A Study to Assess the Efficacy and Safety of BIVV009 in Participants With Primary Cold Agglutinin Disease Without A Recent History of Blood Transfusion (Cadenza Study)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT03347422
Recruitment Status : Recruiting
First Posted : November 20, 2017
Last Update Posted : May 18, 2018
Information provided by (Responsible Party):
Bioverativ Therapeutics Inc.

Brief Summary:
The purpose of Part A is to determine whether BIVV009 administration results in a greater than or equal to (>=)1.5 gram per deciliter (g/dL) increase in hemoglobin (Hgb) level and avoidance of transfusion in participants with primary cold agglutinin disease (CAgD) without a recent history of blood transfusion. The purpose of Part B is to evaluate the long-term safety and tolerability of BIVV009 in participants with primary CAgD.

Condition or disease Intervention/treatment Phase
Agglutinin Disease, Cold Drug: BIVV009 Drug: Placebo Phase 3

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 40 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: A Randomized, Double-blind, Placebo-controlled Study to Assess the Efficacy and Safety of BIVV009 in Patients With Primary Cold Agglutinin Disease Without a Recent History of Blood Transfusion
Actual Study Start Date : November 20, 2017
Estimated Primary Completion Date : December 2019
Estimated Study Completion Date : December 2020

Resource links provided by the National Library of Medicine

U.S. FDA Resources

Arm Intervention/treatment
Experimental: Part A: BIVV009 or Placebo
In Part A, participants will be randomized 1:1 to receive an intravenous (IV) infusion of BIVV009 or placebo.
Drug: BIVV009
BIVV009 will be administered by IV.
Drug: Placebo
Placebo will be administered by IV.
Experimental: Part B: Response Extension Phase (BIVV009)
In Part B, all participants will undergo blinded cross-over loading doses to allow all participants to receive BIVV009 while maintaining Part A blinding.
Drug: BIVV009
BIVV009 will be administered by IV.

Primary Outcome Measures :
  1. Part A: Percentage of Participants With Response (R) [ Time Frame: Up to Week 26 ]
    A participant will be considered a responder if he or she did not receive a blood transfusion from Week 5 through Week 26 (EOT) and did not receive treatment for primary cold agglutinin disease (CAgD) beyond what is permitted per protocol. Additionally, the participant's hemoglobin (Hgb) level must meet the following criterion: Hgb increase greater than or equal to (>=) 1.5 gram per deciliter (g/dL) from baseline (defined as the last Hgb value before administration of the first dose of study drug) at treatment assessment endpoint.

  2. Part B: Number of Participants With Treatment-emergent Adverse Events (AEs) and Serious AEs (SAEs) [ Time Frame: Approximately 1 year ]
    An adverse event (AE) was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship.

Secondary Outcome Measures :
  1. Part A: Mean Change From Baseline in Hemoglobin (Hgb) Level up to Week 26 [ Time Frame: Baseline Up to Week 26 ]
    Mean change from baseline in hemoglobin (Hgb) level up to Week 26 will be assessed.

  2. Part A: Mean Change From Baseline in Bilirubin up to Week 26 [ Time Frame: Baseline up to Week 26 ]
    Mean change from baseline in bilirubin up to Week 26 will be assessed.

  3. Part A: Mean Change From Baseline in Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale Score (Quality of Life) [ Time Frame: Baseline up to Week 26 ]
    FACIT-Fatigue scale consists of 13 questions assessed using a 5 point scale (0=not at all; 1 = a little bit, 2 = somewhat, 3 = quite a bit and 4 = very much). Responses to each question are added to obtain a total score. The range of possible scores is 0-52, with higher score indicating more fatigue.

  4. Part A: Mean Change From Baseline in Lactate Dehydrogenase (LDH) up to Week 26 [ Time Frame: Baseline up to Week 26 ]
    Mean change from baseline in LDH up to Week 26 will be assessed.

  5. Part A: Percentage of Participants With Solicited Symptomatic Anemia at End of Treatment (EOT) [ Time Frame: At EOT (Day 182) ]
    Symptomatic anemia is defined as fatigue, weakness, shortness of breath, palpitations, fast heart beat, light headedness, and/or chest pain.

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Body weight of greater than or equal to (>=) 39 kilogram (kg) at Screening
  • Confirmed diagnosis of primary cold agglutinin disease (CAgD) based on the following criteria: a) Chronic hemolysis, b) Polyspecific direct antiglobulin test (DAT) positive, c) Monospecific DAT strongly positive for C3d, d) Cold agglutinin titer >= 64 at 4 degree Celsius, and e) Immunoglobulin G (IgG) DAT less than or equal to (<=) 1+, and, f) No overt malignant disease
  • Hemoglobin level <= 10.0 gram per deciliter (g/dL)
  • Bilirubin level above the normal reference range

Exclusion Criteria:

  • Cold agglutinin syndrome secondary to infection, rheumatologic disease, or active hematologic malignancy
  • Clinically relevant infection of any kind within the month preceding enrollment (example, active hepatitis C, pneumonia)
  • Clinical diagnosis of systemic lupus erythematosus (SLE); or other autoimmune disorders with anti-nuclear antibodies at Screening
  • Positive hepatitis panel (including hepatitis B surface antigen and/or hepatitis C virus antibody) prior to or at Screening
  • Positive human immunodeficiency virus (HIV) antibody at Screening
  • Treatment with rituximab monotherapy within 3 months or rituximab combination therapies (example, with bendamustine, fludarabine, ibrutinib, or cytotoxic drugs) within 6 months prior to enrollment

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 identifier (NCT number): NCT03347422

Contact: Bioverativ Therapeutics Inc, Waltham, MA, USA 1-844-308-0808(US only)

United States, California
The Oncology Institute of Hope and Innovation Recruiting
Whittier, California, United States, 90603
Contact: Kirsten Bettino, Study Coordinator    1 562-693-4477   
Principal Investigator: Dr. Richy Agajanian         
United States, District of Columbia
Georgetown University Medical Center Recruiting
Georgetown, District of Columbia, United States, 20007
Contact: Helena Jacobs, Study Coordinator    202-687-4868   
Principal Investigator: Dr. Catherine Broome         
United States, New York
Montefiore Medical Center Recruiting
New York, New York, United States, 10461
Contact: Kelsey Branch, Study Coordinator    1-844-308-0808   
Contact: Elena Crouch   
Principal Investigator: Dr. Irina Murakhovskaya         
New York Medical College at Westchester Medical Center Recruiting
Valhalla, New York, United States, 10595
Contact: Saleha Batool    914-493-3045   
Principal Investigator: Robert G. Lerner, MD         
United States, Pennsylvania
University of Pittsburgh Medical Center Recruiting
Pittsburgh, Pennsylvania, United States, 15232
Contact: Beata Pasek, Study Coordinator    1-412-623-2697   
Principal Investigator: Dr. Joseph E. Kiss         
Medical University of Vienna Recruiting
Vienna, Austria, 1090
Contact: Sarah Ely    +43 1 40 400 29850   
Principal Investigator: Dr Bernd Jilma, MD         
ZNA Stuivenberg Recruiting
Antwerpen, Belgium, 2060
Contact: Caroline De Man    +32 (0)3 217 74 48   
Principal Investigator: Dr Ka Lung WU         
Centre Hospitalier Jolimont Recruiting
La Louvière, Belgium, 7100
Contact: Hélène Pêtre    +32 (0)64 23 46 68   
Principal Investigator: Dr Alain Kentos,         
University Hospitals Leuven Recruiting
Leuven, Belgium, 3000
Contact: Jill Pannecoucke    +32 (0)16 34 15 74   
Principal Investigator: Pr Daan Dierickx         
University of Alberta Recruiting
Edmonton, Canada, T6G1Z1
Contact: Adult Hematology Research    780-407-6090      
Principal Investigator: Dr. A. Peters, 780-407-1584 ext. 5         
Gemeinschaftspraxis Hämatologie-Onkologie Recruiting
Dresden, Germany, 1307
Contact: Antje van der Seylberg    +49 351 44 00022   
Principal Investigator: Dr Thomas Illmer, MD         
Universitätsklinikum Essen Recruiting
Essen, Germany, 45147
Contact: Nicole Preising    +49 201 723 4620   
Principal Investigator: Dr Alexander Roeth, MD         
Laniado Hospital Recruiting
Netanya, Israel, 4244916
Contact: Dikla Varsano    +972-9-8925248   
Contact: Aviv Avdi   
Principal Investigator: Dr Shlomo Bulvik, MD         
Tel Aviv Sourasky Medical Center Recruiting
Tel Aviv, Israel, 64239
Contact: Ela Shai    +972-5-05172903   
Principal Investigator: Dr Yosef Kalish, MD         
U.O.C. Ematologia Ospedale San Bortolo Recruiting
Vicenza, Italy, 36100
Contact: Laura Lissandrini    +39 444 753518   
Principal Investigator: Dr Eros di Bona, MD         
Haukeland University Hospital Recruiting
Bergen, Norway, 5053
Contact: Anita Bøtter Brevik    +4755975362   
Contact: Kristin Eikevåg         
Principal Investigator: Dr Tor Henrik Anderson Tvedt         
Oslo University Hospital Recruiting
Oslo, Norway, 0372
Principal Investigator: Pr Geir Tjonnfjord, 0047 23 07 07 13 0         
St Olavs Hospital, Avdeling for blodsykdommer Recruiting
Trondheim, Norway, 7030
Contact: Turid Neverdal Almvik    +4772925041   
Principal Investigator: Dr Henrik Hjort Hansen         
Hospital Universitario Puerta de Hierro Recruiting
Majadahonda, Madrid, Spain, 28222
Contact: Isabel Salcedo    +34 911 916 481   
Principal Investigator: Dr Jose Luis Bueno, MD         
Hospital Clinci i Provincial de Barcelona Recruiting
Barcelona, Spain, 08036
Principal Investigator: Dr Joan Cid, +34 932 275 448         
Hospital Universitario Virgen del Rocio Recruiting
Sevilla, Spain, 41013
Contact: Rocio Roncel    +34 955 013 277   
Principal Investigator: Dr Jesus Martin Sanchez, MD         
Hospital Universitario Dr. Peset Recruiting
Valencia, Spain, 46017
Contact: David Ivars    +34 961 622 536   
Principal Investigator: Dr Miguel Fernandez Zarzoso, MD         
Sponsors and Collaborators
Bioverativ Therapeutics Inc.

Responsible Party: Bioverativ Therapeutics Inc. Identifier: NCT03347422     History of Changes
Other Study ID Numbers: BIVV009-04
2017-003539-12 ( EudraCT Number )
BIVV009-04 ( Other Identifier: Bioverativ Therapeutics Inc. )
First Posted: November 20, 2017    Key Record Dates
Last Update Posted: May 18, 2018
Last Verified: May 2018

Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:
Anemia, Hemolytic, Autoimmune
Anemia, Hemolytic
Hematologic Diseases
Autoimmune Diseases
Immune System Diseases
Cold agglutinins
Immunologic Factors
Physiological Effects of Drugs