A Study to Evaluate the Efficacy, Safety, and Pharmacokinetics of Prophylactic Emicizumab Versus no Prophylaxis in Hemophilia A Participants With Inhibitors
Status: | Active, not recruiting |
---|---|
Conditions: | Anemia, Hematology |
Therapuetic Areas: | Hematology |
Healthy: | No |
Age Range: | 12 - Any |
Updated: | 2/17/2019 |
Start Date: | November 18, 2015 |
End Date: | January 1, 2021 |
A Randomized, Multicenter, Open-Label, Phase III Clinical Trial to Evaluate the Efficacy, Safety, and Pharmacokinetics of Prophylactic Emicizumab Versus no Prophylaxis in Hemophilia A Patients With Inhibitors
This multicenter, open-label study will evaluate the safety, efficacy and pharmacokinetics of
prophylactic emicizumab treatment in participants previously treated with episodic or
prophylactic bypassing agents. Episodic bypassing agent participants will be randomized in a
2:1 fashion to receive emicizumab prophylaxis (Arm A) versus no prophylaxis (Arm B) and will
be stratified across Arms A and B according to the number of bleeds they experienced over the
last 24 weeks prior to study entry (less than [<] 9 or greater than or equal to [>/=] 9
bleeds); Arm B participants will have the opportunity to switch to emicizumab prophylaxis
after at least 24 weeks on-study. Prophylactic bypassing agent participants will switch to
emicizumab prophylaxis (Arm C) from the start of the trial; enrollment will be extended for
24 weeks after the last participant has enrolled in Arms A or B or until approximately 50
participants have enrolled in Arm C, whichever occurs first. Episodic bypassing agent
participants who previously participated in the non-interventional study BH29768
(NCT02476942) who were unable to enroll in Arms A or B, or participants on prophylactic
bypassing agents who were unable to enroll in Arm C, prior to their closure will have the
opportunity to enroll in Arm D. Like participants in Arms A and C, Arm D participants will
receive emicizumab prophylaxis from the start of the trial. All participants will continue to
receive episodic bypassing agent therapy to treat breakthrough bleeds, preferably with
recombinant activated factor VII (rFVIIa).
prophylactic emicizumab treatment in participants previously treated with episodic or
prophylactic bypassing agents. Episodic bypassing agent participants will be randomized in a
2:1 fashion to receive emicizumab prophylaxis (Arm A) versus no prophylaxis (Arm B) and will
be stratified across Arms A and B according to the number of bleeds they experienced over the
last 24 weeks prior to study entry (less than [<] 9 or greater than or equal to [>/=] 9
bleeds); Arm B participants will have the opportunity to switch to emicizumab prophylaxis
after at least 24 weeks on-study. Prophylactic bypassing agent participants will switch to
emicizumab prophylaxis (Arm C) from the start of the trial; enrollment will be extended for
24 weeks after the last participant has enrolled in Arms A or B or until approximately 50
participants have enrolled in Arm C, whichever occurs first. Episodic bypassing agent
participants who previously participated in the non-interventional study BH29768
(NCT02476942) who were unable to enroll in Arms A or B, or participants on prophylactic
bypassing agents who were unable to enroll in Arm C, prior to their closure will have the
opportunity to enroll in Arm D. Like participants in Arms A and C, Arm D participants will
receive emicizumab prophylaxis from the start of the trial. All participants will continue to
receive episodic bypassing agent therapy to treat breakthrough bleeds, preferably with
recombinant activated factor VII (rFVIIa).
Inclusion Criteria:
- Body weight >/= 40 kilograms (kg) at the time of screening
- Diagnosis of congenital hemophilia A of any severity and documented history of
high-titer inhibitor ( that is [i.e.], >/= 5 Bethesda Units [BU])
- Documentation of treatment with episodic or prophylactic bypassing agents for at least
the last 24 weeks
- >/= 6 bleeds in the last 24 weeks prior to screening (if on an episodic bypassing
agent regimen) or >/=2 bleeds in the last 24 weeks prior to screening (if on a
prophylactic bypassing agent regimen)
- Adequate hematologic, hepatic and renal function
- For women who are not postmenopausal or surgically sterile: agreement to remain
abstinent or use single or combined highly effective contraceptive methods
Exclusion Criteria:
- Participants with inherited or acquired bleeding disorder other than hemophilia A
- Participants with ongoing (or plan to receive during the study) immune tolerance
induction therapy or prophylaxis with Factor VIII (FVIII), with the exception of
participants who have received a treatment regimen of FVIII prophylaxis with
concurrent bypassing agent prophylaxis
- Previous (in the past 12 months) or current treatment for thromboembolic disease (with
the exception of previous catheter-associated thrombosis for which antithrombotic
treatment is not currently ongoing) or current signs of thromboembolic disease
- Participants with other conditions (for example [e.g.], certain autoimmune diseases)
that may increase the risk of bleeding or thrombosis
- History of clinically significant hypersensitivity associated with monoclonal antibody
therapies or components of the emicizumab injection
- Known human immunodeficiency virus (HIV) infection with cluster of differentiation 4
(CD4) count < 200 cells per microliter (cells/mcL) within 24 weeks prior to screening
- Use of systemic immunomodulators (e.g., interferon or rituximab) at enrolment or
planned use during the study, with the exception of antiretroviral therapy
- Participants who are at high risk for thrombotic microangiopathy (TMA; e.g., have a
previous medical or family history of TMA), in the investigator's judgment
- Concurrent disease, treatment, or abnormality in clinical laboratory tests that could
interfere with the conduct of the study or that would, in the opinion of the
investigator or Sponsor, preclude the participant's safe participation in and
completion of the study or interpretation of the study results
- Planned surgery (excluding minor procedures such as tooth extraction or incision and
drainage) during the study
- Receipt of emicizumab in a prior investigational study; An investigational drug to
treat or reduce the risk of hemophilic bleeds within 5 half-lives of last drug
administration; A non-hemophilia-related investigational drug within last 30 days or 5
half-lives, whichever is shorter; An investigational drug concurrently
- Unwillingness to use highly effective contraception methods for the specified duration
in the protocol (females only, unless required otherwise by the local health
authority)
- Clinically significant abnormality on screening evaluations or laboratory tests that,
in the opinion of the investigator, may pose an additional risk in administering study
drug to the participant
- Pregnancy or lactation, or intent to become pregnant during the study
We found this trial at
14
sites
University of Pittsburgh The University of Pittsburgh is a state-related research university, founded as the...
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Childrens Hospital Los Angeles Children's Hospital Los Angeles is a 501(c)(3) nonprofit hospital for pediatric...
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Boston Children's Hospital Boston Children's Hospital is a 395-bed comprehensive center for pediatric health care....
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500 University Drive
Hershey, Pennsylvania 17033
Hershey, Pennsylvania 17033
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7000 Fannin Street
Houston, Texas 77030
Houston, Texas 77030
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921 Terry Avenue
Seattle, Washington 98104
Seattle, Washington 98104
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