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Patients with hereditary antithrombin deficiency are at increased risk of venous thrombosis and pulmonary embolism, particularly during certain high risk procedures. The trial focused on patients with confirmed hereditary antithrombin deficiency who were undergoing a surgical procedure or induced/spontaneous labor and delivery, and/or caesarean section. The study assessed the incidence of thromboembolic events following prophylactic intravenous administration of recombinant human antithrombin (rhAT) to patients with hereditary antithrombin (AT) deficiency in situations usually associated with a high risk for thromboembolic events.
GTC Biotherapeutics established clinical trial sites in Europe, Canada, Australia, Austria and Canada. GTC Biotherapeutics provided an international clinical team to support site registration requirements once a patient was identified for treatment. GTC Biotherapeutics also provided consultation to help evaluate patient eligibility.
In September 2006, GTC Biotherapeutics modified exclusion criteria 1 (below) to allow for the participation of previously excluded patients with the hereditary thrombophilic disorders Factor V Leiden and prothrombin gene mutation (G20210A).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Recombinant Human Antithrombin (rhAT) Infusion | Experimental | Intravenous infusion of rhAT. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Recombinant human antithrombin (rhAT) | Biological | Up to 24 hours prior to the scheduled elective surgical procedure, caesarean section, or delivery induction, each patient will receive an initial intravenous loading dose followed by a continuous intravenous infusion of recombinant human antithrombin (rhAT) that will target and maintain an AT activity that is > 80% and < 120% of normal. The dosing objective for all study patients is maintenance of the AT activity at > 80% and < 120% of normal during the high-risk period for thromboembolic events. Dosing and dose adjustments will be based on the results of AT activity determinations performed prior to and during treatment. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Thromboembolic Events Acute Deep Venous Thrombosis (DVT) and/or Thromboembolic Events Other Than Acute Deep Venous Thrombosis (DVT) | To assess the incidence of thromboembolic events acute deep venous thrombosis (DVT) and/or thromboembolic events other than acute deep venous thrombosis (DVT) by clinical signs and symptoms of venous thromboembolism (VTE), confirmed by diagnostic assessments. | During treatment and follow up period of 7 days |
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Inclusion Criteria:
In addition, hospitalized pregnant HD patients in active labor and eligible HD patients previously treated with rhAT were allowed entry into the study.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Robert C Tait, MD | Glasgow Royal Infirmary | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| New Haven | Connecticut | United States | ||||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24335249 | Derived | DeJongh J, Frieling J, Lowry S, Drenth HJ. Pharmacokinetics of recombinant human antithrombin in delivery and surgery patients with hereditary antithrombin deficiency. Clin Appl Thromb Hemost. 2014 May;20(4):355-64. doi: 10.1177/1076029613516188. Epub 2013 Dec 11. |
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Eighteen patients were treated with recombinant human antithrombin (rhAT) and analyzed for safety.
The study population included non pregnant patients who were scheduled for surgery and pregnant patients who were scheduled for caesarean section or delivery induction or were hospitalized in active labor.
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| ID | Title | Description |
|---|---|---|
| FG000 | Recombinant Human Antithrombin (rhAT) Infusion | Up to 24 hours prior to the scheduled elective surgical procedure, caesarean section, or delivery induction, each patient received an initial intravenous loading dose of recombinant human antithrombin (rhAT)followed by a continuous intravenous infusion dose of recombinant human antithrombin (rhAT) to maintain an antithrombin (AT) activity level of >80% and <120% of normal. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| St Louis |
| Missouri |
| United States |
| New York | New York | United States |
| North Gosford | Australia |
| Vienna | Austria |
| Ottawa | Ontario | Canada |
| Vancouver | Canada |
| Montpellier | France |
| Berlin | Germany |
| Alessandria | Italy |
| Exeter | Devon | United Kingdom |
| Chichester | West Sussex | United Kingdom |
| Cambridge | United Kingdom |
| Glasgow | United Kingdom |
| London | United Kingdom |
| Nottingham | United Kingdom |
| Plymouth | United Kingdom |
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | Recombinant Human Antithrombin (rhAT) Infusion | Up to 24 hours prior to the scheduled elective surgical procedure, caesarean section, or delivery induction, each patient received an initial intravenous loading dose of recombinant human antithrombin (rhAT)followed by a continuous intravenous infusion dose of recombinant human antithrombin (rhAT) to maintain an antithrombin (AT) activity level of >80% and <120% of normal. |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
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| Age Continuous | Mean | Standard Deviation | years |
| ||||||||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Prior history of thromboembolism | Number | Participants |
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| Antithrombin (AT) activity level <60% | Number | Participants |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Incidence of Thromboembolic Events Acute Deep Venous Thrombosis (DVT) and/or Thromboembolic Events Other Than Acute Deep Venous Thrombosis (DVT) | To assess the incidence of thromboembolic events acute deep venous thrombosis (DVT) and/or thromboembolic events other than acute deep venous thrombosis (DVT) by clinical signs and symptoms of venous thromboembolism (VTE), confirmed by diagnostic assessments. | Intent to treat population | Posted | Number | Participants | During treatment and follow up period of 7 days |
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Until 28 days after end of treatment.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Recombinant Human Antithrombin (rhAT) Infusion | Up to 24 hours prior to the scheduled elective surgical procedure, caesarean section, or delivery induction, each patient received an initial intravenous loading dose of recombinant human antithrombin (rhAT)followed by a continuous intravenous infusion dose of recombinant human antithrombin (rhAT) to maintain an antithrombin (AT) activity level of >80% and <120% of normal. | 5 | 18 | 16 | 18 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Haemarthrosis | Musculoskeletal and connective tissue disorders | MedDRA (6.1) | Systematic Assessment |
| |
| Haematoma | Vascular disorders | MedDRA (6.1) | Systematic Assessment |
| |
| Enterobacter Sepsis | Infections and infestations | MedDRA (6.1) | Systematic Assessment |
| |
| Intra-Abdominal | Gastrointestinal disorders | MedDRA (6.1) | Systematic Assessment |
| |
| DVT | Vascular disorders | MedDRA (6.1) | Systematic Assessment | An ultrasound of the lower extremities performed on post-operative day 14, revealed an occlusive thrombus in the right saphenous vein which was noted on previous ultrasound performed and had progressed to the popliteal vein. Reported as not related. |
|
| Hemoglobin decreased | Investigations | MedDRA (6.1) | Systematic Assessment |
| |
| Pulmonary Embolism | Respiratory, thoracic and mediastinal disorders | MedDRA (6.1) | Systematic Assessment | The patient received study drug from 21 November 2005 through 25 November 2005. On 09 December 2005, the patient experienced bilateral pulmonary embolism, which was reported as an important medical event and described as severe. |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anemia | Blood and lymphatic system disorders | MedDRA (6.1) | Systematic Assessment |
| |
| Vomiting | Gastrointestinal disorders | MedDRA (6.1) | Systematic Assessment |
| |
| Headache | Nervous system disorders | MedDRA (6.1) | Systematic Assessment |
| |
| Non-Cardiac Chest Pain | General disorders | MedDRA (6.1) | Systematic Assessment |
| |
| Oedema Peripheral | General disorders | MedDRA (6.1) | Systematic Assessment |
| |
| Urinary Tract Infection | Infections and infestations | MedDRA (6.1) | Systematic Assessment |
| |
| Post Procedural Hemmorhage | Injury, poisoning and procedural complications | MedDRA (6.1) | Systematic Assessment |
| |
| Syncope | Nervous system disorders | MedDRA (6.1) | Systematic Assessment |
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| Vaginal Laceration | Reproductive system and breast disorders | MedDRA (6.1) | Systematic Assessment |
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| Haematoma | Vascular disorders | MedDRA (6.1) | Systematic Assessment |
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| Tachycardia | Cardiac disorders | MedDRA (6.1) | Systematic Assessment |
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| Vision Blurred | Eye disorders | MedDRA (6.1) | Systematic Assessment |
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| Abdominal Distention | Gastrointestinal disorders | MedDRA (6.1) | Systematic Assessment |
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| Abdominal Pain | Gastrointestinal disorders | MedDRA (6.1) | Systematic Assessment |
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| Constipation | Gastrointestinal disorders | MedDRA (6.1) | Systematic Assessment |
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| Dental Discomfort | Gastrointestinal disorders | MedDRA (6.1) | Systematic Assessment |
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| Dyspepsia | Gastrointestinal disorders | MedDRA (6.1) | Systematic Assessment |
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| Flatulence | Gastrointestinal disorders | MedDRA (6.1) | Systematic Assessment |
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| Haemorrhoids | Gastrointestinal disorders | MedDRA (6.1) | Systematic Assessment |
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| Feeling Hot | General disorders | MedDRA (6.1) | Systematic Assessment |
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| Injection Site Bruising | Gastrointestinal disorders | MedDRA (6.1) | Systematic Assessment |
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| Gastroenteritis Viral | Infections and infestations | MedDRA (6.1) | Systematic Assessment |
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| Wound Infection | Infections and infestations | MedDRA (6.1) | Systematic Assessment |
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| Incision Site Complication | Injury, poisoning and procedural complications | MedDRA (6.1) | Systematic Assessment |
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| Procedural Pain | Injury, poisoning and procedural complications | MedDRA (6.1) | Systematic Assessment |
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| Vascular Graft Occlusion | Injury, poisoning and procedural complications | MedDRA (6.1) | Systematic Assessment |
| |
| Wound Complicaton | Injury, poisoning and procedural complications | MedDRA (6.1) | Systematic Assessment |
| |
| C-Reactive Protein Increased | Investigations | MedDRA (6.1) | Systematic Assessment |
| |
| Hepatic Enzyme Abnormal | Investigations | MedDRA (6.1) | Systematic Assessment |
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| Hypokalemia | Metabolism and nutrition disorders | MedDRA (6.1) | Systematic Assessment |
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| Arthropathy | Musculoskeletal and connective tissue disorders | MedDRA (6.1) | Systematic Assessment |
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| Muscle Spasms | Musculoskeletal and connective tissue disorders | MedDRA (6.1) | Systematic Assessment |
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| Afterbirth Pain | Pregnancy, puerperium and perinatal conditions | MedDRA (6.1) | Systematic Assessment |
| |
| Anxiety | Psychiatric disorders | MedDRA (6.1) | Systematic Assessment |
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| Hematuria | Renal and urinary disorders | MedDRA (6.1) | Systematic Assessment |
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| Incontinence | Renal and urinary disorders | MedDRA (6.1) | Systematic Assessment |
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| Nipple Pain | Reproductive system and breast disorders | MedDRA (6.1) | Systematic Assessment |
| |
| Crackles Lung | Respiratory, thoracic and mediastinal disorders | MedDRA (6.1) | Systematic Assessment |
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| Dyspnea | Respiratory, thoracic and mediastinal disorders | MedDRA (6.1) | Systematic Assessment |
| |
| Epistaxis | Respiratory, thoracic and mediastinal disorders | MedDRA (6.1) | Systematic Assessment |
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| Hyperhidrosis | Skin and subcutaneous tissue disorders | MedDRA (6.1) | Systematic Assessment |
| |
| Rash | Skin and subcutaneous tissue disorders | MedDRA (6.1) | Systematic Assessment |
| |
| Lymphangitis | Vascular disorders | MedDRA (6.1) | Systematic Assessment |
|
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Denise Tilton, RN, MHA, Director Clinical Affairs | GTC Biotherapeutics | 508-370-5257 | denise.tilton@gtc-bio.com |
| ID | Term |
|---|---|
| D020152 | Antithrombin III Deficiency |
| ID | Term |
|---|---|
| D025861 | Blood Coagulation Disorders, Inherited |
| D001778 | Blood Coagulation Disorders |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D001796 | Blood Protein Disorders |
| D019851 | Thrombophilia |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
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| Australia |
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| Germany |
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| United Kingdom |
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| Italy |
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| United States |
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