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| Name | Class |
|---|---|
| Larix A/S | INDUSTRY |
| Fraunhofer Institute for Translational Medicine and Pharmacology ITMP | OTHER |
| Deutsches Rotes Kreuz DRK-Blutspendedienst Baden-Wurttemberg-Hessen | OTHER |
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The current phase 0 trial is preceding the phase 1/2 trial of a newly developed drug, NAITgam, for the prevention of fetal and neonatal alloimmune thrombocytopenia (FNAIT) - a rare, but potentially very severe bleeding condition in the fetus or newborn. FNAIT may occur in women whose blood platelets do not express HPA-1a. If the fetus has inherited HPA-1a from the father, the mother's immune system may be stimulated to produce HPA-1a antibodies if HPA-1a positive fetal blood platelets enter the maternal circulation during delivery. In a subsequent pregnancy, such antibodies will cross the placenta and may reduce the number of HPA-1a positive blood platelets in the fetus, which in turn may result in severe bleeding in the fetus or newborn.
The phase 1/2 study of NAITgam will examine NAITgam's ability to eliminate HPA-1a positive blood platelets that has been transfused to healthy male subjects, whose blood platelet do not express HPA-1a. The ability to quickly eliminate transfused HPA-1a positive platelets is considered as a surrogate endpoint for NAITgam's ability to prevent formation of antibodies against HPA-1a after delivery of an HPA-1a positive child.
The current phase 0 trial will examine the survival of blood platelets transfused to healthy male individuals without subsequent administration of NAITgam. The natural survival of transfused platelet, as determined in the phase 0 trial, will be compared with the survival of transfused HPA-1a positive platelets after administration of NAITgam in the phase 1/2 trial. The aim of the phase 0 trial is first, to determine the dose of blood platelet that should be transfused to the healthy subjects in the phase 1/2 trial; and secondly, to determine the optimal time point, after transfusion of platelets, for administration of NAITgam in the phase 1/2 trial.
Eight to 24 healthy male subjects will be included in the phase 0 trial. After transfusion of platelets, blood samples will be collected at regular intervals to determine the proportion of transfused blood platelets. Differences between tissue type antigens between donor and recipient will be used to determine the proportion of transfused platelets. Survival of transfused platelets will be performed by flow cytometry - a method that can be used to quantify very small proportions of cells in the blood. Fluorochrome-conjugated monoclonal antibodies against HLA-A2 and HLA-A9 will be used for flow cytometric identification the transfused platelets.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Platelet transfusion | Other | HLA-A2 and/or HLA A9 negative healthy study subjects will be transfused with a small dose of platelets from an HLA-A2 and/or HLA-A9 positive donor. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Platelet transfusion | Other | Transfusion of a platelet dose from 20 × 10ˆ9 to 100 × 10ˆ9. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Terminal elimination half live | Determination of the terminal elimination half live of a single platelet dose transfused to healthy male subjects | The terminal elimination half live of transfused platelets will be determined based on the survival of platelets within the first 5 days after trandfusion |
| Measure | Description | Time Frame |
|---|---|---|
| Cmax | The peak platelet concentration | Will be determined within the first 5 days after transfusion |
| AUC | The area under the platelet concentration versus time curve |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jens Kjeldsen-Kragh, MD, PhD | Prophylix Pharma AS | Study Chair |
| Michaela Köhm, MD | Fraunhofer Institute for Molecular Biology and Applied Ecology IME | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Fraunhofer Institute for Molecular Biology and Applied Ecology IME | Frankfurt am Main | Hessia | 60596 | Germany |
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| ID | Term |
|---|---|
| D054098 | Thrombocytopenia, Neonatal Alloimmune |
| ID | Term |
|---|---|
| D013921 | Thrombocytopenia |
| D001791 | Blood Platelet Disorders |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
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| ID | Term |
|---|---|
| D017713 | Platelet Transfusion |
| ID | Term |
|---|---|
| D016913 | Blood Component Transfusion |
| D001803 | Blood Transfusion |
| D001691 | Biological Therapy |
| D013812 | Therapeutics |
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| Bioscientia Central Laboratory |
| UNKNOWN |
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| Will be determined within the first 5 days after transfusion |
| Clearance | Natural clearance of platelets from the circulation | Will be determined within the first 5 days after transfusion |
| D000095542 | Cytopenia |
| D007232 | Infant, Newborn, Diseases |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |