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This study will compare the blood level of Gamunex in patients. Patients will take it as an injection under the skin or in a vein. The study will compare how safe and tolerable the two methods are in the patients. The patients in this study have a defect in their immune system from a genetic cause.
This is an open-label, single-sequence, multi-center trial with subjects previously diagnosed with primary immune deficiency. Subjects will be on IGIV until a steady state is reached at which time PK profiling during the IV phase will occur. Subjects will begin SC administration 1 week following last IV dose and followed for a period of six months. PK profiling in SC phase will occur when subject reaches approximate steady-state on SC administration.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Immune Globulin Intravenous (Human) | Experimental | Immune Globulin Intravenous (Human), 10%, Caprylate/Chromatography Purified |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Immune Globulin Intravenous (Human) | Biological | This trial was an open-label, single-sequence, study. The enrolled subjects received IGIV-C via two routes of administration (IV for 4 -5 weeks and SC for 24 weeks) in order to compare the PK variables, safety and tolerability of SC administration of IGIV-C. Certain subjects required IV IGIV-C dosing during a Run-in Phase (3 - 4 months) for steady-state conditions prior to the IV phase. Subjects received two IV infusions of IGIV (between 200 - 600 mg based on the subject's previous IgG dosing regimen, 3 to 4 weeks apart) until a steady-state was reached at which time PK profiling was performed. Subjects began weekly SC administration (1.37 times the weekly equivalency of each subject's monthly IV dose) 1 week following last IV dose and followed for a period of six months. |
| Measure | Description | Time Frame |
|---|---|---|
| Geometric Least Square Means of Area Under the Curve (AUC) for Plasma Total Immunoglobulin G (IgG) | Geometric least-squares mean of steady-state plasma concentration of total IgG vs. time profile (AUC). | IV Phase (21 or 28 days) at IV Visit #1, pre- and post-dose: 0 hr., 1 hr., and 1, 2, 3, 5, 7, 14, 21, and 28 days; SC Phase at Week #17, pre- and post-dose: 0 hr., and 1, 3, 4, 5, and 7 days |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Susan Sorrells | Grifols Therapeutics LLC | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of California, Irvine | Irvine | California | 92697 | United States | ||
| UCLA School of Medicine |
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| Label | URL |
|---|---|
| FDA approved labeling information | View source |
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First Patient, First Visit: Nov. 21, 2006, Last patient, Last visit: Aug. 26, 2008. This study was performed at medical clinics.
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| ID | Title | Description |
|---|---|---|
| FG000 | IGIV-C | 21 subjects were required to enter a Run-In Phase (3 to 4 months) and received IGIV-C between 200 and 600 mg/kg by intravenous infusion every 3 or 4 weeks. 18 subjects completed the Run-In Phase and entered the Intravenous Phase. A total of 32 subjects entered the IV Phase: 14 subjects who had received IV IGIV-C prior to screening directly entered the IV Phase and 18 subjects who had completed the Run-in Phase continued in the study to enter the IV Phase. Subjects in the IV Phase received two IV infusions at the same dose (200-600 mg/kg) and frequency (every 3 or 4 weeks) as their regular dose at screening or during the Run-In Phase. All 32 subjects completed the IV Phase and entered the SC Phase. A total of 32 subjects who completed the IV Phase entered the SC Phase. Subjects in the SC Phase received IGIV-C via weekly SC administration for 24 weeks total at a dose that was calculated using a conversion factor and their established IV dose. 25 subjects completed the SC Phase. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Run-In Phase |
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| Los Angeles |
| California |
| 90095 |
| United States |
| Family Allergy & Asthma Center, PC | Atlanta | Georgia | 30342 | United States |
| Allergy, Asthma & Immunology Associates, PC | Omaha | Nebraska | 68124 | United States |
| Pediatric Allergy / Immunology Associates, PA | Dallas | Texas | 75230 | United States |
| Virginia Commonwealth University | Richmond | Virginia | 23219 | United States |
| Dr. Donald F. Stark, Inc | Vancouver | British Columbia | V6H3K2 | Canada |
| McGill University - Montreal General Hospital | Montreal | Quebec | H3G1A4 | Canada |
| COMPLETED |
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| NOT COMPLETED |
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| Intravenous Phase |
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| Subcutaneous Phase |
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| ID | Title | Description |
|---|---|---|
| BG000 | Safety Population | The safety population included all subjects who received any amount of study medication (IGIV-C) via intravenous (IV) and/or subcutaneous (SC) routes of administration. As such, the safety population included all study participants combined (who received any dose), whether they entered the study in the Run-In or Intravenous Phase. |
| 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 |
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| Sex: Female, Male | Count of Participants | Participants |
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| Region of Enrollment | Number | 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 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Primary | Geometric Least Square Means of Area Under the Curve (AUC) for Plasma Total Immunoglobulin G (IgG) | Geometric least-squares mean of steady-state plasma concentration of total IgG vs. time profile (AUC). | A total of 32 subjects in the IV phase and 26 subjects in the SC phase had sufficient plasma concentration of total IgG vs. time profiles (AUC) for assessment of steady-state PK parameters. | Posted | Aug 2009 | Least Squares Mean | Standard Deviation | mg*hr/ml | IV Phase (21 or 28 days) at IV Visit #1, pre- and post-dose: 0 hr., 1 hr., and 1, 2, 3, 5, 7, 14, 21, and 28 days; SC Phase at Week #17, pre- and post-dose: 0 hr., and 1, 3, 4, 5, and 7 days |
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Run-in phase (if required): 3 - 4 months; Intravenous Phase: 4 - 5 weeks; Subcutaneous Phase: 24 weeks.
Subjects were carefully monitored for adverse events. This monitoring includes clinical and laboratory tests and physical signs such as local reactions at subcutaneous infusion sites. Adverse events were assessed in terms of their seriousness, severity, and relationship to the study drug.
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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 | Run-In Phase | All subjects who participated in the Run-In Phase. | 2 | 21 | 11 | 21 | ||
| EG001 | Intravenous Phase | All subjects who participated in the Intravenous Phase. | 0 | 32 | 9 | 32 | ||
| EG002 | Subcutaneous Phase | All subjects who participated in the Subcutaneous Phase. | 1 | 32 | 29 | 32 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Pneumonia | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Sepsis syndrome | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Incisional hernia | Injury, poisoning and procedural complications | MedDRA 10.0 | Systematic Assessment |
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| Drug dependence | Psychiatric disorders | MedDRA 10.0 | Systematic Assessment |
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| Respiratory failure | Respiratory, thoracic and mediastinal disorders | MedDRA 10.0 | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Diarrhoea | Gastrointestinal disorders | MedDRA 10.0 | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA 10.0 | Systematic Assessment |
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| Toothache | Gastrointestinal disorders | MedDRA 10.0 | Systematic Assessment |
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| Fatigue | General disorders | MedDRA 10.0 | Systematic Assessment |
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| Pyrexia | General disorders | MedDRA 10.0 | Systematic Assessment |
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| Acute sinusitis | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Bronchitis | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Ear infection | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Nasopharyngitis | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Sinusitis | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Upper respiratory tract infection | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Urinary tract infection | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Viral infection | Infections and infestations | MedDRA 10.0 | Systematic Assessment |
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| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA 10.0 | Systematic Assessment |
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| Myalgia | Musculoskeletal and connective tissue disorders | MedDRA 10.0 | Systematic Assessment |
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| Dizziness | Nervous system disorders | MedDRA 10.0 | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA 10.0 | Systematic Assessment |
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| Migraine | Nervous system disorders | MedDRA 10.0 | Systematic Assessment |
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| Depression | Psychiatric disorders | MedDRA 10.0 | Systematic Assessment |
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| Insomnia | Psychiatric disorders | MedDRA 10.0 | Systematic Assessment |
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| Pharyngolaryngeal pain | Respiratory, thoracic and mediastinal disorders | MedDRA 10.0 | Systematic Assessment |
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| Dermatitis allergic | Skin and subcutaneous tissue disorders | MedDRA 10.0 | Systematic Assessment |
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| Erythema | Skin and subcutaneous tissue disorders | MedDRA 10.0 | Systematic Assessment |
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| Infusion site bruising | General disorders | MedDRA (10.0) | Systematic Assessment |
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| Infusion site erythema | General disorders | MedDRA (10.0) | Systematic Assessment |
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| Infusion site extravasation | General disorders | MedDRA (10.0) | Systematic Assessment |
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| Infusion site haemorrhage | General disorders | MedDRA (10.0) | Systematic Assessment |
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| Infusion site induration | General disorders | MedDRA (10.0) | Systematic Assessment |
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| Infusion site oedema | General disorders | MedDRA (10.0) | Systematic Assessment |
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| Infusion site pain | General disorders | MedDRA (10.0) | Systematic Assessment |
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| Infusion site pruritus | General disorders | MedDRA (10.0) | Systematic Assessment |
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| Infusion site rash | General disorders | MedDRA (10.0) | Systematic Assessment |
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| Infusion site swelling | General disorders | MedDRA (10.0) | Systematic Assessment |
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| Infusion site urticaria | General disorders | MedDRA (10.0) | Systematic Assessment |
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Institution or Principal investigator (PI) furnishes Talecris a copy of any proposed publication (either in writing or oral) of results of the study performed under the protocol, at least 30 days before the date of submission for publication or presentation. Talecris can ask the Principal Investigator to remove Confidential Information before publication or Talecris shall have an additional time, not to exceed 60 days, to file a patent application for such Confidential Information.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Henry Li, PhD | Grifols Therapeutics, Inc. | 800-520-2807 | henry.li@grifols.com |
| ID | Term |
|---|---|
| D007153 | Immunologic Deficiency Syndromes |
| D000081207 | Primary Immunodeficiency Diseases |
| ID | Term |
|---|---|
| D007154 | Immune System Diseases |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
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| ID | Term |
|---|---|
| D016756 | Immunoglobulins, Intravenous |
| ID | Term |
|---|---|
| D007074 | Immunoglobulin G |
| D007132 | Immunoglobulin Isotypes |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
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| Lost to Follow-up |
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The administration effect between SC and IV was assessed by exponentiation of the difference in least squares means between study phases (Test minus Reference) and the corresponding 90% confidence interval (CI) for the geometric LSM ratio between study phases (Test/Reference) for AUC. The Test (SC) was to be considered non-inferior to Reference (IV) if the lower bound of 90% CIs for the geometric LSM ratios of AUC between the Test and Reference was above 0.80 (80%). |