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Subcutaneous Treatment With Icatibant for Acute Attacks of Hereditary Angioedema

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ClinicalTrials.gov Identifier: NCT00097695
Recruitment Status : Completed
First Posted : November 29, 2004
Results First Posted : December 24, 2013
Last Update Posted : June 5, 2014
Sponsor:
Information provided by (Responsible Party):
Shire

Tracking Information
First Submitted Date  ICMJE November 26, 2004
First Posted Date  ICMJE November 29, 2004
Results First Submitted Date  ICMJE January 24, 2011
Results First Posted Date  ICMJE December 24, 2013
Last Update Posted Date June 5, 2014
Study Start Date  ICMJE August 2004
Actual Primary Completion Date March 2008   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: November 4, 2013)
Time to Onset of Symptom Relief (TOSR) [ Time Frame: 5 days ]
The primary efficacy endpoint was TOSR assessed by the patient using a Visual Analogue Scale (VAS). The VAS is a scale used to measure intensity of each symptom of the attack at baseline and at the pre-determined time points throughout treatment period. It consists of a horizontal 10cm line, with the 0 point corresponding to a state where patient experiences no symptoms at all and the 10cm point represents the worst symptoms ever experienced by patient. The patient indicates his/her current state of symptoms by drawing a mark across the horizontal line. TOSR was defined as the time between time of injection to time of first documented onset of symptom relief for the 3 primary symptoms: cutaneous swelling, cutaneous skin, and abdominal pain. The primary symptom was based on the type of attack. For abdominal attacks, the single primary symptom was abdominal pain. For cutaneous attacks, the single primary symptom was either skin swelling or skin pain, whichever was most severe.
Original Primary Outcome Measures  ICMJE
 (submitted: June 23, 2005)
Symptom relief (patient)
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: November 4, 2013)
  • Time to Regression (Start of Improvement) According to Patient [ Time Frame: 5 days ]
    This parameter assessed the time to regression (start of improvement) of observable(visible) symptoms according to the patients. Patients were asked "Report date and time when you feel that your symptoms start to improve".
  • Time to Almost Complete Symptom Relief [ Time Frame: 5 days ]
    The time to almost complete symptom relief was defined as a score between 0 and 10 mm on the VAS for at least 3 consecutive measurements for all symptom.
Original Secondary Outcome Measures  ICMJE
 (submitted: June 23, 2005)
  • Safety and tolerability
  • Additional efficacy assessments
  • Pharmacoeconomics
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Subcutaneous Treatment With Icatibant for Acute Attacks of Hereditary Angioedema
Official Title  ICMJE Randomized, Double Blind, Placebo-Controlled, Multicenter Study of a Subcutaneous Formulation of Icatibant for the Treatment of Hereditary Angioedema
Brief Summary The purpose of this study is to assess the efficacy and safety of Icatibant, a bradykinin antagonist in the treatment of acute cutaneous and/or abdominal attacks in patients with hereditary angioedema (HAE).
Detailed Description This Phase II/III study consisted of two parts: A controlled phase and An Open label extension(OLE) phase. The controlled phase describes the double blind part of the study and was intended to evaluate the efficacy of icatibant in decreasing the time to onset of symptom relief compared with placebo for the first treated cutaneous and/or abdominal attack in randomised patients. Patients experienced a laryngeal attack were not randomised, but treated with open label icatibant according to the controlled phase procedures and assessments. The outcome of this group was to be reported descriptively. After treatment of the first attack in the controlled phase, the patients were eligible to enter the OLE phase. In the OLE phase, patients who experienced angioedema attacks severe enough to warrant treatment were to be treated with s.c. icatibant as appropriate until the end of the study.The OLE phase became a modified open label extension where all 56 patients who had been randomised and the last randomised patient had concluded the double-blind phase. The modified open label extension period permitted treatment for patients who were screened and found eligible but did not experience an angioedema attack, or had an attack that was not severe enough to merit treatment while the double blind phase was still ongoing.
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 3
Study Design  ICMJE Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Condition  ICMJE Angioedema
Intervention  ICMJE
  • Drug: Icatibant
    30 mg (3mL) subcutaneous icatibant injection in the abdominal region
    Other Name: Brand name, Firazyr®
  • Drug: Placebo
    Solution for injection, matched to study drug Single dose: 3 mL
Study Arms  ICMJE
  • Experimental: Icatibant- Randomized
    Patients who were randomized to icatibant in the controlled phase after they had an eligible first in-study attack.
    Intervention: Drug: Icatibant
  • Placebo Comparator: Placebo-Randomized
    Patients who were randomized to placebo in the controlled phase after they had an eligible first in-study attack.
    Intervention: Drug: Placebo
  • Experimental: Controlled Open-label / laryngeal attack
    Patients with laryngeal symptoms at the baseline were not randomised but treated with icatibant open label during the controlled phase.
    Intervention: Drug: Icatibant
  • Experimental: Untreated Patients at the baseline
    Patients who were screened and found eligible but did not experience an angioedema attack, or had an attack that was not severe enough to merit treatment while the controlled phase was ongoing (they were not treated during the Controlled phase but treated with icatibant during the Open Label Extension Phase (OLE) )
    Intervention: Drug: Icatibant
Publications *

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Completed
Actual Enrollment  ICMJE
 (submitted: November 4, 2013)
84
Original Enrollment  ICMJE
 (submitted: June 23, 2005)
56
Actual Study Completion Date  ICMJE March 2008
Actual Primary Completion Date March 2008   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • Age above 18 years;
  • Documented diagnosis of HAE Type I or II (confirmed complement 1 esterase inhibitor [C1-INH] deficiency);
  • Current edema be in the cutaneous, abdominal and/or laryngeal areas;
  • Current edema be moderate to severe according to the investigator's Symptom Score.

Exclusion Criteria:

  • Diagnosis of angioedema other than HAE, for example, acquired angioedema (AAE);
  • Participation in a clinical trial of another investigational medicinal product (IMP) within the past month;
  • Treatment with any pain medication since onset of the current edema attack;
  • Treatment with replacement therapy, including C1-INH products (e.g. human C1-INH preparations), less than 3 days from onset of the current edema attack;
  • Treatment with ACE inhibitors (e.g. Lotensin, Prinivil, Accupril);
  • Evidence of severe, symptomatic coronary artery disease based on medical history or screening examination;
  • Serious concomitant illnesses that the physician considers to be a contraindication for participation in the trial;
  • Pregnancy and/or breast-feeding.
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT00097695
Other Study ID Numbers  ICMJE JE049 #2103
FAST1 ( Other Identifier: Shire HGT )
Has Data Monitoring Committee No
U.S. FDA-regulated Product Not Provided
IPD Sharing Statement  ICMJE Not Provided
Responsible Party Shire
Study Sponsor  ICMJE Shire
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Francisco Bracho, MD Children's Hospital Los Angeles
PRS Account Shire
Verification Date May 2014

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP