients With Severe (FIX Level < 1%) or Moderately Severe (FIX Level 1-2%) Hemophilia B
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Completed
Study Start Date
December 20, 2011 (Actual)
Primary Completion Date
May 14, 2013 (Actual)
Study Completion Date
May 14, 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Baxalta now part of Shire

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to assess BAX 326 pharmacokinetic parameters, to evaluate its hemostatic efficacy, safety, immunogenicity, and changes in health-related quality of life in pediatric patients.
Detailed Description
The secondary outcome measure: Area Under the Plasma Concentration Versus Time Curve From 0 to 72 Hours (h) Post-infusion analysis was not done due to the different time-points for the last PK blood sample, AUC0-72 h was redundant and only total AUC was included in the PK analysis.

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, Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
23 (Actual)

8. Arms, Groups, and Interventions

Arm Title
BAX326 < 6 years of age
Arm Type
Experimental
Arm Title
BAX326 6 to <12 years of age
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
BAX326
Other Intervention Name(s)
BAX 326, RIXUBIS
Intervention Description
All participants underwent a pharmacokinetic evaluation with BAX326 (recombinant Factor IX) followed by twice weekly prophylactic treatment for 6 months or for at least 50 exposure days, whichever occurred last.
Primary Outcome Measure Information:
Title
Adverse Events (AEs) Possibly or Probably Related to BAX326
Time Frame
Throughout study period (approximately 17 months)
Secondary Outcome Measure Information:
Title
Pharmacokinetics (PK): Total Area Under the Plasma Concentration Versus Time Curve From 0 to 72 Hours Post-infusion Per Dose (AUC 0-72h/Dose)
Time Frame
Within 30 mins pre-infusion and 4 post-infusion timepoints
Title
Pharmacokinetics (PK): Total Area Under the Plasma Concentration Versus Time Curve From 0 to Infinity Post-infusion Per Dose (Total AUC/Dose)
Time Frame
Within 30 mins pre-infusion and 4 post-infusion timepoints. Refer to Population Description below for more details.
Title
Pharmacokinetics (PK): Mean Residence Time (MRT)
Description
Computed as total area under the first moment curve (total AUMC) divided by the total area under the concentration versus time curve (total AUC)
Time Frame
Within 30 mins pre-infusion and 4 post-infusion timepoints. Refer to Population Description below for more details.
Title
Pharmacokinetics (PK): Factor IX (FIX) Clearance (CL)
Description
Computed as the dose divided by total Area under the curve (AUC)
Time Frame
Within 30 mins pre-infusion and 4 post-infusion timepoints. Refer to Population Description below for more details.
Title
Pharmacokinetics (PK): Incremental Recovery (IR)
Description
The rise in FIX activity in IU/dL per unit dose administered in IU/kg. Calculated as follows: (FIX activity at post-infusion minus FIX activity at pre-infusion) divided by weight-adjusted dose
Time Frame
Within 30 mins pre-infusion and 30 mins post-infusion
Title
Pharmacokinetics (PK): Elimination Phase Half-life (T 1/2)
Description
Calculated as log_e2/λ, where λ is the regression slope in the terminal phase of the least absolute deviations regression model
Time Frame
Within 30 mins pre-infusion and 4 post-infusion timepoints. Refer to Population Description below for more details.
Title
Pharmacokinetics (PK): Volume of Distribution at Steady State (Vss)
Description
Computed as Clearance (CL) * Mean residence time (MRT)
Time Frame
Within 30 mins pre-infusion and 4 post-infusion timepoints. Refer to Population Description below for more details.
Title
Pharmacokinetics (PK): Incremental Recovery (IR) Over Time
Description
IR calculated as follows: (FIX activity at post-infusion minus FIX activity at pre-infusion) divided by weight-adjusted dose. IR is determined at baseline (PK analysis), Week 5, Week 13 and Week 26 timepoints. Number of participants contributing data (N) for this outcome measure is included in the category title in the order: pediatric participants > 6 years of age; pediatric participants 6 to <12 years of age; pharmacokinetic Full Analysis Set (PKFAS).
Time Frame
Within 30 mins pre-infusion and 30 mins post-infusion at baseline, Week 5, Week 13 and Week 26.
Title
Hemostatic Efficacy: Treatment of Bleeding Episodes: Number of Infusions Per Bleeding Episode
Time Frame
Throughout study period (approximately 17 months)
Title
Hemostatic Efficacy: Treatment of Bleeding Episodes: Overall Hemostatic Efficacy Rating at Resolution of Bleed
Description
Rating Scale for Treatment of bleeding episodes (4-point ordinal scale): - Excellent: Full relief of pain and cessation of objective signs of bleeding (eg, swelling, tenderness, and decreased range of motion in the case of musculoskeletal hemorrhage) after a single infusion. No additional infusion required for the control of bleeding. Administration of further infusions to maintain hemostasis did not affect this scoring. - Good: Definite pain relief and/or improvement in signs of bleeding after a single infusion. Possibly requires more than 1 infusion for complete resolution. - Fair: Probable and/or slight relief of pain and slight improvement in signs of bleeding after single infusion. Required more than 1 infusion for complete resolution. - None: No improvement or condition worsens.
Time Frame
Throughout study period (approximately 17 months)
Title
Hemostatic Efficacy: Prophylaxis: Annualized Bleeding Rate (ABR)
Description
The annualized bleeding rate (ABR) during prophylaxis was calculated only for participants who had adequate treatment time for bleeding rate assessment (i.e., more than 3 months of prophylaxis treatment). The observation period for prophylaxis was to be the time between the first and the last prophylactic infusions. The treatment period for surgery was to be excluded from the bleed rate calculation. ABR calculated as (Number of bleeding episodes/observed treatment period in days) * 365.25.
Time Frame
Throughout study period (approximately 17 months)
Title
Consumption of BAX326: Number of Infusions Per Month
Time Frame
Throughout study period (approximately 17 months)
Title
Consumption of BAX326: Number of Infusions Per Year
Time Frame
Throughout study period (approximately 17 months)
Title
Consumption of BAX326: Weight-adjusted Consumption Per Month
Time Frame
Throughout study period (approximately 17 months)
Title
Consumption of BAX326: Weight-adjusted Consumption Per Year (Annualized)
Time Frame
Throughout study period (approximately 17 months)
Title
Consumption of BAX326: Weight-adjusted Consumption Per Event
Description
Event includes prophylactic infusions of study product and infusions of study product for treatment of bleeding episodes (BEs).
Time Frame
Throughout study period (approximately 17 months)
Title
Safety and Immunogenicity: Number of Participants Who Developed Inhibitory Antibodies to Factor IX (FIX)
Time Frame
Throughout study period (approximately 17 months)
Title
Safety and Immunogenicity: Number of Participants Who Developed Total Binding Antibodies to Factor IX (FIX)
Description
If more than 2-dilution increase as compared to pre-study level at screening and titers verified for specificity in the confirmatory assay. AB=antibodies in category for outcome measure data.
Time Frame
Throughout study period (approximately 17 months)
Title
Safety: Number of Participants With Severe Allergic Reactions, e.g. Anaphylaxis
Time Frame
Throughout study period (approximately 17 months)
Title
Safety: Number of Participants With Thrombotic Events
Time Frame
Throughout study period (approximately 17 months)
Title
Safety: Number of Participants With Clinically Significant Changes in Routine Laboratory Parameters (Haematology and Clinical Chemistry), and Vital Signs
Description
Categories consist of Clinically Significant (CS) changes in haemaotology parameters, clinical chemistry parameters and vital signs. Abbreviations in categories; Clin=clinical; params=parameters
Time Frame
Throughout study period (approximately 17 months)
Title
Safety: Number of Participants Who Developed Antibodies to Chinese Hamster Ovary (CHO) Proteins and Recombinant Furin (rFurin)
Description
If more than 2-dilution increase as compared to pre-study level at screening and titers verified for specificity in the confirmatory assay.
Time Frame
Throughout study period (approximately 17 months)
Title
Health-related Quality of Life (HRQoL): PedsQL™ Change From Baseline in Total Score
Description
For this study, the PedsQL™ questionnaires for participants 2 to 7 years of age (parent-proxy versions for age groups 2-4 years and 5-7 years) and PedsQL™ Child version for participants 8 to 12 years of age were used. The Peds-QL is a generic Health-Related Quality of Life (HR QoL) instrument designed specifically for a pediatric population. It captures the following domains: general health/activities, feelings/emotional, social functioning, school functioning. A 5-point score is used for each domain: from 0 (never) to 4 (almost always). Items are reversed scored and linearly transformed to a 0-100 scale as follows: 0=100, 1=75, 2=50, 3=25, 4=0 so that higher scores indicate better quality of life (QoL). The total score is the mean (average) of all scores from the 4 domains. The change from baseline in total score is reported- a positive score indicates a better QoL compared to baseline and a negative score indicates a poorer QoL compared to baseline.
Time Frame
Baseline and 6 months
Title
Health-related Quality of Life (HRQoL): Haemo-QoL, Change From Baseline in Total Score
Description
The Haemo-QoL is a quality of life (QoL) assessment instrument for children and adolescents with haemophilia. As a hemophilia-specific instrument, this measure assesses very specific aspects of dealing with hemophilia. For the Haemo-QoL, higher scores indicate a worse quality of life. Scores on a scale range between 0 and 100.
Time Frame
Baseline and 6 months
Title
Health Resource Use: Number of Hospitalizations
Description
The number of hospitalizations per participant. Number of participants contributing data (N) for this outcome measure is included in the category title in the order: pediatric participants < 6 years of age; pediatric participants 6 to <12 years of age; Full Analysis Set.
Time Frame
Baseline (Pharmacokinetic [PK] assessment), Week 5, Week 13 and Week 26
Title
Health Resource Use: Length of Hospitalization
Description
The length of hospitalization per participant. Number of participants contributing data (N) for this outcome measure is included in the category title in the order: pediatric participants < 6 years of age; pediatric participants 6 to <12 years of age; Full Analysis Set.
Time Frame
Baseline (Pharmacokinetic [PK] assessment), Week 5, Week 13 and Week 26
Title
Health Resource Use: Unscheduled Doctor's Office Visits
Description
The number of unscheduled doctor's Office visits per participant. Number of participants contributing data (N) for this outcome measure is included in the category title in the order: pediatric participants < 6 years of age; pediatric participants 6 to <12 years of age; Full Analysis Set.
Time Frame
Baseline (Pharmacokinetic [PK] assessment), Week 5, Week 13 and Week 26
Title
Health Resource Use: Emergency Room Visits
Description
The number of Emergency Room visits per participant. Number of participants contributing data (N) for this outcome measure is included in the category title in the order: pediatric participants < 6 years of age; pediatric participants 6 to <12 years of age; Full Analysis Set.
Time Frame
Baseline (Pharmacokinetic [PK] assessment), Week 5, Week 13 and Week 26
Title
Health Resource Use: Days Lost From School
Description
The number of days lost from school per participant. Number of participants contributing data (N) for this outcome measure is included in the category title in the order: pediatric participants < 6 years of age; pediatric participants 6 to <12 years of age; Full Analysis Set.
Time Frame
Baseline (Pharmacokinetic [PK] assessment), Week 5, Week 13 and Week 26

10. Eligibility

Sex
All
Maximum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Main Inclusion Criteria: Participant and/or legal representative has/have voluntarily provided signed informed consent Participant has severe (FIX level < 1%) or moderately severe (FIX level ≤ 2%) hemophilia B Participant is < 12 years old at the time of screening Participant has no evidence of a history of FIX inhibitors (based on the participant's medical records) Participant is immunocompetent as evidenced by a CD4 count ≥ 200 cells/mm^3 Main Exclusion Criteria: Participant has a detectable FIX inhibitor at screening, with a titer ≥ 0.6 Bethesda Unit (BU) Participant has a history of allergic reaction, e.g. anaphylaxis, following exposure to FIX concentrate(s) Participant has evidence of an ongoing or recent thrombotic disease Participant has an inherited or acquired hemostatic defect other than hemophilia B
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Study Director
Organizational Affiliation
Takeda
Official's Role
Study Director
Facility Information:
Facility Name
LNJP Maulana Azad Medical College & Associated Hospitals
City
New Delhi
ZIP/Postal Code
110002
Country
India
Facility Name
University Pediatric Hospital
City
Krakow
ZIP/Postal Code
30-663
Country
Poland
Facility Name
Stanislaw Popowski Provincial Specialist Pediatric Hospital
City
Olsztyn
ZIP/Postal Code
10-561
Country
Poland
Facility Name
Professor Tadeusz Sokolowski Independent Public Teaching Hospital of the Pomeranian Medical University in Szczecin
City
Szczecin
ZIP/Postal Code
71-252
Country
Poland
Facility Name
S.C. Sanador SRL
City
Bucharest
ZIP/Postal Code
11156
Country
Romania
Facility Name
Louis Turcanu Emergency Children's Hospital
City
Timisoara
ZIP/Postal Code
300011
Country
Romania
Facility Name
Regional Clinical Hospital
City
Ekaterinburg
ZIP/Postal Code
620149
Country
Russian Federation
Facility Name
Pediatric Regional Clinical Hospital, Hematology Department
City
Krasnodar
ZIP/Postal Code
350007
Country
Russian Federation
Facility Name
Republican Center for Hemophilia Treatment
City
St. Petersburg
ZIP/Postal Code
195213
Country
Russian Federation
Facility Name
State Institution "Institute of Blood Pathology and Transfusion Medicine of the Academy of Medical Sciences of Ukraine"
City
Lviv
ZIP/Postal Code
79044
Country
Ukraine
Facility Name
Manchester Children´s Hospital
City
Manchester
ZIP/Postal Code
M13 9WL
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
25495591
Citation
Urasinski T, Stasyshyn O, Andreeva T, Rusen L, Perina FG, Oh MS, Chapman M, Pavlova BG, Valenta-Singer B, Abbuehl BE. Recombinant factor IX (BAX326) in previously treated paediatric patients with haemophilia B: a prospective clinical trial. Haemophilia. 2015 Mar;21(2):196-203. doi: 10.1111/hae.12548. Epub 2014 Dec 11.
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BAX 326 Pediatric Study

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