Trial Outcomes & Findings for Early Prophylaxis Immunologic Challenge (EPIC) Study (NCT NCT01376700)

NCT ID: NCT01376700

Last Updated: 2021-05-24

Results Overview

Inhibitor testing will be performed in the central laboratory and a non-zero result must be confirmed in the central laboratory as soon as possible, preferably 1 week after inhibitor testing. Confirmed FVIII inhibitor is defined as any FVIII inhibitor assay result equal or greater than 0.6 Bethesda Units (BU)/mL confirmed by the central laboratory on 2 consecutive samples, i.e. at least 2 positive inhibitor results (including the first positive inhibitor test, in accordance with the study protocol) assessed as either: - i. High FVIII inhibitor titer (\> 5 BU/mL) or - ii. Low FVIII inhibitor titer (≥0.6 - ≤5.0 BU/mL).

Recruitment status

TERMINATED

Study phase

PHASE3

Target enrollment

22 participants

Primary outcome timeframe

50 exposure days to ADVATE

Results posted on

2021-05-24

Participant Flow

Enrollment was conducted in Europe and North America at 19 clinical sites.

22 participants were enrolled. One was a screen failure; one did not have screening laboratory assessments performed prior to study termination; and one met screening criteria, but was not exposed to investigational product prior to study termination. Therefore 19 participants were treated

Participant milestones

Participant milestones
Measure
ADVATE - Prophylactic Regimen
Weekly infusions of ADVATE. Study visits (physical examination, lab tests including FVIII inhibitor tests) every week during the first 10 exposure days (EDs), every 5 weeks during the next 10 EDs and every 10 weeks thereafter.
Overall Study
STARTED
19
Overall Study
COMPLETED
3
Overall Study
NOT COMPLETED
16

Reasons for withdrawal

Reasons for withdrawal
Measure
ADVATE - Prophylactic Regimen
Weekly infusions of ADVATE. Study visits (physical examination, lab tests including FVIII inhibitor tests) every week during the first 10 exposure days (EDs), every 5 weeks during the next 10 EDs and every 10 weeks thereafter.
Overall Study
Sponsor terminated study early
8
Overall Study
Low or high titer inhibitor
8

Baseline Characteristics

Early Prophylaxis Immunologic Challenge (EPIC) Study

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
ADVATE - Prophylactic Regimen
n=19 Participants
Weekly infusions of ADVATE. Study visits (physical examination, lab tests including FVIII inhibitor tests) every week during the first 10 exposure days (EDs), every 5 weeks during the next 10 EDs and every 10 weeks thereafter.
Age, Continuous
43.3 weeks
STANDARD_DEVIATION 10.2 • n=5 Participants
Sex: Female, Male
Female
0 Participants
n=5 Participants
Sex: Female, Male
Male
19 Participants
n=5 Participants
Region of Enrollment
Serbia
1 Participants
n=5 Participants
Region of Enrollment
United States
2 Participants
n=5 Participants
Region of Enrollment
Czech Republic
2 Participants
n=5 Participants
Region of Enrollment
Canada
1 Participants
n=5 Participants
Region of Enrollment
Spain
1 Participants
n=5 Participants
Region of Enrollment
Poland
4 Participants
n=5 Participants
Region of Enrollment
Austria
1 Participants
n=5 Participants
Region of Enrollment
Russian Federation
3 Participants
n=5 Participants
Region of Enrollment
Bulgaria
1 Participants
n=5 Participants
Region of Enrollment
Netherlands
1 Participants
n=5 Participants
Region of Enrollment
Germany
2 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 50 exposure days to ADVATE

Population: Safety Analysis Set All study participants had severe Hemophilia A, less than 1% Factor VIII levels. (ie there were no moderately severe hemophilia A participants (FVIII levels \>1% to ≤ 2%) in this study.

Inhibitor testing will be performed in the central laboratory and a non-zero result must be confirmed in the central laboratory as soon as possible, preferably 1 week after inhibitor testing. Confirmed FVIII inhibitor is defined as any FVIII inhibitor assay result equal or greater than 0.6 Bethesda Units (BU)/mL confirmed by the central laboratory on 2 consecutive samples, i.e. at least 2 positive inhibitor results (including the first positive inhibitor test, in accordance with the study protocol) assessed as either: - i. High FVIII inhibitor titer (\> 5 BU/mL) or - ii. Low FVIII inhibitor titer (≥0.6 - ≤5.0 BU/mL).

Outcome measures

Outcome measures
Measure
ADVATE - Prophylactic Regimen
n=19 Participants
Weekly infusions of ADVATE. Study visits (physical examination, lab tests including FVIII inhibitor tests) every week during the first 10 exposure days (EDs), every 5 weeks during the next 10 EDs and every 10 weeks thereafter. Recombinant antihemophilic factor, plasma/albumin-free method (rAHF-PFM): Intravenous infusion at a dose of 25 ± 5 IU/kg once per week. After 20 exposure days, the weekly infusions should be continued for as long as possible following the early prophylaxis period. If required by the clinical situation, dosing may be increased to twice weekly or even three times weekly after 20 exposure days, while keeping the low dose.
MTPs
≤4 previous FVIII exposures
Number of Participants With Severe and Moderately Severe Hemophilia A (FVIII ≤ 2%) With Factor VIII (FVIII) Inhibitor Formation Within the First 50 Exposure Days to ADVATE
8 participants

SECONDARY outcome

Timeframe: 50 exposure days to ADVATE

Population: Safety Analysis Set

Inhibitor testing will be performed in the central laboratory and a non-zero result must be confirmed in the central laboratory as soon as possible, preferably 1 week after inhibitor testing. Confirmed FVIII inhibitor is defined as any FVIII inhibitor assay result equal or greater than 0.6 Bethesda Units (BU)/mL confirmed by the central laboratory on 2 consecutive samples, i.e. at least 2 positive inhibitor results (including the first positive inhibitor test, in accordance with the study protocol) assessed as either: - i. High FVIII inhibitor titer (\> 5 BU/mL) or - ii. Low FVIII inhibitor titer (≥0.6 - ≤5.0 BU/mL).

Outcome measures

Outcome measures
Measure
ADVATE - Prophylactic Regimen
n=19 Participants
Weekly infusions of ADVATE. Study visits (physical examination, lab tests including FVIII inhibitor tests) every week during the first 10 exposure days (EDs), every 5 weeks during the next 10 EDs and every 10 weeks thereafter. Recombinant antihemophilic factor, plasma/albumin-free method (rAHF-PFM): Intravenous infusion at a dose of 25 ± 5 IU/kg once per week. After 20 exposure days, the weekly infusions should be continued for as long as possible following the early prophylaxis period. If required by the clinical situation, dosing may be increased to twice weekly or even three times weekly after 20 exposure days, while keeping the low dose.
MTPs
≤4 previous FVIII exposures
Number of Participants With Severe Hemophilia A (FVIII ≤ 1%) With Factor VIII (FVIII) Inhibitor Formation Within the First 50 Exposure Days to ADVATE
8 participants

SECONDARY outcome

Timeframe: 50 exposure days to ADVATE

Population: Safety Analysis Set

Confirmed inhibitor is defined as any FVIII inhibitor assay result equal or greater than 0.6 BU/mL confirmed by the central laboratory on 2 consecutive samples, i.e. at least 2 positive inhibitor results (including the first positive inhibitor test, in accordance with the study protocol) assessed as either: - i. High FVIII inhibitor titer (\> 5 BU/mL) or - ii. Low FVIII inhibitor titer (≥0.6 - ≤5.0 BU/mL).

Outcome measures

Outcome measures
Measure
ADVATE - Prophylactic Regimen
n=19 Participants
Weekly infusions of ADVATE. Study visits (physical examination, lab tests including FVIII inhibitor tests) every week during the first 10 exposure days (EDs), every 5 weeks during the next 10 EDs and every 10 weeks thereafter. Recombinant antihemophilic factor, plasma/albumin-free method (rAHF-PFM): Intravenous infusion at a dose of 25 ± 5 IU/kg once per week. After 20 exposure days, the weekly infusions should be continued for as long as possible following the early prophylaxis period. If required by the clinical situation, dosing may be increased to twice weekly or even three times weekly after 20 exposure days, while keeping the low dose.
MTPs
≤4 previous FVIII exposures
Number of Exposure Days of Treatment With Advate Prior to First Positive Factor VIII (FVIII) Confirmed Inhibitor Assessment
14.5 days
Interval 7.0 to 21.0

SECONDARY outcome

Timeframe: 50 exposure days to ADVATE

Population: Safety Analysis Set

\- High FVIII inhibitor titer (\> 5 Bethesda Unit (BU)/mL) - Low FVIII inhibitor titer (≥0.6 - ≤5.0 BU/mL)

Outcome measures

Outcome measures
Measure
ADVATE - Prophylactic Regimen
n=19 Participants
Weekly infusions of ADVATE. Study visits (physical examination, lab tests including FVIII inhibitor tests) every week during the first 10 exposure days (EDs), every 5 weeks during the next 10 EDs and every 10 weeks thereafter. Recombinant antihemophilic factor, plasma/albumin-free method (rAHF-PFM): Intravenous infusion at a dose of 25 ± 5 IU/kg once per week. After 20 exposure days, the weekly infusions should be continued for as long as possible following the early prophylaxis period. If required by the clinical situation, dosing may be increased to twice weekly or even three times weekly after 20 exposure days, while keeping the low dose.
MTPs
≤4 previous FVIII exposures
Number of Participants With Low-titer, High-titer, Transient, and All Factor VIII (FVIII) Inhibitors
Low FVIII inhibitor titer
5 participants
Number of Participants With Low-titer, High-titer, Transient, and All Factor VIII (FVIII) Inhibitors
High FVIII inhibitor titer
3 participants
Number of Participants With Low-titer, High-titer, Transient, and All Factor VIII (FVIII) Inhibitors
All FVIII inhibitors
8 participants

SECONDARY outcome

Timeframe: 50 exposure days to ADVATE

Population: Safety Analysis Set

Nominal Dosing Frequency: - 1 time per week - 2 times per week - Unknown dosing frequency (UK) Bleeding Type (BT): - Skin - Muscle and Soft Tissue - Mucosal - Joint - Other - Multiple - Total Bleeding severity: - Minor - Moderate - Severe - Total

Outcome measures

Outcome measures
Measure
ADVATE - Prophylactic Regimen
n=193 Bleeds
Weekly infusions of ADVATE. Study visits (physical examination, lab tests including FVIII inhibitor tests) every week during the first 10 exposure days (EDs), every 5 weeks during the next 10 EDs and every 10 weeks thereafter. Recombinant antihemophilic factor, plasma/albumin-free method (rAHF-PFM): Intravenous infusion at a dose of 25 ± 5 IU/kg once per week. After 20 exposure days, the weekly infusions should be continued for as long as possible following the early prophylaxis period. If required by the clinical situation, dosing may be increased to twice weekly or even three times weekly after 20 exposure days, while keeping the low dose.
MTPs
≤4 previous FVIII exposures
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Skin; Minor Bleed
130 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Skin; Moderate Bleed
2 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Skin; Severe Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Skin; Total Bleeds
132 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Muscle & Soft Tissue; Minor Bleed
8 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Muscle & Soft Tissue; Moderate Bleed
10 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Muscle & Soft Tissue; Severe Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Muscle & Soft Tissue; Total Bleeds
18 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Mucosal; Minor Bleed
9 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Mucosal; Moderate Bleed
3 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Mucosal; Severe Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Mucosal; Total Bleeds
12 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Joint; Minor Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Joint; Moderate Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Joint; Severe Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Joint; Total Bleeds
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Other BT; Minor Bleed
3 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Other BT; Moderate Bleed
3 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Other BT; Severe Bleed
1 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Other BT; Total Bleeds
7 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Multiple BT; Minor Bleed
2 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Multiple BT; Moderate Bleed
1 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Multiple BT; Severe Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Multiple BT; Total Bleeds
3 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Total BT; Minor Bleed
152 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Total BT; Moderate Bleed
19 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Total BT; Severe Bleed
1 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 1/week; Total BT; Total Bleeds
172 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Skin; Minor Bleed
9 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Skin; Moderate Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Skin; Severe Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Skin; Total Bleeds
9 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Muscle & Soft Tissue; Minor Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Muscle & Soft Tissue; Moderate Bleed
1 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Muscle & Soft Tissue; Severe Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Muscle & Soft Tissue; Total Bleeds
1 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Mucosal; Minor Bleed
3 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Mucosal; Moderate Bleed
1 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Mucosal; Severe Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Mucosal; Total Bleeds
4 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Joint; Minor Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Joint; Moderate Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Joint; Severe Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Joint; Total Bleeds
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Other BT; Minor Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Other BT; Moderate Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Other BT; Severe Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Other BT; Total Bleeds
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Multiple BT; Minor Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Multiple BT; Moderate Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Multiple BT; Severe Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Multiple BT; Total Bleeds
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Total BT; Minor Bleed
12 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Total BT; Moderate Bleed
2 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Total BT; Severe Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: 2/week; Total BT; Total Bleeds
14 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Skin; Minor Bleed
4 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Skin; Moderate Bleed
1 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Skin; Severe Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Skin; Total Bleeds
5 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Muscle & Soft Tissue; Minor Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Muscle & Soft Tissue;Moderate Bleed
1 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Muscle & Soft Tissue; Severe Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Muscle & Soft Tissue; Total Bleeds
1 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Mucosal; Minor Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Mucosal; Moderate Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Mucosal; Severe Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Mucosal; Total Bleeds
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Joint; Minor Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Joint; Moderate Bleed
1 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Joint; Severe Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Joint; Total Bleeds
1 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Other BT; Minor Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Other BT; Moderate Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Other BT; Severe Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Other BT; Total Bleeds
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Multiple BT; Minor Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK/week; Multiple BT; Moderate Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK /week; Multiple BT; Severe Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK /week; Multiple BT; Total Bleeds
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK /week; Total BT; Minor Bleed
4 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK /week; Total BT; Moderate Bleed
3 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK /week; Total BT; Severe Bleed
0 Bleeds
Number, Type, and Severity of All Bleeds Experienced When Different Prophylactic Dosing Frequencies Are Used (Once or Twice Per Week and Unknown Frequency)
Dose: UK /week; Total BT; Total Bleeds
7 Bleeds

SECONDARY outcome

Timeframe: 50 exposure days to ADVATE

Population: Safety Analysis Set

\- Elective surgery is not allowed during period of first 20 exposure days (EDs) - Peripherally inserted central catheter (PICC)

Outcome measures

Outcome measures
Measure
ADVATE - Prophylactic Regimen
n=19 Participants
Weekly infusions of ADVATE. Study visits (physical examination, lab tests including FVIII inhibitor tests) every week during the first 10 exposure days (EDs), every 5 weeks during the next 10 EDs and every 10 weeks thereafter. Recombinant antihemophilic factor, plasma/albumin-free method (rAHF-PFM): Intravenous infusion at a dose of 25 ± 5 IU/kg once per week. After 20 exposure days, the weekly infusions should be continued for as long as possible following the early prophylaxis period. If required by the clinical situation, dosing may be increased to twice weekly or even three times weekly after 20 exposure days, while keeping the low dose.
MTPs
≤4 previous FVIII exposures
Number and Type of Surgeries
Surgery: Cimino Shunt
1 surgeries
Number and Type of Surgeries
Surgery: PICC Line Insertion in right arm
1 surgeries

SECONDARY outcome

Timeframe: 50 exposure days to ADVATE

Population: Due to the low number of subjects available for evaluation, no statistical tests were performed to assess associations between known risk factors to inhibitor formation.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 50 exposure days to ADVATE

Population: Due to the low number of subjects available for evaluation, no statistical tests were performed to assess the total FVIII consumption by participant

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 50 exposure days to ADVATE

Population: Summary statistics of FVIII-Specific Antibody Isotypes were not performed due to the early termination of the study

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 50 exposure days to ADVATE

Population: Safety Analysis Set

Possibly or probably related adverse events

Outcome measures

Outcome measures
Measure
ADVATE - Prophylactic Regimen
n=19 Participants
Weekly infusions of ADVATE. Study visits (physical examination, lab tests including FVIII inhibitor tests) every week during the first 10 exposure days (EDs), every 5 weeks during the next 10 EDs and every 10 weeks thereafter. Recombinant antihemophilic factor, plasma/albumin-free method (rAHF-PFM): Intravenous infusion at a dose of 25 ± 5 IU/kg once per week. After 20 exposure days, the weekly infusions should be continued for as long as possible following the early prophylaxis period. If required by the clinical situation, dosing may be increased to twice weekly or even three times weekly after 20 exposure days, while keeping the low dose.
MTPs
≤4 previous FVIII exposures
Number of Serious Adverse Events (SAEs) and Non-serious Adverse Events (Non-SAEs) at Least Possibly Related to ADVATE
SAEs
9 adverse events
Number of Serious Adverse Events (SAEs) and Non-serious Adverse Events (Non-SAEs) at Least Possibly Related to ADVATE
non-SAEs
1 adverse events

POST_HOC outcome

Timeframe: 50 exposure days to ADVATE

Population: Safety Analysis Set

'True' positive inhibitor (PI) defined as any FVIII inhibitor assay result ≥0.6 Bethesda Units (BU)/mL confirmed by central lab on 2 consecutive samples, ie ≥2 PI results (including first PI test, in accordance with study protocol) assessed as either: i. High FVIII inhibitor titer (\> 5 BU/mL) ii. Low FVIII inhibitor titer (≥0.6 - ≤5.0 BU/mL). In addition, to be classified as 'true' positive low FVIII inhibitors titer (≥0.6 - ≤5.0 BU/mL), one of following criteria must be met: - a) Lower or absent therapeutic response at infusion of standard replacement doses ("clinically relevant") as deemed by the clinician in charge. - b) Any lab result of binding FVIII antibodies (IgM, IgA, IgG, IgG1, IgG2, IgG3, or IgG4) must be positive. Classification based on first positive FVIII inhibitor assessment. Inhibitor test result is: - \> 5 BU/mL, then categorized as a high-titer inhibitor - ≥0.6 BU/mL but ≤5 BU/mL, then categorized as a low-titer.

Outcome measures

Outcome measures
Measure
ADVATE - Prophylactic Regimen
n=19 Participants
Weekly infusions of ADVATE. Study visits (physical examination, lab tests including FVIII inhibitor tests) every week during the first 10 exposure days (EDs), every 5 weeks during the next 10 EDs and every 10 weeks thereafter. Recombinant antihemophilic factor, plasma/albumin-free method (rAHF-PFM): Intravenous infusion at a dose of 25 ± 5 IU/kg once per week. After 20 exposure days, the weekly infusions should be continued for as long as possible following the early prophylaxis period. If required by the clinical situation, dosing may be increased to twice weekly or even three times weekly after 20 exposure days, while keeping the low dose.
MTPs
≤4 previous FVIII exposures
Number of Participants With Factor VIII (FVIII) Inhibitors by Inhibitor Type (Only 'True' Inhibitors)
Inhibitor Type: Low-Titer
3 participants
Interval 3.4 to 39.6
Number of Participants With Factor VIII (FVIII) Inhibitors by Inhibitor Type (Only 'True' Inhibitors)
Inhibitor Type: High-Titer
3 participants
Interval 3.4 to 39.6
Number of Participants With Factor VIII (FVIII) Inhibitors by Inhibitor Type (Only 'True' Inhibitors)
Inhibitor Type: All Inhibitors
6 participants
Interval 12.6 to 56.6

POST_HOC outcome

Timeframe: 50 exposure days to ADVATE

Population: Safety Analysis Set

PUPs = no previous FVIII exposure; MTPs ≤4 previous FVIII exposures 'True' positive inhibitor (PI) = any FVIII inhibitor assay result ≥0.6 Bethesda Units (BU)/mL confirmed by central lab on 2 consecutive samples, ie ≥2 PI results (including first PI test, per study protocol) assessed as either: i. High FVIII inhibitor titer (\>5 BU/mL) ii. Low FVIII inhibitor titer (≥0.6 - ≤5.0 BU/mL). In addition, to be classified as 'true' positive low FVIII inhibitors titer (≥0.6 - ≤5.0 BU/mL), one of following criteria must be met: - a) Lower or absent therapeutic response at infusion of standard replacement doses ("clinically relevant") as deemed by clinician in charge. - b) Any lab result of binding FVIII antibodies (IgM, IgA, IgG, IgG1, IgG2, IgG3, or IgG4) must be positive. Classification based on first positive FVIII inhibitor assessment. Inhibitor test result is: - \> 5 BU/mL, categorized as high-titer inhibitor - ≥0.6 BU/mL but ≤5 BU/mL, categorized as low-titer

Outcome measures

Outcome measures
Measure
ADVATE - Prophylactic Regimen
n=11 Participants
Weekly infusions of ADVATE. Study visits (physical examination, lab tests including FVIII inhibitor tests) every week during the first 10 exposure days (EDs), every 5 weeks during the next 10 EDs and every 10 weeks thereafter. Recombinant antihemophilic factor, plasma/albumin-free method (rAHF-PFM): Intravenous infusion at a dose of 25 ± 5 IU/kg once per week. After 20 exposure days, the weekly infusions should be continued for as long as possible following the early prophylaxis period. If required by the clinical situation, dosing may be increased to twice weekly or even three times weekly after 20 exposure days, while keeping the low dose.
MTPs
n=8 Participants
≤4 previous FVIII exposures
Number of Inhibitors in Previously Untreated Patients (PUPs) and Minimally Treated Patients (MTPs) - (Only 'True' Inhibitors)
3 inhibitors
3 inhibitors

Adverse Events

ADVATE - Prophylactic Regimen

Serious events: 11 serious events
Other events: 19 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
ADVATE - Prophylactic Regimen
n=19 participants at risk
Weekly infusions of ADVATE. Study visits (physical examination, lab tests including FVIII inhibitor tests) every week during the first 10 exposure days (EDs), every 5 weeks during the next 10 EDs and every 10 weeks thereafter. Recombinant antihemophilic factor, plasma/albumin-free method (rAHF-PFM): Intravenous infusion at a dose of 25 ± 5 IU/kg once per week. After 20 exposure days, the weekly infusions should be continued for as long as possible following the early prophylaxis period. If required by the clinical situation, dosing may be increased to twice weekly or even three times weekly after 20 exposure days, while keeping the low dose.
Blood and lymphatic system disorders
FACTOR VIII INHIBITION
42.1%
8/19 • Number of events 8 • 1 year and 3 months
Injury, poisoning and procedural complications
HEAD INJURY
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Injury, poisoning and procedural complications
TRAUMATIC HAEMATOMA
5.3%
1/19 • Number of events 2 • 1 year and 3 months
Musculoskeletal and connective tissue disorders
SOFT TISSUE HAEMORRHAGE
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Surgical and medical procedures
ARTERIOVENOUS FISTULA OPERATION
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Vascular disorders
HAEMORRHAGE
10.5%
2/19 • Number of events 2 • 1 year and 3 months

Other adverse events

Other adverse events
Measure
ADVATE - Prophylactic Regimen
n=19 participants at risk
Weekly infusions of ADVATE. Study visits (physical examination, lab tests including FVIII inhibitor tests) every week during the first 10 exposure days (EDs), every 5 weeks during the next 10 EDs and every 10 weeks thereafter. Recombinant antihemophilic factor, plasma/albumin-free method (rAHF-PFM): Intravenous infusion at a dose of 25 ± 5 IU/kg once per week. After 20 exposure days, the weekly infusions should be continued for as long as possible following the early prophylaxis period. If required by the clinical situation, dosing may be increased to twice weekly or even three times weekly after 20 exposure days, while keeping the low dose.
Blood and lymphatic system disorders
FACTOR VIII INHIBITION (UNCONFIRMED)
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Blood and lymphatic system disorders
LYMPHADENOPATHY
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Ear and labyrinth disorders
MIDDLE EAR EFFUSION
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Eye disorders
EYE DISCHARGE
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Eye disorders
LACRIMATION INCREASED
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Gastrointestinal disorders
CONSTIPATION
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Gastrointestinal disorders
DIARRHOEA
15.8%
3/19 • Number of events 3 • 1 year and 3 months
Gastrointestinal disorders
TEETHING
21.1%
4/19 • Number of events 10 • 1 year and 3 months
Gastrointestinal disorders
VOMITING
26.3%
5/19 • Number of events 6 • 1 year and 3 months
General disorders
PYREXIA
52.6%
10/19 • Number of events 13 • 1 year and 3 months
Immune system disorders
FOOD ALLERGY
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Infections and infestations
ACUTE TONSILLITIS
5.3%
1/19 • Number of events 2 • 1 year and 3 months
Infections and infestations
BRONCHITIS
5.3%
1/19 • Number of events 2 • 1 year and 3 months
Infections and infestations
CANDIDIASIS
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Infections and infestations
COXSACKIE VIRAL INFECTION
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Infections and infestations
EAR INFECTION
10.5%
2/19 • Number of events 2 • 1 year and 3 months
Infections and infestations
GASTROENTERITIS
5.3%
1/19 • Number of events 2 • 1 year and 3 months
Infections and infestations
GASTROENTERITIS VIRAL
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Infections and infestations
HORDEOLUM
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Infections and infestations
NASOPHARYNGITIS
31.6%
6/19 • Number of events 7 • 1 year and 3 months
Infections and infestations
RESPIRATORY TRACT INFECTION
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Infections and infestations
RHINITIS
42.1%
8/19 • Number of events 13 • 1 year and 3 months
Infections and infestations
TONSILLITIS
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Infections and infestations
UPPER RESPIRATORY TRACT INFECTION
15.8%
3/19 • Number of events 7 • 1 year and 3 months
Infections and infestations
VIRAL INFECTION
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Injury, poisoning and procedural complications
FACE INJURY
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Injury, poisoning and procedural complications
FALL
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Injury, poisoning and procedural complications
LIP INJURY
5.3%
1/19 • Number of events 2 • 1 year and 3 months
Injury, poisoning and procedural complications
TONGUE INJURY
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Injury, poisoning and procedural complications
VACCINATION COMPLICATION
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Injury, poisoning and procedural complications
WRONG DRUG ADMINISTERED
5.3%
1/19 • Number of events 3 • 1 year and 3 months
Metabolism and nutrition disorders
VITAMIN D DEFICIENCY
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Musculoskeletal and connective tissue disorders
JOINT RANGE OF MOTION DECREASED
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Respiratory, thoracic and mediastinal disorders
COUGH
31.6%
6/19 • Number of events 6 • 1 year and 3 months
Respiratory, thoracic and mediastinal disorders
NASAL CONGESTION
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Respiratory, thoracic and mediastinal disorders
NASAL DRYNESS
5.3%
1/19 • Number of events 2 • 1 year and 3 months
Respiratory, thoracic and mediastinal disorders
OROPHARYNGEAL PAIN
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Respiratory, thoracic and mediastinal disorders
RHINORRHOEA
10.5%
2/19 • Number of events 3 • 1 year and 3 months
Skin and subcutaneous tissue disorders
DERMATITIS
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Skin and subcutaneous tissue disorders
DERMATITIS ALLERGIC
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Skin and subcutaneous tissue disorders
DERMATITIS DIAPER
5.3%
1/19 • Number of events 5 • 1 year and 3 months
Skin and subcutaneous tissue disorders
ECZEMA
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Skin and subcutaneous tissue disorders
ERYTHEMA
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Skin and subcutaneous tissue disorders
RASH
15.8%
3/19 • Number of events 3 • 1 year and 3 months
Vascular disorders
HAEMATOMA
5.3%
1/19 • Number of events 1 • 1 year and 3 months
Vascular disorders
VASCULAR RUPTURE
5.3%
1/19 • Number of events 1 • 1 year and 3 months

Additional Information

Study Director

Shire

Phone: +1 866 842 5335

Results disclosure agreements

  • Principal investigator is a sponsor employee Agreements may vary with individual PIs, but contain common elements. For this study, PIs are restricted from independently publishing results until the earlier of the primary multicenter publication or up to 2 years after study completion. Baxter requires a review of results communications (eg for confidential information) ≥30 days prior to submission/communication. Baxter may request additional delay of ≤6 months (e.g., for intellectual property protection). Prior authorization may be required
  • Publication restrictions are in place

Restriction type: OTHER