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NCT Number: NCT04644575

Long-term Safety and Efficacy of Efanesoctocog Alfa (BIVV001) in Previously Treated Patients With Hemophilia A

Primary Objective:

- To evaluate the long-term safety of BIVV001 in previously treated subjects with hemophilia A

Secondary Objectives:

* To evaluate the efficacy of BIVV001 as a prophylaxis treatment. * To evaluate the efficacy of BIVV001 in the treatment of bleeding episodes. * To evaluate BIVV001 consumption for prevention and treatment of bleeding episodes. * To evaluate the effect of BIVV001 prophylaxis on joint health outcomes. * To evaluate the effect of BIVV001 prophylaxis on Quality of Life (QoL) outcomes. * To evaluate the safety and tolerability of BIVV001 treatment. * To assess the PK of BIVV001 based on the one stage activated partial thromboplastin time (aPTT) and two-stage chromogenic FVIII activity assays (only applicable to Arm B). * To evaluate the efficacy of BIVV001 for perioperative management

Active, Not Recruiting

This study is active but is not currently recruiting participants.

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Key information

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Investigational Site Number : 0320001, CABA, Buenos Aires F.D., Argentina

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About this study

Participants will receive BIVV001 once weekly for a total of at least 100 exposure days to BIVV001 (including exposure during a BIVV001 parent study, if applicable). Participants will have the opportunity to continue in this study for up to 4 years, unless BIVV001 is commercially available in their applicable participating country.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • For participants rolling over into Arm A
  • Participants who have completed the studies EFC16923, EFC16925, Arm B or Arm C of the current study, or any other potential BIVV001 study.
  • Male or Female
  • For participants new to BIVV001 (Arm B and C)
  • Participants who have severe hemophilia A, defined as <1 IU/dL (<1%) endogenous FVIII activity as documented either by central laboratory testing at screening or in historical medical records from a clinical laboratory demonstrating <1% FVIII coagulant activity (FVIII:C) or a documented genotype known to produce severe hemophilia A.
  • Previous treatment for hemophilia A (prophylaxis or on-demand) with any recombinant and/or plasma-derived FVIII, or cryoprecipitate for at least 150 EDs or 50 EDs for participants aged <6 years.
  • Platelet count ≥100 000 cells/μL at screening.
  • A participant known to be human immunodeficiency virus (HIV) antibody positive, either previously documented or identified from screening assessments, must have the following results prior to enrollment: CD4 lymphocyte count >200 cells/mm³ and viral load of <400 000 copies/mL
  • Male
  • Only for Arm B: Chinese participants
  • Only for Arm C: planned major surgery within 6 months after Day 1.

Exclusion criteria

  • For participants rolling over into Arm A
  • Positive inhibitor result, defined as ≥0.6 Bethesda units (BU)/mL.
  • Participation in another study.
  • For participants new to BIVV001 (Arm B and Arm C)
  • Any concurrent clinically significant liver disease that, in the opinion of the Investigator, would make the participant unsuitable for enrollment. This may include, but is not limited to cirrhosis, portal hypertension, and acute hepatitis.
  • Serious active bacterial, fungal, or viral infection (other than chronic hepatitis or HIV) present within 30 days of screening.
  • Other known coagulation disorder(s) in addition to hemophilia A.
  • History of hypersensitivity or anaphylaxis associated with any FVIII product.
  • History of a positive inhibitor (to FVIII) test defined as ≥0.6 BU/mL, or any value greater than or equal to the lower sensitivity cut-off for laboratories with cut-offs for inhibitor detection between 0.7 and 1.0 BU/mL, or clinical signs or symptoms of decreased response to FVIII administrations. Family history of inhibitors will not exclude the participant.
  • Positive inhibitor test (FVIII) result, defined as ≥0.6 BU/mL at screening.
  • Treatment with acetylsalicylic acid (ASA) or antiplatelet agents that are not nonsteroidal anti-inflammatory drugs (NSAIDs) within 2 weeks prior to screening.
  • Treatment with NSAIDs greater than the maximum dose specified in the regional prescribing information within 2 weeks prior to screening.
  • Systemic treatment within 12 weeks prior to Screening with chemotherapy and/or other immunosuppressive drugs (except for the treatment of hepatitis C virus [HCV] or HIV).
  • Emicizumab use within the 20 weeks prior to screening.
  • Major surgery within 8 weeks prior to screening.

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Treatment and study plan

efanesoctocog alfa (BIVV001)

Drug

Pharmaceutical form:Solution for Injection Route of administration: Intravenous

Primary outcomes

  1. Number of participants with the occurrence of inhibitor development (neutralizing antibodies detected against factor VIII [FVIII])

    Time frame: Baseline to month 48

    The number of participants with the occurrence of inhibitor development (neuatralizing antibodies detected against factor VIII [FVIII]) as determined via the Nijmegen modified Bethesda assay.

Secondary outcomes

  1. Annual bleeding rate (ABR)

    Time frame: Baseline to month 48

    Annualized bleeding rate (ABR) for treated bleeding episodes and all bleeding episodes (including untreated bleeds).

  2. Annualized bleeding rate (ABR) by type of bleed

    Time frame: Baseline to month 48

    Annualized bleeding rate (ABR) by type during prophylaxis treatment per study arm and parent study.

  3. Annualized bleeding rate (ABR) by location

    Time frame: Baseline to month 48

    Annualized bleeding rate (ABR) by location during prophylaxis treatment per study arm and parent study.

  4. Percentage of patients who maintain factor VIII (FVIII) above prespecified activity levels

    Time frame: Baseline to month 48

    Percentage of participants who maintain factor VIII (FVIII) activity levels over 7 days post dose during prophylaxis treatment per study arm and per parent study or arm.

  5. Number of injections and dose of BIVV0001 to treat a bleeding episode

    Time frame: Month 48

  6. Percentage of bleeding episode treated with a single injection of BIVV001

    Time frame: Month 48

  7. Assessment of response to BIVV001 treatment of individual bleeding episodes

    Time frame: Baseline to month 48

    Assessment of response to BIVV001 treatment of individual bleeding episodes based on the International Society on Thrombosis and Haemostasis (ISTH) 4-point response scale

  8. Physician's global assessment (PGA) of participants response to BIVV001

    Time frame: Baseline to month 48

    Physician's global assessment (PGA) of participant's response to BIVV001 treatment based on a 4-point response scale .

  9. Total annualized BIVV001 consumption

    Time frame: Baseline to month 48

    Total annualized BIVV001 consumption per participant during prophylaxis treatment

  10. Annualized joint bleeding rate (AJBR)

    Time frame: Baseline to month 48

  11. Target joint resolution

    Time frame: Month 48

    Target joint development, resolution and maintenance of target joint resolution based on ISTH criteria.

  12. Change from baseline in Hemophilia Joint Health Score (HJHS)

    Time frame: Baseline to month 48

    Change from Baseline to the end of study visit in total score and domain scores (eg, swelling and strength) assessed by the Hemophilia Joint Health Score (HJHS)

  13. Change from baseline in PROMIS-SF Physical Function

    Time frame: Baseline to month 48

    Change in Quality of Life (QoL) measures from baseline to end of study visit per study arm and per parent study arm: PROMIS-SF Physical Function (participants aged ≥18 years old).)

  14. Change from baseline in Haem-A-QoL total score and physical health score

    Time frame: Baseline to month 48

    Change from baseline in Haemophilia QoL Questionnaire for Adults (Haem-A-QoL) total and physical health domain score on participants aged ≥17 years old.

  15. Change from baselin in Haemo-QoL total score and physical health score

    Time frame: Baseline to month 48

    Change from baseline in Haemophilia QoL Questionnaire for Children (Haemo-QoL) total and physical health domain score on participants aged ≥4 to 16 years old and parent proxy for participants aged ≥4 to to <12 years old.

  16. Number of participants with adverse events (AEs) and serious adverse events (SAEs)

    Time frame: Baseline to month 48

    Participants with occurrences of treatment emergent adverse events (AEs) and serious adverse events (SAEs).

  17. Number of participants with the occurrence of embolic and thrombotic events

    Time frame: Baseline to month 48

    Participants with the occurrence of embolic and thrombotic events.

  18. PK parameter: Maximum activity (Cmax)

    Time frame: Baseline to week 52

  19. PK parameter: Elimination half-life (t1/2)

    Time frame: Baseline to week 26

  20. PK parameter: Total clearance (CL)

    Time frame: Baseline to week 26

  21. PK parameter: Total clearance at steady state (CLss)

    Time frame: Baseline to week 26

  22. PK parameter: Accumulation index (AI)

    Time frame: Baseline to week 26

  23. PK parameter: Area under the activity time curve (AUC)

    Time frame: Baseline to week 26

  24. PK parameter: Volume of distribution at steady state (Vss)

    Time frame: Baseline to week 26

  25. PK parameter: Mean residence time (MRT)

    Time frame: Baseline to week 26

  26. PK parameter: Incremental recovery (IR)

    Time frame: Baseline to week 52

  27. PK parameter: Trough activity (Ctrough)

    Time frame: Baseline to week 52

  28. PK parameter: Time above FVIII activity levels

    Time frame: Baseline to week 26

  29. Investigators' or Surgeons' assessment of participant's hemostatic response to BIVV001 treatment

    Time frame: Baseline to month 48

    Investigators' or Surgeons' assessment of participant's hemostatic response to BIVV001 treatment on the ISTH 4 point response for surgical procedures scale.

  30. Number of injections and dose to maintain hemostasis during perioperative period for major surgery

    Time frame: Baseline to month 48

  31. Total BIVV001 consumption during perioperative period for major surgery

    Time frame: Baseline to month 48

  32. Number and type of blood component transfusions used during perioperative period for major surgery

    Time frame: Baseline to month 48

  33. Estimated blood loss during perioperative period for major surgery

    Time frame: Baseline to month 48

Sponsors and collaborators

Lead sponsor

Bioverativ, a Sanofi company

Industry

Registry information

Official study title

A Phase 3 Open-label, Multicenter Study of the Long-term Safety and Efficacy of Intravenous Recombinant Coagulation Factor VIII Fc-von Willebrand Factor-XTEN Fusion Protein (rFVIIIFc-VWF-XTEN; BIVV001) in Previously Treated Patients With Severe Hemophilia A

Acronym: XTEND-ed

Important dates

Study start
2021
Primary completion
2027
Study completion
2027
First posted
Nov 25, 2020
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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