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NCT Number: NCT06003387

Efficacy and Safety of CSL222 (Etranacogene Dezaparvovec) Gene Therapy in Adults With Hemophilia B With Pretreatment Adeno-associated Virus Serotype 5 (AAV5) Neutralizing Antibodies (Nabs)

The purpose of this study is to assess the risk of bleeding due to failure of expected pharmacological action of CSL222 in adults with severe or moderately severe hemophilia B with detectable pretreatment AAV5 Nabs.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia

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Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Considered legally an adult, as defined by country regulations.
  • Has congenital hemophilia B with known severe or moderately severe FIX deficiency (less than or equal to [<=] 2% of normal circulating FIX) for which the participant is on continuous routine FIX prophylaxis.
  • Has 2 consecutive detectable AAV5 NAb titer results between Screening and Visit L-Final using a validated AAV5 NAb assay (based on central laboratory results).
  • Has greater than (>) 150 previous exposure days to FIX replacement therapy.
  • Has been on stable FIX prophylaxis for at least 2 months before Screening.
  • Has demonstrated capability to independently, accurately, and in a timely manner complete the eDiary during the Lead-in Period, as judged by the investigator.
  • Acceptance to adhere to contraception guidelines.
  • Able to provide informed consent after receipt of verbal and written information about the study.
  • Investigator believes that the participant (or the participant's legally acceptable representative[s]) understands the nature, scope, and possible consequences of the study and is able to adhere to the study procedures.

Exclusion criteria

  • History of FIX inhibitors or positive FIX inhibitor test at Prescreening, Screening or Visit L-Final (based on central laboratory results).
  • Screening or Visit L-Final laboratory values (based on central laboratory results) of total bilirubin > 2 × the upper limit of normal (ULN) (except if caused by Gilbert's syndrome).
  • Screening or Visit L-Final laboratory values (based on central laboratory results) of any of the following laboratory abnormalities:
  • ALT > 2 × the ULN
  • AST > 2 × the ULN
  • Alkaline phosphatase > 2 × the ULN
  • Serum creatinine > 2 × the ULN
  • Hemoglobin less than (<) 8 g/dL
  • Any condition other than hemophilia B resulting in an increased bleeding tendency.
  • Thrombocytopenia, defined as a platelet count <50 × 10^9/L, at Screening or Visit L Final (based on central laboratory results).
  • Any uncontrolled or untreated infection (human immunodeficiency virus [HIV], hepatitis B virus [HBV] and hepatitis C virus [HCV], or any other significant concurrent, uncontrolled medical condition including, but not limited to, renal, hepatic, cardiovascular, hematological, gastrointestinal, endocrine, pulmonary, neurological, cerebral or psychiatric disease, alcoholism, drug dependency, or any other psychological disorder evaluated by the investigator to interfere with adherence to the clinical study protocol procedures or with the degree of tolerance to CSL222.
  • Known history of allergy to corticosteroids or known medical condition that would require chronic administration of oral corticosteroids.
  • Known uncontrolled allergic conditions or allergy / hypersensitivity to any component of the CSL222 excipients (ie, sucrose, potassium chloride, potassium dihydrogen phosphate, sodium chloride, and disodium hydrogen phosphate).
  • Previous AAV5 gene therapy treatment.
  • Receipt of an experimental agent or device within 60 days before Screening until the end of the study.

Treatment and study plan

CSL222 (AAV5-hFIXco-Padua)

Genetic

Administered as a single IV infusion.

Other names: Etranacogene dezaparvovec

Primary outcomes

  1. Annualized Bleeding Rate (ABR)

    Time frame: Months 7 to 18 after CSL222 treatment

    The total bleeding episodes will be analyzed. ABR is calculated as the total bleeding episodes divided by the total time at risk.

Secondary outcomes

  1. Number of participants with Treatment Emergent Adverse Events (TEAEs)

    Time frame: Up to 60 months after CSL222 treatment

  2. Percentage of participants with TEAEs

    Time frame: Up to 60 months after CSL222 treatment

  3. Number of TEAEs

    Time frame: Up to 60 months after CSL222 treatment

  4. Change in Liver ultrasound

    Time frame: Up to 60 months after CSL222 treatment

  5. Number of participants who develop Factor IX (FIX) Inhibitors

    Time frame: Up to 60 months after CSL222 treatment

  6. Percentage of participants who develop FIX Inhibitors

    Time frame: Up to 60 months after CSL222 treatment

  7. Change in hematology and biochemistry parameters

    Time frame: Up to 60 months after CSL222 treatment

  8. Number of participants with clinically significant increase in Alanine Aminotransferase (ALT) or Aspartate Aminotransferase (AST)

    Time frame: Up to 60 months after CSL222 treatment

  9. Percentage of participants with clinically significant increase in ALT or AST

    Time frame: Up to 60 months after CSL222 treatment

  10. Corticosteroid use for ALT or AST increases after CSL222 treatment

    Time frame: Up to 60 months after CSL222 treatment

  11. Number of participants with clinically significant Alpha-fetoprotein (AFP)

    Time frame: Baseline and up to 60 months after CSL222 treatment

  12. Percentage of participants with clinically significant AFP

    Time frame: Baseline and up to 60 months after CSL222 treatment

  13. Number of participants with infusion related reactions or hypersensitivity reactions

    Time frame: Throughout CSL222 infusion period and up to 60 months after CSL222 treatment

  14. Percentage of participants with infusion related reactions or hypersensitivity reactions

    Time frame: Throughout CSL222 infusion period and up to 60 months after CSL222 treatment

  15. Change in the Uncontaminated Endogenous FIX activity

    Time frame: Baseline and up to Months 6, 12, and 18 after CSL222 treatment

  16. Annualized consumption of FIX replacement therapy

    Time frame: Months 7 to 18 after CSL222 treatment

  17. Annualized infusion rate of FIX replacement therapy

    Time frame: Months 7 to 18 after CSL222 treatment

  18. Number of participants remaining free of continuous FIX prophylaxis

    Time frame: Months 7 to 18 after CSL222 treatment

  19. Percentage of participants remaining free of continuous FIX prophylaxis

    Time frame: Months 7 to 18 after CSL222 treatment

  20. ABR for spontaneous bleeding episodes

    Time frame: Months 7 to 18 after CSL222 treatment

  21. ABR for joint bleeding episodes

    Time frame: Months 7 to 18 after CSL222 treatment

  22. ABR for FIX-treated bleeding episodes

    Time frame: Months 7 to 18 after CSL222 treatment

  23. Correlation analysis of FIX activity levels with baseline AAV5 NAb titers

    Time frame: Months 7 to 18 after CSL222 treatment

  24. Number of participants with new target joints and resolved pre-existing target joints

    Time frame: Months 7 to 18 after CSL222 treatment

    Target joint is defined as 3 or more spontaneous bleeding episodes into a single joint.

  25. Number of participants with zero bleeding episodes and zero FIX-treated bleeding episodes

    Time frame: Months 7 to 18 after CSL222 treatment

  26. Percentage of participants with zero bleeding episodes and zero FIX-treated bleeding episodes

    Time frame: Months 7 to 18 after CSL222 treatment

  27. Change in the EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) Visual Analogue Scale (VAS) Overall Score

    Time frame: Baseline and up to 18 months after CSL222 treatment

    The EQ-5D-5L questionnaire visual analogue scale (VAS) measures overall health status on a vertical VAS ranging from 0 to 100. A higher score indicates better quality of life. The change from baseline in the EQ-5D-5L VAS score will be determined.

  28. Change in the EQ-5D-5L Index Scores

    Time frame: Baseline and up to 18 months after CSL222 treatment

    The EQ-5D-5L questionnaire descriptive system of health-related quality of life consists of 5 dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) for which responses will be recorded on 5 levels of severity (no problems, slight problems, moderate problems, severe problems, and extreme problems). The responses will be converted into a single index utility score (typically between -0.6 and 1). A higher score indicates better quality of life. The change from baseline in the EQ-5D-5L index score will be determined.

  29. Number of Participants with Uncontaminated Endogenous FIX Activity of Greater than or Equal to (>=) 5%

    Time frame: Months 7 to 18 after CSL222 treatment

  30. Percentage of Participants with Uncontaminated Endogenous FIX Activity of >= 5%

    Time frame: Months 7 to 18 after CSL222 treatment

Study contacts

Contact information is provided by the study sponsor or research team.

Trial Registration Coordinator

CONTACT

[email protected]

1-610-878-4697

Sponsors and collaborators

Lead sponsor

CSL Behring

Industry

Registry information

Official study title

Phase 3b, Open-label, Multicenter, Single-dose Study Investigating Efficacy and Safety of CSL222 (Etranacogene Dezaparvovec) Gene Therapy Administered to Adult Subjects With Severe or Moderately Severe Hemophilia B With Detectable Pretreatment AAV5 Neutralizing Antibodies

Important dates

Study start
2024
Primary completion
2028
Study completion
2032
First posted
Aug 22, 2023
Registry last updated
Jul 28, 2026

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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