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| ID | Type | Description | Link |
|---|---|---|---|
| SHP616-400 | Other Identifier | Sponsor |
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The objectives of the study were:
Qualifying subjects entered a 3-step dose escalation algorithm:
Each step consisted of 12 weeks of safety monitoring, followed by calculation of average monthly angioedema attack rate based on subject reports of angioedema symptoms (regardless of intensity) and actual duration of therapy for that step.
If a subject was deemed a "success" at a given step and the investigator and medical monitor determined that it was safe for the subject to continue on that dose, the subject entered a 3 month follow-up period at that dose level with continued safety monitoring. The subject could not re-enter the study for purposes of dose escalation during the follow-up period.
If a subject was not deemed a "success," the subject initiated the next highest step of the dose escalation algorithm provided that the investigator and medical monitor agreed that dose escalation was appropriate. If at the end of Step 3 (2500 Units), a subject was not deemed a "success," then the Week 12 visit represented study completion and the subject was referred to the physician who manages their HAE care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CINRYZE | Experimental | There were 3 potential dose escalation steps:
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| C1 inhibitor (human) [C1 INH] | Biological |
|
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| Measure | Description | Time Frame |
|---|---|---|
| Number of Subjects With Adverse Events, Hospitalizations, Thrombotic Events, Treatment-emergent C1 INH Antibodies, Post-baseline Toxicity Grade Increases in Clinical Laboratory Parameters, and Post-dose Vital Signs Changes of Potential Clinical Importance | Events reported during the 3 month follow-up period are counted with the dose level at which they occurred. | 12 to 24 weeks at each dose level |
| Measure | Description | Time Frame |
|---|---|---|
| Treatment Effect of Escalating Doses of CINRYZE on HAE Attack Rates | Two definitions of success were applied in this study: 1) Per-protocol success - Average angioedema attack rate of ≤1.0 per month at the end of any dose escalation step (Week 12). The a priori definition of study success was 4 or more subjects with per-protocol success. 2) Investigator-determined success - Based on the investigator's clinical judgment, an average monthly angioedema attack rate demonstrating improvement sufficient for progression to follow-up. In addition, subjects who were not a per-protocol or investigator-determined success, but who experienced a reduction of >1.0 attack per month from their historical angioedema attack rate at the end of any dose escalation step (Week 12), were summarized. |
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Inclusion Criteria:
To be eligible for this protocol, subjects must:
Be ≥6 years of age and ≥25 kg body weight.
Have a confirmed diagnosis of HAE with a documented history of swelling of the face, extremities, gastrointestinal tract, genitalia, or larynx and a history of at least one of the following:
Have a history of >1.0 HAE attack per month (average) of any severity during the 3 consecutive months prior to screening while receiving the recommended CINRYZE dosing of 1000 Units every 3 to 4 days via intravenous injection.
If an adult, be informed of the nature of the study and provide written informed consent before any study-specific procedures are performed.
OR
If a child, have a parent/legal guardian who is willing and able to provide written informed consent for the child to participate in the study (with assent from the child when appropriate).
Exclusion Criteria:
To be eligible for this protocol, subjects must not:
Have, as determined by the investigator and/or the sponsor's medical monitor, any surgical or medical condition that could interfere with the administration of study drug or interpretation of study results.
Have a history of abnormal blood clotting or other coagulopathy.
Be taking prescription anticoagulant medication.
Have a history of allergic reaction to CINRYZE or other blood products.
Have participated in any other investigational drug study within the past 30 days (other than CINRYZE protocols).
Have received any blood products (other than CINRYZE) within 60 days prior to screening.
Have any of the following laboratory values at screening:
Be pregnant or breastfeeding.
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| Name | Affiliation | Role |
|---|---|---|
| Study Director | Takeda | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Allergy, Asthma and Immunology Associates | Scottsdale | Arizona | 85251 | United States | ||
| Family Allergy and Asthma Center |
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| ID | Title | Description |
|---|---|---|
| FG000 | CINRYZE | There were 3 potential dose escalation steps: - Step 1: 1500 Units of CINRYZE (C1 inhibitor [human]) administered by IV infusion twice per week for 12 weeks (starting dosing regimen for all subjects in the study) - Step 2: 2000 Units of CINRYZE (C1 inhibitor [human]) administered by IV infusion twice per week for 12 weeks - Step 3: 2500 Units of CINRYZE (C1 inhibitor [human]) administered by IV infusion twice per week for 12 weeks |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Step 1: 1500 Units |
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| Step 2: 2000 Units |
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| Step 3: 2500 Units |
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| ID | Title | Description |
|---|---|---|
| BG000 | CINRYZE | There were 3 potential dose escalation steps: - Step 1: 1500 Units of CINRYZE (C1 inhibitor [human]) administered by IV infusion twice per week for 12 weeks (starting dosing regimen for all subjects in the study) - Step 2: 2000 Units of CINRYZE (C1 inhibitor [human]) administered by IV infusion twice per week for 12 weeks - Step 3: 2500 Units of CINRYZE (C1 inhibitor [human]) administered by IV infusion twice per week for 12 weeks |
| 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, Continuous | Mean |
| 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 | Number of Subjects With Adverse Events, Hospitalizations, Thrombotic Events, Treatment-emergent C1 INH Antibodies, Post-baseline Toxicity Grade Increases in Clinical Laboratory Parameters, and Post-dose Vital Signs Changes of Potential Clinical Importance | Events reported during the 3 month follow-up period are counted with the dose level at which they occurred. | Posted | Number | participants | 12 to 24 weeks at each dose level |
|
12 to 24 weeks at each dose level. Events reported during the 3 month follow-up period are counted with the dose level at which they occurred.
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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 | Step 1: 1500 Units | 1500 Units of CINRYZE (C1 inhibitor [human]) administered by IV infusion twice per week for 12 weeks |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anemia | Blood and lymphatic system disorders | MedDRA 15.0 | Not related to study drug |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Upper respiratory tract infection | Infections and infestations | MedDRA 15.0 | 83% mild, 17% moderate |
Per Changes in the Planned Analyses:
The clinical presentation of disease manifestations and response to therapy are highly variable among patients with HAE and as such, the efficacy results from this study are presented in this report by individual participant in narrative summaries rather than as summary statistics.
Thus, one outcome measure (Use of rescue therapy and/or other therapy for treatment of HAE symptoms) is not presented.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Study Director | Shire | +1 866 842 5335 | ClinicalTransparency@shire.com |
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| ID | Term |
|---|---|
| D054179 | Angioedemas, Hereditary |
| ID | Term |
|---|---|
| D000799 | Angioedema |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D000081208 | Hereditary Complement Deficiency Diseases |
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| ID | Term |
|---|---|
| D050718 | Complement C1 Inhibitor Protein |
| C469952 | SERPING1 protein, human |
| ID | Term |
|---|---|
| D006023 | Glycoproteins |
| D006001 | Glycoconjugates |
| D002241 | Carbohydrates |
| D003174 | Complement C1 Inactivator Proteins |
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| 12 weeks at each dose level |
| Atlanta |
| Georgia |
| 30342 |
| United States |
| Institute for Asthma and Allergy | Wheaton | Maryland | 20902 | United States |
| Winthrop University Hospital | Mineola | New York | 11501 | United States |
| University of Cincinnati Medical Center | Cincinnati | Ohio | 45267 | United States |
| Allergy and Asthma Research Group | Eugene | Oregon | 97401 | United States |
| Baker Allergy, Asthma and Dermatology Research Center | Lake Oswego | Oregon | 97035 | United States |
| East Tennessee Center for Clinical Research | Knoxville | Tennessee | 37909 | United States |
| Bryan | Texas | 77802 | United States |
| AARA Research Center | Dallas | Texas | 75231 | United States |
| Marycliff Allergy Specialist | Spokane | Washington | 99204 | United States |
|
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
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| OG002 | Step 3: 2500 Units | 2500 Units of CINRYZE (C1 inhibitor [human]) administered by IV infusion twice per week for 12 weeks. |
|
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| Secondary | Treatment Effect of Escalating Doses of CINRYZE on HAE Attack Rates | Two definitions of success were applied in this study: 1) Per-protocol success - Average angioedema attack rate of ≤1.0 per month at the end of any dose escalation step (Week 12). The a priori definition of study success was 4 or more subjects with per-protocol success. 2) Investigator-determined success - Based on the investigator's clinical judgment, an average monthly angioedema attack rate demonstrating improvement sufficient for progression to follow-up. In addition, subjects who were not a per-protocol or investigator-determined success, but who experienced a reduction of >1.0 attack per month from their historical angioedema attack rate at the end of any dose escalation step (Week 12), were summarized. | Posted | Number | participants | 12 weeks at each dose level |
|
|
|
| 1 |
| 20 |
| 12 |
| 20 |
| EG001 | Step 2: 2000 Units | 2000 Units of CINRYZE (C1 inhibitor [human]) administered by IV infusion twice per week for 12 weeks | 1 | 13 | 5 | 13 |
| EG002 | Step 3: 2500 Units | 2500 Units of CINRYZE (C1 inhibitor [human]) administered by IV infusion twice per week for 12 weeks | 1 | 12 | 6 | 12 |
| EG003 | All Subjects | 2 | 20 | 13 | 20 |
| Hereditary angioedema | Congenital, familial and genetic disorders | MedDRA 15.0 | Laryngeal HAE attack; Not related to study drug |
|
| Bile duct stone | Hepatobiliary disorders | MedDRA 15.0 | Not related to study drug |
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| Cerebral hygroma | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA 15.0 | Not related to study drug |
|
| Nasopharyngitis | Infections and infestations | MedDRA 15.0 | 100% mild |
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| Abdominal discomfort | Gastrointestinal disorders | MedDRA 15.0 | 100% mild |
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| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA 15.0 | 100% moderate |
|
| Diarrhea | Gastrointestinal disorders | MedDRA 15.0 | 50% mild, 50% severe |
|
| Ligament sprain | Injury, poisoning and procedural complications | MedDRA 15.0 | 33% mild, 33% moderate, 33% severe |
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| Medical device complication | General disorders | MedDRA 15.0 | 100% mild |
|
| Peripheral edema | General disorders | MedDRA 15.0 | 100% moderate |
|
| Pain in extremity | Musculoskeletal and connective tissue disorders | MedDRA 15.0 | 100% moderate |
|
| Rhinitis | Infections and infestations | MedDRA 15.0 | 50% mild, 50% moderate |
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| Sinusitis | Infections and infestations | MedDRA 15.0 | 50% mild, 50% moderate |
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| Urinary tract infection | Infections and infestations | MedDRA 15.0 | 100% mild |
|
Clinical Study Agreement. Most restrictive provision - PI will not publish results until after first of: multicenter publication is published or 24 months from study end. Thereafter, PI may publish his results. PI must provide copy of proposed publication to Sponsor for pre-review. If Sponsor requests, PI must delete Sponsor confidential information before publication and/or delay publication for 60 days so Sponsor can file for patents or take other action to protect its patent rights.
| D000081207 | Primary Immunodeficiency Diseases |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D014581 | Urticaria |
| D017445 | Skin Diseases, Vascular |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |
| D007153 | Immunologic Deficiency Syndromes |
| D015843 |
| Serpins |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D003169 | Complement Inactivator Proteins |
| D003165 | Complement System Proteins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
|
| Reduction of >1 attack/month from historical rate |
|
| Non-responder |
|