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Completed

NCT Number: NCT02170402

China ADVATE PTP Study

The purpose of this study is to assess efficacy, safety and pharmacokinetics of ADVATE in the treatment and prevention of bleeding episodes (BEs)

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Key information

Sex eligibility

Male

Study type

Interventional

Phase

Phase 4

Primary location

Peking Union Medical College Hospital, Dongcheng, Beijing Municipality, China

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Main Inclusion Criteria:

  • Ethnic Chinese
  • is of any age
  • has a documented diagnosis of severe or moderately severe hemophilia A (congenital FVIII deficiency: baseline Factor VIII (FVIII) ≤ 2%)
  • has documented and verified >50 exposure days (EDs) to FVIII (recombinant or plasma derived)
  • is receiving on-demand treatment with FVIII at the time of enrolment in this study
  • has negative history of inhibitor development
  • is HIV negative or HIV positive with stable disease and CD4+ count ≥ 200 cells per mm^3
  • is negative for Hepatitis C virus (HCV); Or participant is HCV positive with chronic stable hepatitis as assessed by investigator

Main Exclusion Criteria:

  • has prior history of hypersensitivity or anaphylaxis associated with receipt of FVIII
  • is diagnosed with other bleeding disorder(s) other than hemophilia A, including but not limited to thrombocytopenia (platelet count < 100000 /mL)
  • has been exposed to an investigational product (IP) within 30 days prior to the screening visit or is scheduled to participate in another clinical study involving an IP or investigational device during participation in the study
  • is planned, or likely to have surgery during the study period
  • has end-stage renal failure or evidence of a severe or uncontrolled systemic disease as judged by the investigator
  • has active hepatic disease (alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels > 5 times the upper limit of normal)
  • has clinical or laboratory evidence of severe liver impairment including (but not limited to) a recent & persistent international normalized ratio (INR) >1.4, and/or the presence of splenomegaly and/or significant spider angioma on physical exam, and/or a history of esophageal hemorrhage or documented esophageal varices
  • is a family member of the investigator or site staff

Treatment and study plan

Octocog alfa (recombinant human coagulation factor VIII)

Biological
  • Part 1: Pharmacokinetic (PK) analysis - Subset of 24 participants
  • Part 2: On-demand treatment regimen
  • Part 3: Prophylaxis treatment regimen

Other names: ADVATE

Primary outcomes

  1. Percentage of reduction in annualized bleed rate (ABR) during prophylactic treatment compared to ABR during on demand treatment

    Time frame: 12 months

    Computed as:

    {[median ABR on-demand - median ABR prophylaxis]÷[median ABR on-demand]}*100%

    The ABR, will be assumed to have a negative binomial distribution. The 2 treatment regimens (on-demand and prophylaxis) will be compared in terms of mean ABR within a generalized linear model framework (with a logarithmic link function which is the default for the negative binomial distribution), accounting for the fixed effect of study arm and the follow-up time (in years) as an offset. Ratios between treatment means (95% CI) will be estimated within this model.

Secondary outcomes

  1. Number of units per kg body weight of ADVATE required to resolve a bleeding episode (BE)

    Time frame: 12 months

  2. Number of infusions of ADVATE required to resolve a bleeding episode (BE)

    Time frame: 12 months

  3. Overall evaluation of efficacy on a four-point scale (Excellent-Good-Fair-Poor)

    Time frame: 12 months

  4. Annualized bleeding episode rates (ABR) according to bleed type and bleed etiology summarized by treatment regimen

    Time frame: 12 months

    Bleed types and etiologies summarized by treatment regimen (prophylaxis, on-demand) including:

    • Joint bleeds
    • Non-joint bleeds
    • Spontaneous bleeds
    • Traumatic bleeds
    • Target joint bleeds
  5. Inhibitor incidence

    Time frame: 13 months

    Inhibitor incidence in:

    • Previously treated patients (PTPs) with previous 51-150 exposure days (EDs) to Factor VIII (FVIII)
    • PTPs with previous >150 EDs to FVIII
  6. Adverse events according to relatedness, seriousness, and severity

    Time frame: 13 months

  7. Area under the plasma concentration/time curve from time 0 to infinity

    Time frame: Within 30 minutes prior to the start of the infusion through 48 hours post-infusion

    Computed as AUC0-t + Ct/ λz, where t is the time of last quantifiable concentration, Ct is the last quantifiable concentration, and λz is the terminal rate constant

  8. Mean Residence Time (MRT)

    Time frame: Within 30 minutes prior to the start of the infusion through 48 hours post-infusion

    Computed as AUMC0-∞ / AUC0-∞ - TI/2, where AUMC0-∞ will be determined in a similar manner as AUC0-∞ and TI represents infusion duration [hour]

  9. Clearance (CL)

    Time frame: Within 30 minutes prior to the start of the infusion through 48 hours post-infusion

    Computed as Dose/ AUC0-∞

  10. Incremental Recovery (IR) at Cmax

    Time frame: Within 30 minutes prior to the start of the infusion, and within 1 hour post-infusion

    Computed as: (Cmax - Cpre-infusion)/Dose, where Cmax will be determined as the highest concentration achieved within one hour after infusion

  11. Elimination phase half-life

    Time frame: Within 30 minutes prior to the start of the infusion through 48 hours post-infusion

    Computed as: ln2/ λz. λz will be estimated from the slope of natural log-linear fitting to latter quantifiable concentrations, with largest adjusted R^2

  12. Volume of distribution at steady state (Vss)

    Time frame: Within 30 minutes prior to the start of the infusion through 48 hours post-infusion

    Computed as: CL * MRT

Sponsors and collaborators

Lead sponsor

Baxalta now part of Shire

Industry

Registry information

Official study title

Study to Evaluate Efficacy and Safety of ADVATE in the Treatment of Previously Treated Patients With Hemophilia A

Important dates

Study start
2014
Primary completion
2016
Study completion
2016
First posted
Jun 23, 2014
Registry last updated
May 3, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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