A Phase III Study on the Safety, Pharmacokinetics and Efficacy of Coagulation Factor VIIa (PERSEPT2)

• ClinicalTrials.gov Identifier: NCT02448680
• Recruitment Status: Completed
• First Posted: May 19, 2015
• Results First Posted: August 28, 2020
• Last Update Posted: September 29, 2020
• Sponsor: LFB USA, Inc.
• Collaborator: Laboratoire français de Fractionnement et de Biotechnologies
• Information provided by (Responsible Party): LFB USA, Inc.

Study Description

Brief Summary:

The purpose of the study is to assess the safety, efficacy and pharmacokinetics of 2 separate dose regimens (75µg/kg and 225 µg/kg) of Coagulation Factor VIIa (Recombinant) for the treatment of bleeding episodes in hemophilia A or B patients with inhibitors to Factor VIII or IX in 12 patients ( birth to <6 years old), and 12 patients (≥6 years old to <12 years old).

Condition or disease	Intervention/treatment	Phase
Hemophilia A With Inhibitors; Hemophilia B With Inhibitors	Biological: Coagulation FVIIa (Recombinant)	Phase 3

Detailed Description:

A Phase III Study on the Safety, Pharmacokinetics, and Efficacy of Coagulation Factor VIIa (Recombinant) in Congenital Hemophilia A or B Pediatric Patients from birth to <12 years old with Inhibitors to Factor VIII or IX: PerSept 2

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 25 participants
• Allocation: Randomized
• Intervention Model: Crossover Assignment
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: A Phase III Study on the Safety, Pharmacokinetics, and Efficacy of Coagulation Factor VIIa (Recombinant) in Congenital Hemophilia A or B Pediatric Patients From Birth to <12 Years Old With Inhibitors to Factor VIII or IX: PerSept 2
• Actual Study Start Date: December 7, 2015
• Actual Primary Completion Date: June 30, 2017
• Actual Study Completion Date: August 30, 2017

Arms and Interventions

Arm	Intervention/treatment
Active Comparator: Coagulation Factor VIIa (Recombinant): 75 µg/kg; 75 µg/kg treatment regimen for 3 months	Biological: Coagulation FVIIa (Recombinant); A cross over design to assess the efficacy of 2 separate dose regimens (75 µg/kg and 225 µg/kg) of Coagulation Factor VIIa (Recombinant) for the treatment of bleeding episodes in hemophilia A or B patients with inhibitors to Factor VIII or Factor IX
Active Comparator: Coagulation Factor VIIa (Recombinant): 225 µg/kg; 225 µg/kg treatment regimen for 3 months	Biological: Coagulation FVIIa (Recombinant); A cross over design to assess the efficacy of 2 separate dose regimens (75 µg/kg and 225 µg/kg) of Coagulation Factor VIIa (Recombinant) for the treatment of bleeding episodes in hemophilia A or B patients with inhibitors to Factor VIII or Factor IX

Outcome Measures

Primary Outcome Measures :

1. Proportion of Successfully Treated Mild/Moderate Bleeding Episodes Per FDA Requirement. [ Time Frame: 12 hours after first administration of study drug ]

   For the primary efficacy endpoint, successful treatment of mild/moderate bleeding episode was defined as meeting all of the following:

   • "Good" or "excellent" response noted by the patient/parent/legal guardian or other caregiver, depending on patient's age and maturity
   • Study drug treatment: No further treatment with LR769 beyond timepoint where a "good" or "excellent" response for this bleeding episode was noted
   • No other hemostatic treatment needed for this bleeding episode
   • No administration of blood products that would indicate continuation of bleeding beyond timepoint where a "good" or "excellent" response for this bleeding episode was noted
   • No increase of pain beyond timepoint where a "good" or "excellent" response for this bleeding episode was noted that could not be explained other than as continuation of bleeding
2. Proportion of Successfully Treated Bleeding Episodes (Mild/Moderate/Severe) Per EMA Definition [ Time Frame: 12 hours after first administration of study drug ]
   • "Good" or "excellent" response noted by the patient/caregiver for mild/moderate bleeding episodes;
   • "Good" or "excellent" response noted by the physician for severe bleeding episodes.

Secondary Outcome Measures :

1. Patient-Reported "Good" or "Excellent" Response for Mild/Moderate Bleeding Episodes [ Time Frame: 12 hour after first administration of study drug ]

   Based on Patient-Reported "Good" or "Excellent" responses as per the below descriptions:

   Good: Symptoms of bleed (e.g., swelling, tenderness, and decreased range of motion in the case of musculoskeletal hemorrhage) had largely been reduced by the treatment, but had not completely disappeared. Symptoms had improved enough to not require more infusions of the study drug.

   Excellent: Full relief of pain and cessation of objective signs of bleed (e.g., swelling, tenderness, and decreased range of motion in the case of musculoskeletal hemorrhage). No additional infusion of study drug was required.

2. Time to Patient Assessment of a "Good" or "Excellent" Response for Mild/Moderate Bleeding Episodes [ Time Frame: Within 24 hours of Bleeding Episode ]

   Categories of Response to Treatment are Described as Follows:

   None: No noticeable effect of the treatment on the bleed or worsening of patient's condition. Continuation of treatment with the study drug was needed.

   Moderate: Some effect of the treatment on the bleed was noticed, e.g., pain decreased or bleeding signs improved, but bleed continued and required continued treatment with the study drug.

   Good: Symptoms of bleed (e.g., swelling, tenderness, and decreased range of motion in the case of musculoskeletal haemorrhage) had largely been reduced by the treatment, but had not completely disappeared. Symptoms had improved enough to not require more infusions of the study drug.

   Excellent: Full relief of pain and cessation of objective signs of bleed (e.g., swelling, tenderness, and decreased range of motion in the case of musculoskeletal haemorrhage). No additional infusion of study drug was required.

3. Number of Administrations of Study Drug Per Mild/Moderate Bleeding Episode [ Time Frame: Within 24 hours of Bleeding Episode ]
   The number of study drug administrations with non-missing dose information in order to treat one mild/moderate bleeding episode.
4. Total Amount of Study Drug Administered Per Mild/Moderate Bleeding Episode [ Time Frame: Within 24 hours of Bleeding Episode ]
   The total amount of study drug administered in order to treat one mild/moderate bleeding episode.

Other Outcome Measures:

1. Mild/Moderate Bleeding Episodes With Successful Pain Relief [ Time Frame: 12 hour after first administration of study drug ]
   Successful pain relief was defined as a Visual Analogue Scale (VAS: 0-100; 0: no pain at all; 100: the worst pain ever possible) pain score at 12 hours after initial study drug administration that was less than the pain score at the start of treatment with study drug.

Eligibility Criteria

• Ages Eligible for Study: up to 11 Years (Child)
• Sexes Eligible for Study: Male
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• be male with a diagnosis of congenital hemophilia A or B of any severity
• have one of the following:
• a positive inhibitor test BU ≥5, OR
• a Bethesda Unit (BU) <5 but expected to have a high anamnestic response to FVIII or FIX, as demonstrated from the patient's medical history, precluding the use of factor VIII or IX products to treat bleeding episodes, OR
• a BU <5 but expected to be refractory to increased dosing of FVIII or FIX, as demonstrated from the patient's medical history, precluding the use of factor VIII or IX products to treat bleeding episodes
• be aged from birth to <12 years old
• have experienced at least 3 bleeding episodes of any severity in the past 6 months
• parents or legal guardians must be capable of understanding and be willing to comply with the conditions of the protocol
• parents or legal guardians must have read, understood, and provided written informed consent

Exclusion Criteria:

• have any coagulation disorder other than hemophilia A or B
• be immunosuppressed (i.e., the patient may not be receiving systemic immunosuppressive medication; cluster of differentiation 4 (CD4) counts at screening must be >200/µL)
• have a known allergy or hypersensitivity to rabbits
• have platelet count <100,000/mL
• have had a major surgical procedure (e.g. orthopedic, abdominal) within 1 month prior to first administration of study drug
• have received an investigational drug within 30 days of first study drug administration, or be expected to receive such drug during participation in this study

Contacts and Locations

Locations

United States, Colorado

University of Colorado Denver Hemophilia & Thrombosis Center

Aurora, Colorado, United States, 80045

United States, Oklahoma

Jimmy Everest Center for Cancer and Bleeding Disorders

Oklahoma City, Oklahoma, United States, 73117

United States, Texas

UT Southwestern Medical Center at Dallas / Children's Medical Center

Dallas, Texas, United States, 75390

Bulgaria

University Multiprofile Hospital for Active Treatment "Sveti Georgi"

Plovdiv, Bulgaria

Czechia

University Hospital Motol

Prague, Czechia

Georgia

Hematology of Department Hemophilia and Thromboses center

Tbilisi, Georgia

South Africa

Worthwhile Clinical Trials

Benoni, South Africa

Ukraine

National Specialized Children's Hospital OKHMATDYT, Centre for Hemostatic Pathology (Ukraine)

Kyiv, Ukraine

Institute of Blood Pathology and Transfusion Medicine

Lviv, Ukraine

Sponsors and Collaborators

LFB USA, Inc.

Laboratoire français de Fractionnement et de Biotechnologies

Investigators

• Principal Investigator: Michael Wang, MD; University of Colorado, Denver

  Study Documents (Full-Text)

Documents provided by LFB USA, Inc.:

Statistical Analysis Plan: Final Version 2.0  [PDF] September 12, 2017

Study Protocol  [PDF] June 29, 2016

Statistical Analysis Plan: Statistical Analysis Plan (v2.0) Addendum  [PDF] September 25, 2017

More Information

• Responsible Party: LFB USA, Inc.
• ClinicalTrials.gov Identifier: NCT02448680
• Other Study ID Numbers: LFB-FVIIa-007-14
• First Posted: May 19, 2015
• Results First Posted: August 28, 2020
• Last Update Posted: September 29, 2020
• Last Verified: September 2020

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

Additional relevant MeSH terms:

Hemophilia A; Hemophilia B; Blood Coagulation Disorders, Inherited; Blood Coagulation Disorders; Hematologic Diseases; Coagulation Protein Disorders; Hemorrhagic Disorders; Genetic Diseases, Inborn; Genetic Diseases, X-Linked