Clinical Benefit, Safety and PK of Raxibacumab in Subjects Exposed to Bacillus Anthracis
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|ClinicalTrials.gov Identifier: NCT02177721|
Recruitment Status : Not yet recruiting
First Posted : June 30, 2014
Last Update Posted : October 1, 2018
|Condition or disease||Intervention/treatment||Phase|
|Infections, Bacterial||Biological: Collection of samples||Phase 4|
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||100 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Official Title:||A Phase 4, Open-label Field Study (200137) to Evaluate the Clinical Benefit, Safety and Pharmacokinetics in Subjects Treated With Raxibacumab (GSK3068483) Following Exposure to Bacillus Anthracis|
|Estimated Study Start Date :||September 2019|
|Estimated Primary Completion Date :||July 2025|
|Estimated Study Completion Date :||July 2025|
Experimental: Raxibacumab arm
This is an open-label, single arm study. The study will be implemented for subjects who receive FDA-approved raxibacumab as part of medical treatment of anthrax or for post-exposure prophylaxis.
Intervention: Sampling of subjects or use of subjects salvaged standard of care samples may be considered for the following assessments (if available/applicable): pregnancy test, pharmacokinetics (PK) sampling, protective antigen, toxin neutralizing antibody (TNA), anti-raxibacumab antibodies.
Biological: Collection of samples
Whenever possible serum samples will be collected from all subjects to determine serum raxibacumab concentrations pre-infusion, and at specific timepoints post-infusion. In the event cerebrospinal fluid (CSF), pleural, ascites, or bronchoalveolar lavage (BAL) fluid are collected for ad hoc clinical laboratory testing, any remaining excess sample will be provided to Sponsor for determination of raxibacumab concentrations.
Any available serum remaining from ad hoc clinical laboratory specimen collections prior to raxibacumab administration will be provided to Sponsor for measurement of serum PA concentrations. In addition, remaining post raxibacumab dose serum specimens may also be analyzed for TNA or ADA.
- Assessment of clinical benefit by overall survival for cohort 1 [ Time Frame: Up to Week 24 ]Overall survival of subjects treated with raxibacumab for established inhalation anthrax or systemic.
- Assessment of clinical benefit by emergence rate of systemic anthrax infection for Cohort 2 [ Time Frame: Up to Week 24 ]The emergence rate of systemic anthrax infection to week 24 among subjects treated with raxibacumab for post exposure prophylaxis in Cohort 2 will be summarized.
- Assessment of clinical benefit by rate of resolution of edema and healing of lesion without emergence of systemic anthrax infection for cohort 3 [ Time Frame: Up to Week 24 ]Rate of resolution will be assessed for subjects treated with raxibacumab for localized uncomplicated cutaneous infection (without systemic symptoms or toxemia).
- Survival rate on Day 14 and Day 28 [ Time Frame: Up to Day 28 ]Fourteen and 28-day survival rate will be estimated using Kaplan-Meier technique.
- Length of (Intensive Care Unit) ICU stay [ Time Frame: Up to Week 24 ]These continuous endpoints will be summarized in mean, standard deviation, median, minimum, maximum and 95% CI
- Incidence of associated complication of anthrax (meningitis, pleural effusion) [ Time Frame: Up to Day 28 ]These categorical endpoints will be summarized in frequency and percentages
- Incidence of the progression of the disease clinical stage for subject in Cohort 1 [ Time Frame: Up to Week 24 ]The incidence of resolution or worsening of clinical symptoms will be summarized. Resolution of symptoms defined as subject demonstrates stabilization or improvement of clinical symptoms based on clinical findings and worsening of symptoms defined as subject demonstrates worsening of symptoms such that the staging moves from a lower stage to a higher stage.
- Incidence of the progression to systemic anthrax infection for subjects in Cohorts 2 and 3 [ Time Frame: Up to Week 24 ]The progression to systemic anthrax infection will be summarized using Kaplan-Meier technique.
- Summary of the area of wound/lesions for subjects in Cohort 3 [ Time Frame: Up to Week 24 ]The area of wound/lesions will be summarized by visits in mean, standard deviation and confidence interval (if appropriate).
- Summary of significant concurrent medical treatment [ Time Frame: Up to Week 24 ]Significant concurrent medical treatment will be summarised in terms of antibiotics, anthrax vaccine absorbed (AVA), corticosteroids and vasopressors.
- Summary of Adverse Events (AEs) and Serious Adverse Events (SAEs) [ Time Frame: Up to Week 24 ]AEs will be summarized by frequency and proportion of total subjects, system organ class and preferred term. Separate summaries will be produced for all AEs, treatment-related AEs and SAEs.
- Summary of ECG data [ Time Frame: Up to Week 24 ]ECG data and findings (and change from baseline) will be summarized by visit.
- Summary of Vital Signs [ Time Frame: Up to Week 24 ]Vital signs (temperature, heart rate, systolic and diastolic blood pressure, respiration rate, oxygen saturation) will be summarized by visit. Concomitant medications, medical and anthrax history and clinical signs and symptoms of anthrax will be presented in listings.
- Summary of serum raxibacumab concentrations [ Time Frame: Up to Week 24 ]Serum raxibacumab concentrations will be determined by an ECL-based immunoassay. Pharmacokinetic data including Cmax, AUC and t 1/2 will be presented in graphical and/or tabular form and will be summarized descriptively.
- Summary of disease markers: Protective Antigen (PA), toxin neutralizing antibody (TNA) and Anti-drug antibody (ADA) levels [ Time Frame: Up to Week 24 ]If adequate specimen remains after raxibacumab analysis is complete, specimens may also be analyzed for PA concentrations, TNA titers, and presence of anti-raxibacumab antibodies. The results for these endpoints will be descriptively and/or graphically summarized as appropriate to the data.
- Length of hospital stay [ Time Frame: Up to Week 24 ]These continuous endpoints will be summarized in mean, standard deviation, median, minimum, maximum and 95% CI
- Summary of neurological function as assessed by Glasgow Coma Scale or Adelaide Pediatric Scale [ Time Frame: Up to 24 weeks ]These continuous endpoints will be summarized in mean, standard deviation, median, minimum, maximum and 95% CI
- Summary of daily functionality as assessed by Katz ADL [ Time Frame: Up to 24 weeks ]
- Incidence of bacteremia [ Time Frame: Up to 24 weeks ]These categorical endpoints will be summarized in frequency and percentages
- Summary of clinical chemistry and hematology laboratory data [ Time Frame: Up to 24 weeks ]Chemistry and hematology laboratory data (absolute values and change from baseline) will be summarized by visit. The frequency of laboratory abnormalities will be tabulated. Laboratory values will be assessed for significant changes from baseline.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02177721
|Contact: Tim Babinchak, MD||(240) email@example.com|
|Study Director:||Christine Hall, PhD||Emergent BioSolutions|