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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04644575
Registration number
NCT04644575
Ethics application status
Date submitted
23/11/2020
Date registered
25/11/2020
Titles & IDs
Public title
Long-term Safety and Efficacy of Efanesoctocog Alfa (BIVV001) in Previously Treated Patients With Hemophilia A
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Scientific title
A Phase 3 Open-label, Multicenter Study of the Long-term Safety and Efficacy of Intravenous Recombinant Coagulation Factor VIII Fc-von Willebrand Factor-XTEN Fusion Protein (rFVIIIFc-VWF-XTEN; BIVV001) in Previously Treated Patients With Severe Hemophilia A
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Secondary ID [1]
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U1111-1244-0517
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Secondary ID [2]
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LTS16294
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Universal Trial Number (UTN)
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Trial acronym
XTEND-ed
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Hemophilia A
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Condition category
Condition code
Blood
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0
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Clotting disorders
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Human Genetics and Inherited Disorders
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Other human genetics and inherited disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - efanesoctocog alfa (BIVV001)
Experimental: Arm A: Previously treated in BIVV001 study - This arm includes participants who have completed study EFC16293 or study EFC16295, participants who have completed Arm B or Arm C of this study (LTS16294) and roll over into Arm A, and participants who have completed any other potential BIVV001 study. Participants in this arm will continue receiving BIVV001 prophylaxis treatment once weekly (QW) for a total of 100 exposure days (EDs) cumulative from the parent study and this study. Participants will have the opportunity to continue in this study for up to 4 years, unless BIVV001 is commercially available in their applicable participating country.
Experimental: Arm B: Newly initiated (China Only) in BIVV001 - This arm includes Chinese participants of any age who will be newly initiated on BIVV001 prophylaxis treatment once-weekly (QW) for 52 weeks. After 52 weeks of treatment in this arm B, participants will be able to roll over into arm A.
Experimental: Arm C: Newly initiated in BIVV001 with planned major surgery - This arm includes participants of any age who will be newly initiated on BIVV001 prophylaxis treatment once-weekly (QW) and will undergo planned major surgery after at least 6 initial EDs with BIVV001, and within 26 weeks from Day 1. After 52 weeks of treatment in arm C, participants will be able to roll into arm A.
Treatment: Drugs: efanesoctocog alfa (BIVV001)
Pharmaceutical form:Solution for Injection Route of administration: Intravenous
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Number of participants with the occurrence of inhibitor development (neutralizing antibodies detected against factor VIII [FVIII])
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Assessment method [1]
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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.
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Timepoint [1]
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Baseline to month 48
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Secondary outcome [1]
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Annual bleeding rate (ABR)
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Assessment method [1]
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Annualized bleeding rate (ABR) for treated bleeding episodes and all bleeding episodes (including untreated bleeds).
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Timepoint [1]
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Baseline to month 48
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Secondary outcome [2]
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Annualized bleeding rate (ABR) by type of bleed
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Assessment method [2]
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Annualized bleeding rate (ABR) by type during prophylaxis treatment per study arm and parent study.
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Timepoint [2]
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Baseline to month 48
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Secondary outcome [3]
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Annualized bleeding rate (ABR) by location
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Assessment method [3]
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Annualized bleeding rate (ABR) by location during prophylaxis treatment per study arm and parent study.
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Timepoint [3]
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Baseline to month 48
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Secondary outcome [4]
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Percentage of patients who maintain factor VIII (FVIII) above prespecified activity levels
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Assessment method [4]
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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.
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Timepoint [4]
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Baseline to month 48
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Secondary outcome [5]
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Number of injections and dose of BIVV0001 to treat a bleeding episode
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Assessment method [5]
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Timepoint [5]
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Month 48
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Secondary outcome [6]
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Percentage of bleeding episode treated with a single injection of BIVV001
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Assessment method [6]
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Timepoint [6]
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Month 48
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Secondary outcome [7]
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Assessment of response to BIVV001 treatment of individual bleeding episodes
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Assessment method [7]
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Assessment of response to BIVV001 treatment of individual bleeding episodes based on the International Society on Thrombosis and Haemostasis (ISTH) 4-point response scale
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Timepoint [7]
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Baseline to month 48
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Secondary outcome [8]
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Physician's global assessment (PGA) of participants response to BIVV001
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Assessment method [8]
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Physician's global assessment (PGA) of participant's response to BIVV001 treatment based on a 4-point response scale .
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Timepoint [8]
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Baseline to month 48
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Secondary outcome [9]
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Total annualized BIVV001 consumption
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Assessment method [9]
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Total annualized BIVV001 consumption per participant during prophylaxis treatment
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Timepoint [9]
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Baseline to month 48
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Secondary outcome [10]
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Annualized joint bleeding rate (AJBR)
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Assessment method [10]
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0
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Timepoint [10]
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Baseline to month 48
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Secondary outcome [11]
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Target joint resolution
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Assessment method [11]
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Target joint development, resolution and maintenance of target joint resolution based on ISTH criteria.
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Timepoint [11]
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Month 48
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Secondary outcome [12]
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Change from baseline in Hemophilia Joint Health Score (HJHS)
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Assessment method [12]
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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)
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Timepoint [12]
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Baseline to month 48
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Secondary outcome [13]
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Change from baseline in PROMIS-SF Physical Function
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Assessment method [13]
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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).)
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Timepoint [13]
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Baseline to month 48
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Secondary outcome [14]
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Change from baseline in Haem-A-QoL total score and physical health score
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Assessment method [14]
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Change from baseline in Haemophilia QoL Questionnaire for Adults (Haem-A-QoL) total and physical health domain score on participants aged =17 years old.
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Timepoint [14]
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Baseline to month 48
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Secondary outcome [15]
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Change from baselin in Haemo-QoL total score and physical health score
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Assessment method [15]
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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.
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Timepoint [15]
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Baseline to month 48
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Secondary outcome [16]
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Number of participants with adverse events (AEs) and serious adverse events (SAEs)
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Assessment method [16]
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Participants with occurrences of treatment emergent adverse events (AEs) and serious adverse events (SAEs).
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Timepoint [16]
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Baseline to month 48
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Secondary outcome [17]
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Number of participants with the occurrence of embolic and thrombotic events
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Assessment method [17]
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Participants with the occurrence of embolic and thrombotic events.
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Timepoint [17]
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Baseline to month 48
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Secondary outcome [18]
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PK parameter: Maximum activity (Cmax)
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Assessment method [18]
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Timepoint [18]
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Baseline to week 52
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Secondary outcome [19]
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PK parameter: Elimination half-life (t1/2)
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Assessment method [19]
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Timepoint [19]
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Baseline to week 26
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Secondary outcome [20]
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PK parameter: Total clearance (CL)
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Assessment method [20]
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Timepoint [20]
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Baseline to week 26
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Secondary outcome [21]
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PK parameter: Total clearance at steady state (CLss)
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Assessment method [21]
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Timepoint [21]
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Baseline to week 26
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Secondary outcome [22]
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PK parameter: Accumulation index (AI)
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Assessment method [22]
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Timepoint [22]
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Baseline to week 26
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Secondary outcome [23]
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PK parameter: Area under the activity time curve (AUC)
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Assessment method [23]
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Timepoint [23]
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Baseline to week 26
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Secondary outcome [24]
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PK parameter: Volume of distribution at steady state (Vss)
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Assessment method [24]
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Timepoint [24]
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Baseline to week 26
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Secondary outcome [25]
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PK parameter: Mean residence time (MRT)
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Assessment method [25]
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Timepoint [25]
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Baseline to week 26
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Secondary outcome [26]
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PK parameter: Incremental recovery (IR)
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Assessment method [26]
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Timepoint [26]
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Baseline to week 52
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Secondary outcome [27]
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PK parameter: Trough activity (Ctrough)
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Assessment method [27]
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Timepoint [27]
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Baseline to week 52
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Secondary outcome [28]
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PK parameter: Time above FVIII activity levels
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Assessment method [28]
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Timepoint [28]
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Baseline to week 26
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Secondary outcome [29]
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Investigators' or Surgeons' assessment of participant's hemostatic response to BIVV001 treatment
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Assessment method [29]
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Investigators' or Surgeons' assessment of participant's hemostatic response to BIVV001 treatment on the ISTH 4 point response for surgical procedures scale.
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Timepoint [29]
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Baseline to month 48
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Secondary outcome [30]
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Number of injections and dose to maintain hemostasis during perioperative period for major surgery
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Assessment method [30]
0
0
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Timepoint [30]
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Baseline to month 48
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Secondary outcome [31]
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Total BIVV001 consumption during perioperative period for major surgery
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Assessment method [31]
0
0
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Timepoint [31]
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Baseline to month 48
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Secondary outcome [32]
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Number and type of blood component transfusions used during perioperative period for major surgery
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Assessment method [32]
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0
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Timepoint [32]
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Baseline to month 48
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Secondary outcome [33]
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Estimated blood loss during perioperative period for major surgery
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Assessment method [33]
0
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Timepoint [33]
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Baseline to month 48
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Eligibility
Key inclusion criteria
Inclusion 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/µL 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/mm³ 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.
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Minimum age
No limit
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion 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.
The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
23/02/2021
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
15/01/2027
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Actual
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Sample size
Target
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Accrual to date
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Final
261
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,WA
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Recruitment hospital [1]
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Investigational Site Number : 0360004 - Camperdown
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Recruitment hospital [2]
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Investigational Site Number : 0360001 - Westmead
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Recruitment hospital [3]
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Investigational Site Number : 0360002 - South Brisbane
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Recruitment hospital [4]
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Investigational Site Number : 0360003 - Murdoch
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Recruitment postcode(s) [1]
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2050 - Camperdown
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Recruitment postcode(s) [2]
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2145 - Westmead
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Recruitment postcode(s) [3]
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4101 - South Brisbane
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Recruitment postcode(s) [4]
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6961 - Murdoch
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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California
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Country [2]
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United States of America
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State/province [2]
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Florida
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United States of America
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State/province [3]
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Georgia
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Country [4]
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United States of America
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State/province [4]
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Illinois
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Country [5]
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United States of America
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State/province [5]
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Iowa
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Country [6]
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United States of America
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State/province [6]
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Michigan
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Country [7]
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United States of America
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State/province [7]
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Nevada
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Country [8]
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United States of America
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State/province [8]
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New York
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Country [9]
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United States of America
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State/province [9]
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North Carolina
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Country [10]
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United States of America
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State/province [10]
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Ohio
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Country [11]
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United States of America
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State/province [11]
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Washington
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Country [12]
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United States of America
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State/province [12]
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Wisconsin
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Country [13]
0
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Argentina
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State/province [13]
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Ciudad De Buenos Aires
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Country [14]
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Argentina
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State/province [14]
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Mendoza
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Country [15]
0
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Argentina
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State/province [15]
0
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Buenos Aires
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Country [16]
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Belgium
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State/province [16]
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Sint-Lambrechts-Woluwe
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Country [17]
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Brazil
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State/province [17]
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São Paulo
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Country [18]
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Bulgaria
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State/province [18]
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Plovdiv
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Country [19]
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Bulgaria
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State/province [19]
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Sofia
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0
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Canada
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Ontario
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Country [21]
0
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China
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State/province [21]
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Beijing
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Country [22]
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China
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State/province [22]
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Guangzhou
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Country [23]
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China
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State/province [23]
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Hangzhou
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Country [24]
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China
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State/province [24]
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Jinan
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0
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China
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State/province [25]
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Kunming
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0
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China
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State/province [26]
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Lanzhou
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Country [27]
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China
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State/province [27]
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Suzhou
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0
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France
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Brest
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France
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Bron
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France
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Kremlin Bicetre
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France
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Lille
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France
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Marseille
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Germany
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Berlin
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Germany
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Bonn
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Germany
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Frankfurt am Main
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Germany
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München
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Greece
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Athens
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Hungary
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Budapest
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Hungary
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Debrecen
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Hungary
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Pécs
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Ireland
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Dublin
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Italy
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Campania
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Italy
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Milano
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Italy
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State/province [44]
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Vicenza
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Japan
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Aichi
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Japan
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Fukuoka
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Japan
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Kanagawa
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Japan
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Niigata
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Japan
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Tokyo
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Korea, Republic of
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Daegu-gwangyeoksi
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Korea, Republic of
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Seoul-teukbyeolsi
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Netherlands
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Amsterdam
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Netherlands
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Utrecht
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Spain
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Catalunya [Cataluña]
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Spain
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Madrid, Comunidad De
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Sweden
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Malmo
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Switzerland
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Zürich
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Taiwan
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Changhua County
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Taiwan
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Taichung
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0
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Taiwan
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0
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Taipei
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0
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Turkey
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0
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Antalya
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Country [62]
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Turkey
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State/province [62]
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Istanbul
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Turkey
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State/province [63]
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Izmir
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Country [64]
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United Kingdom
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State/province [64]
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London, City Of
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Country [65]
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United Kingdom
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Birmingham
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United Kingdom
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State/province [66]
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Hampshire
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Bioverativ, a Sanofi company
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Ethics approval
Ethics application status
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Summary
Brief summary
Primary Objective: - To evaluate the long-term safety of BIVV001 in previously treated subjects with hemophilia A Secondary Objectives: * To evaluate the efficacy of BIVV001 as a prophylaxis treatment. * To evaluate the efficacy of BIVV001 in the treatment of bleeding episodes. * To evaluate BIVV001 consumption for prevention and treatment of bleeding episodes. * To evaluate the effect of BIVV001 prophylaxis on joint health outcomes. * To evaluate the effect of BIVV001 prophylaxis on Quality of Life (QoL) outcomes. * To evaluate the safety and tolerability of BIVV001 treatment. * To assess the PK of BIVV001 based on the one stage activated partial thromboplastin time (aPTT) and two-stage chromogenic FVIII activity assays (only applicable to Arm B). * To evaluate the efficacy of BIVV001 for perioperative management
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Trial website
https://clinicaltrials.gov/study/NCT04644575
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
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Clinical Sciences & Operations
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Sanofi
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Contact person for public queries
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org
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When will data be available (start and end dates)?
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Available to whom?
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04644575