Trial Outcomes & Findings for Phase III Study of Coagulation FVIIa (Recombinant) in Congenital Hemophilia A or B Patients With Inhibitors (NCT NCT02020369)

NCT ID: NCT02020369

Last Updated: 2017-06-14

Results Overview

For the primary efficacy endpoint, successful treatment of a bleeding episode was defined as a combination of the following: * "Good" or "Excellent" response noted by the patient * Study drug treatment: No further treatment with study drug beyond timepoint for this bleeding episode * No other hemostatic treatment needed for this bleeding episode * No administration of blood products that would indicate continuation of bleeding beyond timepoint * No increase of pain beyond timepoint that could not otherwise be explained

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

27 participants

Primary outcome timeframe

12 hours after first administration of study drug

Results posted on

2017-06-14

Participant Flow

Participant milestones

Participant milestones
Measure
FVIIa: 225 µg/kg First, Then 75 µg/kg
Coagulation Factor VIIa (Recombinant) : First Intervention (3 months), Second Intervention (3 months), repeat sequence for entirety of study.
FVIIa: 75 µg/kg First, Then 225 µg/kg
Coagulation Factor VIIa (Recombinant): Coagulation Factor VIIa (Recombinant) : First Intervention (3 months), Second Intervention (3 months), repeat sequence for entirety of study.
Overall Study
STARTED
14
13
Overall Study
COMPLETED
11
11
Overall Study
NOT COMPLETED
3
2

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Phase III Study of Coagulation FVIIa (Recombinant) in Congenital Hemophilia A or B Patients With Inhibitors

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
FVIIa 75 µg/kg First, Then 225 µg/kg
n=13 Participants
Coagulation Factor VIIa (Recombinant): First Intervention (3 months), Second Intervention (3 months), continue cycle until end of study.
FVIIa 225 µg/kg First, Then 75 µg/kg
n=14 Participants
Coagulation Factor VIIa (Recombinant): First Intervention (3 months), Second Intervention (3 months), continue cycle until end of study.
Total
n=27 Participants
Total of all reporting groups
Age, Categorical
<=18 years
2 Participants
n=5 Participants
3 Participants
n=7 Participants
5 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
11 Participants
n=5 Participants
11 Participants
n=7 Participants
22 Participants
n=5 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Continuous
31.8 years
STANDARD_DEVIATION 12.10 • n=5 Participants
30.1 years
STANDARD_DEVIATION 12.98 • n=7 Participants
31.0 years
STANDARD_DEVIATION 12.35 • n=5 Participants
Sex/Gender, Customized
Male (n)
13 participants
n=5 Participants
14 participants
n=7 Participants
27 participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
12 Participants
n=5 Participants
14 Participants
n=7 Participants
26 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
White
12 Participants
n=5 Participants
13 Participants
n=7 Participants
25 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
Russian Federation
2 participants
n=5 Participants
3 participants
n=7 Participants
5 participants
n=5 Participants
Region of Enrollment
United States
2 participants
n=5 Participants
2 participants
n=7 Participants
4 participants
n=5 Participants
Region of Enrollment
Ukraine
6 participants
n=5 Participants
6 participants
n=7 Participants
12 participants
n=5 Participants
Region of Enrollment
Poland
1 participants
n=5 Participants
0 participants
n=7 Participants
1 participants
n=5 Participants
Region of Enrollment
United Kingdom
0 participants
n=5 Participants
1 participants
n=7 Participants
1 participants
n=5 Participants
Region of Enrollment
Georgia
1 participants
n=5 Participants
1 participants
n=7 Participants
2 participants
n=5 Participants
Region of Enrollment
Bulgaria
1 participants
n=5 Participants
1 participants
n=7 Participants
2 participants
n=5 Participants

PRIMARY outcome

Timeframe: 12 hours after first administration of study drug

Population: Treated Population

For the primary efficacy endpoint, successful treatment of a bleeding episode was defined as a combination of the following: * "Good" or "Excellent" response noted by the patient * Study drug treatment: No further treatment with study drug beyond timepoint for this bleeding episode * No other hemostatic treatment needed for this bleeding episode * No administration of blood products that would indicate continuation of bleeding beyond timepoint * No increase of pain beyond timepoint that could not otherwise be explained

Outcome measures

Outcome measures
Measure
FVIIa 75 µg/kg
n=252 Bleeding Episodes (BEs)
75 µg/kg Treatment Regimen at Time of Mild/Moderate Bleeding Episode
FVIIa 225µg/kg
n=213 Bleeding Episodes (BEs)
225 µg/kg Treatment Regimen at Time of Mild/Moderate Bleeding Episode
Proportion of Successfully Treated Mild/Moderate Bleeding Episodes
.849 Proportion of Success of BEs
Interval 0.74 to 0.957
.932 Proportion of Success of BEs
Interval 0.881 to 0.983

SECONDARY outcome

Timeframe: at 12 hours

Population: Treated Population

Based on Patient-Reported "Good" or "Excellent" responses as per the below descriptions: Good: Symptoms of bleed (e.g., swelling, tenderness, and decreased range of motion in the case of musculoskeletal haemorrhage) had largely been reduced by the treatment, but had not completely disappeared. Symptoms had improved enough to not require more infusions of the study drug. Excellent: Full relief of pain and cessation of objective signs of bleed (e.g., swelling, tenderness, and decreased range of motion in the case of musculoskeletal haemorrhage). No additional infusion of study drug was required.

Outcome measures

Outcome measures
Measure
FVIIa 75 µg/kg
n=252 Bleeding Episodes (BEs)
75 µg/kg Treatment Regimen at Time of Mild/Moderate Bleeding Episode
FVIIa 225µg/kg
n=213 Bleeding Episodes (BEs)
225 µg/kg Treatment Regimen at Time of Mild/Moderate Bleeding Episode
Proportion of Mild/Moderate Bleeding Episodes With Patient (Pt)-Reported "Good" or "Excellent" Responses at 12 Hours
0.857 Pt-reported proportion success of BEs
Interval 0.75 to 0.964
0.937 Pt-reported proportion success of BEs
Interval 0.888 to 0.986

SECONDARY outcome

Timeframe: Within 24 hours of Bleeding Episode

Population: Treated Population with non-missing measurements

Categories of Response to Treatment are Described as Follows: None: No noticeable effect of the treatment on the bleed or worsening of patient's condition. Continuation of treatment with the study drug was needed. Moderate: Some effect of the treatment on the bleed was noticed, e.g., pain decreased or bleeding signs improved, but bleed continued and required continued treatment with the study drug. Good: Symptoms of bleed (e.g., swelling, tenderness, and decreased range of motion in the case of musculoskeletal haemorrhage) had largely been reduced by the treatment, but had not completely disappeared. Symptoms had improved enough to not require more infusions of the study drug. Excellent: Full relief of pain and cessation of objective signs of bleed (e.g., swelling, tenderness, and decreased range of motion in the case of musculoskeletal haemorrhage). No additional infusion of study drug was required.

Outcome measures

Outcome measures
Measure
FVIIa 75 µg/kg
n=240 Bleeding Episodes with event
75 µg/kg Treatment Regimen at Time of Mild/Moderate Bleeding Episode
FVIIa 225µg/kg
n=208 Bleeding Episodes with event
225 µg/kg Treatment Regimen at Time of Mild/Moderate Bleeding Episode
Time to Assessment of a "Good" or "Excellent" Response of Mild/Moderate Bleeding Episodes by the Patient
5.98 Hours
Interval 5.95 to 6.0
3.00 Hours
The confidence interval (CI) for the median time is a pointwise CI. The median was 3 hours and approximately 30% of bleeding episodes had good/excellent response exactly at 3 hours which made the confidence limits non-calculable.

SECONDARY outcome

Timeframe: Within 24 hours of Bleeding Episode

Population: Treated Population with non-missing measurements

Outcome measures

Outcome measures
Measure
FVIIa 75 µg/kg
n=252 Bleeding episodes
75 µg/kg Treatment Regimen at Time of Mild/Moderate Bleeding Episode
FVIIa 225µg/kg
n=211 Bleeding episodes
225 µg/kg Treatment Regimen at Time of Mild/Moderate Bleeding Episode
Number of Administrations of Study Drug Per Mild/Moderate Bleeding Episode
2.5 Number of Administrations of Study Drug
Standard Deviation 1.75
1.4 Number of Administrations of Study Drug
Standard Deviation 0.96

SECONDARY outcome

Timeframe: Through study completion

Population: Treated Population with non-missing measurements

Outcome measures

Outcome measures
Measure
FVIIa 75 µg/kg
n=251 Bleeding Episodes
75 µg/kg Treatment Regimen at Time of Mild/Moderate Bleeding Episode
FVIIa 225µg/kg
n=211 Bleeding Episodes
225 µg/kg Treatment Regimen at Time of Mild/Moderate Bleeding Episode
Total Amount of Study Drug Administered Per Mild/Moderate Bleeding Episode
187.868 µg/kg per bleeding episode
Standard Deviation 131.7982
252.963 µg/kg per bleeding episode
Standard Deviation 78.9732

Adverse Events

Coagulation Factor VIIa (Recombinant): 75 µg/kg

Serious events: 1 serious events
Other events: 3 other events
Deaths: 0 deaths

Coagulation Factor VIIa (Recombinant): 225 µg/kg

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Coagulation Factor VIIa (Recombinant): 75 µg/kg
n=25 participants at risk
Coagulation Factor VIIa (Recombinant): 75 µg/kg for 3 months Coagulation Factor VIIa (Recombinant): A cross over design to assess the efficacy of 2 separate dose regimens (75µg/kg and 225 µg/kg) of Coagulation Factor VIIa (Recombinant) for the treatment of bleeding episodes in hemophilia A or B patients with inhibitors to Factor VIII/IX
Coagulation Factor VIIa (Recombinant): 225 µg/kg
n=25 participants at risk
Coagulation Factor VIIa (Recombinant) : 225 µg/kg for 3 months Coagulation Factor VIIa (Recombinant): A cross over design to assess the efficacy of 2 separate dose regimens (75µg/kg and 225 µg/kg) of Coagulation Factor VIIa (Recombinant) for the treatment of bleeding episodes in hemophilia A or B patients with inhibitors to Factor VIII/IX
Infections and infestations
acute tonsillitis
4.0%
1/25 • Number of events 1 • Adverse event data was collected 2 years, 3 months, 2 days
0.00%
0/25 • Adverse event data was collected 2 years, 3 months, 2 days
Nervous system disorders
subarachnoid hemorrhage
4.0%
1/25 • Number of events 1 • Adverse event data was collected 2 years, 3 months, 2 days
0.00%
0/25 • Adverse event data was collected 2 years, 3 months, 2 days

Other adverse events

Other adverse events
Measure
Coagulation Factor VIIa (Recombinant): 75 µg/kg
n=25 participants at risk
Coagulation Factor VIIa (Recombinant): 75 µg/kg for 3 months Coagulation Factor VIIa (Recombinant): A cross over design to assess the efficacy of 2 separate dose regimens (75µg/kg and 225 µg/kg) of Coagulation Factor VIIa (Recombinant) for the treatment of bleeding episodes in hemophilia A or B patients with inhibitors to Factor VIII/IX
Coagulation Factor VIIa (Recombinant): 225 µg/kg
n=25 participants at risk
Coagulation Factor VIIa (Recombinant) : 225 µg/kg for 3 months Coagulation Factor VIIa (Recombinant): A cross over design to assess the efficacy of 2 separate dose regimens (75µg/kg and 225 µg/kg) of Coagulation Factor VIIa (Recombinant) for the treatment of bleeding episodes in hemophilia A or B patients with inhibitors to Factor VIII/IX
Infections and infestations
Nasopharyngitis
4.0%
1/25 • Number of events 1 • Adverse event data was collected 2 years, 3 months, 2 days
8.0%
2/25 • Number of events 2 • Adverse event data was collected 2 years, 3 months, 2 days
Nervous system disorders
Headache
8.0%
2/25 • Number of events 3 • Adverse event data was collected 2 years, 3 months, 2 days
4.0%
1/25 • Number of events 1 • Adverse event data was collected 2 years, 3 months, 2 days

Additional Information

Jeffry Lawrence, MD, Vice President, Clinical Development

LFB USA Inc.

Phone: +1.508.370.5113

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: LTE60