Fitusiran Prophylaxis in Male Pediatric Subjects Aged 1 to Less Than 12 Years With Hemophilia A or B (ATLAS-PEDS)
Primary Purpose
Hemophilia
Status
Active
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Fitusiran
Sponsored by
About this trial
This is an interventional treatment trial for Hemophilia
Eligibility Criteria
Inclusion criteria :
- Male, aged 1 to <12 years at the time of enrollment
- Severe hemophilia A or B (Factor VIII (FVIII) <1% or Factor IX (FIX) ≤2%)
Participants must have inhibitory antibodies to FVIII or FIX and must meet one of the following Nijmegen-modified Bethesda assay results criteria:
- Inhibitor titer of ≥0.6 BU/mL at screening, OR
- Inhibitor titer of <0.6 BU/mL at screening with medical record evidence of 2 consecutive titers ≥0.6 BU/mL, OR
- Inhibitor titer of <0.6 BU/mL at screening with medical record evidence of 1 inhibitor titer ≥0.6 BU/mL and a history of anamnestic response or severe allergic reaction (anaphylaxis or nephrotic syndrome)
- Adequate peripheral venous access, as determined by the Investigator, to allow the blood draws required by the study protocol
- Weight requirements at the time of enrollment: 8 to <45 kg
- Willing and able to comply with the study requirements and to provide signed written informed consent obtained from parent(s)/legal guardian (hereinafter the "parent") and written or oral assent obtained from participant, per local and national requirements
Exclusion criteria:
- Known co-existing bleeding disorders other than hemophilia A or B
- Antithrombin (AT) activity <60% at Screening
- Co-existing thrombophilic disorder
- Clinically significant liver disease
- Active Hepatitis C virus infection
- Acute or chronic Hepatitis B virus infection
- Acute Hepatitis A or hepatitis E infection
- HIV positive with a CD4 count of <400 cells/μL
- History of arterial or venous thromboembolism, unrelated to an indwelling venous access
- Inadequate renal function
- History of multiple drug allergies or history of allergic reaction to an oligonucleotide or N-Acetylgalactosamine (GalNAc)
- Participants with central or peripheral indwelling catheters, with history of venous access complications leading to hospitalization and/or systemic anticoagulation therapy
- History of intolerance to subcutaneous (SC) injection(s)
- The use of emicizumab (Hemlibra®) within 6 months prior to screening
- Any other conditions or comorbidities that would make the patient unsuitable for enrollment or could interfere with participation in or completion of the study, per Investigator judgment
The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
Sites / Locations
- Children's Hospital Los Angeles-Site Number:8400002
- Hackensack University Medical Center-Site Number:8400008
- University Hospitals of Cleveland-Site Number:8400007
- Penn State Milton S. Hershey Medical Center-Site Number:8400006
- Investigational Site Number :1240001
- Investigational Site Number :1240002
- Investigational Site Number :3560006
- Investigational Site Number :3560002
- Investigational Site Number :3560001
- Investigational Site Number :3560004
- Investigational Site Number :3800002
- Investigational Site Number :3800001
- Investigational Site Number :7240002
- Investigational Site Number :7920001
- Investigational Site Number :7920002
- Investigational Site Number :7920003
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Fitusiran
Arm Description
Participants will receive a selected dose of fitusiran on regular intervals, as per study protocol
Outcomes
Primary Outcome Measures
Plasma antithrombin (AT) activity levels
Characterize the AT activity at the optimal therapeutic dose
Secondary Outcome Measures
Number of participants reported with adverse events
Number of participants reported with treatment-emergent adverse events (TEAEs)
Fitusiran plasma concentrations
Plasma samples will be collected for measurement of plasma concentrations of fitusiran at specific time points postdose on Day 1 and predose on Day 85
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03974113
Brief Title
Fitusiran Prophylaxis in Male Pediatric Subjects Aged 1 to Less Than 12 Years With Hemophilia A or B
Acronym
ATLAS-PEDS
Official Title
ATLAS-PEDS: An Open-label, Multinational Study of Fitusiran Prophylaxis in Male Pediatric Subjects Aged 1 to Less Than 12 Years With Hemophilia A or B
Study Type
Interventional
2. Study Status
Record Verification Date
June 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
January 28, 2020 (Actual)
Primary Completion Date
October 31, 2024 (Anticipated)
Study Completion Date
December 27, 2024 (Anticipated)
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 confirm appropriate dose levels of fitusiran when administered to male pediatric participants (ages 1 to <12 years of age) with severe hemophilia A or B
Secondary Objective:
To characterize the safety and tolerability
To determine fitusiran plasma concentrations at selected time points
Detailed Description
The estimated total time on study is up to 160 weeks in participants who roll over into the extension study and up to 184 weeks in participants who do not roll over into the extension study (due to the requirement for up to an additional 6 months of follow-up for monitoring of AT levels).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hemophilia
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
37 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Fitusiran
Arm Type
Experimental
Arm Description
Participants will receive a selected dose of fitusiran on regular intervals, as per study protocol
Intervention Type
Drug
Intervention Name(s)
Fitusiran
Intervention Description
Pharmaceutical form:Solution for injection Route of administration: Subcutaneous
Primary Outcome Measure Information:
Title
Plasma antithrombin (AT) activity levels
Description
Characterize the AT activity at the optimal therapeutic dose
Time Frame
Day 1 to the AT analysis time point at the optimal therapeutic dose (approximately 160 weeks)
Secondary Outcome Measure Information:
Title
Number of participants reported with adverse events
Description
Number of participants reported with treatment-emergent adverse events (TEAEs)
Time Frame
Up to 184 weeks (up to 160 weeks of treatment + up to 24 weeks of AT follow up)
Title
Fitusiran plasma concentrations
Description
Plasma samples will be collected for measurement of plasma concentrations of fitusiran at specific time points postdose on Day 1 and predose on Day 85
Time Frame
Day 1 and Day 85
10. Eligibility
Sex
Male
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
11 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria :
Male, aged 1 to <12 years at the time of enrollment
Severe hemophilia A or B (Factor VIII (FVIII) <1% or Factor IX (FIX) ≤2%)
Participants must have inhibitory antibodies to FVIII or FIX and must meet one of the following Nijmegen-modified Bethesda assay results criteria:
Inhibitor titer of ≥0.6 BU/mL at screening, OR
Inhibitor titer of <0.6 BU/mL at screening with medical record evidence of 2 consecutive titers ≥0.6 BU/mL, OR
Inhibitor titer of <0.6 BU/mL at screening with medical record evidence of 1 inhibitor titer ≥0.6 BU/mL and a history of anamnestic response or severe allergic reaction (anaphylaxis or nephrotic syndrome)
Adequate peripheral venous access, as determined by the Investigator, to allow the blood draws required by the study protocol
Weight requirements at the time of enrollment: 8 to <45 kg
Willing and able to comply with the study requirements and to provide signed written informed consent obtained from parent(s)/legal guardian (hereinafter the "parent") and written or oral assent obtained from participant, per local and national requirements
Exclusion criteria:
Known co-existing bleeding disorders other than hemophilia A or B
Antithrombin (AT) activity <60% at Screening
Co-existing thrombophilic disorder
Clinically significant liver disease
Active Hepatitis C virus infection
Acute or chronic Hepatitis B virus infection
Acute Hepatitis A or hepatitis E infection
HIV positive with a CD4 count of <400 cells/μL
History of arterial or venous thromboembolism, unrelated to an indwelling venous access
Inadequate renal function
History of multiple drug allergies or history of allergic reaction to an oligonucleotide or N-Acetylgalactosamine (GalNAc)
Participants with central or peripheral indwelling catheters, with history of venous access complications leading to hospitalization and/or systemic anticoagulation therapy
History of intolerance to subcutaneous (SC) injection(s)
The use of emicizumab (Hemlibra®) within 6 months prior to screening
Any other conditions or comorbidities that would make the patient unsuitable for enrollment or could interfere with participation in or completion of the study, per Investigator judgment
The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Sciences & Operations
Organizational Affiliation
Sanofi
Official's Role
Study Director
Facility Information:
Facility Name
Children's Hospital Los Angeles-Site Number:8400002
City
Los Angeles
State/Province
California
ZIP/Postal Code
90027
Country
United States
Facility Name
Hackensack University Medical Center-Site Number:8400008
City
Hackensack
State/Province
New Jersey
ZIP/Postal Code
07601
Country
United States
Facility Name
University Hospitals of Cleveland-Site Number:8400007
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Facility Name
Penn State Milton S. Hershey Medical Center-Site Number:8400006
City
Hershey
State/Province
Pennsylvania
ZIP/Postal Code
17033
Country
United States
Facility Name
Investigational Site Number :1240001
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8N 3Z5
Country
Canada
Facility Name
Investigational Site Number :1240002
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1H 8L1
Country
Canada
Facility Name
Investigational Site Number :3560006
City
Bangalore
ZIP/Postal Code
560034
Country
India
Facility Name
Investigational Site Number :3560002
City
Mumbai
ZIP/Postal Code
400 022
Country
India
Facility Name
Investigational Site Number :3560001
City
Pune-411011
ZIP/Postal Code
411 011
Country
India
Facility Name
Investigational Site Number :3560004
City
Vellore
ZIP/Postal Code
632004
Country
India
Facility Name
Investigational Site Number :3800002
City
Firenze
ZIP/Postal Code
50134
Country
Italy
Facility Name
Investigational Site Number :3800001
City
Milano
ZIP/Postal Code
20121
Country
Italy
Facility Name
Investigational Site Number :7240002
City
Madrid
State/Province
Madrid, Comunidad De
ZIP/Postal Code
28046
Country
Spain
Facility Name
Investigational Site Number :7920001
City
Adana
ZIP/Postal Code
01130
Country
Turkey
Facility Name
Investigational Site Number :7920002
City
Istanbul
ZIP/Postal Code
34093
Country
Turkey
Facility Name
Investigational Site Number :7920003
City
Izmir
ZIP/Postal Code
TR-35100
Country
Turkey
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
Learn more about this trial
Fitusiran Prophylaxis in Male Pediatric Subjects Aged 1 to Less Than 12 Years With Hemophilia A or B
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