Study of Subcutaneous Immune Globulin in Patients Requiring IgG Replacement Therapy (EU Extension Study)

Study Description

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Brief Summary:

This study is a continuation of the study ZLB06_001CR with the objective of assessing efficacy, tolerability, safety of IgPro, as well as long-term health-related quality of life in patients with PID.

Condition or disease	Intervention/treatment	Phase
Primary Immunodeficiency (PID)	Biological: IgPro20	Phase 3

Study Design

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Study Type :	Interventional (Clinical Trial)
Actual Enrollment :	40 participants
Intervention Model:	Single Group Assignment
Masking:	None (Open Label)
Primary Purpose:	Treatment
Official Title:	A Multicenter Extension Study of the Efficacy, Tolerability, and Safety of Immune Globulin Subcutaneous (Human) IgPro20 in Subjects With Primary Immunodeficiency (IgPro20 EU Extension Study)
Study Start Date :	August 2008
Actual Primary Completion Date :	December 2011
Actual Study Completion Date :	December 2011

Arms and Interventions

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Arm	Intervention/treatment
Experimental: IgPro20; Subcutaneous (SC) administration by the subject/parent/guardian with the planned weekly dose of IgPro20 to be the same as the subject's last dose recommended by the investigator in study ZLB06_001CR (NCT00542997).	Biological: IgPro20; Other Names: IgG with Proline (IgPro); Hizentra

Outcome Measures

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Primary Outcome Measures :

1. Total Serum IgG Trough Levels [ Time Frame: Up to 42 months ]
   The IgG trough values per subject were aggregated to a median value, and then median values across subjects were summarized using descriptive statistics.

Secondary Outcome Measures :

1. Annualized Rate of Clinically Documented Serious Bacterial Infections (SBIs) [ Time Frame: Up to 42 months ]

   The annualized rate was based on the total number of SBIs and the total number of subject study days for all subjects in the specified analysis population and adjusted to 365 days.

   Potential SBIs included bacterial pneumonia, bacteremia and septicemia, osteomyelitis/septic arthritis, bacterial meningitis, and visceral abscess. If an adverse event (AE) was identified as a potential SBI, the AE was adjudicated by the Medical Monitor and Investigator to determine if the event fulfilled the predefined criteria for SBIs.

2. Annualized Rate of Infection Episodes [ Time Frame: Up to 42 months ]
   The annualized rate was based on the total number of infection episodes occurring during the study divided by the total number of subject study days for all subjects in the specified analysis population and adjusted to 365 days.
3. Number of Infection Episodes [ Time Frame: Up to 42 months ]
   Total number of infections for the specified analysis population
4. Annualized Rate of Days Out of Work / School / Kindergarten / Day Care or Unable to Perform Normal Activities Due to Infections [ Time Frame: Up to 42 months ]
   The annualized rate was based on the total number of days out of work / school / kindergarten / day care or inability to perform normal activities due to infection, and the total number of subject diary days for all subjects in the specified analysis population and adjusted to 365 days.
5. Number of Days Out of Work / School / Kindergarten / Day Care or Unable to Perform Normal Activities Due to Infections [ Time Frame: Up to 42 months ]
   Total number of days out of work / school / kindergarten / day care or unable to perform normal activities due to infections, for the specified analysis population
6. Annualized Rate of Hospitalization Due to Infections [ Time Frame: Up to 42 months ]
   The annualized rate was based on the total number of days of hospitalization due to infections and the total number of subject diary days for all subjects in the specified analysis population and adjusted to 365 days.
7. Number of Days of Hospitalization Due to Infections [ Time Frame: Up to 42 months ]
   Total number of days of hospitalization due to infections for the specified analysis population
8. Use of Antibiotics for Infection Prophylaxis and Treatment [ Time Frame: Up to 42 months ]
   Annualized rate of days with antibiotics for infection prophylaxis and treatment. The annualized rate was based on the total number of days of antibiotic use for infection prophylaxis and treatment in the efficacy period, and the total number of subject study days for all subjects in the specified analysis population, and adjusted to 365 days.
9. Health Related Quality of Life (Short Form 36 Health Survey) [ Time Frame: At baseline and at the last available post-baseline observation for each subject (up to 42 months) ]
   The Short Form 36 Health Survey (SF-36) is a 36-item questionnaire that measures generic health concepts that are relevant across age, disease, and treatment groups. The questions are grouped into eight domains: physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health. Scores range from 0 to 100, with higher scores indicating a better health state.
10. Clinically Relevant Changes in Vital Signs From Baseline to the Completion Visit. [ Time Frame: At baseline (data either from Infusion 40 or the completion visit of study ZLB06_001CR), and at completion (up to 42 months). ]
    The total number of subjects with clinically relevant changes in vital signs from baseline to the completion visit. Vital signs included heart rate, systolic blood pressure, diastolic blood pressure, and body temperature.
11. Clinically Significant Abnormal Changes in Routine Laboratory Parameters Between Baseline and the Completion Visit. [ Time Frame: At baseline (data either from Infusion 40 or the completion visit of study ZLB06_001CR), and at completion (up to 42 months). ]
    The total number of subjects with clinically significant abnormal changes in routine laboratory parameters between baseline and the completion visit. Routine laboratory parameters included haematology, serum chemistry and urinalysis.
12. Rate, Severity and Relatedness of Any Adverse Events (AEs) Per Infusion [ Time Frame: Up to 42 months ]
    The rate of AEs was the number of AEs over the number of infusions administered. Mild AE: Did not interfere with routine activities; Moderate AE: Interfered somewhat with routine activities; Severe AE: Impossible to perform routine activities. At least possibly related AEs included possibly related AEs, probably related AEs, and related AEs.

Eligibility Criteria

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Ages Eligible for Study:	2 Years to 65 Years (Child, Adult)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

• Subjects with primary humoral immunodeficiency, namely with a diagnosis of Common variable immunodeficiency (CVID) as defined by the Pan-American Group for Immunodeficiency (PAGID) and the European Society for Immunodeficiencies (ESID), or X-linked agammaglobulinemia (XLA) as defined by PAGID and ESID, or autosomal recessive agammaglobulinemia who have participated in the study ZLB06_001CR and who have tolerated IgPro well
• Written informed consent

Exclusion Criteria:

• Hypoalbuminemia, protein-losing enteropathies, and any proteinuria (defined as total urine protein concentration > 0.2g/L)
• Other significant medical conditions that could increase the risk to the subject
• Females who are pregnant, breast feeding or planning a pregnancy during the course of the study
• Participation in a study with an investigational medicinal product within three months prior to enrollment, except for ZLB06_001CR
• Evidence of uncooperative attitude
• Any condition that is likely to interfere with evaluation of the IMP or satisfactory conduct of the study
• Subjects who are employees at the investigational site, relatives or spouse of the investigator

Contacts and Locations

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Locations

France
Study Site
Paris, France, 75743
Germany
Study Site
Berlin, Germany, 13353
Study Site
Freiburg, Germany, 79095
Study Site
Leipzig, Germany, 04129
Study Site
Mainz, Germany, 55131
Poland
Study Site
Warsaw, Poland
Romania
Study Site
Cluj-Napoca, Romania, 400162
Study Site
Timisoara, Romania, 300011
Spain
Study Site
Barcelona, Spain, 08036
Study Site
Sevilla, Spain, 41013
Sweden
Study Site
Göteborg, Sweden, 41685
Switzerland
Study Site
Bern, Switzerland, 3010
United Kingdom
Study Site
London, United Kingdom, EC1A7BE

Sponsors and Collaborators

CSL Behring

Investigators

Study Director:	Program Director, Clinical R&D	CSL Behring

More Information

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Additional Information:

Click here to request more information about this study 

Publications of Results:

Jolles S, Borte M, Nelson RP Jr, Rojavin M, Bexon M, Lawo JP, Wasserman RL. Long-term efficacy, safety, and tolerability of Hizentra® for treatment of primary immunodeficiency disease. Clin Immunol. 2014 Feb;150(2):161-9. doi: 10.1016/j.clim.2013.10.008. Epub 2013 Oct 26.

Responsible Party:	CSL Behring
ClinicalTrials.gov Identifier:	NCT00751621 History of Changes
Other Study ID Numbers:	ZLB07_002CR; 1472 ( Other Identifier: CSL Behring ); 2008-000830-30 ( EudraCT Number )
First Posted:	September 12, 2008
Results First Posted:	January 25, 2013
Last Update Posted:	April 2, 2014
Last Verified:	December 2012

Keywords provided by CSL Behring:

Immune globulin subcutaneous; SCIG; primary immunodeficiency; PID

Additional relevant MeSH terms:

Immunologic Deficiency Syndromes; Immune System Diseases; Immunoglobulins; Antibodies; gamma-Globulins	Immunoglobulins, Intravenous; Rho(D) Immune Globulin; Immunologic Factors; Physiological Effects of Drugs