Clinical trial NCT04647227: SEVENFACT® for Bleeding Events in Hemophilia With Inhibitors
Official title: Safety of SEVENFACT® for the Treatment of Bleeding Events in Patients With Hemophilia A or B With Inhibitors
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: PHASE4
Conditions: Hemophilia A With Inhibitor
Hemophilia B With Inhibitor
Keywords: Hemophilia A
Hemophilia B
bleeding event
prophylactic treatment
Lead sponsor: American Thrombosis and Hemostasis Network
Sponsor class: NETWORK
Collaborators: name: LFB USA, Inc.
First posted: 2020-11-30
Enrollment: 55
Sex: ALL
Minimum age (years): 12
Maximum age (years): 100
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: ATHN 16 is a phase IV multi-center, US-centric, open-label, safety study
Primary purpose: TREATMENT

Brief summary: Phase IV multi-center, US-centric, open-label, safety study enrolling participants with Hemophilia A or B with inhibitors, 12 years of age and older, who are either on long term prophylactic treatment (e.g., emicizumab) at risk of experiencing a breakthrough bleeding event (BE), or who are not on prophylactic treatment who may need to control a BE.

Detailed description: Primary Objective:

To evaluate the safety of SEVENFACT® when used to treat bleeding episodes in participants with Hemophilia A or B with inhibitors either with or without prophylactic treatment

Study Design:

Phase IV multi-center, US-centric, open-label, safety study enrolling participants with Hemophilia A and B with inhibitors12 years of age and older, who are either on long term prophylactic treatment (e.g., emicizumab) at risk of experiencing a breakthrough bleeding event (BE), or who are not on prophylactic treatment who may need to control a BE.

Study Duration:

Participants will be followed longitudinally from the time of enrollment to the end of their participation in the study. The maximal study duration for any participant in the study will be approximately 4 years from the time of enrollment.

Target Accrual:

This is a multi-site study in which it is anticipated approximately 28 to 55 participants will be enrolled. The study will target enrollment of participants with Hemophilia A and B with inhibitors on prophylaxis with FDA-approved therapies. Enrollment will continue until September 30, 2026, or until the time that the 28th participant is enrolled, whichever comes first.

Data Analysis:

Sample Size Determination:

Results from the study (March 19, 2024, data transfer) with 19 participants enrolled and 3 participant discontinuations were used to calculate the annual bleeding rate for participants receiving prophylactic treatment. Adjusted annualized bleeding rate was calculated at 0.58.

Based on these data, up to 28 participants with hemophilia A and B with inhibitors on FDA-approved prophylaxis treatments will be attempted to enroll.

Analysis Populations:

The Safety Analysis Set is defined as all participants who received at least a single dose of SEVENFACT®. All analyses of safety will be performed based on the safety population, and participants will be analyzed according to the dose of SEVENFACT® that they actually received.

Baseline Characteristics:

Baseline characteristics will be summarized using descriptive statistics for continuous variables, and frequencies and percentages for categorical variables.

Safety Evaluations:

All Adverse Events (AEs) will be graded for severity utilizing Common Terminology Criteria for Adverse Events (CTCAE) v5.0 and coded using Medical Dictionary of Regulatory Activities (MedDRA) version 23.x. The number and percentage of participants with treatment-emergent AEs (TEAEs), serious AEs (SAEs), serious TEAEs and treatment related TEAEs (i.e., adverse drug reactions \[ADRs\]) will be presented for all participants.

The number of TEAEs, as well as the number and percentage of participants with TEAEs, serious TEAEs, and treatment-related TEAEs will be presented by MedDRA System Organ Class (SOC) and preferred term for all participants.

The number and percentage of participants with treatment-emergent adverse event and/or allergic and anaphylactic reactions will be presented for all participants.

Efficacy Evaluations:

There are no pre-specified efficacy endpoints.

Interim Analysis:

An interim analysis will be conducted after 20 participants have been enrolled into the study. The analysis will seek to characterize baseline, disease, dosing and safety outcome profiles of participants treated with SEVENFACT.

Eligibility criteria: Inclusion Criteria:

1. Have a diagnosis of hemophilia A or B with inhibitors.
2. Be 12 years of age and older
3. Be capable of understanding and willing to comply with the conditions of the protocol or have a legal guardian who is capable of understanding and complying with the conditions of the protocol
4. Have read, understood, and documented written informed consent/assent
5. Be able to provide medical evidence through prior medical history of previous inhibitor levels
6. Be willing and able to use the ATHN mobile application or a paper diary to document BEs and medication usage

Exclusion Criteria:

1. Have a disorder of hemostasis in addition to Hemophilia A or B
2. Have a known or suspected intolerance or hypersensitivity to SEVENFACT® or its ingredients
3. Have a known allergy or hypersensitivity to rabbits or rabbit proteins
4. Are receiving prophylactic treatment for bleeding with a drug or biologic that is not approved for this use by the FDA
5. Have had implantation of an investigational medical device within the prior 6 months
6. Have received an investigational drug within 30 days of the baseline visit
7. Have an elective surgical procedure planned during the duration of their participation in the study\*
8. Have any life-threatening disease, or other disease or condition which, in the investigator's judgment, could pose a potential hazard to the patient or interfere with study participation or study outcome (e.g., a history of non responsiveness to bypassing products or thromboembolic disease)

   * Should a participant require an unplanned surgery, the participant will not be withdrawn from the study unless the investigator deems it necessary. Instead, the participant will receive standard of care treatment as determined by the attending physician. If the participant is not withdrawn from the study, the participant's participation in the study will be paused until the investigator feels it is safe for them to continue.

Primary outcomes:
measure: Number of participants and percentage of Safety Events (AEs)
timeFrame: From time of consent through BE onset until 3 days after last dose of SEVENFACT®.
Secondary outcomes:
Other outcomes:
Locations:
city: Phoenix
country: United States
facility: Arizona Hemophilia and Thrombosis Center at Phoenix Children's Hospital
state: Arizona
city: Little Rock
country: United States
facility: Arkansas Center for Bleeding Disorders
state: Arkansas
city: Los Angeles
country: United States
facility: Orthopaedic Institute for Children
state: California
city: Sacramento
country: United States
facility: University of California at Davis UC Davis Hemostasis and Thrombosis Center
state: California
city: Washington
country: United States
facility: Children's National Hemophilia Center
state: District of Columbia
city: Orlando
country: United States
facility: Arnold Palmer Hospital for Children - The Haley Center for Children's Cancer and Blood Disorders
state: Florida
city: Atlanta
country: United States
facility: Hemophilia of Georgia Center for Bleeding and Clotting Disorders of Emory, Adult Division
state: Georgia
city: Savannah
country: United States
facility: Willett Children's Hospital at Memorial University Medical Center
state: Georgia
city: New Orleans
country: United States
facility: Louisiana Center for Bleeding and Clotting Disorders, Tulane
state: Louisiana
city: Boston
country: United States
facility: Massachusetts General Hospital Comprehensive Hemophilia and Thrombosis Treatment Center
state: Massachusetts
city: Detroit
country: United States
facility: Children's Hospital of Michigan
state: Michigan
city: Detroit
country: United States
facility: Henry Ford Health System
state: Michigan
city: Lansing
country: United States
facility: MSU Center for Bleeding and Clotting Disorders
state: Michigan
city: Minneapolis
country: United States
facility: Center for Bleeding and Clotting Disorders, University of Minnesota
state: Minnesota
city: Rochester
country: United States
facility: Mayo Comprehensive Hemophilia Center
state: Minnesota
city: Kansas City
country: United States
facility: Kansas City Regional Hemophilia Center
state: Missouri
city: New Hyde Park
country: United States
facility: Northwell Health, Long Island Jewish
state: New York
city: Greenville
country: United States
facility: Brody School of Medicine at East Carolina University
state: North Carolina
city: Cleveland
country: United States
facility: University Hospitals Health System Cleveland
state: Ohio
city: Oklahoma City
country: United States
facility: Oklahoma Center for Bleeding and Clotting Disorders
state: Oklahoma
city: Nashville
country: United States
facility: Vanderbilt University Medical Center
state: Tennessee
city: Houston
country: United States
facility: Gulf States Hemophilia and Thrombophilia Center-University of Texas Health Science Center @Houston
state: Texas
Study officials:
affiliation: American Thrombosis and Hemostasis Network
name: Tammuella Chrisentery-Singleton, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: University of Minnesota
name: Mark Reding, MD
role: PRINCIPAL_INVESTIGATOR
References: