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Open-Label C1 Esterase Inhibitor (C1INH-nf) for the Treatment of Acute Hereditary Angioedema (HAE) Attacks (CHANGE 2)

This study has been completed.
Information provided by:
Shire Identifier:
First received: February 21, 2007
Last updated: March 19, 2014
Last verified: March 2014
The study objective was to evaluate the safety and efficacy of repeat use of C1INH-nf for the treatment of acute HAE attacks.

Condition Intervention Phase
Hereditary Angioedema Biological: C1 esterase inhibitor [human] (C1INH-nf) Phase 3

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: LEVP2006-1 CHANGE 2 Trial (C1-Inhibitor in Hereditary Angioedema Nanofiltration Generation Evaluating Efficacy): Open-Label Safety/Efficacy Repeat Exposure Study of C1INH-nf (Human) in the Treatment of Acute HAE Attacks

Resource links provided by NLM:

Further study details as provided by Shire:

Primary Outcome Measures:
  • Number of Hereditary Angioedema (HAE) Attacks Treated With C1INH-nf [ Time Frame: Duration of the study (2.5 years) ]
  • Percent of HAE Attacks With Substantial Relief of the Defining Symptom [ Time Frame: Within 4 hours after initial treatment ]
    Subjects were to assess their symptoms every 15 minutes up to 4 hours after the initial dose or until substantial relief of the defining symptom was achieved. The conservative analysis defined substantial relief as 3 consecutive assessments of improvement of the defining symptom; any attack that did not have 3 consecutive documented reports of improvement was considered a treatment failure. In the less conservative analysis, attacks also were considered to have responded if clinical improvement of the defining symptom occurred but data were incomplete due to cessation of symptom assessments.

Secondary Outcome Measures:
  • Time to Beginning of Substantial Relief of the Defining Symptom [ Time Frame: Within 4 hours after initial treatment ]
    Subjects were to assess their symptoms every 15 minutes up to 4 hours after the initial dose or until substantial relief of the defining symptom was achieved. Substantial relief was defined as 3 consecutive assessments of improvement of the defining symptom. Beginning of substantial relief was considered the first of the 3 consecutive assessments.

  • Time to Beginning of Substantial Relief of the Defining Symptom for Subjects Who Received Multiple Treatments [ Time Frame: Within 4 hours after initial treatment ]
    For attack number 1, the number of censored observations precluded estimation of the 95% confidence interval (CI) upper bound for median time to event (subjects who did not experience beginning of substantial relief of the defining symptom within 4 hours after initial treatment were included in the analysis as censored observations). Entry of 4.0 hours indicates that data were not estimable (NE); as non-numeric data are not supported by the 95% CI field, entry of the actual result (ie, NE or >4.0) was not possible.

  • Antigenic C1 Inhibitor (C1INH) Serum Levels [ Time Frame: Pre-infusion to 1 hour post-infusion ]
    Change in antigenic C1INH serum levels from pre-infusion to 1 hour after the initial dose of study drug.

  • Functional C1INH Serum Levels [ Time Frame: Pre-infusion to 1 hour post-infusion ]

    Percent change in functional C1INH serum levels from pre-infusion to 1 hour after the initial dose of study drug.

    Functional C1INH serum levels are expressed as a percent of total detectable C1INH (ie, functional C1INH/total detectable C1INH).

  • Complement C4 Serum Levels [ Time Frame: Pre-infusion to 1 hour post-infusion ]
    Change in complement C4 serum levels from pre-infusion to 1 hour after the initial dose of study drug.

Enrollment: 113
Study Start Date: September 2006
Study Completion Date: March 2009
Primary Completion Date: March 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Open-label C1INH-nf
1,000 Units (U) of C1INH-nf administered intravenously. If there was no response to treatment 60 minutes after the first dose, a second 1,000 U dose could be administered.
Biological: C1 esterase inhibitor [human] (C1INH-nf)

Detailed Description:
A total of 113 subjects were enrolled in the study. One-hundred-one (101) subjects received C1INH-nf for the treatment of 1 or more HAE attacks and were analyzed for efficacy. The study design also allowed for short-term prophylaxis with C1INH-nf prior to emergency or non-cosmetic surgical or dental procedures, and an additional 12 subjects received C1INH-nf only for this purpose. All 113 subjects were exposed to C1INH-nf and analyzed for safety.

Ages Eligible for Study:   1 Year and older   (Child, Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

This study was open to all subjects who:

  • Completed participation in LEVP2005-1/A (NCT00289211) and were not participating in LEVP2005-1/B (NCT01005888), any time after the 3-day telephone follow-up
  • Completed participation in LEVP2005-1/B any time after the final prophylactic therapy in Part B
  • Were enrolled but not randomized in LEVP2005-1/A after Part A was closed
  • Were excluded from LEVP2005-1 for any of the following reasons:

    • Pregnancy or lactation
    • Age less than 6 years
    • Narcotic addiction
    • Presence of anti-C1INH autoantibodies
  • Were not enrolled in LEVP2005-1 after enrollment in LEVP2005-1 was closed, under the following circumstances:

    • Had a diagnosis of HAE: evidence of a low C4 level plus either a low C1INH antigenic level or a low C1INH functional level, or
    • Had a known HAE-causing C1INH mutation, or
    • Had a diagnosis of HAE based on a strong family history of HAE as determined by the principal investigator

Exclusion Criteria:

  • History of allergic reaction to C1INH or other blood products
  • Participated in any other investigational drug study within the past 30 days
  • Received blood or a blood product in the past 60 days other than C1INH-nf
  Contacts and Locations
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, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00438815

  Hide Study Locations
United States, Arizona
Allergy and Immunology Associates
Scottsdale, Arizona, United States, 85251
United States, Arkansas
Allergy and Asthma Clinic of Northwest Arkansas
Bentonville, Arkansas, United States, 72712
United States, California
UCLA-David Geffen School of Medicine
Los Angeles, California, United States, 90095
University of California, San Diego
San Diego, California, United States, 92093-0732
Allergy and Asthma Clinical Research, Inc
Walnut Creek, California, United States, 94598
United States, Florida
Allergy and Asthma Center
Fort Lauderdale, Florida, United States, 33334
Orlando Regional Healthcare
Orlando, Florida, United States, 32806
United States, Georgia
Family Allergy and Asthma Center
Atlanta, Georgia, United States, 30342
United States, Indiana
Welborn Clinic Allergy and Immunology
Evansville, Indiana, United States, 47713
United States, Maryland
Institute for Asthma and Allergy
Wheaton, Maryland, United States, 20902
United States, Massachusetts
University of Massachusetts Medical School
Worcester, Massachusetts, United States, 01655
United States, Michigan
Grand Traverse Allergy
Traverse City, Michigan, United States, 49684
United States, Minnesota
MeritCare Clinical Research
Bemidji, Minnesota, United States, 56601
United States, Nevada
Nevada Access to Research and Education Society
Las Vegas, Nevada, United States, 89102
United States, New Jersey
UMDNJ Asthma and Allergy Research Center
Newark, New Jersey, United States, 07103
United States, New York
Montefiore Medical Center
Bronx, New York, United States, 10461
Winthrop University Hospital
Mineola, New York, United States, 11501
Mount Sinai School of Medicine
New York, New York, United States, 10029
United States, North Dakota
MeritCare Clinical Research
Fargo, North Dakota, United States, 58122
United States, Ohio
Allergy & Asthma Centre of Dayton
Centerville, Ohio, United States, 45458
United States, Oklahoma
Allergy Clinic of Tulsa
Tulsa, Oklahoma, United States, 74133
United States, Oregon
Allergy Asthma and Dermatology Research Center
Lake Oswego, Oregon, United States, 97035
United States, Pennsylvania
Penn State University
Hershey, Pennsylvania, United States, 17033
United States, South Carolina
Allergy Partners of the Upstate
Greenville, South Carolina, United States, 29615
United States, Texas
AARA Research Center
Dallas, Texas, United States, 75231
University of Texas Medical Branch
Galveston, Texas, United States, 77555-1083
Baylor College of Medicine
Houston, Texas, United States, 77030
Allergy and Asthma Research Center
San Antonio, Texas, United States, 78229
United States, Washington
Marycliff Allergy Specialists
Spokane, Washington, United States, 99204
United States, West Virginia
Cornerstone Healthcare
Parkersburg, West Virginia, United States, 26101
Sponsors and Collaborators
Principal Investigator: Bruce Zuraw, MD University of California, San Diego
  More Information

Publications automatically indexed to this study by Identifier (NCT Number):

Responsible Party: Chief Scientific Officer, ViroPharma Identifier: NCT00438815     History of Changes
Other Study ID Numbers: LEVP2006-1
Study First Received: February 21, 2007
Results First Received: March 31, 2010
Last Updated: March 19, 2014

Keywords provided by Shire:
Hereditary angioedema
C1 esterase inhibitor (human)

Additional relevant MeSH terms:
Angioedemas, Hereditary
Vascular Diseases
Cardiovascular Diseases
Skin Diseases, Vascular
Skin Diseases
Hypersensitivity, Immediate
Immune System Diseases
Genetic Diseases, Inborn
Complement C1s
Complement C1 Inhibitor Protein
Complement C1 Inactivator Proteins
Immunologic Factors
Physiological Effects of Drugs
Complement Inactivating Agents
Immunosuppressive Agents processed this record on August 21, 2017