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The purpose of this open-label study is to evaluate the pharmacokinetics, safety, and tolerability of subcutaneously (SC; under the skin) administered GAMUNEX-C compared to intravenously (IV; through the vein) administered GAMUNEX-C in subjects 2-16 years of age with Primary Immunodeficiency.
This study was a multi-center, open-label, single-sequence, crossover study to evaluate the pharmacokinetics (PK), safety and tolerability of SC-administered GAMUNEX-C in pediatric PI subjects (ages 2-16). The study consisted of a Screening Phase, Run-in Phase, two treatment phases (an IV Phase and a SC Phase), and an End of Study/Early Termination (EOS/ET) visit. Run-in phase: 3 - 4 months, IV Phase: ~ 4 - 5 weeks, SC Phase: 12 weeks, and End of Study/Early Termination (EOS/ET) visit: one week after SC Week #12.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intravenous GAMUNEX-C | Active Comparator |
| |
| Subcutaneous GAMUNEX-C | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| GAMUNEX-C | Biological | GAMUNEX-C Immune Globulin Injection (Human), 10%, Caprylate/Chromatography Purified, Intravenous Administration: 200-600 mg/kg per intravenous infusion every 3-4 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Steady-state Area Under the Curve (AUC) for Serum Total Immunoglobulin (IgG) | Steady-state area under the curve (AUC): For the IV phase, the mean adjusted AUC was calculated for all 11 subjects, which included subjects on both 3 and 4 week intravenous (IV) dosing schedules and who had sufficient immunoglobulin G (IgG) data. For the SC phase, the mean AUC was calculated for 10 subjects on weekly subcutaneous (SC) administration and who had sufficient IgG data. | 4 to 5 weeks for IV administration; 12 weeks for SC administration |
| Mean Trough of Serum Total IgG | Mean trough serum total IgG values were calculated for each subject for the IV Phase (IV #1 and IV #2) and the SC phase (SC Weeks #9 and #12, and End of Treatment/Early termination visit). Mean trough concentration values of serum total IgG during the IV and SC phases were calculated based on the IgG population (subjects who received any amount of study drug and had serum total IgG concentration data). | 4 - 5 weeks of IV administration and 12 weeks for SC administration |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Childrens Hospital Los Angeles | Los Angeles | California | 90027 | United States | ||
| IMMUNOe International Research Centers |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27342758 | Derived | Heimall J, Chen J, Church JA, Griffin R, Melamed I, Kleiner GI. Pharmacokinetics, Safety, and Tolerability of Subcutaneous Immune Globulin Injection (Human), 10 % Caprylate/Chromatography Purified (GAMUNEX(R)-C) in Pediatric Patients with Primary Immunodeficiency Disease. J Clin Immunol. 2016 Aug;36(6):600-9. doi: 10.1007/s10875-016-0311-4. Epub 2016 Jun 25. |
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A total of 13 subjects were screened for participation in this study. After screening, one subject discontinued the study and did not receive study drug. Eleven subjects entered the Run-in phase. One subject entered intravenous Gamunex-C phase directly. A total of 11 subjects entered the IV phase and subsequently entered the SC phase.
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| ID | Title | Description |
|---|---|---|
| FG000 | Intravenous GAMUNEX-C | GAMUNEX-C: Immune Globulin Injection (Human), 10%, Caprylate/Chromatography Purified: In the Run-in Phase, subjects received intravenous infusions of Gamunex-C at a dose between 200 to 600 mg/kg every three or four weeks for 3 months. In the subsequent IV phase, subjects received two IV infusions of Gamunex-C at a dose between 200 to 600 mg/kg for four to five weeks. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Run-in Phase |
|
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| GAMUNEX-C | Biological | GAMUNEX-C Immune Globulin Injection (Human), 10%, Caprylate/Chromatography Purified, Subcutaneous Administration: weekly subcutaneous infusion at a mg/kg dose based on subject's intravenous dose and dosing interval x 1.37 conversion factor |
|
| Centennial |
| Colorado |
| 80112 |
| United States |
| Joe DiMaggio Children's Hospital | Hollywood | Florida | 33021 | United States |
| The Children's Hospital of Philadelphia | Philadelphia | Pennsylvania | 19104 | United States |
| FG001 | Subcutaneous GAMUNEX-C | GAMUNEX-C: Immune Globulin Injection (Human), 10%, Caprylate/Chromatography Purified: weekly subcutaneous infusion at a mg/kg dose based on intravenous dose of subject and dosing interval x 1.37 conversion factor for 12 weeks. |
| COMPLETED |
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| NOT COMPLETED |
|
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| Intravenous (IV) Phase |
|
| Subcutaneous (SC) Phase |
|
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All 12 enrolled subjects who were infused with any amount of study drug (GAMUNEX-C) were included in the safety population. The demographic data of the safety population are provided.
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| ID | Title | Description |
|---|---|---|
| BG000 | Safety Population | The safety population consisted of all subjects who received any amount of GAMUNEX-C. In the Run-in Phase, subjects received intravenous infusions of Gamunex-C at a dose between 200 to 600 mg/kg every three or four weeks for 3 months. In the subsequent IV phase, subjects received two IV infusions of Gamunex-C at a dose between 200 to 600 mg/kg for four to five weeks. In the SC Phase, subjects received weekly subcutaneous infusion of Gamunex-C at a mg/kg dose based on intravenous dose of the subject and dosing interval x 1.37 conversion factor 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, 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 | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Steady-state Area Under the Curve (AUC) for Serum Total Immunoglobulin (IgG) | Steady-state area under the curve (AUC): For the IV phase, the mean adjusted AUC was calculated for all 11 subjects, which included subjects on both 3 and 4 week intravenous (IV) dosing schedules and who had sufficient immunoglobulin G (IgG) data. For the SC phase, the mean AUC was calculated for 10 subjects on weekly subcutaneous (SC) administration and who had sufficient IgG data. | The PK population included the subjects with the availability of sufficient pharmacokinetics (PK) data to calculate area under the curve (AUC) for either the IV or SC phases. | Posted | Mean | Full Range | h*mg/dL | 4 to 5 weeks for IV administration; 12 weeks for SC administration |
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| Primary | Mean Trough of Serum Total IgG | Mean trough serum total IgG values were calculated for each subject for the IV Phase (IV #1 and IV #2) and the SC phase (SC Weeks #9 and #12, and End of Treatment/Early termination visit). Mean trough concentration values of serum total IgG during the IV and SC phases were calculated based on the IgG population (subjects who received any amount of study drug and had serum total IgG concentration data). | The IgG Population was used to calculate the trough serum concentrations. The IgG population consisted of all subjects who received any amount of GAMUNEX-C and had any serum total IgG concentration data. | Posted | Mean | Full Range | mg/dL | 4 - 5 weeks of IV administration and 12 weeks for SC administration |
|
Eligible subjects entered into a 3-month Run-in Phase to receive GAMUNEX-C intravenous infusions. Subjects who completed the Run-in Phase then entered the Intravenous (IV) phase (4 - 5 weeks) followed by the subcutaneous (SC) phase (12 weeks).
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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 | Intravenous GAMUNEX-C | GAMUNEX-C: Immune Globulin Injection (Human), 10%, Caprylate/Chromatography Purified: In the Run-in Phase, subjects received intravenous infusions of Gamunex-C at a dose between 200 to 600 mg/kg every three or four weeks for 3 months. In the subsequent IV phase, subjects received two IV infusions of Gamunex-C at a dose between 200 to 600 mg/kg for four to five weeks. | 0 | 12 | 10 | 12 | ||
| EG001 | Subcutaneous GAMUNEX-C | GAMUNEX-C: Immune Globulin Injection (Human), 10%, Caprylate/Chromatography Purified, Subcutaneous Administration: weekly subcutaneous infusion at a mg/kg dose based on intravenous dose and dosing interval x 1.37 conversion factor for 12 weeks. | 1 | 11 | 11 | 11 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Lower limb fracture | Injury, poisoning and procedural complications | MedDRA 14.0 | Systematic Assessment | One subject experienced a serious adverse event (SAE) of lower limb fracture (verbatim term: spiral fracture of right tibia and fibula) during the SC phase that was "not related" to GAMUNEX-C administration. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Infusion site erythema | General disorders | MedDRA 14.0 | Systematic Assessment |
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| infusion site pain | General disorders | MedDRA 14.0 | Systematic Assessment |
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| Infusion site pruritus | General disorders | MedDRA 14.0 | Systematic Assessment |
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| Infusion site discomfort | General disorders | MedDRA 14.0 | Systematic Assessment |
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| Infusion site haematoma | General disorders | MedDRA 14.0 | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA 14.0 | Systematic Assessment |
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| Infusion site swelling | General disorders | MedDRA 14.0 | Systematic Assessment |
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| Pyrexia | Nervous system disorders | MedDRA 14.0 | Systematic Assessment |
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| Abdominal pain | Gastrointestinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Abdominal pain upper | Gastrointestinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Autoimmune thyroiditis | Endocrine disorders | MedDRA 14.0 | Systematic Assessment |
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| Corona virus infection | Infections and infestations | MedDRA 14.0 | Systematic Assessment |
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| Drug hypersensitivity | Immune system disorders | MedDRA 14.0 | Systematic Assessment |
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| Dyspnoea | Respiratory, thoracic and mediastinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Gastroenteritis | Infections and infestations | MedDRA 14.0 | Systematic Assessment |
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| Gastroenteritis viral | Infections and infestations | MedDRA 14.0 | Systematic Assessment |
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| Influenza | Infections and infestations | MedDRA 14.0 | Systematic Assessment |
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| Infusion site extravasation | General disorders | MedDRA 14.0 | Systematic Assessment |
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| Infusion site haemorrhage | General disorders | MedDRA 14.0 | Systematic Assessment |
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| Infusion site induration | General disorders | MedDRA 14.0 | Systematic Assessment |
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| Infusion site inflammation | General disorders | MedDRA 14.0 | Systematic Assessment |
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| Infusion site warmth | General disorders | MedDRA 14.0 | Systematic Assessment |
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| Muscle strain | Injury, poisoning and procedural complications | MedDRA 14.0 | Systematic Assessment |
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| Nasal congestion | Respiratory, thoracic and mediastinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Oropharyngeal pain | Respiratory, thoracic and mediastinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Pain in extremity | Musculoskeletal and connective tissue disorders | MedDRA 14.0 | Systematic Assessment |
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| Pharyngitis streptococcal | Infections and infestations | MedDRA 14.0 | Systematic Assessment |
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| Rhinovirus infection | Infections and infestations | MedDRA 14.0 | Systematic Assessment |
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| Skin chapped | Skin and subcutaneous tissue disorders | MedDRA 14.0 | Systematic Assessment |
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| Upper respiratory tract infection | Infections and infestations | MedDRA 14.0 | Systematic Assessment |
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| Viral upper respiratory tract infection | Infections and infestations | MedDRA 14.0 | Systematic Assessment |
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| Wheezing | Respiratory, thoracic and mediastinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA 14.0 | Systematic Assessment |
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| Asthma | Respiratory, thoracic and mediastinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Cellulitis | Infections and infestations | MedDRA 14.0 | Systematic Assessment |
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| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Croup infectious | Infections and infestations | MedDRA 14.0 | Systematic Assessment |
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| Eczema | Skin and subcutaneous tissue disorders | MedDRA 14.0 | Systematic Assessment |
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| Fatigue | General disorders | MedDRA 14.0 | Systematic Assessment |
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| Gastrostomy tube insertion | Surgical and medical procedures | MedDRA 14.0 | Systematic Assessment |
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| Incontinence | Renal and urinary disorders | MedDRA 14.0 | Systematic Assessment |
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| Joint sprain | Injury, poisoning and procedural complications | MedDRA 14.0 | Systematic Assessment |
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| Learning disability | Social circumstances | MedDRA 14.0 | Systematic Assessment |
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| Migraine | Nervous system disorders | MedDRA 14.0 | Systematic Assessment |
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| Molluscum contagiosum | Infections and infestations | MedDRA 14.0 | Systematic Assessment |
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| Rheumatoid arthritis | Musculoskeletal and connective tissue disorders | MedDRA 14.0 | Systematic Assessment |
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| Seasonal allergy | Immune system disorders | MedDRA 14.0 | Systematic Assessment |
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| Sneezing | Respiratory, thoracic and mediastinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Soft tissue disorder | Musculoskeletal and connective tissue disorders | MedDRA 14.0 | Systematic Assessment |
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| Viral pharyngitis | Infections and infestations | MedDRA 14.0 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Henry Li, PhD | Grifols Therapeutics Inc | 800-20-2807 | henry.li@grifols.com |
| ID | Term |
|---|---|
| D000081207 | Primary Immunodeficiency Diseases |
| ID | Term |
|---|---|
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D007153 | Immunologic Deficiency Syndromes |
| D007154 | Immune System Diseases |
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| ID | Term |
|---|---|
| C558471 | Hizentra |
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