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Hemophilia APhase 3NCT00543439

Study Evaluating Prophylaxis Treatment & Characterizing Efficacy, Safety, & PK Of B-Domain Deleted Recombinant FVIII

A Phase 3 study testing Moroctocog alfa (AF-CC) in people with Hemophilia A, run by Pfizer at 28 sites in 13 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this research study is to determine the effectiveness, safety, and pharmacokinetics (PK) of moroctocog alfa (AF-CC) in previously treated subjects, who are younger than 6 years of age, with severe or moderately severe hemophilia A. Read more about this study

Who is it for?
Ages 6 months to 15 years, men only
Conditions the study is for
Hemophilia A
What is being tested?
Moroctocog alfa (AF-CC)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
66 participants
Where
28 sitesin 13 countries
Study dates
Dec 2007to Apr 2018
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 6 months to 15 years
  • Men only
  • No healthy volunteers
  • Child

Who may be able to join

  • Male subjects, aged less than 6 years, with moderately severe to severe hemophilia A.
  • A negative FVIII inhibitor titer at screening, and a medical history negative for a past FVIII inhibitor.
  • At least 20 exposure days to any FVIII replacement product.
  • Adequate hepatic and renal function
  • CD4 count > 400 cells/uL, and if receiving antiviral therapy must be on a stable regimen
  • Additional criteria for subjects participating in the PK assessment:
Show all 10Show fewer
  • Male subjects as described immediately above except they must have a FVIII Activity of less than or equal to 1% confirmed by the central laboratory screening test
  • Age < 6 years at time of PK assessment.
  • The subject's size is sufficient to permit PK-related phlebotomy.
  • The subject is able to comply with the procedures conducted during the PK assessment, including a mandatory 72-hour washout period preceding the PK assessment.

Who cannot join

  • A history of FVIII inhibitor.
  • Presence of a bleeding disorder in addition to hemophilia A.
  • Treatment with any investigational drug or device within 30 days before the time of signing the informed consent form.
  • Major or orthopedic surgery planned to occur during the course of the study.
  • Regular (e.g., daily, every other day) use of antifibrinolytic agents or medications known to influence platelet function such as aspirin or certain nonsteroidal anti-inflammatory drugs (NSAIDs), or regular, concomitant therapy with immunomodulating drugs (e.g., intravenous immunoglobulin [IVIG], routine systemic corticosteroids).
  • Known hypersensitivity to hamster protein.

Trial locations and contacts

28 sites in 13 countries.

28 sites in 13 countries

United States7 sites
  • Cincinnati Children's Hospital Medical Center

    Cincinnati, Ohio, 45229

  • Childrens Medical Center Dallas

    Dallas, Texas, 75235

  • University of Texas Southwestern Medical Center at Dallas

    Dallas, Texas, 75390-9063

  • OHSU Investigational Pharmacy

    Portland, Oregon, 97239

  • Oregon Health & Science University

    Portland, Oregon, 97239

  • University of Utah

    Salt Lake City, Utah, 84108

  • Primary Children's Hospital

    Salt Lake City, Utah, 84113

Other trials in United States

Turkey (Türkiye)7 sites
  • Akdeniz Universitesi Tip Fakultesi

    Antalya, 07059

  • Cukurova University Tip Fakultesi

    Balcali/Adana, Adana, 01330

  • Istanbul Universtesi Istanbul Tip Fakultesi

    Çapa, Istanbul, 34390

  • Ege Universitesi Tip Fakultesi Cocuk Hastanesi

    Izmir, Bornova, 35100

  • Dr. Behcet Uz Child and Diseases And Surgery Education and Research Hospital

    Izmir, 35210

  • Erciyes Universitesi Tip Fakultesi

    Kayseri, 38039

  • On Dokuz Mayis University Faculty of Medicine

    Samsun, Kurupelit, 55139

Other trials in Turkey (Türkiye)

Mexico3 sites
  • Hospital y Clinica OCA S.A. de C.V.

    Colonia Centro, Monterrey, Nuevo LEON, 64000

  • Hospital Civil de Guadalajara Dr. Juan I. Menchaca

    Guadalajara, Jalisco, 44340

  • Hospital Universitario "Dr. Jose Eleuterio Gonzalez"

    Monterrey, Nuevo León, 64460

Other trials in Mexico

New Zealand2 sites
  • Christchurch Hospital

    Christchurch, South Island, 8001

  • Canterbury District Health Board

    Christchurch, 8001

Other trials in New Zealand

Argentina1 site
  • Fundacion de la Hemofilia

    Buenos Aires, C1425BWE

Other trials in Argentina

Austria1 site
  • Medizinische Universitaet Wien

    Vienna, 1090

Other trials in Austria

Colombia1 site
  • Liga Colombiana de Hemofílicos y otras Deficiencias Sanguíneas

    Bogotá

Other trials in Colombia

Croatia1 site
  • Clinical Hospital Centre Split

    Split, 21000

Other trials in Croatia

Jordan1 site
  • Jordan University of Science and Technology, King Abdullah University Hospital

    Irbid, 22110

Other trials in Jordan

Oman1 site
  • Sultan Qaboos University Hospital

    Muscat, 123

Other trials in Oman

Peru1 site
  • Centro Medico Monte Carmelo

    Urbanización La Victoria, Arequipa, 054

Other trials in Peru

Poland1 site
  • Samodzielny Publiczny Dzieciecy Szpital Kliniczny

    Warsaw, 00-576

Other trials in Poland

Romania1 site
  • Sanador

    Bucharest, 011026

Other trials in Romania

About this study

Official title: An Open-label Study To Evaluate Prophylaxis Treatment, And To Characterize The Efficacy, Safety, And Pharmacokinetics Of B-domain Deleted Recombinant Factor Viii Albumin Free (Moroctocog Alfa [Af-cc]) In Children With Hemophilia A

The purpose of this research study is to determine the effectiveness, safety, and pharmacokinetics (PK) of moroctocog alfa (AF-CC) in previously treated subjects, who are younger than 6 years of age, with severe or moderately severe hemophilia A.

Conditions
Hemophilia A
Being tested
Moroctocog alfa (AF-CC)
Medical subject headings
Hemophilia A

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Moroctocog alfa (AF-CC)Biological

    Also called Xyntha

    On-demand therapy for 6 months, followed by routine prophylaxis 25 IU/kg, administered every other day for 1 year.

  • Moroctocog alfa (AF-CC)Biological

    Also called Xyntha

    Routine prophylaxis crossover:

    45 IU/kg, administered 2 times a week for 1 year followed by 25 IU/kg administered every other day for 1 year, or, 25 IU/kg, administered every other day for 1 year, followed by 45 IU/kg, administered 2 times a week for 1 year.

Study groups in NCT00543439
Study groupRoleWhat they receive
1ExperimentalOn-Demand therapy for 6 months, followed by Routine Prophylaxis treatment for 1 year.
Receives: Biological: Moroctocog alfa (AF-CC)
2ExperimentalRoutine Prophylaxis Crossover
Receives: Biological: Moroctocog alfa (AF-CC)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mean Annualized Bleed Rate (ABR) by Treatment: On Demand Cohort

    ABR for each participant was calculated as the number of bleeds requiring administration of moroctocog alfa (AF-CC) divided by the total therapy duration (in days), then multiplied by 365.25 (days in a year).

    Measured: Day 1 up to Month 6 (OD Cohort, OD Therapy, Period 1); Month 7 up to Month 18 (OD Cohort, RP 25 IU/kg, Period 2)

Secondary outcomes (22)
  1. Mean Annualized Bleed Rate (ABR) by Treatment: Routine Prophylaxis Cohort

    ABR for each participant was calculated as the number of bleeds requiring administration of moroctocog alfa (AF-CC) divided by the total therapy duration (in days), then multiplied by 365.25 (days in a year).

    Measured: Day 1 up to Month 24 (RP Cohort, Period 1 and Period 2)

  2. Mean of Moroctocog Alfa (AF-CC) Infusions Administered To Treat Bleeding Episode: All Participants

    In this outcome measure, the mean of total number of moroctocog alfa (AF-CC) on-demand infusions administered to treat each bleeding episode was reported, regardless of participant cohort or period during which it occurred.

    Measured: Day 1 up to Month 24

  3. Number of Treated Bleeds Classified on Basis of Response to First Infusion of Moroctocog Alfa (AF-CC) as On-Demand Treatment: OD Therapy (OD and RP Cohort)

    Number (no.) of bleeds treated are reported on basis of response to first infusion of study drug, at 4-point scale: excellent, good, moderate, no response. Excellent:definite pain relief and/or improvement in bleeding signs within 8 hours (hr) after infusion, no additional infusion administered; Good:definite pain relief and/or improvement in bleeding signs within 8 hr after infusion, at least 1 additional infusion administered for complete resolution or with no additional infusion administered; Moderate:probable or slight improvement starting after 8 hr following infusion,at least 1 additional infusion administered for complete resolution; No Response: no improvement at all between infusions or during 24 hr interval following infusion or condition worsen. Bleeds for which response not recorded, reported as:Data Not Recorded. Total no. of first infusions may not be equal to total no. of bleeds if bleed was: missing start date/dose information or treated initially with non-study FVIII.

    Measured: Day 1 up to Month 24

  4. Number of Treated Spontaneous Bleeds by Time Interval Between Bleed Onset and Prior Moroctocog Alfa (AF-CC) Prophylaxis Dose: Routine Prophylaxis Therapy

    In this outcome measure number of treated spontaneous bleeds are reported according to the time interval between bleed onset and prior moroctocog alfa (AF-CC) routine prophylaxis dose. Following time intervals used to report this outcome measure: lesser than or equal to (<=) 24 hours, greater than (>) 24 hours to <=48 hours, >48 hours to <=72 hours, >72 hours. For reporting arm: "Moroctocog alfa (AF-CC),OD and RP Cohort: RP Therapy 25 IU/kg" cumulative data for routine prophylaxis cohort (Day 1 up to Month 24, Period 1 and Period 2) and on demand cohort (Month 7 up to Month 18, Period 2) is reported.

    Measured: Day 1 up to Month 24 (RP Cohort, RP 25 IU/kg and 45 IU/kg, Period 1 and 2); Month 7 up to Month 18 (OD Cohort, RP 25 IU/kg, Period 2)

  5. Number of Participants Requiring Prophylaxis Regimen Escalation: Routine Prophylaxis Therapy

    During prophylaxis, criteria for prophylaxis regimen escalation are the occurrence, over a 4-week duration (and in the absence of a confirmed FVIII inhibitor), of (a) 2 or more spontaneous bleeds into a major joint and/or target joint, or (b) 3 or more spontaneous bleeds (consisting of joint bleeds and/or significant soft tissue/muscle or other site bleeds). If either criterion was met, the participant was escalated to a more intense prophylaxis regimen of 45 IU/kg, administered every other day. Participant who meet dose escalation criteria while on prophylaxis regimen of 45 IU/kg, were escalated to a higher intensity regimen designated by the investigator. Significant spontaneous bleeds were those that led to a transient or persistent loss of function. For reporting arm: "Moroctocog alfa (AF-CC),OD and RP Cohort: RP Therapy 25 IU/kg", cumulative data for RP cohort (Day 1 up to Month 24, Period 1 and Period 2) and OD cohort (Month 7 up to Month 18, Period 2) is reported.

    Measured: Day 1 up to Month 24 (RP Cohort, RP 25 IU/kg and 45 IU/kg, Period 1 and 2); Month 7 up to Month 18 (OD Cohort, RP 25 IU/kg, Period 2)

  6. Mean Routine Prophylaxis Dose (IU/kg) of Moroctocog Alfa (AF-CC) Received: Routine Prophylaxis Therapy

    Mean RP dose (by weight) for each participant was calculated as his total moroctocog alfa (AF-CC) consumption (in IU) divided by weight (in kg). For reporting arm: "Moroctocog alfa (AF-CC),OD and RP Cohort: RP Therapy 25 IU/kg", cumulative data for routine prophylaxis cohort (Day 1 up to Month 24, Period 1 and Period 2) and on demand cohort (Month 7 up to Month 18, Period 2) is reported.

    Measured: Day 1 up to Month 24 (RP Cohort, RP 25 IU/kg and 45 IU/kg, Period 1 and 2); Month 7 up to Month 18 (OD Cohort, RP 25 IU/kg, Period 2)

  7. Mean of Total Number Moroctocog Alfa (AF-CC) Infusions Received: Routine Prophylaxis Therapy

    In this outcome measure mean of total number of infusions of moroctocog alfa (AF-CC) received by participant is reported. For reporting arm: "Moroctocog alfa (AF-CC),OD and RP Cohort: RP Therapy 25 IU/kg", cumulative data for routine prophylaxis cohort (Day 1 up to Month 24, Period 1 and Period 2) and on demand cohort (Month 7 up to Month 18, Period 2) is reported.

    Measured: Day 1 up to Month 24 (RP Cohort, RP 25 IU/kg and 45 IU/kg, Period 1 and 2); Month 7 up to Month 18 (OD Cohort, RP 25 IU/kg, Period 2)

  8. Mean of Total Number of Days Participants Exposed to Moroctocog Alfa (AF-CC): Routine Prophylaxis Therapy

    For reporting arm: "Moroctocog alfa (AF-CC),OD and RP Cohort: RP Therapy 25 IU/kg", cumulative data for routine prophylaxis cohort (Day 1 up to Month 24, Period 1 and Period 2) and on demand cohort (Month 7 up to Month 18, Period 2) is reported.

    Measured: Day 1 up to Month 24 (RP Cohort, RP 25 IU/kg and 45 IU/kg, Period 1 and 2); Month 7 up to Month 18 (OD Cohort, RP 25 IU/kg, Period 2)

  9. Mean of Total Number of Infusions of Moroctocog Alfa (AF-CC) Received Per Week to Assess Compliance: Routine Prophylaxis Therapy

    Participants' compliance to their assigned prophylaxis regimen was measured by following: a) number of infusions received per week and b) dose received. In this outcome measure mean of total number of infusions of moroctocog alfa (AF-CC) received by participants per week is reported. For reporting arm: "Moroctocog alfa (AF-CC),OD and RP Cohort: RP Therapy 25 IU/kg" cumulative data for routine prophylaxis cohort (Day 1 up to Month 24, Period 1 and Period 2) and on demand cohort (Month 7 up to Month 18, Period 2) is reported.

    Measured: Day 1 up to Month 24 (RP Cohort, RP 25 IU/kg and 45 IU/kg, Period 1 and 2); Month 7 up to Month 18 (OD Cohort, RP 25 IU/kg, Period 2)

  10. Terminal Phase Half Life (t1/2) of Factor VIII (FVIII) Activity

    Plasma decay half-life is the time measured for the FVIII activity to decrease by one half.

    Measured: 0.5, 8, 24, 28 and 32 hours post dose on Day 1

  11. Clearance (CL) of Factor VIII Activity

    Clearance is a measure of the volume of plasma from which FVIII activity is removed per unit time. It was reported in units milliliter per hour per kilogram (mL/hr/kg).

    Measured: 0.5, 8, 24, 28 and 32 hours post dose on Day 1

  12. Incremental Recovery of Factor VIII Activity

    Incremental recovery was the increase in circulating FVIII activity for every international unit (IU) of moroctocog alfa (AF-CC) administered per kilogram of body weight of participant. It was measured in international units per deciliter per international units per kilogram ([IU/dL]/[IU/kg]).

    Measured: Day 1, Month 6

  13. Maximum Concentration of Factor VIII Activity

    Maximum concentration of FVIII activity was measured in international units per milliliter (IU/mL).

    Measured: 0.5, 8, 24, 28 and 32 hours post dose on Day 1

  14. Area Under the Curve From Time Zero to Extrapolated Infinite Time (AUCinf) of Factor VIII Activity

    Area under FVIII activity-time profile from time zero extrapolated to infinite time. AUCinf is reported in units: international units*hour per milliliter (IU*hour/mL).

    Measured: 0.5, 8, 24, 28 and 32 hours post dose on Day 1

  15. Area Under the Curve From Time Zero to Last Measurable Concentration (AUClast) of Factor VIII Activity

    Area under the FVIII activity -versus-time curve from time zero to the time of the last quantifiable concentration.

    Measured: 0.5, 8, 24, 28 and 32 hours post dose on Day 1

  16. Steady-State Volume of Distribution (Vss) of Factor VIII Activity

    Volume of distribution is defined as the theoretical volume in which the total amount of FVIII would need to be uniformly distributed to produce the observed plasma concentration of FVIII. Steady state volume of distribution (Vss) is the apparent volume of distribution at steady-state.

    Measured: 0.5, 8, 24, 28 and 32 hours post dose on Day 1

  17. Mean Residence Time (MRT) of Factor VIII Activity

    MRT was calculated as AUMCinf /AUCinf-TI/2, where AUMCinf is the area under the moment curve from time zero to infinity and TI is the duration of infusion.

    Measured: 0.5, 8, 24, 28 and 32 hours post dose on Day 1

  18. Number of Participants With Treatment Emergent Adverse Events (AEs) According to Severity

    AE is untoward medical occurrence in clinical investigation participant administered product or medical device;event need not necessarily had causal relationship with treatment or usage.Treatment-emergent are events between first dose of study drug and up to 28 days after last dose of study drug (up to 25 months)that were absent before treatment or that worsened relative to pretreatment state.AEs were classified into following on basis of severity:1)mild = did not interfere with participant's usual function;2)moderate=interfered to some extent with participant's usual function;3)severe=interfered significantly with participant's usual function;4)life threatening=AE required discontinuation of study drug,participant was at immediate risk of death.All participants in study received AF-CC.AEs were not collected separately for each intervention for participants.All participants were properly combined for analysis,regardless of regimen were following at time,regardless of OD or RP cohort.

    Measured: Day 1 up to Month 25

  19. Number of Participants With Treatment-Related Adverse Events

    A treatment related AE is any untoward medical occurrence in a clinical investigation participant administered a product or medical device; the event had a causal relationship with the treatment or usage. All participants in the study received moroctocog alfa-(AF-CC). Adverse events were not collected separately for each intervention for the participants. All participants were properly combined for the analysis and was regardless of the regimen they were following at the time, and regardless of OD or RP cohort.

    Measured: Day 1 up to Month 25

  20. Number of Participants With Confirmed FVIII Inhibitor Development

    Confirmed FVIII inhibitors were defined as a neutralizing antibody to FVIII with a titer value of greater than or equal to (>=) 0.6 Bethesda units (BU) per millimeter in a sample assayed using the Nijmegen assay at the central laboratory.

    Measured: Day 1 up to Month 24

  21. Number of Participants With Incidence of Less Than Expected Therapeutic Effect (LETE): On Demand Therapy

    LETE occurs in OD setting if participant recorded 2 successive "No Response" (no improvement at all between infusions, or condition worsens) ratings after 2 successive infusions of study drug. Infusions must have been given within 24 hours (hr) of each other for treatment of same bleeding event in absence of confounding factors (known presence or subsequent identification of a FVIII inhibitor, known inadequate dose for type and/or severity of bleed in opinion of investigator, delay of >4 hr between onset of bleed to infusion, delay of >24 hr before administration of a follow-up infusion, known compromised study drug, faulty administration of study drug, participant had an underlying, predisposing condition responsible for bleed in opinion of investigator. For reporting arm: "Moroctocog alfa (AF-CC), OD and RP Cohort: RP Therapy 25 IU/kg", cumulative data for RP cohort (Day 1 up to Month 24, Period 1 and Period 2) and OD cohort (Month 7 up to Month 18, Period 2) is reported.

    Measured: Day 1 up to Month 24 (RP Cohort, RP 25 IU/kg and 45 IU/kg, Period 1 and 2); Day 1 up to Month 6 (OD Cohort, OD Therapy, Period 1); Month 7 up to Month 18 (OD Cohort, RP 25 IU/kg, Period 2)

  22. Number of Participants With Incidence of Less Than Expected Therapeutic Effect (LETE): Routine Prophylaxis Therapy

    LETE in prophylaxis setting if there was a spontaneous bleed within 48 hours after a regularly scheduled prophylactic dose of study drug (which was not used to treat a bleed) in the absence of confounding factors (known presence or subsequent identification of a FVIII inhibitor, known inadequate prophylactic dose [a dose less than that prescribed in participant's regimen], known lack of adherence to the prescribed prophylaxis regimen, bleed occurs in a target joint identified at the start of the study, known compromised study drug, faulty administration of study drug, participant had an underlying, predisposing condition responsible for the bleed in the opinion of the investigator. Therefore, LETE in the prophylaxis setting was the occurrence of a bleed. For reporting arm: "Moroctocog alfa (AF-CC), OD and RP Cohort: RP Therapy 25 IU/kg", cumulative data for RP cohort (Day 1 up to Month 24, Period 1 and Period 2) and OD cohort (Month 7 up to Month 18, Period 2) is reported.

    Measured: Day 1 up to Month 24 (RP Cohort, RP 25 IU/kg and 45 IU/kg, Period 1 and 2); Month 7 up to Month 18 (OD Cohort, RP 25 IU/kg, Period 2)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Oct 2007 (estimated)
  2. Study startDec 2007
  3. Primary completionApr 2018
  4. Study completionApr 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
None (open label)
Enrolment
66 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00543439
Sponsor's protocol ID
3082B2-313
Other IDs
B1831001, 2006-005575-17
Status last verified
Dec 2018
First submitted
11 Oct 2007
Last updated
11 Jan 2019
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Moroctocog alfa (AF-CC) in people with Hemophilia A, run by Pfizer at 28 sites in 13 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 11 Jan 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 28 sites in United States, Turkey (Türkiye), Mexico, New Zealand, Argentina and 8 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 11 Jan 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mean Annualized Bleed Rate (ABR) by Treatment: On Demand Cohort (time frame: Day 1 up to Month 6 (OD Cohort, OD Therapy, Period 1); Month 7 up to Month 18 (OD Cohort, RP 25 IU/kg, Period 2)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Jan 2019.

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Clinical Trial NCT00543439 | AzTrials