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Efficacy, Safety and Pharmacokinetics Study of Kedrion IVIG 10% to Treat Participants With Primary Immunodeficiency (PID)

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ClinicalTrials.gov Identifier: NCT03961009
Recruitment Status : Recruiting
First Posted : May 23, 2019
Last Update Posted : May 23, 2019
Sponsor:
Information provided by (Responsible Party):
Kedrion S.p.A.

Brief Summary:
The purpose of this study is to assess efficacy and safety of Kedrion Immunoglobulin 10% (KIg10) in participants with Primary Immunodeficiency (PID).

Condition or disease Intervention/treatment Phase
Primary Immunodeficiency Disease Biological: Kedrion IVIG 10% Phase 3

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 50 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase III, Open-label, Prospective, Multicenter Study to Assess Efficacy, Safety and Pharmacokinetics of Kedrion Intravenous Immunoglobulin (IVIg) 10% in Primary Immunodeficiency Disease (PID) Patients
Actual Study Start Date : April 30, 2019
Estimated Primary Completion Date : February 16, 2021
Estimated Study Completion Date : February 16, 2021


Arm Intervention/treatment
Experimental: Kedrion IVIG 10%
Participants will receive intravenous infusion of Kedrion IVIG 10% at a dose of 200 to 800 milligram per kilogram (mg/kg) body weight every 21 or 28 days for period of 48 weeks.
Biological: Kedrion IVIG 10%
Kedrion intravenous immunoglobulin (IVIg) 10%




Primary Outcome Measures :
  1. Incidence Rate of Acute Serious Bacterial Infections [ Time Frame: Day 1 up to Week 52 ]
    Incidence rate is defined as the mean number of acute serious bacterial infections (bacterial pneumonia, bacteraemia/sepsis, bacterial meningitis, visceral abscess, osteomyelitis/septic arthritis) per patient-year.


Secondary Outcome Measures :
  1. Serum Immunoglobulin G (IgG) Trough Levels [ Time Frame: Before each infusion and at the study termination visit (Week 51/52) ]
  2. Immunoglobulin G (IgG) Subclasses Levels (IgG1, IgG2, IgG3, IgG4) [ Time Frame: Before infusions on Day 1, 5, 9 and 13 (28-day infusion schedule) and before infusions on Day 1, 7, 11 and 17 (21-day infusion schedule) ]
  3. Number of Participants with Total Immunoglobulin G (IgG) Below 6 Gram Per Liter (g/L) Criteria [ Time Frame: Up to 12 months ]
  4. Anti-Tetanus Toxoid Antibody Level [ Time Frame: Before infusions on Day 1, 5, 9 and 13 (28-day infusion schedule) and before infusions on Day 1, 7, 11 and 17 (21-day infusion schedule) ]
    The quantitative evaluation of the anti-Tetanus toxoid antibody level will be reported.

  5. Anti-Pneumococcal Capsular Polysaccharide Antibody Level [ Time Frame: Before infusions on Day 1, 5, 9 and 13 (28-day infusion schedule) and before infusions on Day 1, 7, 11 and 17 (21-day infusion schedule) ]
    The quantitative evaluation of the Anti-Pneumococcal Capsular Polysaccharide Antibody level will be reported.

  6. Anti-Measles Antibody Level [ Time Frame: Before infusions on Day 1, 5, 9 and 13 (28-day infusion schedule) and before infusions on Day 1, 7, 11 and 17 (21-day infusion schedule) ]
    The quantitative evaluation of the Anti-Measles Antibody level will be reported

  7. Anti-Haemophilus Influenza Type B Antibody Level [ Time Frame: Before infusions on Day 1, 5, 9 and 13 (28-day infusion schedule) and before infusions on Day 1, 7, 11 and 17 (21-day infusion schedule) ]
    The quantitative evaluation of the Anti-Haemophilus Influenza Type B Antibody Level will be reported.

  8. Incidence Rate of Any Infection Other Than Acute Serious Bacterial Infections [ Time Frame: Day 1 up to week 51 and 52 ]
    Information regarding incidence rate of infections other than serious acute bacterial infections collected by the participant/participants parent(s)/legal guardian(s) in the Participant Diary or during clinic visit will be recorded.

  9. Duration Of Any Infection Other Than Acute Serious Bacterial Infections [ Time Frame: Day 1 up to Week 51 and 52 ]
    Information regarding infections (other than serious acute bacterial infections), including the number of days for resolution, collected by the participant/participant's parent(s)/legal guardian(s) in the Participant Diary or during clinic visit will be recorded.

  10. Incidence Rate of Fever Episodes [ Time Frame: Day 1 up to Week 51 and 52 ]
    Information regarding fever episodes collected by the participant/participant's parent(s)/legal guardian(s) in the Participant Diary or during clinic visit will be recorded.

  11. Duration Of Fever Episodes [ Time Frame: Day 1 up to Week 51 and 52 ]
    Information regarding duration of Fever Episodes will be collected by the participant/participant's parent(s)/legal guardian(s) in the Participant Diary or during clinic visit will be recorded.

  12. Overall Hospitalization Days [ Time Frame: Day 1 up to week 51 and 52 ]
    The participant/participant's parent(s)/legal guardian(s) will also provide the information regarding the overall hospitalization days due to infection in the Patient Diary that will be provided starting from the first infusion

  13. Days of Hospitalizations Due To Infection [ Time Frame: Day 1 up to Week 51 and 52 ]
    The participant/participant's parent(s)/legal guardian(s) will also provide the information regarding days of hospitalizations due to infection in the Patient Diary that will be provided starting from the first infusion

  14. Incidence Rate of Participants on Antibiotics for Treatment of Any Kind of Infections [ Time Frame: Day 1 up to Week 51 and 52 ]
    The information regarding the use of therapeutic antibiotics for the treatment of any kind of infections in the Participant Diary will be reported starting from the first infusion visit.

  15. Duration of Participants on Antibiotics for Treatment Of Any Kind of Infection [ Time Frame: Day 1 up to Week 51 and 52 ]
    The information regarding the duration of participant on antibiotics for the treatment of any kind of infections in the Participant Diary that will be reported starting from the first infusion visit.

  16. Days of Missed Work/School/Other Major Activities Due to Infections [ Time Frame: Day 1 up to Week 51 and 52 ]
  17. Pediatric Quality of Life Inventory (Pedsql) Score [ Time Frame: At Baseline, Week 24 and Week 52 ]

    PedsQL™ Measurement Model is a modular approach to measure health-related Quality of Life Questionnaires (QoL) in healthy children,adolescents and those with acute and chronic health conditions. The 23-item PedsQL™ Generic Core Scales were designed to measure the core dimension of health as delineated by the World Health Organization, as well as role (school) functioning. The total scale score (23 items) consists of Physical health summary score (8 items) and Psychosocial health summary score (15 items). Physical health summary includes Physical Functioning (8 items) and Psychosocial health summary score includes Emotional Functioning (5 items), Social Functioning (5 items) and School Functioning (5 items)

    The overall range for PedsQL scores is 0 to 100, with a higher score indicating better quality of life.


  18. Number of Participants Experiencing at Least one Adverse events (AEs) [ Time Frame: Baseline (Day 1) up to Week 52 ]
  19. Number of Participants Experiencing at Least one Serious Adverse Events (SAEs) [ Time Frame: Baseline (Day 1) up to Week 52 ]
  20. Number of Participants Experiencing at Least one Related Infusion Adverse events (AEs) [ Time Frame: Baseline (Day 1) up to Week 52 ]
  21. Number of Infusions With Decreased Infusion Rate Due to Adverse Events (AEs) [ Time Frame: Baseline (Day 1) up to Week 52 ]
  22. Number of Infusions With one or More Infusion Associated Adverse Events (AEs) [ Time Frame: Baseline (Day 1) up to Week 52 ]
  23. Number of Participants With Clinically Significant Change from Baseline Values in Vital Signs, Physical Examinations, Safety Laboratory Tests [ Time Frame: Up to Week 52 ]
    Number of participants with clinically significant change from baseline in vital signs (including blood pressure, heart rate, and temperature); Physical examination (including evaluation of all body systems and body weight); Safety Laboratory Tests (including hematology, serum chemistry, and urinalysis) will be reported.

  24. Number of Participants With Positive Coomb's Test [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  25. Number of Participants With Positive Urine Hemosiderin Test [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  26. Number of Participants With Plasma-free Haemoglobin Level [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  27. Number of Participants With Serum Haptoglobin Level [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  28. Serum Total Immunoglobulin G (IgG) IgG levels, IgG Subclasses Levels and Selected Specific Antibody Levels [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  29. Plasma Concentration- Time Curve Of Total Immunoglobulin G (IgG) [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  30. Elimination Half-Life (t1/2) of Total Immunoglobulin G (IgG) [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  31. Area Under the Plasma Concentration-time Curve From Time Zero to Time of the Last Quantifiable Concentration (AUC(0-T)) of Total Immunoglobulin G (IgG) [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  32. Area Under the Plasma Concentration-time Curve (AUC) From Time Zero to Infinity (AUC[0-inf]) of Total Immunoglobulin G (IgG) [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  33. Volume of Distribution of Total Immunoglobulin G (IgG) [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  34. Maximum Observed Plasma Concentration (Cmax) Of Total IgG [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  35. Time to Reach the Maximum Plasma Concentration (Tmax) of Total Immunoglobulin G (IgG) [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  36. Elimination Rate Constant of Total Immunoglobulin G (IgG) [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  37. Area Under the Concentration-Time Curve From Time Zero up to Time Tau (AUC0-Tau) of Total Immunoglobulin G (IgG) [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  38. Plasma Concentration-Time Curve Of Specific Immunoglobulin G (IgG) Antibodies [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
    The quantitative evaluation of the anti-Tetanus toxoid, anti-pneumococcal capsular polysaccharide, anti-Haemophilus influenza type B and anti-measles antibodies level will be reported

  39. Elimination Half-Life (t1/2) of Specific IgG Antibodies [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  40. Area Under the Plasma Concentration-time Curve From Time Zero to Time of the Last Quantifiable Concentration (AUC(0-T)) of Specific Immunoglobulin G (IgG) Antibodies [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  41. Volume Of Distribution of Specific Immunoglobulin G (IgG) Antibodies [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  42. Maximum Observed Plasma Concentration (Cmax) of Specific Immunoglobulin G (IgG) Antibodies [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  43. Time to Reach the Maximum Plasma Concentration (Tmax) of Specific Immunoglobulin G (IgG) Antibodies [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  44. Elimination Rate Constant of Specific Immunoglobulin G (IgG) Antibodies [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  45. Area Under the Plasma Concentration-time Curve From Time Zero to Infinity (AUC[0-inf]) of Specific Immunoglobulin G (IgG) Antibodies [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  46. Area Under the Concentration-Time Curve From Time Zero up to Time Tau (AUC0-Tau) of Specific Immunoglobulin G (IgG) Antibodies [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  47. Average Concentration of Drug Over the Dosing Interval (Cave) [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]
  48. Average Concentration of Drug at Steady State Clearance (CLss) [ Time Frame: At 5th Infusion (During 28 Day Infusion) and 7th Infusion (During 21 Day Infusion) ]


Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   2 Years to 70 Years   (Child, Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Written informed consent/assent obtained from patients/patients' parent(s) or legally acceptable representative indicating that they understand the purpose of and procedures required for the study and are willing to participate in it.
  • Confirmed clinical diagnosis of a PID, requiring treatment with IVIg and have documented agammaglobulinemia or hypogammaglobulinemia
  • Male or female, ages 2 to 70 years at screening.
  • Received 200 to 800 mg/kg of a commercially available IVIg therapy at approximately 21- or 28-day intervals for at least 3 infusion cycles prior to receiving Kedrion intravenous immunoglobulin (IVIg) 10% (KIg10)
  • At least 2 documented IgG trough levels while receiving an IVIg, of greater than or equals to (>=) 6 gram per liter (g/L) obtained at 2 infusion cycles within 12 months (1 must be within 6 months) prior to Informed Consent Form (ICF) signature
  • Participant is willing to comply all requirements of the protocol.
  • Females of child-bearing potential with a negative urine pregnancy test and who agree to employ adequate birth control measures during the study
  • Authorization to access personal health information
  • Participant previously participating in a clinical trial with another experimental IVIg may be enrolled if they have received stable commercially available IVIg therapy for at least 3 infusion cycles (21 or 28 days) prior to receiving KIg10
  • Participant currently on treatment with any subcutaneous immunoglobulin (SCIG) can be enrolled if they are switched to stable commercially available IVIg therapy for at least 3 infusion cycles (21 or 28 days) prior to receiving KIg10

Exclusion Criteria:

  • Newly diagnosed PID and and naïve to IgG replacement therapy
  • Dysgammaglobulinemia or isolated IgG subclass deficiency or profound primary T-cell deficiency
  • Has history of severe or serious reactions or hypersensitivity to IVIg or other injectable forms of IgG
  • Has history of thrombotic events (including deep vein thrombosis, cerebrovascular accident, pulmonary embolism, transient ischemic attacks, or myocardial infarction), as defined by at least 1 event in participant's lifetime
  • Has IgA deficiency and documented antibodies to IgA
  • Have received blood products that have not undergone viral inactivation measures within 12 months prior to enrolment
  • Has significant protein losing enteropathy, nephrotic syndrome, or lymphangiectasia
  • Has an acute infection as documented by culture or diagnostic imaging and/or a body temperature exceeding 38.5 degree Celsius (°C) (101.3 degree Fahrenheit (°F) within 7 days prior to screening
  • Has acquired immunodeficiency syndrome (AIDS) and/or hepatitis B/C active disease at enrolment
  • Has levels of Alanine aminotransferase (ALT) or aspartate aminotransferase (AST), 2.5 times of the upper limit of normal for the laboratory designated for the study
  • Using an implanted venous access device
  • Has profound anemia (haemoglobin less than10 gram per decilitre (g/dl)) or persistent severe neutropenia (<= 1000 neutrophils per millimiter cube (mm^3) or lymphopenia of less than 500 cells per microliter
  • Have severe chronic condition such as renal failure (creatinine concentration > 2.0 times the upper limit of normal) with proteinuria, congestive heart failure (New York Heart Association III/IV), cardiomyopathy, cardiac arrhythmia associated with thromboembolic events (e.g., atrial fibrillation), unstable or advanced ischemic heart disease, hyper viscosity, or any other condition that the Investigator believes is likely to interfere with evaluation of the study drug or with satisfactory conduct of the trial
  • Has history of a malignant disease other than properly treated carcinoma in situ of the cervix or basal cell or squamous cell carcinoma of the skin within 24 months prior to enrolment
  • Has history of pharmacoresistant epilepsy or multiple episodes of migraine (defined as at least 1 episode within 6 months of enrolment) not completely controlled by medication
  • Participants must not be receiving steroids (oral or parenteral daily dose of>= 0.15 milligram per kilogram per day (mg/kg/day) of prednisone or equivalent) or other immunosuppressive drugs or chemotherapy
  • Females who are pregnant, breast feeding or planning a pregnancy during the course of the study. Women who become pregnant during the study will be withdrawn from the study
  • Has participated in another clinical study within 3 weeks prior to study enrolment
  • Has history of drug or alcohol abuse within the 6 months before screening
  • Has Employed or a direct relative of an employee of the CRO, the study site, or the Sponsor
  • Previously treated under this protocol
  • Unable to provide informed consent or provide informed consent by a legally authorized representative

Information from the National Library of Medicine

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): NCT03961009


Contacts
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Contact: Study Director (416) 813-8623 chaim.roifman@sickkids.ca

Locations
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United States, Florida
Allergy Associates of the Palm Beaches Recruiting
North Palm Beach, Florida, United States, 33408
Contact: Study Coordinator    561-626-4561      
Division of Allergy and Immunology Children's Research Institute Not yet recruiting
Saint Petersburg, Florida, United States, 33701
Contact: Study Coordinator    727-553-3524      
United States, Illinois
Rush University Medical Center Not yet recruiting
Chicago, Illinois, United States, 60612
Contact: Study Coordinator    312-942-8701      
United States, Kansas
Dr. Henry J. Kanarek - Allergy, Asthma & Immunology Not yet recruiting
Overland Park, Kansas, United States, 66211
Contact: Study Coordinator    913-451-8555      
United States, Minnesota
Midwest Immunology Clinic and Infusion Center Not yet recruiting
Plymouth, Minnesota, United States, 55446
Contact: Study Coordinator    763-577-0008      
United States, New Jersey
Allergy and Immunology Associates Recruiting
Little Silver, New Jersey, United States, 07739
Contact: Study Coordinator    732-741-8222      
United States, New York
University of Buffalo Not yet recruiting
Buffalo, New York, United States, 14203
Contact: Study Coordinator    716-323-0062      
United States, Ohio
Optimed Research Recruiting
Columbus, Ohio, United States, 43235
Contact: Study Coordinator    614-430-3030      
Ohio Clinical Research Associates, Inc. Not yet recruiting
Mayfield Heights, Ohio, United States, 44124
Contact: Study Coordinator    440-443-0710      
Toledo Institute of Clinical Research Inc Recruiting
Toledo, Ohio, United States, 43617
Contact: Study Coordinator    631-601-7155      
United States, Texas
USF Department of Pediatrics Not yet recruiting
Dallas, Texas, United States, 75230
Contact: Study Coordinator    972-566-6801      
AARA Research Center Not yet recruiting
Dallas, Texas, United States, 75231
Contact: Study Coordinator    214-365-0365      
Canada, Alberta
University of Alberta Not yet recruiting
Edmonton, Alberta, Canada, T6G 2B7
Contact: Study Coordinator    780 616 1559      
Canada, Ontario
Gordon Sussman Clinical Research, Inc. Recruiting
Toronto, Ontario, Canada, M4V 1R2
Contact: Study Coordinator    416-944-8333      
The Hospital for Sick Children Not yet recruiting
Toronto, Ontario, Canada, M5G 1X8
Contact: Study Coordinator    416-813-8623      
Sponsors and Collaborators
Kedrion S.p.A.
Investigators
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Principal Investigator: Medical Director Kedrion SpA

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Responsible Party: Kedrion S.p.A.
ClinicalTrials.gov Identifier: NCT03961009     History of Changes
Other Study ID Numbers: KIG10_US3_PID01
First Posted: May 23, 2019    Key Record Dates
Last Update Posted: May 23, 2019
Last Verified: May 2019

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Kedrion S.p.A.:
Immunoglobulin
Kedrion IVIg10%
IgG antibodies
Agammaglobulinemia
Hypogammaglobulinemia
Additional relevant MeSH terms:
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Immunologic Deficiency Syndromes
Immune System Diseases
Immunoglobulins
Antibodies
Immunoglobulins, Intravenous
gamma-Globulins
Rho(D) Immune Globulin
Immunologic Factors
Physiological Effects of Drugs