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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/ct2/show/NCT02234310
Registration number
NCT02234310
Ethics application status
Date submitted
17/07/2014
Date registered
9/09/2014
Date last updated
25/03/2022
Titles & IDs
Public title
Study to Determine the Safety and Efficacy of rFIXFc in Previously Untreated Males With Severe Hemophilia B
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Scientific title
An Open-Label, Multicenter Evaluation of the Safety and Efficacy of Recombinant Coagulation Factor IX Fc Fusion Protein (rFIXFc; BIIB029) in the Prevention and Treatment of Bleeding in Previously Untreated Patients With Severe Hemophilia B
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Secondary ID [1]
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2013-003629-27
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Secondary ID [2]
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998HB303
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Universal Trial Number (UTN)
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Trial acronym
PUPs B-LONG
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Hemophilia B
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Condition category
Condition code
Blood
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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
Other interventions - rFIXFc
Experimental: Recombinant Coagulation Factor IX Fc Fusion Protein (rFIXFc) - Participants received rFIXFc intravenous (IV) injection as follows: Prophylactic treatment regimen: started with rFIXFc 50 International Units per kilogram (IU/kg) weekly until a participant reached at least 50 exposure days (ED=24-hour period in which greater than or equal to (>=1) injection/dose of rFIXFc was given) to rFIXFc, withdrawal from study or end of study. Adjustments to dose and dosing interval was based on incremental recovery, subsequent Factor IX (FIX) levels, physical activity, bleeding pattern, in accordance with local standards of care for prophylactic regimen (PR). Treatment with episodic (on demand) regimen can be initiated before PR at investigators discretion. Episodic (On demand; optional): rFIXFc at individual doses based on participant's clinical condition, type and severity of bleeding event until PR.
Other interventions: rFIXFc
Adjustments to the dose and interval of rFIXFc was made in this study based on investigator discretion using available pharmacokinetic (PK) data, subsequent FIX trough and peak levels, level of physical activity, and bleeding pattern, in accordance with local standards of care for a prophylactic regimen. There was an option to start study dosing as episodic treatment (on-demand).
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Intervention code [1]
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Other interventions
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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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Percentage of Participants With Confirmed Inhibitor Development as Measured by the Nijmegen-Modified Bethesda Assay
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Assessment method [1]
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Development of an inhibitor was defined as an inhibitor test result of >= 0.60 Bethesda units per milliliter (BU/mL) that was confirmed by a second test result of >=0.60 BU/mL from a separate sample, drawn 2 to 4 weeks after the date when the original sample was drawn, with both tests performed by the central laboratory using Nijmegen-modified Bethesda assay.
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Timepoint [1]
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Up to 3 years
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Secondary outcome [1]
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Annualized Number of Bleeding Episodes (Spontaneous and Traumatic) Per Participant (Annualized Bleeding Rate [ABR])
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Assessment method [1]
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ABR was annualized number of bleeding episodes during efficacy period (EP) per participant normalized to a 1-year interval of time. Bleeding episodes were classified as: spontaneous if parent/caregiver/participant records bleeding event when there is no known contributing factor such as definite trauma or antecedent strenuous activity; and traumatic when there is known reason for bleed. ABR=(Number of bleeding episodes during EP/total number of days during EP)*365.25. EP reflects the sum of all intervals of time during which participants were treated with rFIXFc per treatment regimens excluding surgical/rehabilitation periods and large injection intervals (greater than [>]28 days). Participants were included in summary of more than 1 treatment regimen if their regimen changed during study.
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Timepoint [1]
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Up to 3 years
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Secondary outcome [2]
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Annualized Number of Spontaneous Joint Bleeding Episodes
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Assessment method [2]
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Bleeding episodes were classified as spontaneous if parent/caregiver/participant records a bleeding event when there is no known contributing factor such as a definite trauma or antecedent "strenuous" activity. Annualized spontaneous joint bleeding episodes=(Total number of spontaneous joint bleeding episodes during efficacy period (EP) divided by total number of days during EP)*365.25. EP reflects the sum of all intervals of time during which participants were treated with rFIXFc per treatment regimen excluding major and minor surgical/rehabilitation periods and large injection intervals (>28 days). Participants were included in summary of more than 1 treatment regimen if their regimen changed during study.
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Timepoint [2]
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Up to 3 years
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Secondary outcome [3]
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Number of rFIXFc Injections With Excellent or Good, Moderate or None Treatment Response Assessed Using a 4-Point Scale
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Assessment method [3]
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Using e-diary, each participant's parent/caregiver rated treatment response to any bleeding episode (BE) at approximately 8 to 12 hours from time of injection and prior to additional doses of rFIXFc given for same BE using 4-point scale:- 1=Excellent: abrupt pain relief and/or improvement in signs of bleeding within approximately 8 hours after initial injection; 2=Good: definite pain relief and/or improvement in signs of bleeding within approx. 8 hours after injection, but possibly requiring more than 1 injection after 24-48 hours for complete resolution; 3=Moderate: Probable/slight beneficial effect within 8 hours after initial injection and requires more than 1 injection and 4=None: No improvement or condition worsens within approx. 8 hours after initial injection. Participants were included in summary of more than 1 treatment regimen if their regimen changed during study.
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Timepoint [3]
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Up to 3 years
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Secondary outcome [4]
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Total Number of Exposure Days (EDs)
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Assessment method [4]
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An ED was defined as a 24-hour period in which a participant received one or more doses of rFIXFc injections, with the time of the first injection of rFIXFc defined as the start of the ED. Participant who did not have a particular injection type were counted as having zero injections for that type.
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Timepoint [4]
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Up to 3 years
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Secondary outcome [5]
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Total Annualized rFIXFc Consumption Per Participant for the Prevention and Treatment of Bleeding Episodes
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Assessment method [5]
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Total annualized rFIXFc consumption (in IU/kg) was calculated for each participant as: Annualized consumption = (Total IU/kg of rFIXFc during efficacy period (EP) divided by total number of days during EP)*365.25. EP reflects the sum of all intervals of time during which participants were treated with rFIXFc according to the treatment regimens of the study excluding surgical/rehabilitation periods and large injection intervals (> 28 days). Participants were included in summary of more than 1 treatment regimen if their regimen changed during study.
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Timepoint [5]
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Up to 3 years
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Secondary outcome [6]
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Number of Injections of rFIXFc Required to Resolve a Bleeding Episode
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Assessment method [6]
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Number of injections of rFIXFc required to resolve a bleeding episode during efficacy period (EP) were reported. EP reflects the sum of all intervals of time during which participants were treated with rFIXFc according to the treatment regimens of the study excluding surgical/rehabilitation periods and large injection intervals (>28 days). All injections given from the initial sign of a bleed, until the last date/time within the bleed window were counted. Participants were included in summary of more than 1 treatment regimen if their regimen changed during study.
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Timepoint [6]
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Up to 3 years
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Secondary outcome [7]
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Average Dose Per Injection of rFIXFc Required to Resolve a Bleeding Episode
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Assessment method [7]
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The average dose of rFIXFc per injection per bleeding episode was calculated as the average of all doses (IU/kg) administered to treat the bleeding episode during efficacy period (EP). EP begins with the first treatment regimen dose of rFIXFc and ends with the last dose (regardless of the reason for dosing). Surgery/rehabilitation periods are not included in the EP. Participants were included in summary of more than 1 treatment regimen if their regimen changed during study.
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Timepoint [7]
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Up to 3 years
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Secondary outcome [8]
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Change From Baseline in rFIXFc Incremental Recovery (IR)
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Assessment method [8]
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Blood samples were taken at trough and Cmax (maximum concentration) for assessment of incremental recovery, measured by the one-stage clotting assay. IR (International Units per deciliter [IU/dL] per IU/kg) = (Cmax for FIX activity - Pre-dose FIX activity) (IU/dL)/ Actual dose (IU/kg), where Cmax is 30 minute FIX activity post-dose and FIX activity less than (<)0.5 IU/dL was set to 0 IU/dL for calculation of IR.
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Timepoint [8]
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Baseline, Weeks 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, and 144
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Eligibility
Key inclusion criteria
Key
- Weight >=3.5 kilogram at the time of informed consent.
- Severe hemophilia B was defined as less than or equal to (<=)2 International Units per
deciliter (IU/dL) (<=2 percent [%]) endogenous FIX documented in the medical record or
as tested during the Screening Period.
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Minimum age
No limit
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Maximum age
17
Years
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Sex
Males
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Can healthy volunteers participate?
No
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Key exclusion criteria
- History of positive inhibitor testing. A prior history of inhibitors was defined based
on a participant's historical positive inhibitor test using the local laboratory
Bethesda value for a positive inhibitor test (that is equal to or above lower limit of
detection).
- History of hypersensitivity reactions associated with any rFIXFc administration.
- Exposure to blood components or injection with a coagulation factor IX (FIX)
concentrate (including plasma derived) other than rFIXFc.
- Injection with commercially available rFIXFc more than 28 days prior to Screening.
- More than 3 injections of commercially available rFIXFc prior to confirmation of
eligibility.
- Other coagulation disorders in addition to hemophilia B.
- Any concurrent clinically significant major disease that, in the opinion of the
Investigator, would have made the participant unsuitable for enrollment (example HIV
infection with cluster of differentiation 4 (CD4) lymphocyte count less than (<)200
cells/microliter (mcL) or a viral load greater than (>)200 particles/mcL, or any other
known congenital or acquired immunodeficiency).
- Current systemic treatment with chemotherapy and/or other immunosuppressant drugs. Use
of steroids for treatment of asthma or management of acute allergic episodes or
otherwise life-threatening episodes was allowed. Treatment in these circumstances
should not have exceeded a 14-day duration.
- Participation within the past 30 days in any other clinical study involving
investigational treatment.
- Current enrollment in any other clinical study involving investigational treatment.
- Inability to comply with study requirements.
- Other unspecified reasons that, in the opinion of the Investigator or Bioverativ,
would have made the participant unsuitable for enrollment.
NOTE: Other protocol-defined inclusion/exclusion criteria may apply.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
N/A
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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
Completed
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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
13/11/2014
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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
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Actual
20/08/2019
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Sample size
Target
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Accrual to date
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Final
33
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Research Site - Westmead
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Recruitment postcode(s) [1]
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2145 - Westmead
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Recruitment outside Australia
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United States of America
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California
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United States of America
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District of Columbia
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United States of America
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Georgia
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United States of America
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Indiana
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United States of America
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Kentucky
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United States of America
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Louisiana
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United States of America
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Michigan
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United States of America
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Ohio
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United States of America
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Oregon
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United States of America
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Pennsylvania
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Denmark
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Aarhus
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France
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Nord
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France
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Rhone
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Ireland
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Dublin
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Italy
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Milano
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Italy
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Napoli
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Italy
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Parma
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Italy
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Roma
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Netherlands
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Utrecht
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New Zealand
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Auckland
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Poland
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Warszawa
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Sweden
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Malmo
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United Kingdom
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Cambridgeshire
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United Kingdom
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London
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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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Address
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Other collaborator category [1]
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Commercial sector/Industry
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Name [1]
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Swedish Orphan Biovitrum
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Ethics approval
Ethics application status
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Summary
Brief summary
The primary objective of the study was to evaluate the safety of recombinant coagulation
factor IX Fc fusion protein (rFIXFc, BIIB029) in previously untreated patients (PUPs) with
severe hemophilia B. Secondary objectives were to evaluate the efficacy of rFIXFc in the
prevention and treatment of bleeding episodes in PUPs, and to evaluate rFIXFc consumption for
prevention and treatment of bleeding episodes in PUPs.
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Trial website
https://clinicaltrials.gov/ct2/show/NCT02234310
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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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Contact person for scientific queries
Summary Results
For IPD and results data, please see
https://clinicaltrials.gov/ct2/show/NCT02234310
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