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The purpose of this study is to determine the effect of 3 doses of ADVATE rAHF-PFM on initial recovery (% increase [IU/dL] per IU/kg infused) and major single-infusion pharmacokinetic parameters. The 3 doses are 15, 30, and 50 IU/kg. Prior to each infusion, subjects will not have received treatment with a factor VIII concentrate for at least 3 days. Blood samples will be drawn within 30 minutes pre-infusion and at 0.25, 0.5, 1, 3, 6, 9, 24, 28, 32 and 48 hours post-infusion. A washout period of at least 3 days, but no more than 30 days between the last blood draw and the next infusion will be observed. During participation, subjects will maintain their preexisting treatment regimens with ADVATE rAHF-PFM or other factor VIII concentrate.
A secondary objective is to investigate the relationship between pharmacokinetic parameters at each dose level and the levels of von Willebrand factor ristocetin cofactor activity and von Willebrand factor antigen at baseline.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Low Dose | Experimental |
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| Medium Dose | Experimental |
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| High Dose | Experimental |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Antihemophilic factor, recombinant, manufactured protein-free | Biological | 15 IU/kg rAHF-PFM |
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| Measure | Description | Time Frame |
|---|---|---|
| Initial Recovery | Percent increase in factor VIII concentration per dose from pre- to post-infusion | Pharmacokinetic evaluations: 30 minutes pre-infusion to 30 minutes post-infusion |
| Measure | Description | Time Frame |
|---|---|---|
| Area Under the Curve/Dose | Area under the plasma factor VIII concentration versus time curve (AUC) estimated by linear trapezoidal method per dose. | Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion |
| Terminal Half-life |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Study Director | Takeda | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Little Rock | Arkansas | United States | ||||
Participants were screened for a maximum of 30 days. Participants were randomized to a single sequence of the 3 doses of Antihemophilic Factor (Recombinant), Plasma/Albumin-Free Method (rAHF-PFM). Before each pharmacokinetic evaluation, at least a 3 day washout period and negative factor VIII inhibitor titer was required.
Recruitment was conducted in the United States at 8 study sites.
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| ID | Title | Description |
|---|---|---|
| FG000 | Low Dose | 15 IU/kg rAHF-PFM |
| FG001 | Medium Dose | 30 IU/kg rAHF-PFM |
| FG002 |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Period 1 |
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| Antihemophilic factor, recombinant, manufactured protein-free |
| Biological |
30 IU/kg rAHF-PFM |
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| Antihemophilic factor, recombinant, manufactured protein-free | Biological | 50 IU/kg rAHF-PFM |
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Computed from the regression slope in the terminal phase of the model (the slope is biphasic). Terminal half life is the time it takes for the plasma concentration or the amount of drug in the body to be reduced by 50%.
| Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion |
| Area Under the Curve | AUC estimated by linear trapezoidal method. The linear trapezoidal method is a numerical method used to approximate the area under a curve. | Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion |
| Total Area Under the Curve | Total AUC with extrapolation using the slope of the β-phase | Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion |
| Total Area Under the Moment Curve | Total area under the first moment curve (AUMC) estimated by linear trapezoidal methods | Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion |
| Weight-adjusted Clearance | Computed as weight-adjusted dose divided by total AUC | Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion |
| Mean Residence Time | Computed as total AUMC divided by total AUC | Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion |
| Volume of Distribution at Steady State | Computed as weight-adjusted CL * Mean Residence Time | Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion |
| Maximum Plasma Concentration | Maximal factor VIII concentration after infusion | Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion |
| Pre-infusion Von Willebrand Factor Ristocetin Cofactor Activity (VWF:Rco) | Percentage of normal VWF:Rco activity. Normal is a lab standard consisting of a non-hemophilic population. Relationships between baseline VWF:Rco and pharmacokinetic parameters (initial recovery, total AUC/dose, and half-life) were evaluated statistically. | At baseline and before each pharmacokinetic evaluation |
| Pre-infusion Von Willebrand Factor Antigen (VWF:Ag) | Percentage of VWF:Ag. Relationships between baseline VWF:Ag and pharmacokinetic parameters (initial recovery, total AUC/dose, and half-life) were evaluated statistically. | At baseline and before each pharmacokinetic evaluation |
| Los Angeles |
| California |
| United States |
| Peoria | Illinois | United States |
| Iowa City | Iowa | United States |
| New Brunswick | New Jersey | United States |
| Cincinnati | Ohio | United States |
| Oklahoma City | Oklahoma | United States |
| Houston | Texas | United States |
| High Dose |
50 IU/kg rAHF-PFM |
| COMPLETED |
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| NOT COMPLETED |
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| Period 2 |
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| Period 3 |
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| ID | Title | Description |
|---|---|---|
| BG000 | Treated Participants | Participants who received at least 1 infusion of rAHF-PFM. |
| Units | Counts |
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| 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 |
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| Sex: Female, Male | Count of Participants | Participants |
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| Region of Enrollment | Count of Participants | Participants |
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| 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 | Initial Recovery | Percent increase in factor VIII concentration per dose from pre- to post-infusion | Per protocol population: participants who were randomized, received all 3 doses of rAHF-PFM, and had pharmacokinetic assessments. | Posted | Median | Full Range | IU/dL per IU/kg | Pharmacokinetic evaluations: 30 minutes pre-infusion to 30 minutes post-infusion |
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| Secondary | Area Under the Curve/Dose | Area under the plasma factor VIII concentration versus time curve (AUC) estimated by linear trapezoidal method per dose. | Per protocol population: participants who were randomized, received all 3 doses of rAHF-PFM, and had pharmacokinetic assessments. | Posted | Median | Full Range | IU*hour/dL per IU/kg | Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion |
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| Secondary | Terminal Half-life | Computed from the regression slope in the terminal phase of the model (the slope is biphasic). Terminal half life is the time it takes for the plasma concentration or the amount of drug in the body to be reduced by 50%. | Per protocol population: participants who were randomized, received all 3 doses of rAHF-PFM, and had pharmacokinetic assessments. | Posted | Median | Full Range | hour | Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion |
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| Secondary | Area Under the Curve | AUC estimated by linear trapezoidal method. The linear trapezoidal method is a numerical method used to approximate the area under a curve. | Per protocol population: participants who were randomized, received all 3 doses of rAHF-PFM, and had pharmacokinetic assessments. | Posted | Median | Full Range | IU*hour/dL | Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion |
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| Secondary | Total Area Under the Curve | Total AUC with extrapolation using the slope of the β-phase | Per protocol population: participants who were randomized, received all 3 doses of rAHF-PFM, and had pharmacokinetic assessments. | Posted | Median | Full Range | IU*hour/dL | Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion |
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| Secondary | Total Area Under the Moment Curve | Total area under the first moment curve (AUMC) estimated by linear trapezoidal methods | Per protocol population: participants who were randomized, received all 3 doses of rAHF-PFM, and had pharmacokinetic assessments. | Posted | Median | Full Range | IU*hour^2/dL | Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion |
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| Secondary | Weight-adjusted Clearance | Computed as weight-adjusted dose divided by total AUC | Per protocol population: participants who were randomized, received all 3 doses of rAHF-PFM, and had pharmacokinetic assessments. | Posted | Median | Full Range | mL/kg*hour | Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion |
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| Secondary | Mean Residence Time | Computed as total AUMC divided by total AUC | Per protocol population: participants who were randomized, received all 3 doses of rAHF-PFM, and had pharmacokinetic assessments. | Posted | Median | Full Range | hour | Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion |
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| Secondary | Volume of Distribution at Steady State | Computed as weight-adjusted CL * Mean Residence Time | Per protocol population: participants who were randomized, received all 3 doses of rAHF-PFM, and had pharmacokinetic assessments. | Posted | Median | Full Range | dL/kg | Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion |
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| Secondary | Maximum Plasma Concentration | Maximal factor VIII concentration after infusion | Per protocol population: participants who were randomized, received all 3 doses of rAHF-PFM, and had pharmacokinetic assessments. | Posted | Median | Full Range | IU/dL | Pharmacokinetic evaluations: 30 minutes pre-infusion up to 48 hours post-infusion |
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| Secondary | Pre-infusion Von Willebrand Factor Ristocetin Cofactor Activity (VWF:Rco) | Percentage of normal VWF:Rco activity. Normal is a lab standard consisting of a non-hemophilic population. Relationships between baseline VWF:Rco and pharmacokinetic parameters (initial recovery, total AUC/dose, and half-life) were evaluated statistically. | Intent to treat: participants who received at least 1 of the 3 infusions of rAHF-PFM and had pharmacokinetic evaluation(s) | Posted | Median | Full Range | Percent of normal VWF:Rco activity | At baseline and before each pharmacokinetic evaluation |
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| Secondary | Pre-infusion Von Willebrand Factor Antigen (VWF:Ag) | Percentage of VWF:Ag. Relationships between baseline VWF:Ag and pharmacokinetic parameters (initial recovery, total AUC/dose, and half-life) were evaluated statistically. | Intent to treat: participants who received at least 1 of the 3 infusions of rAHF-PFM and had pharmacokinetic evaluation(s). | Posted | Median | Full Range | U/dL | At baseline and before each pharmacokinetic evaluation |
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15 months
AEs were collected by the investigators at study visits, and may result from laboratory and vital sign assessments collected or measured at the study visits
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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 | Safety Population (26 Participants) | Participants who received at least 1 infusion of rAHF-PFM | 0 | 26 | 4 | 26 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Headache | Nervous system disorders | MedDRA (10.0) | Systematic Assessment |
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| Pain in extremity | Musculoskeletal and connective tissue disorders | MedDRA (10.0) | Systematic Assessment |
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Baxter's agreements with PIs vary per individual PI, but contain common elements. For this study, PIs are restricted from independently publishing results until the earlier of the primary multicenter publication or 1 year after study completion. Baxter requires a review of results communications (e.g., for confidential information) ≥45 days prior to submission or communication. Baxter may request an additional delay of up to 60 days (e.g., to allow for intellectual property protection).
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Study Director | Shire | +1 866 842 5335 | ClinicalTransparency@shire.com |
| ID | Term |
|---|---|
| D006467 | Hemophilia A |
| ID | Term |
|---|---|
| D025861 | Blood Coagulation Disorders, Inherited |
| D001778 | Blood Coagulation Disorders |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D020147 | Coagulation Protein Disorders |
| D006474 | Hemorrhagic Disorders |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
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| ID | Term |
|---|---|
| D005169 | Factor VIII |
| ID | Term |
|---|---|
| D001779 | Blood Coagulation Factors |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D011498 | Protein Precursors |
| D001685 | Biological Factors |
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