Trial Outcomes & Findings for Bleeding Incidence in VWD Patients Undergoing On-Demand Treatment (NCT NCT04053699)

NCT ID: NCT04053699

Last Updated: 2023-12-07

Results Overview

The total annualized bleeding rate (TABR) will be calculated as the total number of spontaneous bleeds, traumatic BEs, and other BEs occurring in the time period between the start of data collection for each patient and the Study Completion Visit, divided by the duration (in years) between the start of data collection and the Study Completion Visit. Surgery periods, and BEs occurring within these surgery periods, will be excluded from the calculation of TABR.

Recruitment status

COMPLETED

Target enrollment

56 participants

Primary outcome timeframe

Screening through study completion (6 months)

Results posted on

2023-12-07

Participant Flow

Participant milestones

Participant milestones
Measure
Patients Undergoing On-demand Treatment With a VWF-containing Product
Patients with type 3, type 2 (except 2N), or severe type 1 Von Willebrand Disease (VWD) undergoing routine on-demand treatment with a VWF-containing product over a period of 6 months VWF-containing products: Active substances: VWF concentrates, VWF/FVIII concentrates, Cryoprecipitate VWF-containing products licensed in each participating country Fifty-six patient were screened and enrolled at 15 centers in 8 countries. 14 patients were excluded from the efficacy analyses due to major deviations, resulting in 42 patients in the per protocol (PP) set.
Full Analysis Set
STARTED
56
Full Analysis Set
COMPLETED
51
Full Analysis Set
NOT COMPLETED
5
Per Protocol Set
STARTED
42
Per Protocol Set
COMPLETED
42
Per Protocol Set
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Bleeding Incidence in VWD Patients Undergoing On-Demand Treatment

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Patients Undergoing On-demand Treatment With a VWF-containing Product
n=56 Participants
Patients with type 3, type 2 (except 2N), or severe type 1 VWD undergoing routine on-demand treatment with a VWF-containing product over a period of 6 months VWF-containing products: Active substances: VWF concentrates, VWF/FVIII concentrates, Cryoprecipitate VWF-containing products licensed in each participating country
Age, Customized
6-11 years
15 Participants
n=5 Participants
Age, Customized
12-16 years
16 Participants
n=5 Participants
Age, Customized
>16 years
25 Participants
n=5 Participants
Sex: Female, Male
Female
25 Participants
n=5 Participants
Sex: Female, Male
Male
31 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=5 Participants
Race (NIH/OMB)
White
55 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Screening through study completion (6 months)

The total annualized bleeding rate (TABR) will be calculated as the total number of spontaneous bleeds, traumatic BEs, and other BEs occurring in the time period between the start of data collection for each patient and the Study Completion Visit, divided by the duration (in years) between the start of data collection and the Study Completion Visit. Surgery periods, and BEs occurring within these surgery periods, will be excluded from the calculation of TABR.

Outcome measures

Outcome measures
Measure
Patients Undergoing On-demand Treatment With a VWF-containing Product
n=42 Participants
Patients with type 3, type 2 (except 2N), or severe type 1 VWF activity undergoing routine on-demand treatment with a VWF-containing product over a period of 6 months VWF-containing products: Active substances: VWF concentrates, VWF/FVIII concentrates, Cryoprecipitate VWF-containing products licensed in each participating country
Total Annualized Bleeding Rate (TABR)
29.13 Bleeding events per year
Standard Deviation 22.925

SECONDARY outcome

Timeframe: Screening through study completion (6 months)

Spontaneous annualized bleeding rate (SABR), calculated in analogy with TABR. This includes all bleeding episodes that occurred spontaneously.

Outcome measures

Outcome measures
Measure
Patients Undergoing On-demand Treatment With a VWF-containing Product
n=42 Participants
Patients with type 3, type 2 (except 2N), or severe type 1 VWF activity undergoing routine on-demand treatment with a VWF-containing product over a period of 6 months VWF-containing products: Active substances: VWF concentrates, VWF/FVIII concentrates, Cryoprecipitate VWF-containing products licensed in each participating country
Spontaneous Annualized Bleeding Rate (SABR)
21.19 Bleeding events per year
Standard Deviation 19.337

SECONDARY outcome

Timeframe: Screening through study completion (6 months)

Population: Four subjects were not treated with VCP, for two subjects the dose administered is unknown for all infusions

Data on the consumption of the VWF-containing product (VWF/FVIII IU/kg per month per patient) used for routine on-demand treatment

Outcome measures

Outcome measures
Measure
Patients Undergoing On-demand Treatment With a VWF-containing Product
n=50 Participants
Patients with type 3, type 2 (except 2N), or severe type 1 VWF activity undergoing routine on-demand treatment with a VWF-containing product over a period of 6 months VWF-containing products: Active substances: VWF concentrates, VWF/FVIII concentrates, Cryoprecipitate VWF-containing products licensed in each participating country
Consumption of the VWF-containing Product
77.94 IUs per kg per month per patient
Standard Deviation 67.898

SECONDARY outcome

Timeframe: Screening through study completion (6 months)

Population: 39 patients who received VWF-containing product in the treatment of BEs

The efficacy assessment of bleeding episodes at the end of a BE was evaluated on a 4 point scale by the patient/legal guardian (together with the Investigator in case of on-site treatment) including the four items 'excellent,' 'good,' moderate,' and 'none.' The assessment was excellent when bleeding was completely stopped within 3 days in case of minor bleed, within 7 days in case of major bleed, and within 10 days in case of gastrointestinal bleed; Good when bleeding was completely stopped, but time and/or dose slightly exceeded expectations ; Moderate when bleeding could be stopped only by significantly exceeding time and/or dose expectations; and None when bleeding could be stopped only by using other VWF-containing products.

Outcome measures

Outcome measures
Measure
Patients Undergoing On-demand Treatment With a VWF-containing Product
n=457 Number of Bleeding Episodes
Patients with type 3, type 2 (except 2N), or severe type 1 VWF activity undergoing routine on-demand treatment with a VWF-containing product over a period of 6 months VWF-containing products: Active substances: VWF concentrates, VWF/FVIII concentrates, Cryoprecipitate VWF-containing products licensed in each participating country
Number of Bleeding Episodes (BEs) Based on a 4-point Efficacy Scale
Excellent
450 Number of Bleeding Episodes
Number of Bleeding Episodes (BEs) Based on a 4-point Efficacy Scale
Good
6 Number of Bleeding Episodes
Number of Bleeding Episodes (BEs) Based on a 4-point Efficacy Scale
Moderate
1 Number of Bleeding Episodes
Number of Bleeding Episodes (BEs) Based on a 4-point Efficacy Scale
None
0 Number of Bleeding Episodes

SECONDARY outcome

Timeframe: From start of surgery until end of post-operative period (within 8 days after surgery)

Population: 6 patients had 7 surgeries that were treated with VWF

Effectiveness of VWF-containing product in surgical prophylaxis based on the proportion of surgeries successfully treated. Overall treatment efficacy will be assessed at the end of the postoperative period by the treating physician using predefined criteria of 'Excellent', 'Good', 'Moderate/Poor' or 'None'.

Outcome measures

Outcome measures
Measure
Patients Undergoing On-demand Treatment With a VWF-containing Product
n=7 Number of Surgeries
Patients with type 3, type 2 (except 2N), or severe type 1 VWF activity undergoing routine on-demand treatment with a VWF-containing product over a period of 6 months VWF-containing products: Active substances: VWF concentrates, VWF/FVIII concentrates, Cryoprecipitate VWF-containing products licensed in each participating country
Number of Surgery With Successful/Unsuccessful Efficacy Assessment
Excellent
7 Surgeries
Number of Surgery With Successful/Unsuccessful Efficacy Assessment
Good
0 Surgeries
Number of Surgery With Successful/Unsuccessful Efficacy Assessment
Moderate
0 Surgeries
Number of Surgery With Successful/Unsuccessful Efficacy Assessment
Poor
0 Surgeries

SECONDARY outcome

Timeframe: At screening visit

QoL assessment based on the results from the PROMIS-29 survey to monitor and evaluate the physical, mental, and social health in all patients, using a scale of a minimum score of 0 and a maximum score of 10, with higher scores representing a better outcome. The survey covers seven domains from the most relevant areas of self-reported health (depression, anxiety, physical function, pain interference, fatigue, sleep disturbance and ability to participate in social roles and activities) for the majority of people with chronic illness. PROMIS scores have a mean of 50 and standard deviation (SD) of 10 in a referent population. Full details of cut off points for each domain can be found here: https://www.healthmeasures.net/score-and-interpret/interpret-scores/promis/promis-score-cut-points

Outcome measures

Outcome measures
Measure
Patients Undergoing On-demand Treatment With a VWF-containing Product
n=56 Participants
Patients with type 3, type 2 (except 2N), or severe type 1 VWF activity undergoing routine on-demand treatment with a VWF-containing product over a period of 6 months VWF-containing products: Active substances: VWF concentrates, VWF/FVIII concentrates, Cryoprecipitate VWF-containing products licensed in each participating country
Quality of Life (QoL) Assessed Using the Patient-Reported Outcomes Measurement Information System (PROMIS-29)
Physical Function
47.24 T-Scores
Standard Deviation 7.947
Quality of Life (QoL) Assessed Using the Patient-Reported Outcomes Measurement Information System (PROMIS-29)
Anxiety/Fear
53.57 T-Scores
Standard Deviation 9.941
Quality of Life (QoL) Assessed Using the Patient-Reported Outcomes Measurement Information System (PROMIS-29)
Depression/Sadness
49.96 T-Scores
Standard Deviation 9.265
Quality of Life (QoL) Assessed Using the Patient-Reported Outcomes Measurement Information System (PROMIS-29)
Fatigue
49.77 T-Scores
Standard Deviation 11.202
Quality of Life (QoL) Assessed Using the Patient-Reported Outcomes Measurement Information System (PROMIS-29)
Sleep Disturbance
49.81 T-Scores
Standard Deviation 10.373
Quality of Life (QoL) Assessed Using the Patient-Reported Outcomes Measurement Information System (PROMIS-29)
Ability to Participate in Social Roles/Activities
52.78 T-Scores
Standard Deviation 9.817
Quality of Life (QoL) Assessed Using the Patient-Reported Outcomes Measurement Information System (PROMIS-29)
Pain Interference
53.87 T-Scores
Standard Deviation 11.134

SECONDARY outcome

Timeframe: At screening visit

Population: 31 patients complete SF-36 questionnaire

QoL assessment based on the results from the SF-36v2 questionnaire to measure functional health and well-being in patients ≥16 years. SF-36v2 ranks 8 different domains using a scale standardized with a scoring algorithm to obtain a score ranging from 0 to 100.The eight health domains include physical functioning (PF), role physical (RP), bodily pain (BP), general health problems (GH), vitality (VT), social functioning (SF), role emotional (RE) and general mental health (MH). Higher scores indicate better health status, and a mean score of 50 has been articulated as a normative value for all scales.

Outcome measures

Outcome measures
Measure
Patients Undergoing On-demand Treatment With a VWF-containing Product
n=31 Participants
Patients with type 3, type 2 (except 2N), or severe type 1 VWF activity undergoing routine on-demand treatment with a VWF-containing product over a period of 6 months VWF-containing products: Active substances: VWF concentrates, VWF/FVIII concentrates, Cryoprecipitate VWF-containing products licensed in each participating country
Quality of Life (QoL) Assessed Using a 36-Item Short Form Health Survey, Version 2 (SF-36v2)
Bodily Pain
49.87 Units on a scale
Standard Deviation 27.304
Quality of Life (QoL) Assessed Using a 36-Item Short Form Health Survey, Version 2 (SF-36v2)
General Health
49.45 Units on a scale
Standard Deviation 21.857
Quality of Life (QoL) Assessed Using a 36-Item Short Form Health Survey, Version 2 (SF-36v2)
Mental Health
62.74 Units on a scale
Standard Deviation 16.923
Quality of Life (QoL) Assessed Using a 36-Item Short Form Health Survey, Version 2 (SF-36v2)
Physical Functioning
64.03 Units on a scale
Standard Deviation 24.509
Quality of Life (QoL) Assessed Using a 36-Item Short Form Health Survey, Version 2 (SF-36v2)
Role Emotional
62.63 Units on a scale
Standard Deviation 27.035
Quality of Life (QoL) Assessed Using a 36-Item Short Form Health Survey, Version 2 (SF-36v2)
Role Physical
51.21 Units on a scale
Standard Deviation 25.435
Quality of Life (QoL) Assessed Using a 36-Item Short Form Health Survey, Version 2 (SF-36v2)
Social Functioning
64.52 Units on a scale
Standard Deviation 24.173
Quality of Life (QoL) Assessed Using a 36-Item Short Form Health Survey, Version 2 (SF-36v2)
Vitality
58.06 Units on a scale
Standard Deviation 18.128

SECONDARY outcome

Timeframe: At screening

Population: 25 subjects completed SF-10 questionnaire

QoL assessment based on the results from a SF-10 parent-completed questionnaire for patients ≥5.5 and \<16 years of age, in order to score physical and psychosocial health. SF-10 uses norm-based scoring where scales have a standardized mean value of 50 and standard deviation of 10.

Outcome measures

Outcome measures
Measure
Patients Undergoing On-demand Treatment With a VWF-containing Product
n=25 Participants
Patients with type 3, type 2 (except 2N), or severe type 1 VWF activity undergoing routine on-demand treatment with a VWF-containing product over a period of 6 months VWF-containing products: Active substances: VWF concentrates, VWF/FVIII concentrates, Cryoprecipitate VWF-containing products licensed in each participating country
Quality of Life (QoL) Assessed Using a 10-item Short Form Health Survey (SF-10)
Physical Summary Score
28.60 Units on a scale
Standard Deviation 14.961
Quality of Life (QoL) Assessed Using a 10-item Short Form Health Survey (SF-10)
Psychosocial Summary Score
46.56 Units on a scale
Standard Deviation 9.428

SECONDARY outcome

Timeframe: At screening

Population: 37 patients from 42 patients in the PP set completed HJHS

Joint health status will be assessed using the Hemophilia Joint Health Score (HJHS), which has been specifically validated for the assessment of the clinical outcome in VWD. HJHS evaluates six index joints to produce a score between 0-124. Higher scores indicate worse joint health.

Outcome measures

Outcome measures
Measure
Patients Undergoing On-demand Treatment With a VWF-containing Product
n=37 Participants
Patients with type 3, type 2 (except 2N), or severe type 1 VWF activity undergoing routine on-demand treatment with a VWF-containing product over a period of 6 months VWF-containing products: Active substances: VWF concentrates, VWF/FVIII concentrates, Cryoprecipitate VWF-containing products licensed in each participating country
Joint Health Status Assessed Using Hemophilia Joint Health Score (HJHS)
6.76 Units on a scale
Standard Deviation 14.611

SECONDARY outcome

Timeframe: Screening through study completion (6 months)

Population: All subjects of child bearing potential who experienced menstrual cycle

Bleeding information from each menstrual period while in this study will be collected using the Pictorial Blood Loss Assessment Chart (PBAC). The PBAC will be provided to all female patients of child-bearing potential. The data documented in the PBAC and the investigator-calculated final score will be recorded in the eCRF. The PBAC records pad and tampon use (as either light \[1 point\], medium \[5 points\], or heavy \[10 points\] flow), clots (small \[1 point\] or large \[5 points\]), and flooding episodes (1 point each) which can be recorded as many times as necessary any day of the month. The PBAC is scored from 0 (no bleeding) onwards, with a score of \>100 defining abnormal coagulation and heavy menstrual bleeding (corresponds to \>80ml of blood loss per menstrual cycle).

Outcome measures

Outcome measures
Measure
Patients Undergoing On-demand Treatment With a VWF-containing Product
n=15 Participants
Patients with type 3, type 2 (except 2N), or severe type 1 VWF activity undergoing routine on-demand treatment with a VWF-containing product over a period of 6 months VWF-containing products: Active substances: VWF concentrates, VWF/FVIII concentrates, Cryoprecipitate VWF-containing products licensed in each participating country
Menstrual Bleeding Assessed Using Pictorial Blood Loss Assessment Chart (PBAC) Score
MC01
521.7 Units on a scale
Standard Deviation 790.96
Menstrual Bleeding Assessed Using Pictorial Blood Loss Assessment Chart (PBAC) Score
MC02
279.2 Units on a scale
Standard Deviation 219.69
Menstrual Bleeding Assessed Using Pictorial Blood Loss Assessment Chart (PBAC) Score
MC03
311.0 Units on a scale
Standard Deviation 261.98
Menstrual Bleeding Assessed Using Pictorial Blood Loss Assessment Chart (PBAC) Score
MC04
408.8 Units on a scale
Standard Deviation 471.92
Menstrual Bleeding Assessed Using Pictorial Blood Loss Assessment Chart (PBAC) Score
MC05
289.9 Units on a scale
Standard Deviation 267.53
Menstrual Bleeding Assessed Using Pictorial Blood Loss Assessment Chart (PBAC) Score
MC06
330.4 Units on a scale
Standard Deviation 327.02
Menstrual Bleeding Assessed Using Pictorial Blood Loss Assessment Chart (PBAC) Score
MC07
411.6 Units on a scale
Standard Deviation 314.99
Menstrual Bleeding Assessed Using Pictorial Blood Loss Assessment Chart (PBAC) Score
MC08
348.5 Units on a scale
Standard Deviation 102.53
Menstrual Bleeding Assessed Using Pictorial Blood Loss Assessment Chart (PBAC) Score
MC09
361.5 Units on a scale
Standard Deviation 400.93

SECONDARY outcome

Timeframe: Screening through study completion (6 months)

Population: All participants that were treated with at least one dose of a VWF-containing product

Noxious and unintended reactions arising from the use of Wilate will be monitored throughout the study.

Outcome measures

Outcome measures
Measure
Patients Undergoing On-demand Treatment With a VWF-containing Product
n=52 Participants
Patients with type 3, type 2 (except 2N), or severe type 1 VWF activity undergoing routine on-demand treatment with a VWF-containing product over a period of 6 months VWF-containing products: Active substances: VWF concentrates, VWF/FVIII concentrates, Cryoprecipitate VWF-containing products licensed in each participating country
Number of Participants With Adverse Drug Reactions (ADRs) Associated With Use of Wilate
0 Participants

Adverse Events

Patients Undergoing Treatment With a VWF-containing Product

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

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Sigurd Knaub, Senior VP CR&D Haematology

Octapharma

Phone: 01554512141

Results disclosure agreements

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