Long-term safety and efficacy of BIVV001 in Previously Treated Patients with hemophilia A

JRCT ID: jRCT2031210133

Registered date:04/06/2021

Basic Information

• Recruitment status: Not Recruiting
• Health condition(s) or Problem(s) studied: Hemophilia A
• Date of first enrollment: 30/06/2021
• Target sample size: 262
• Countries of recruitment: China,Japan,United States,Japan,Argentina,Japan,Australia,Japan,Belgium,Japan,Bulgaria,Japan,Canada,Japan,France,Japan,Germany,Japan,Greece,Japan,Hungary,Japan,Italy,Japan,Netherlands,Japan,Spain,Japan,United Kingdom,Japan,Brazil,Japan,Korea,Japan,Taiwan,Japan
• Study type: Interventional

Intervention(s)

Drug: efanesoctocog alfa (BIVV001)
Pharmaceutical form:Solution for Injection, Route of administration: Intravenous

Outcome(s)

Primary Outcome

1. Number of participants with the occurrence of inhibitor development (neutralizing antibodies detected against factor VIII [FVIII]) [ Time Frame: Baseline to month 48 ]
The number of participants with the occurrence of inhibitor development (neuatralizing antibodies detected against factor VIII [FVIII]) as determined via the Nijmegen modified Bethesda assay.

Secondary Outcome

1. Annual bleeding rate (ABR) [ Time Frame: Baseline to month 48 ]
Annualized bleeding rate (ABR) for treated bleeding episodes and all bleeding episodes (including untreated bleeds).

2. Annualized bleeding rate (ABR) by type of bleed [ Time Frame: Baseline to month 48 ]
Annualized bleeding rate (ABR) by type during prophylaxis treatment per study arm and parent study.

3. Annualized bleeding rate (ABR) by location [ Time Frame: Baseline to month 48 ]
Annualized bleeding rate (ABR) by location during prophylaxis treatment per study arm and parent study.

4. Percentage of patients who maintain factor VIII (FVIII) above prespecified activity levels [ Time Frame: Baseline to month 48 ]
Percentage of participants who maintain factor VIII (FVIII) activity levels over 7 days post dose during prophylaxis treatment per study arm and per parent study or arm.

5. Number of injections and dose of BIVV0001 to treat a bleeding episode [ Time Frame: Month 48 ]

6. Percentage of bleeding episode treated with a single injection of BIVV001 [ Time Frame: Month 48 ]

7. Assessment of response to BIVV001 treatment of individual bleeding episodes [ Time Frame: Baseline to month 48 ]
Assessment of response to BIVV001 treatment of individual bleeding episodes based on the International Society on Thrombosis and Haemostasis (ISTH) 4-point response scale

8.Physician's global assessment (PGA) of participants response to BIVV001 [ Time Frame: Baseline to month 48 ]
Physician's global assessment (PGA) of participant's response to BIVV001 treatment based on a 4-point response scale.

9. Total annualized BIVV001 consumption [ Time Frame: Baseline to month 48 ]
Total annualized BIVV001 consumption per participant during prophylaxis treatment

10. Annualized joint bleeding rate (AJBR) [ Time Frame: Baseline to month 48 ]

11. Target joint resolution [ Time Frame: Month 48 ]
Target joint development, resolution and maintenance of target joint resolution based on ISTH criteria.

12. Change from baseline in Hemophilia Joint Health Score (HJHS) [ Time Frame: Baseline to month 48 ]
Change from Baseline to the end of study visit in total score and domain scores (eg, swelling and strength) assessed by the Hemophilia Joint Health Score (HJHS)

13. Change from baseline in PROMIS-SF Physical Function [ Time Frame: Baseline to month 48 ]
Change in Quality of Life (QoL) measures from baseline to end of study visit per study arm and per parent study arm: PROMIS-SF Physical Function (participants aged >=18 years old).)

14. Change from baseline in Haem-A-QoL total score and physical health score [ Time Frame: Baseline to month 48 ]
Change from baseline in Haemophilia QoL Questionnaire for Adults (Haem-A-QoL) total and physical health domain score on participants aged >=17 years old.

15. Change from baselin in Haemo-QoL total score and physical health score [ Time Frame: Baseline to month 48 ]
Change from baseline in Haemophilia QoL Questionnaire for Children (Haemo-QoL) total and physical health domain score on participants aged >=4 to 16 years old and parent proxy for participants aged >=4 to to <12 years old.

16. Number of participants with adverse events (AEs) and serious adverse events (SAEs) [ Time Frame: Baseline to month 48 ]
Participants with occurrences of treatment emergent adverse events (AEs) and serious adverse events (SAEs).

17. Number of participants with the occurrence of embolic and thrombotic events [ Time Frame: Baseline to month 48 ]
Participants with the occurrence of embolic and thrombotic events.

18. PK parameter: Maximum activity (Cmax) [ Time Frame: Baseline to week 52 ]

19. PK parameter: Elimination half-life (t1/2) [ Time Frame: Baseline to week 26 ]

20. PK parameter: Total clearance (CL) [ Time Frame: Baseline to week 26 ]

21. PK parameter: Total clearance at steady state (CLss) [ Time Frame: Baseline to week 26 ]

22. PK parameter: Accumulation index (AI) [ Time Frame: Baseline to week 26 ]

23. PK parameter: Area under the activity time curve (AUC) [ Time Frame: Baseline to week 26 ]

24. PK parameter: Volume of distribution at steady state (Vss) [ Time Frame: Baseline to week 26 ]

25. PK parameter: Mean residence time (MRT) [ Time Frame: Baseline to week 26 ]

26. PK parameter: Incremental recovery (IR) [ Time Frame: Baseline to week 52 ]

27. PK parameter: Trough activity (Ctrough) [ Time Frame: Baseline to week 52 ]

28. PK parameter: Time above FVIII activity levels [ Time Frame: Baseline to week 26 ]

29. Investigators' or Surgeons' assessment of participant's hemostatic response to BIVV001 treatment [ Time Frame: Baseline to month 48 ]
Investigators' or Surgeons' assessment of participant's hemostatic response to BIVV001 treatment on the ISTH 4 point response for surgical procedures scale.

30. Number of injections and dose to maintain hemostasis during perioperative period for major surgery [ Time Frame: Baseline to month 48 ]

31. Total BIVV001 consumption during perioperative period for major surgery [ Time Frame: Baseline to month 48 ]

32. Number and type of blood component transfusions used during perioperative period for major surgery [ Time Frame: Baseline to month 48 ]

33. Estimated blood loss during perioperative period for major surgery [ Time Frame: Baseline to month 48 ]

Key inclusion & exclusion criteria

• Age minimum: Not applicable
• Age maximum: Not applicable
• Gender: Both

Include criteria

For participants rolling over into Arm A
- Participants who have completed the studies EFC16923, EFC16925, Arm B or Arm C of the current study, or any other potential BIVV001 study.
- Male or Female

For participants new to BIVV001 (Arm B and C)
- Participants who have severe hemophilia A, defined as <1 IU/dL (<1%) endogenous FVIII activity as documented either by central laboratory testing at screening or in historical medical records from a clinical laboratory demonstrating <1% FVIII coagulant activity (FVIII:C) or a documented genotype known to produce severe hemophilia A.
- Previous treatment for hemophilia A (prophylaxis or on-demand) with any recombinant and/or plasma-derived FVIII, or cryoprecipitate for at least 150 EDs or 50 EDs for participants aged <6 years.
- Platelet count >=100 000 cells/microL at screening.
- A participant known to be human immunodeficiency virus (HIV) antibody positive, either previously documented or identified from screening assessments, must have the following results prior to enrollment: CD4 lymphocyte count >200 cells/mm^3 and viral load of <400 000 copies/mL
- Male
- Only for Arm B: Chinese participants
- Only for Arm C: planned major surgery within 6 months after Day 1.

Exclude criteria

For participants rolling over into Arm A
- Positive inhibitor result, defined as >=0.6 Bethesda units (BU)/mL.
- Participation in another study.

For participants new to BIVV001 (Arm B and Arm C)
- Any concurrent clinically significant liver disease that, in the opinion of the Investigator, would make the participant unsuitable for enrollment. This may include, but is not limited to cirrhosis, portal hypertension, and acute hepatitis.
- Serious active bacterial, fungal, or viral infection (other than chronic hepatitis or HIV) present within 30 days of screening.
- Other known coagulation disorder(s) in addition to hemophilia A.
- History of hypersensitivity or anaphylaxis associated with any FVIII product.
- History of a positive inhibitor (to FVIII) test defined as >=0.6 BU/mL, or any value greater than or equal to the lower sensitivity cut-off for laboratories with cut-offs for inhibitor detection between 0.7 and 1.0 BU/mL, or clinical signs or symptoms of decreased response to FVIII administrations. Family history of inhibitors will not exclude the participant.
- Positive inhibitor test (FVIII) result, defined as >=0.6 BU/mL at screening.
- Treatment with acetylsalicylic acid (ASA) or antiplatelet agents that are not nonsteroidal anti-inflammatory drugs (NSAIDs) within 2 weeks prior to screening.
- Treatment with NSAIDs greater than the maximum dose specified in the regional prescribing information within 2 weeks prior to screening.
- Systemic treatment within 12 weeks prior to Screening with chemotherapy and/or other immunosuppressive drugs (except for the treatment of hepatitis C virus [HCV] or HIV).
- Emicizumab use within the 20 weeks prior to screening.
- Major surgery within 8 weeks prior to screening.

Related Information

• Primary Sponsor: Tanaka Tomoyuki
• Secondary ID(s): NCT04644575,2020-002215-22