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Study on the Dose-response Relationship of Pharmacodynamic Parameters in Patients With Hemophilia With Inhibitors

Primary Purpose

Hemophilia A With Inhibitor, Hemophilia B With Inhibitor

Status
Completed
Phase
Early Phase 1
Locations
Iran, Islamic Republic of
Study Type
Interventional
Intervention
Eptacog alfa, activated
Sponsored by
AryoGen Pharmed Co.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hemophilia A With Inhibitor

Eligibility Criteria

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

Inclusion Criteria:

  • Confirmed diagnosis of congenital haemophilia A or B with inhibitors to FVIII or FIX titer >5 Bethesda Units [BU]
  • with > 2 episodes of bleeding/year requiring treatment with FVII infusions, not in bleeding episode
  • Male adults and adolescents (>12 years)
  • Patient informed consent has been obtained [Patients to be enrolled must also provide voluntary written informed consent to the protocol prior to screening to be eligible for the study. For adolescents, parent/legal guardian must provide consent and, wherever possible, patient assent will also be obtained. For compromised patients, their designated proxy must provide informed consent].
  • Patients willing and able to be hospitalized prior to time of study medication administration for plasma sampling (5 times during the study).

Exclusion Criteria:

  • Any other type of congenital or acquired coagulopathy, such as: liver disease (hepatitis), vitamin k deficiency, uremia, malignancy.
  • Antibodies against Factor VII
  • Ongoing bleeding prophylaxis regimens with AryoSeven/NovoSeven or planned to occur during the trial
  • Platelet count less than 100.000 platelets/mcL (at screening visit)
  • Any clinical sign or known history of arterial thrombotic event or deep venous- thrombosis or pulmonary embolism
  • HIV positive with current CD4+ count of less than 200/µL
  • Liver cirrhosis
  • Factor VIII/IX immune tolerance induction regimen planned to occur during the trial
  • Known hypersensitivity to the study medication
  • Parallel participation in another experimental drug trial.
  • Parallel participation in another marketed drug trial that may affect the primary end-point of the study.
  • Concomitant diseases and/or medications, or any other conditions, that render the patient unsuitable for inclusion into the study in the judgement of the investigator.

Sites / Locations

  • Comprehensive Hemophilia Care Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Active Comparator

Arm Label

AryoSeven 10 μg/kg

AryoSeven 30 μg/kg

AryoSeven 90 μg/kg

AryoSeven 270 μg/kg

NovoSeven 30 μg/kg

Arm Description

Single dose, intravenously

Single dose, intravenously

Single dose, intravenously

Single dose, intravenously

Single dose, intravenously

Outcomes

Primary Outcome Measures

Lag time of the thrombin generation curve
Time to 16.7% of peak plasmatic concentration, in minutes.

Secondary Outcome Measures

Endogenous Thrombin Potential (PD parameter)
Area under the curve plasma levels of thrombin generation curve (in nmol/per minute)
Time to Peak (PD parameter)
Time to Peak of thrombin generation curve (in minutes)
Peak height (PD parameter)
Peak height of thrombin generation curve (in nmol/ml)
F1.2 prothrombin fragments (PD parameter)
Peak height (micg/L)
D-dimer (PD parameter)
Peak height (micg/L)
AUCinf (PK parameter)
Area under the plasma concentration time curve from time 0 to infinity, based on the last observed concentration;
Cmax (PK parameter)
Observed maximum plasma concentration
Time of Cmax (PK parameter)
Time of observed maximum plasma concentration

Full Information

First Posted
March 4, 2021
Last Updated
September 9, 2022
Sponsor
AryoGen Pharmed Co.
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1. Study Identification

Unique Protocol Identification Number
NCT04789954
Brief Title
Study on the Dose-response Relationship of Pharmacodynamic Parameters in Patients With Hemophilia With Inhibitors
Official Title
An Exploratory Study to Evaluate the Dose Response-Relationship of Pharmacodynamic Parameters of AryoSeven, in Patients With Hemophilia With Inhibitors
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Completed
Study Start Date
December 29, 2020 (Actual)
Primary Completion Date
August 13, 2021 (Actual)
Study Completion Date
July 31, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AryoGen Pharmed Co.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Randomized, double-blind, single-dose, 5 ways crossover, exploratory clinical trial evaluating four different doses of AryoSeven (eptacog alfa, activated) and NovoSeven on selected pharmacodynamic parameters in patients with hemophilia with inhibitors.
Detailed Description
Randomized, double-blind, single dose, 5 ways crossover, clinical trial evaluating four different doses (10 µg/kg, 30 µg/kg, 90 µg/kg, and 270 µg/kg) of AryoSeven (recombinant human FVII activated or eptacog alfa, activated) and one dose of NovoSeven (30 µg/kg) on selected pharmacodynamic parameters (PD) [Primary: Thrombin Generation Assay (TGA)] in male adult and adolescent (>12 years) patients with hemophilia A or B, with an inhibitors titer >5 Bethesda Units [BU] and not in bleeding status. This will be an exploratory study to evaluate dose-response relationship of PD markers as surrogate efficacy endpoints.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hemophilia A With Inhibitor, Hemophilia B With Inhibitor

7. Study Design

Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
14 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AryoSeven 10 μg/kg
Arm Type
Experimental
Arm Description
Single dose, intravenously
Arm Title
AryoSeven 30 μg/kg
Arm Type
Experimental
Arm Description
Single dose, intravenously
Arm Title
AryoSeven 90 μg/kg
Arm Type
Experimental
Arm Description
Single dose, intravenously
Arm Title
AryoSeven 270 μg/kg
Arm Type
Experimental
Arm Description
Single dose, intravenously
Arm Title
NovoSeven 30 μg/kg
Arm Type
Active Comparator
Arm Description
Single dose, intravenously
Intervention Type
Biological
Intervention Name(s)
Eptacog alfa, activated
Intervention Description
A dose sequence for each injection will be randomly selected from the following doses: 10 μg/kg, 30 μg/kg, 90 μg/kg, or 270 μg/kg, separated by a wash-out period of 3 days.
Primary Outcome Measure Information:
Title
Lag time of the thrombin generation curve
Description
Time to 16.7% of peak plasmatic concentration, in minutes.
Time Frame
Up to 30 hours after AryoSeven and NovoSeven injection
Secondary Outcome Measure Information:
Title
Endogenous Thrombin Potential (PD parameter)
Description
Area under the curve plasma levels of thrombin generation curve (in nmol/per minute)
Time Frame
Up to 30 hours after AryoSeven and NovoSeven injection
Title
Time to Peak (PD parameter)
Description
Time to Peak of thrombin generation curve (in minutes)
Time Frame
Up to 30 hours after AryoSeven and NovoSeven injection
Title
Peak height (PD parameter)
Description
Peak height of thrombin generation curve (in nmol/ml)
Time Frame
Up to 30 hours after AryoSeven and NovoSeven injection
Title
F1.2 prothrombin fragments (PD parameter)
Description
Peak height (micg/L)
Time Frame
Up to 30 hours after AryoSeven and NovoSeven injection
Title
D-dimer (PD parameter)
Description
Peak height (micg/L)
Time Frame
Up to 30 hours after AryoSeven and NovoSeven injection
Title
AUCinf (PK parameter)
Description
Area under the plasma concentration time curve from time 0 to infinity, based on the last observed concentration;
Time Frame
Up to 30 hours after AryoSeven and NovoSeven injection
Title
Cmax (PK parameter)
Description
Observed maximum plasma concentration
Time Frame
Up to 30 hours after AryoSeven and NovoSeven injection
Title
Time of Cmax (PK parameter)
Description
Time of observed maximum plasma concentration
Time Frame
Up to 30 hours after AryoSeven and NovoSeven injection

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
12 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Confirmed diagnosis of congenital haemophilia A or B with inhibitors to FVIII or FIX titer >5 Bethesda Units [BU] with > 2 episodes of bleeding/year requiring treatment with FVII infusions, not in bleeding episode Male adults and adolescents (>12 years) Patient informed consent has been obtained [Patients to be enrolled must also provide voluntary written informed consent to the protocol prior to screening to be eligible for the study. For adolescents, parent/legal guardian must provide consent and, wherever possible, patient assent will also be obtained. For compromised patients, their designated proxy must provide informed consent]. Patients willing and able to be hospitalized prior to time of study medication administration for plasma sampling (5 times during the study). Exclusion Criteria: Any other type of congenital or acquired coagulopathy, such as: liver disease (hepatitis), vitamin k deficiency, uremia, malignancy. Antibodies against Factor VII Ongoing bleeding prophylaxis regimens with AryoSeven/NovoSeven or planned to occur during the trial Platelet count less than 100.000 platelets/mcL (at screening visit) Any clinical sign or known history of arterial thrombotic event or deep venous- thrombosis or pulmonary embolism HIV positive with current CD4+ count of less than 200/µL Liver cirrhosis Factor VIII/IX immune tolerance induction regimen planned to occur during the trial Known hypersensitivity to the study medication Parallel participation in another experimental drug trial. Parallel participation in another marketed drug trial that may affect the primary end-point of the study. Concomitant diseases and/or medications, or any other conditions, that render the patient unsuitable for inclusion into the study in the judgement of the investigator.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Massimo Iacobelli, MD
Organizational Affiliation
Consultant
Official's Role
Study Director
Facility Information:
Facility Name
Comprehensive Hemophilia Care Center
City
Teheran
Country
Iran, Islamic Republic of

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Study on the Dose-response Relationship of Pharmacodynamic Parameters in Patients With Hemophilia With Inhibitors

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