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Study to Evaluate Safety and Pharmacokinetics of BIVIGAM® in Primary Immune Deficiency Subjects Aged 2 to 16

Primary Purpose

Humoral Immune Response

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Bivigam
Sponsored by
ADMA Biologics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Humoral Immune Response

Eligibility Criteria

2 Years - 16 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Written informed consent/Assent
  • Male or female between 2 and 16 years, inclusive, at time of Signing Informed Consent/Assent
  • Have a confirmed and documented clinical diagnosis of Primary Immune Deficiency Disorder, including hypogammaglobulinemia or agammaglobulinemia.
  • Have received IGIV therapy which was maintained at a steady dose (± 25% of the mean dose) for at least 3 months prior to study entry, and have maintained a trough IgG level at least 500mg/dL prior to receiving BIVIGAM®.
  • Subjects and/or parents/legal guardians must be able to understand and adhere to the study visit schedule and all other protocol requirements.

Exclusion Criteria:

  • Known intolerance to immunoglobulins or comparable substances (e.g. vaccination reaction).
  • Known intolerance to proteins of human origin or known allergic reactions to components of the study product(s).
  • Any previous randomization/participation in this clinical study must be discussed with and approved by the medical director (or designee).
  • Inability or lacking motivation to participate in the study.
  • Medical condition, laboratory finding, or physical exam finding (specify, e.g., vital signs outside of specific range that precludes participation. Per lab results at the Screening visit through Baseline.
  • Confirmed Screening visit laboratory results ˃2.5 X ULN as defined for pediatric populations for any of the following: ALT (alanine aminotransferase/SGPT), AST (aspartate aminotransferase/SGOT), LDH (lactate dehydrogenase), BUN (blood urea nitrogen), Serum creatinine
  • Has selective IgA deficiency or demonstrated antibodies to IgA.
  • History of thrombotic complications of IGIV therapy or history of (deep vein thrombosis)DVT.
  • Current use of daily corticosteroids (>10 mg of prednisone equivalent/day),immunosuppressants or immunomodulators are not allowed unless approved in advance by the medical monitor. Intermittent use of corticosteroids during the study is allowed if medically necessary.
  • Positive diagnosis of hepatitis B or hepatitis C.
  • Positive human immunodeficiency virus (HIV) test.
  • Subject has had a serious bacterial infection (SBI) within the last 3 months.
  • Subject has an active infection and is receiving antibiotic therapy for the treatment of this infection at the time of Screening. Note: if the subject is deemed a Screen Failure due to a nonserious active infection requiring antibiotic therapy, the subject may be rescreened 3 or 4 weeks (depending on drug administration schedule) after the initial screening.
  • Subject has a history of thrombotic events (including deep vein thrombosis, myocardial infarction, cerebrovascular accident and pulmonary embolism) within 6 months before 1st IGIV dose or has preexisting risk factors for thrombotic events.
  • Acquired medical condition known to cause secondary immune deficiency such as chronic lymphacitic leukemia, lymphoma or multiple lymphoma.
  • Subjects with protein-losing enteropathies, hypoalbuminaemia.
  • Females taking oral contraceptives.
  • Pregnancy or unreliable contraceptive measures or lactation period (females of childbearing potential (female capable of becoming pregnant) only. Males capable of reproduction must agree to a double barrier method of contraception during their study participation.

Sites / Locations

  • IMMUNOe Research Centers
  • Duke University Medical Center
  • Allergy Associates of the Palm Beaches
  • USF Health, Pediatric Allergy, Immunology & Rheumatology
  • Ohio Clinical Research Associates
  • Oklahoma Institute of Allergy and Asthma Clinical Research
  • Discovery Clinical Trials
  • Lysosomal Rare Disorders Research & Treatment Center

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Active Drug

Arm Description

All subjects will receive Bivigam based on their prior dosing to be adjusted as clinically necessary.

Outcomes

Primary Outcome Measures

Temporally Associated Adverse Events
Incidence of adverse events (During or within 1 hour, 24 hours and 72 hours of completion of an infusion)
Number of Temporally Associated Adverse Events
Mean number of temporally associated per infusion
Serious Adverse Events
Incidence of serious adverse events
Related Serious Adverse Events
Incidence of related serious adverse events
Treatment Emergent Adverse Events
Incidence of treatment emergent adverse events
Related Treatment Emergent Averse Events
Incidence of adverse events that first appear, or that worsen relative to the pre-treatment state, which occur during and within 72 hours of treatment administration
Non-treatment Emergent Adverse Events
Incidence of adverse events which do not have a causal relationship with study treatment
Temporally Associated Infusion Adverse Events
Incidence of adverse events which have a causal relationship with infusion treatment
Adverse Reactions
Number and incidence of adverse reactions plus suspected adverse reactions combined
Related Adverse Reactions
Incidence of adverse infusion related reactions
Infusion Site Reactions
Incidence reactions occuring at the infusion site
Vital Signs
Change in vital signs
Temporally Associated Adverse Events Following Infusions
Incidence of adverse events

Secondary Outcome Measures

Total IgG Trough
Levels taken before any infusion
IgG subclasses
Levels of subclasses 1- 4 before infusion
Total IgG Post
End of infusion level of Total IgG
Cmax
Pharmacokinetic measure at 5th or 7th infusion
Tmax
Pharmacokinetic measure at 5th or 7th infusion
AUC(0-ʈ)
Pharmacokinetic measure at 5th or 7th infusion
AUC(0-∞)
Pharmacokinetic measure at 5th or 7th infusion
Terminal phase elimination half-life (ʈ½)
Pharmacokinetic measure at 5th or 7th infusion
Antibodies
Levels of specific antibodies (antipneumococcal capsular polysaccharide, antihaemophilus influenza B
Infections
Number of infections of any kind, serious and non-serious
First Serious Bacterial Infection
Time to first Serious Bacterial Infections in days
Serious Bacterial Infections
Incidence of Serious Bacterial Infections
Other Infections
Incidence of infections other than Serious Bacterial Infections
Resolution of Infections
Time to resolution of Infections in days
Fever
Episodes of Fever
Missed Days
Number of days missed of school or work due to infections and treatment
Hospitalizations
Number of hospitalizations due to infections
Terminal phase elimination rate (λZ)
Pharmacokinetic measure at 5th or 7th infusion

Full Information

First Posted
January 30, 2017
Last Updated
January 30, 2023
Sponsor
ADMA Biologics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03164967
Brief Title
Study to Evaluate Safety and Pharmacokinetics of BIVIGAM® in Primary Immune Deficiency Subjects Aged 2 to 16
Official Title
A Phase IV, Multicenter, Open-label Study to Evaluate the Safety and Pharmacokinetics of BIVIGAM® in Primary Immune Deficiency Disorders in Subjects Aged 2 to 16
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Completed
Study Start Date
December 29, 2016 (Actual)
Primary Completion Date
August 30, 2022 (Actual)
Study Completion Date
December 31, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
ADMA Biologics, Inc.

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
This study is part of the BIVIGAM® post marketing requirement (PMR). It is being conducted in subjects aged 2-16 with primary immune deficiency disorders associated with defects in humoral immunity to generate additional data on these populations, and more specifically safety and pharmacokinetic (PK) assessments.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Humoral Immune Response

7. Study Design

Primary Purpose
Other
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
16 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Active Drug
Arm Type
Other
Arm Description
All subjects will receive Bivigam based on their prior dosing to be adjusted as clinically necessary.
Intervention Type
Biological
Intervention Name(s)
Bivigam
Primary Outcome Measure Information:
Title
Temporally Associated Adverse Events
Description
Incidence of adverse events (During or within 1 hour, 24 hours and 72 hours of completion of an infusion)
Time Frame
During each infusion (During or within 1 hour, 24 hours and 72 hours of completion of an infusion)
Title
Number of Temporally Associated Adverse Events
Description
Mean number of temporally associated per infusion
Time Frame
Up to 72 hours of completion of an infusion
Title
Serious Adverse Events
Description
Incidence of serious adverse events
Time Frame
Up to approximately 7 months
Title
Related Serious Adverse Events
Description
Incidence of related serious adverse events
Time Frame
Up to approximately 7 months
Title
Treatment Emergent Adverse Events
Description
Incidence of treatment emergent adverse events
Time Frame
Up to approximately 7 months
Title
Related Treatment Emergent Averse Events
Description
Incidence of adverse events that first appear, or that worsen relative to the pre-treatment state, which occur during and within 72 hours of treatment administration
Time Frame
Within 72 hours of infusion
Title
Non-treatment Emergent Adverse Events
Description
Incidence of adverse events which do not have a causal relationship with study treatment
Time Frame
Up to approximately 7 months
Title
Temporally Associated Infusion Adverse Events
Description
Incidence of adverse events which have a causal relationship with infusion treatment
Time Frame
Up to approximately 7 months
Title
Adverse Reactions
Description
Number and incidence of adverse reactions plus suspected adverse reactions combined
Time Frame
Up to approximately 7 months
Title
Related Adverse Reactions
Description
Incidence of adverse infusion related reactions
Time Frame
Up to approximately 7 months
Title
Infusion Site Reactions
Description
Incidence reactions occuring at the infusion site
Time Frame
Up to approximately 7 months
Title
Vital Signs
Description
Change in vital signs
Time Frame
Before and after each administration of study drug through study completion, up to approximately 7 months
Title
Temporally Associated Adverse Events Following Infusions
Description
Incidence of adverse events
Time Frame
Up to 72 hours after each infusion through study completion, up tp approximately 7 months
Secondary Outcome Measure Information:
Title
Total IgG Trough
Description
Levels taken before any infusion
Time Frame
At each visit through study completion, up tp approximately 7 months
Title
IgG subclasses
Description
Levels of subclasses 1- 4 before infusion
Time Frame
Prior to first and last infusion, up tp approximately 7 months
Title
Total IgG Post
Description
End of infusion level of Total IgG
Time Frame
At each infusion through study completion, up tp approximately 7 months
Title
Cmax
Description
Pharmacokinetic measure at 5th or 7th infusion
Time Frame
At prior to, at end of infusion, and 6 hours, 24 hours, 7 days, and 4 days, 21 days and 28 days (if still enrolled) after final infusion, up tp approximately 7 months
Title
Tmax
Description
Pharmacokinetic measure at 5th or 7th infusion
Time Frame
At prior to, at end of infusion, and 6 hours, 24 hours, 7 days, and 4 days, 21 days and 28 days (if still enrolled) after final infusion, up tp approximately 7 months
Title
AUC(0-ʈ)
Description
Pharmacokinetic measure at 5th or 7th infusion
Time Frame
At prior to, at end of infusion, and 6 hours, 24 hours, 7 days, and 4 days, 21 days and 28 days (if still enrolled) after final infusion, up tp approximately 7 months
Title
AUC(0-∞)
Description
Pharmacokinetic measure at 5th or 7th infusion
Time Frame
At prior to, at end of infusion, and 6 hours, 24 hours, 7 days, and 4 days, 21 days and 28 days (if still enrolled) after infusion
Title
Terminal phase elimination half-life (ʈ½)
Description
Pharmacokinetic measure at 5th or 7th infusion
Time Frame
At prior to, at end of infusion, and 6 hours, 24 hours, 7 days, and 4 days, 21 days and 28 days (if still enrolled) after final infusion, up tp approximately 7 months
Title
Antibodies
Description
Levels of specific antibodies (antipneumococcal capsular polysaccharide, antihaemophilus influenza B
Time Frame
At prior to, at end of infusion, and 6 hours, 24 hours, 7 days, and 4 days, 21 days and 28 days (if still enrolled) after final infusion, up tp approximately 7 months
Title
Infections
Description
Number of infections of any kind, serious and non-serious
Time Frame
Up to approximately 7 months
Title
First Serious Bacterial Infection
Description
Time to first Serious Bacterial Infections in days
Time Frame
Up to approximately 7 months
Title
Serious Bacterial Infections
Description
Incidence of Serious Bacterial Infections
Time Frame
Up to approximately 7 months
Title
Other Infections
Description
Incidence of infections other than Serious Bacterial Infections
Time Frame
Up to approximately 7 months
Title
Resolution of Infections
Description
Time to resolution of Infections in days
Time Frame
Up to approximately 7 months
Title
Fever
Description
Episodes of Fever
Time Frame
Up to approximately 7 months
Title
Missed Days
Description
Number of days missed of school or work due to infections and treatment
Time Frame
Up to approximately 7 months
Title
Hospitalizations
Description
Number of hospitalizations due to infections
Time Frame
Up to approximately 7 months
Title
Terminal phase elimination rate (λZ)
Description
Pharmacokinetic measure at 5th or 7th infusion
Time Frame
At prior to, at end of infusion, and 6 hours, 24 hours, 7 days, and 4 days, 21 days and 28 days (if still enrolled) after final infusion, up tp approximately 7 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
16 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Written informed consent/Assent Male or female between 2 and 16 years, inclusive, at time of Signing Informed Consent/Assent Have a confirmed and documented clinical diagnosis of Primary Immune Deficiency Disorder, including hypogammaglobulinemia or agammaglobulinemia. Have received IGIV therapy which was maintained at a steady dose (± 25% of the mean dose) for at least 3 months prior to study entry, and have maintained a trough IgG level at least 500mg/dL prior to receiving BIVIGAM®. Subjects and/or parents/legal guardians must be able to understand and adhere to the study visit schedule and all other protocol requirements. Exclusion Criteria: Known intolerance to immunoglobulins or comparable substances (e.g. vaccination reaction). Known intolerance to proteins of human origin or known allergic reactions to components of the study product(s). Any previous randomization/participation in this clinical study must be discussed with and approved by the medical director (or designee). Inability or lacking motivation to participate in the study. Medical condition, laboratory finding, or physical exam finding (specify, e.g., vital signs outside of specific range that precludes participation. Per lab results at the Screening visit through Baseline. Confirmed Screening visit laboratory results ˃2.5 X ULN as defined for pediatric populations for any of the following: ALT (alanine aminotransferase/SGPT), AST (aspartate aminotransferase/SGOT), LDH (lactate dehydrogenase), BUN (blood urea nitrogen), Serum creatinine Has selective IgA deficiency or demonstrated antibodies to IgA. History of thrombotic complications of IGIV therapy or history of (deep vein thrombosis)DVT. Current use of daily corticosteroids (>10 mg of prednisone equivalent/day),immunosuppressants or immunomodulators are not allowed unless approved in advance by the medical monitor. Intermittent use of corticosteroids during the study is allowed if medically necessary. Positive diagnosis of hepatitis B or hepatitis C. Positive human immunodeficiency virus (HIV) test. Subject has had a serious bacterial infection (SBI) within the last 3 months. Subject has an active infection and is receiving antibiotic therapy for the treatment of this infection at the time of Screening. Note: if the subject is deemed a Screen Failure due to a nonserious active infection requiring antibiotic therapy, the subject may be rescreened 3 or 4 weeks (depending on drug administration schedule) after the initial screening. Subject has a history of thrombotic events (including deep vein thrombosis, myocardial infarction, cerebrovascular accident and pulmonary embolism) within 6 months before 1st IGIV dose or has preexisting risk factors for thrombotic events. Acquired medical condition known to cause secondary immune deficiency such as chronic lymphacitic leukemia, lymphoma or multiple lymphoma. Subjects with protein-losing enteropathies, hypoalbuminaemia. Females taking oral contraceptives. Pregnancy or unreliable contraceptive measures or lactation period (females of childbearing potential (female capable of becoming pregnant) only. Males capable of reproduction must agree to a double barrier method of contraception during their study participation.
Facility Information:
Facility Name
IMMUNOe Research Centers
City
Centennial
State/Province
Colorado
ZIP/Postal Code
80112
Country
United States
Facility Name
Duke University Medical Center
City
Durham
State/Province
Florida
ZIP/Postal Code
27710
Country
United States
Facility Name
Allergy Associates of the Palm Beaches
City
North Palm Beach
State/Province
Florida
ZIP/Postal Code
33408
Country
United States
Facility Name
USF Health, Pediatric Allergy, Immunology & Rheumatology
City
Saint Petersburg
State/Province
Florida
ZIP/Postal Code
33701
Country
United States
Facility Name
Ohio Clinical Research Associates
City
Mayfield Heights
State/Province
Ohio
ZIP/Postal Code
44124
Country
United States
Facility Name
Oklahoma Institute of Allergy and Asthma Clinical Research
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73131
Country
United States
Facility Name
Discovery Clinical Trials
City
Dallas
State/Province
Texas
ZIP/Postal Code
75225
Country
United States
Facility Name
Lysosomal Rare Disorders Research & Treatment Center
City
Fairfax
State/Province
Virginia
ZIP/Postal Code
22030
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided
IPD Sharing Plan Description
Not yet determined

Learn more about this trial

Study to Evaluate Safety and Pharmacokinetics of BIVIGAM® in Primary Immune Deficiency Subjects Aged 2 to 16

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