Study was discontinued for non-safety reasons and the rapidly evolving treatment landscape for AL amyloidosis.

The purpose of this study is to evaluate the efficacy and safety of Coagadex in treating active bleeds and to manage peri-operative bleeding in participants with acquired factor X deficiency associated with AL amyloidosis.

This study is designed to evaluate the efficacy and safety of Coagadex® in treating active bleeds and to manage peri-operative bleeding in participants with aFXD associated with AL amyloidosis. Coagadex® is a plasma-derived human coagulation factor concentrate expected to treat bleeding episodes in patients with aFXD associated with AL amyloidosis by delivering concentrated Factor X to address the clotting deficiency caused by the disease.

aFXD is a rare condition (prevalence of <1 / 1 000 000 [Orphanet 2024]) and may occur due to infections, neoplastic and chronic diseases (Lee G et al., 2012). aFXD is considered severe when the FX coagulant activity (FX:C) level is < 25% of normal (normal range 70 - 150 IU/dL), and moderate when FX:C level is 25% to 50% of normal (Choufani et al., 2001).

AL amyloidosis is the most common cause of acquired FX Deficiency (aFXD). In AL amyloidosis, amyloid fibrils bind to and reduce the levels of circulating FX and shorten its half-life, causing aFXD, leading to an increase in risk of bleeding. Bleeding may occur both in patients with moderate and severe deficiency

Inclusion Criteria:

1. Male or female participants ages 18-70 years old.
2. Diagnosis of aFXD associated with AL amyloidosis with FX:C ≤ 50 IU/dL.
3. Woman of Childbearing Potential (defined in Appendix 2) and men of reproductive potential who agree to use an effective contraception measure during the study.

Exclusion Criteria:

1. Female participants that are pregnant or lactating.
2. Presence of FX inhibitors.
3. Uncontrolled arterial hypertension.
4. On anticoagulant therapy (not antiplatelets), unstable heart disease, clinically significant thrombotic event in the past 180 days or any other condition that the Investigator believes is likely to interfere with evaluation of the study drug or with satisfactory conduct of the trial.
5. Any factor X containing product taken within 2 weeks of first Coagadex® administration.
6. Participation in another interventional clinical study with an investigational drug, biologic, or device within 30 days prior to screening.
7. Hemodynamically unstable due to any cause or even after blood transfusion, fluid resuscitation and pharmacologic or volume replacement pressor therapy.
8. Prior history of bleeding disorder other than aFXD.

Publishing of data and IPD that underlie results in the publication will be determined at study completion to comply with ICMJE minimum requirements.

None (open label)