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Pharmacokinetic Study of ARALAST (Human Alpha1- PI)

Primary Purpose

Alpha 1-Antitrypsin Deficiency

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Dose of 60 mg/kg Fraction IV-1 Alpha1-Proteinase Inhibitor
Dose of 60 mg/kg alpha1-proteinase inhibitor
Sponsored by
Baxalta now part of Shire
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alpha 1-Antitrypsin Deficiency focused on measuring Severe congenital Alpha1-Proteinase Inhibitor (Alpha1-PI) deficiency

Eligibility Criteria

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

Inclusion Criteria: The subject or subject´s legally authorized representative has provided written informed consent Subject is 18 years of age or older Subject has a documented, endogenous plasma Alpha1-PI level < 8 Micromolar Subject is of the genotype Pi*Z/Z, Pi*Z/Null, Pi*Null/Null, Pi*Malton/Z, or others, dependent on the approval by the Sponsor If the subject is female or of childbearing potential, the subject has a negative urine test for pregnancy within 7 days prior to first study product administration and agrees to employ adequate birth control measures for the duration of the study Laboratory results obtained at the screening visit, meeting the following criteria: Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) <= 2 times the upper limit of normal (ULN) Serum total bilirubin <= 2 times ULN Proteinuria < +2 on dipstick analysis Serum creatinine <= 1.5 times ULN Absolute neutrophil count (ANC) >= 1500 cells/mm3 Hemoglobin >= 10.0 g/dL Platelet count >= 10^5/mm3 If the subject is treated with any respiratory medications, including inhaled bronchodilators and inhaled or oral corticosteroids, the subjects´ medication doses were unchanged for at least 14 days prior to first study product administration Nonsmoker for a minimum of 3 months prior to first study product administration Exclusion Criteria: The subject has received any Alpha1-PI augmentation therapy (including Aralast and investigational Alpha1-PIs, by any route including intravenous and inhaled) within 42 days prior to first study product administration The subject has received an investigational drug or device within 1 month prior to first study product administration, or the subject is currently receiving an investigational drug The subject has a known selective immunoglobulin A (IgA) deficiency (IgA level < 15 mg/dL) and/or antibody to IgA The subject has a pulmonary exacerbation or had a pulmonary exacerbation in the past 14 days prior to first study product administration The subject is pregnant or lactating, or intends to become pregnant during the course of the study The subject has a clinically significant medical, psychiatric, or cognitive illness, or recreational drug/alcohol use that, in the opinion of the investigator, would affect subject safety or compliance

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

ARALAST Fr. IV-1

ARALAST

Arm Description

60 mg/kg

60mg/kg

Outcomes

Primary Outcome Measures

Area Under the Curve/Dose
Area under the plasma alpha1-proteinase inhibitor (α1-PI) concentration versus time curve (AUC) calculated by linear trapezoidal method per dose.

Secondary Outcome Measures

Total Area Under the Curve Per Dose
Total area under the α1-PI concentration vs. time curve from pharmacokinetic day 0 to time infinity (AUC 0-infinity) per dose
Systemic Clearance (CL)
Computed as dose divided by AUC 0-infinity (AUC 0-infinity was calculated as the sum of AUC from time 0 to the time of last quantifiable concentration plus a tail area correction)
Mean Residence Time (MRT)
Computed as total area under the moment curve (AUMC) divided by total AUC
Apparent Volume of Distribution at Steady State
Computed as weight-adjusted CL * MRT
Terminal Half-life
Computed from the terminal or disposition rate constant obtained from log_e -linear fitting using the least squares deviation to the last five quantifiable concentrations above pre-infusion level.
Maximum Plasma Concentration (Cmax)
Maximum α1-PI concentration following infusion
Time to Maximum α1-PI Concentration Post-infusion (Tmax)
Time to reach C-max. Tmax is the number of days from infusion to maximum concentration. Samples drawn at the end of infusion are considered to be time zero.
Incremental Recovery
Computed from Cmax (mg/ml) divided by dose per kg body weight (mg/kg).
Adverse Events (AEs)
Investigators assessed severity of AEs (occurring during or after infusions) based on: MILD: Transient discomfort, does not interfere in a significant manner with participant's normal functioning level; Resolves spontaneously or may require minimal therapeutic intervention MODERATE: AE produces limited impairment of function, can require therapeutic intervention; AE produces no sequelae; SEVERE: AE results in marked impairment of function, can lead to temporary inability to resume usual life pattern; AE produces sequelae, which require prolonged therapeutic intervention

Full Information

First Posted
October 19, 2005
Last Updated
April 17, 2021
Sponsor
Baxalta now part of Shire
Collaborators
Baxter Healthcare, Ltd. (New Zealand), Baxter Healthcare Pty. Ltd. (Australia)
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1. Study Identification

Unique Protocol Identification Number
NCT00242385
Brief Title
Pharmacokinetic Study of ARALAST (Human Alpha1- PI)
Official Title
Single-Dose, Double-Blind, Crossover Study to Evaluate the Pharmacokinetic Comparability of ARALAST Fraction IV-1 Alpha1-Proteinase Inhibitor (ARALAST Fr. IV-1) and ARALAST
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Completed
Study Start Date
December 20, 2005 (Actual)
Primary Completion Date
June 5, 2006 (Actual)
Study Completion Date
June 5, 2006 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Baxalta now part of Shire
Collaborators
Baxter Healthcare, Ltd. (New Zealand), Baxter Healthcare Pty. Ltd. (Australia)

4. Oversight

5. Study Description

Brief Summary
The primary purpose of this study is to characterize the pharmacokinetic profile of intravenous Aralast Fraction (Fr.) IV-1, a sterile, stable, lyophilized preparation of functionally intact human Alpha1- Proteinase Inhibitor (α1-PI). This pharmacokinetic study will be a randomized controlled clinical trial with a cross-over design. Twenty-four subjects will be enrolled into the study. Overall study duration will be approximately 6-8 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alpha 1-Antitrypsin Deficiency
Keywords
Severe congenital Alpha1-Proteinase Inhibitor (Alpha1-PI) deficiency

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Crossover Assignment
Masking
Double
Allocation
Randomized
Enrollment
25 (Actual)

8. Arms, Groups, and Interventions

Arm Title
ARALAST Fr. IV-1
Arm Type
Experimental
Arm Description
60 mg/kg
Arm Title
ARALAST
Arm Type
Active Comparator
Arm Description
60mg/kg
Intervention Type
Biological
Intervention Name(s)
Dose of 60 mg/kg Fraction IV-1 Alpha1-Proteinase Inhibitor
Intervention Description
Subjects meeting the eligibility criteria were randomized to receive either single dose ARALAST alpha1-proteinase inhibitor 60 mg/kg or single-dose ARALAST alpha1-proteinase inhibitor Fr. IV-1 60 mg/kg at 0.2 mL/kg/min during the first treatment period with crossover to the alternate study product during the second treatment period, with a minimum of 7 days between the two treatment periods.
Intervention Type
Biological
Intervention Name(s)
Dose of 60 mg/kg alpha1-proteinase inhibitor
Intervention Description
Subjects meeting the eligibility criteria were randomized to receive either single dose ARALAST alpha1-proteinase inhibitor 60 mg/kg or single-dose ARALAST alpha1-proteinase inhibitor Fr. IV-1 60 mg/kg at 0.2 mL/kg/min during the first treatment period with crossover to the alternate study product during the second treatment period, with a minimum of 7 days between the two treatment periods.
Primary Outcome Measure Information:
Title
Area Under the Curve/Dose
Description
Area under the plasma alpha1-proteinase inhibitor (α1-PI) concentration versus time curve (AUC) calculated by linear trapezoidal method per dose.
Time Frame
Pharmacokinetic evaluation: 30 minutes pre-infusion up to 35 days post-infusion
Secondary Outcome Measure Information:
Title
Total Area Under the Curve Per Dose
Description
Total area under the α1-PI concentration vs. time curve from pharmacokinetic day 0 to time infinity (AUC 0-infinity) per dose
Time Frame
Pharmacokinetic evaluation: 30 minutes pre-infusion up to 35 days post-infusion
Title
Systemic Clearance (CL)
Description
Computed as dose divided by AUC 0-infinity (AUC 0-infinity was calculated as the sum of AUC from time 0 to the time of last quantifiable concentration plus a tail area correction)
Time Frame
Pharmacokinetic evaluation: 30 minutes pre-infusion up to 35 days post-infusion
Title
Mean Residence Time (MRT)
Description
Computed as total area under the moment curve (AUMC) divided by total AUC
Time Frame
Pharmacokinetic evaluation: 30 minutes pre-infusion up to 35 days post-infusion
Title
Apparent Volume of Distribution at Steady State
Description
Computed as weight-adjusted CL * MRT
Time Frame
Pharmacokinetic evaluation: 30 minutes pre-infusion up to 35 days post-infusion
Title
Terminal Half-life
Description
Computed from the terminal or disposition rate constant obtained from log_e -linear fitting using the least squares deviation to the last five quantifiable concentrations above pre-infusion level.
Time Frame
Pharmacokinetic evaluation: 30 minutes pre-infusion up to 35 days post-infusion
Title
Maximum Plasma Concentration (Cmax)
Description
Maximum α1-PI concentration following infusion
Time Frame
Pharmacokinetic evaluation: 30 minutes pre-infusion up to 35 days post-infusion
Title
Time to Maximum α1-PI Concentration Post-infusion (Tmax)
Description
Time to reach C-max. Tmax is the number of days from infusion to maximum concentration. Samples drawn at the end of infusion are considered to be time zero.
Time Frame
Pharmacokinetic evaluation: 30 minutes pre-infusion up to 35 days post-infusion
Title
Incremental Recovery
Description
Computed from Cmax (mg/ml) divided by dose per kg body weight (mg/kg).
Time Frame
Pharmacokinetic evaluation: 30 minutes pre-infusion up to 35 days post-infusion
Title
Adverse Events (AEs)
Description
Investigators assessed severity of AEs (occurring during or after infusions) based on: MILD: Transient discomfort, does not interfere in a significant manner with participant's normal functioning level; Resolves spontaneously or may require minimal therapeutic intervention MODERATE: AE produces limited impairment of function, can require therapeutic intervention; AE produces no sequelae; SEVERE: AE results in marked impairment of function, can lead to temporary inability to resume usual life pattern; AE produces sequelae, which require prolonged therapeutic intervention
Time Frame
Throughout study period (7 months)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The subject or subject´s legally authorized representative has provided written informed consent Subject is 18 years of age or older Subject has a documented, endogenous plasma Alpha1-PI level < 8 Micromolar Subject is of the genotype Pi*Z/Z, Pi*Z/Null, Pi*Null/Null, Pi*Malton/Z, or others, dependent on the approval by the Sponsor If the subject is female or of childbearing potential, the subject has a negative urine test for pregnancy within 7 days prior to first study product administration and agrees to employ adequate birth control measures for the duration of the study Laboratory results obtained at the screening visit, meeting the following criteria: Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) <= 2 times the upper limit of normal (ULN) Serum total bilirubin <= 2 times ULN Proteinuria < +2 on dipstick analysis Serum creatinine <= 1.5 times ULN Absolute neutrophil count (ANC) >= 1500 cells/mm3 Hemoglobin >= 10.0 g/dL Platelet count >= 10^5/mm3 If the subject is treated with any respiratory medications, including inhaled bronchodilators and inhaled or oral corticosteroids, the subjects´ medication doses were unchanged for at least 14 days prior to first study product administration Nonsmoker for a minimum of 3 months prior to first study product administration Exclusion Criteria: The subject has received any Alpha1-PI augmentation therapy (including Aralast and investigational Alpha1-PIs, by any route including intravenous and inhaled) within 42 days prior to first study product administration The subject has received an investigational drug or device within 1 month prior to first study product administration, or the subject is currently receiving an investigational drug The subject has a known selective immunoglobulin A (IgA) deficiency (IgA level < 15 mg/dL) and/or antibody to IgA The subject has a pulmonary exacerbation or had a pulmonary exacerbation in the past 14 days prior to first study product administration The subject is pregnant or lactating, or intends to become pregnant during the course of the study The subject has a clinically significant medical, psychiatric, or cognitive illness, or recreational drug/alcohol use that, in the opinion of the investigator, would affect subject safety or compliance
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Study Director
Organizational Affiliation
Takeda
Official's Role
Study Director
Facility Information:
City
Adelaide
State/Province
South Australia
Country
Australia
City
Woodville
State/Province
South Australia
Country
Australia
City
Fitzroy
State/Province
Victoria
Country
Australia
City
Nedlands
State/Province
Western Australia
Country
Australia
City
Otahuhu
State/Province
Auckland
Country
New Zealand
City
Christchurch
Country
New Zealand
City
Hamilton
Country
New Zealand

12. IPD Sharing Statement

Citations:
PubMed Identifier
36001294
Citation
Li Z, Franke RM, Morris DN, Yel L. Pharmacokinetics and Biochemical Efficacy of an alpha1-Proteinase Inhibitor (Aralast NP) in alpha1-Antitrypsin Deficiency: a Cross-Product Retrospective Comparability Analysis. Pulm Ther. 2022 Sep;8(3):311-326. doi: 10.1007/s41030-022-00199-4. Epub 2022 Aug 24.
Results Reference
derived

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Pharmacokinetic Study of ARALAST (Human Alpha1- PI)

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