check_circleStudy Completed

Hemophilia A

Trial to evaluate the effect of secondary prophylaxis with rFVIII therapy in severe hemophilia A adult and/or adolescent subjects compared to that of episodic treatment

Trial purpose

To evaluate the effect of secondary prophylaxis as compared to episodic treatment on bleeding frequency (number of bleeds per year) and on joint damage.

Key Participants Requirements

Sex

Male

Age

12 - 50 Years
  • - Males aged 12 to 50 years (US and Argentina)
    - Males aged 18 to 50 years (other countries)
    - Subjects with severe hemophilia A (<1% FVIII:C) as confirmed by the central lab from a sample obtained at least 96 hours after FVIII administration wash-out. Allow for the inclusion of a maximum of 10% (n=8) of patients with 1-2% FVIII:C baseline levels as long as they exhibit clinical severity and comply with all other inclusion criteria.
    - Subjects with at least 150 prior exposure days with any FVIII
    - Subjects who have been on episodic treatment and no known regular prophylaxis treatment for more than 12 consecutive months in the previous 5 years
    - Subjects with 6 to 24 bleeding events and/or treatments in the previous 6 months prior to study entry which are documented and available in the subjects medical records. Documentation can include records from previous physicians, specific home treatment records, emergency room or hospital records, x-ray reports, etc. The investigator can also document with a detailed note the number of bleeds reported by the subject in the last 6 months.
    - Subjects with inhibitor formation surveillance (inhibitor or recovery testing) over the ten years prior to enrollment documented by the investigator and who do not have a history of any of the following:
     -- A positive inhibitor titer of 5.0 Bethesda Unit (BU) or greater by either BU assay system at any time since first exposure to exogenous factor VIII
     -- A positive inhibitor test result of 1.0 or greater performed by the original BU assay at any time in the past 10 years (A subject can have more than one positive inhibitor test of 0.6 or greater by the original BU assay test but all must be less than 1.0 BU using the original BU assay.)
     -- A positive inhibitor test result of 0.6 or greater performed by the Nijmegen method at any time in the past 10 years
    - Subjects with no inhibitor activity by Nijmegen-modified Bethesda assay, either positive (> 0.6 BU is considered positive) or borderline (> 0.3 and < 0.6 BU is considered borderline) as measured in the current study reference laboratory
  • - Subjects with any other bleeding disease besides hemophilia A (i.e. von Willebrand disease)
    - Subjects with thrombocytopenia (platelets < 100,000/mm3)
    - Subjects with abnormal renal function (Cockcroft-Gault Creatinine Clearance value of 60 mL/min or lower)
    - Subjects with active hepatic disease (Aspartate aminotransferase [AST] or Alanine aminotransferase [ALT] > 5xUpper Limit of Normal (ULN))
    - Subjects on treatment with immunomodulatory agents within the last 3 months prior to study entry or during the study (the following drugs are however allowed: interferon-a treatment for Hepatitis C virus (HCV), Highly active anti-retroviral therapy (HAART) therapy for human immunodeficiency virus (HIV) and/or a total of two courses of pulse treatment with steroids for a maximum of 7 days at 1mg/kg or less)
    - Subjects with an absolute CD4 lymphocyte cell count < 200 cells/mm3 (due to HIV, HCV or another suspected medical condition)
    - Subjects with known hypersensitivity to rFVIII, mouse or hamster proteins
    - Subjects who are receiving or had received other experimental drugs within 1 month prior to study entry
    - Subjects who require any pre-medication to tolerate FVIII injections (e.g. anti-histamines)
    - Subjects who are unwilling to comply with study visits or either of the possible treatment regimens
    - Subjects who have a planned orthopedic intervention to be performed during the study that may substantially affect bleeding (e.g. surgical or chemical or radiological synovectomy)
    - Subjects who are not suitable for participation in this study for any reason, according to the Investigator
    - Subjects who have poor joint status as defined by routine need for a wheelchair or unable to ambulate without the assistance of a brace, cane or crutches
    - Three or more joints that are already fused or "frozen" also called ankylosis

Trial summary

Enrollment Goal
84
Trial Dates
March 2008 - November 2013
Phase
Phase 3
Could I Receive a placebo
No
Products
Kogenate FS (Recombinant Factor VIII, BAY14-2222)
Accepts Healthy Volunteer
No

Where to participate

StatusInstitutionLocation
Completed
Hemophilia Treatment Center of Las VegasLas Vegas, 89109-2803, United States
Completed
Comprehensive Center for Bleeding DisordersMilwaukee, 53226, United States
Completed
University of Minnesota Medical Center-FairviewMinneapolis, 55455, United States
Completed
Mountain States Regional Hemophilia & Thrombosis CenterAurora, 80045, United States
Completed
Children's Hospital of Orange CountyOrange, 92868, United States
Completed
Arkansas Children's HospitalLittle Rock, 72202, United States
Completed
Mount Sinai Medical CenterNew York, 10029, United States
Terminated
Rush University Medical CenterChicago, 60612, United States
Completed
Hemophilia Center of Western PennsylvaniaPittsburgh, 15213, United States
Completed
University of Iowa Hospitals & ClinicsIowa City, 52242-1089, United States
Completed
Northwestern UniversityChicago, 60611, United States
Terminated
Children's Hospital of MichiganDetroit, 48201-2196, United States
Completed
University of LouisvilleLouisville, 40202, United States
Terminated
University of California - DavisSacramento, 95817, United States
Completed
Gulf States Hemophilia & Thrombophilia CenterHouston, 77030, United States
Completed
New York-Presbyterian HospitalNew York, 10065, United States
Completed
Emory UniversityAtlanta, 30322, United States
Completed
Riley Hospital For ChildrenIndianapolis, 46260, United States
Terminated
Georgetown University Medical CenterWashington, 20007-2197, United States
Completed
Penn State Milton S. Hershey Medical CenterHershey, 17033-0850, United States
Terminated
Brigham & Women's HospitalBoston, 02115, United States
Completed
Newark Beth Israel Medical CenterNewark, 07112, United States
Completed
University of Arizona Health Science CenterTucson, 85724, United States
Completed
University of Tennessee Medical CenterKnoxville, 37920, United States
Completed
Nemour's Children's Clinic - OrlandoOrlando, 32801, United States
Completed
Children's Mercy HospitalKansas City, 64108, United States
Completed
MHAT Sveta Marina EADVarna, 9010, Bulgaria
Completed
Hospital Ramos MejíaBuenos Aires, C1221 ADC, Argentina
Completed
University Hospitals Case Medical CenterCleveland, 44106, United States
Completed
University of UtahSalt Lake City, 84132, United States
Completed
Specialized Hospital for Active Treatment of OncologySofia, 1756, Bulgaria
Completed
UMHAT "Sveti Georgi"Plovdiv, 4002, Bulgaria
Completed
Instituto de Hematología Dr. Rubén DávoliRosario, S2000CKF, Argentina
Completed
S.C. SANADOR SRLBucharest, 11026, Romania
Completed
Constanta Clinical Country Emergency HospitalConstanta, 900591, Romania
Terminated
Clinical Emergency Hospital for Children "Louis Turcanu"Timisoara, 300011, Romania
Completed
Fundeni Clinical InstituteBucharest, 022328, Romania
Terminated
Clinical Emergency County Hospital BrasovBrasov, 50035, Romania

Primary Outcome

  • Bleeding Frequency (number of total bleeds)
    date_rangeTime Frame:
    After the last enrolled patient has been in the study for 1 year. At the cut-off, the median follow-up duration was 616 days (minimum was 111 days and maximum was 1109 days)
    enhanced_encryption
    Safety Issue:
    No

Secondary Outcome

  • Change from baseline to 3 years in the MRI (Magnetic resonance imaging) scale.
    The Extended MRI Scale total score has a range between 0 (normal unaffected joint) to 45 (maximal joint damage) points. It is composed of 2 domains, the soft tissue domain with a maximum of 9 points and the osteochondral domain with a maximum of 36 points. A single score for each subject was to be calculated from the sum of both domains and the average over all joints for the Extended MRI endpoint. Higher MRI score denotes greater joint structure damage thus a positive change from baseline means worsening.
    date_rangeTime Frame:
    Baseline and 3 years
    enhanced_encryption
    Safety Issue:
    No
  • Change from baseline to 3 years in the Colorado Adult Joint Assessment Scale
    The total joint score is derived for each of six joints: left and right sides for knees (score: 0-25), ankles (score: 0-25), and elbows (score: 0-21). Higher CAJAS (Colorado Adult Joint Assessment Scale) score denotes greater joint structure damage thus a positive change from baseline means worsening.
    date_rangeTime Frame:
    Baseline and 3 years
    enhanced_encryption
    Safety Issue:
    No

Trial design

Randomized, controlled, parallel, prospective trial to evaluate the effect of secondary prophylaxis with rFVIII therapy in severe hemophilia A adult and/or adolescent subjects, as applicable, compared to that of episodic treatment
Trial Type
Interventional
Intervention Type
Biological/Vaccine
Trial Purpose
Treatment
Allocation
Randomized
Blinding
Open Label
Assignment
Parallel Assignment
Trial Arms
2