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Hemophilia APhase 3NCT02234323

An Open Label Study to Determine the Safety and Efficacy of Replacement Factor VIII Protein (Known as rFVIIIFc) in Previously Untreated Males With Severe Hemophilia A

A Phase 3 study testing rFVIIIFc in people with Hemophilia A, run by Bioverativ, a Sanofi company at 71 sites in 14 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 primary objective of the study was to evaluate the safety of rFVIIIFc (BIIB031) in previously untreated participants (PUPs) with severe hemophilia A. The secondary objectives were to evaluate the efficacy of rFVIIIFc in the prevention and treatment of bleeding episodes in PUPs, to evaluate rFVIIIFc consumption for… Read more about this study

Who is it for?
Ages Up to 5 years, men only
Conditions the study is for
Hemophilia A
What is being tested?
rFVIIIFc
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
108 participants
Where
71 sitesin 14 countries
Study dates
12 Jan 2015to 23 Sep 2019
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 Up to 5 years
  • Men only
  • No healthy volunteers
  • Child

Who may be able to join

  • Ability of the participant's legally authorized representative (e.g. their parent or legal guardian) to understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use confidential health information in accordance with national and local participant privacy regulations.
  • Weight >=3.5 kg at the time of screening.
  • Severe hemophilia A defined as less than (<) 1 IU/dL (<1%) endogenous FVIII documented in the medical record or as tested during the Screening Period.

Who cannot join

  • Any exposure to blood components, factor VIII replacement products, including commercially available rFVIIIFc at any time prior to or during screening.
  • History of positive inhibitor testing. A prior history of inhibitors was defined based on a patient's historical positive inhibitor test using the local laboratory Bethesda value for a positive inhibitor test (ie, equal to or above lower level of detection).
  • History of hypersensitivity reactions associated with any rFVIIIFc administration.
  • Other coagulation disorder(s) in addition to hemophilia A.
  • Any concurrent clinically significant major disease that, in the opinion of the Investigator, would make the participant unsuitable for enrollment.
  • Current systemic treatment with chemotherapy and/or other immunosuppressant drugs.
  • Note: Other protocol defined Inclusion/Exclusion criteria may apply.

Trial locations and contacts

71 sites in 14 countries.

71 sites in 14 countries

United States20 sites
  • Research Site

    Brewer, Maine, 04412

  • Research Site

    Buffalo, New York, 14209

  • Research Site

    Columbus, Ohio, 43205

  • Research Site

    Dallas, Texas, 75230

  • Research Site

    Dallas, Texas, 75235

  • Research Site

    Duarte, California, 91010

  • Research Site

    East Lansing, Michigan, 48823

  • Research Site

    Indianapolis, Indiana, 46260

  • Research Site

    Little Rock, Arkansas, 72202

  • Research Site

    Louisville, Kentucky, 40202

  • Research Site

    Milwaukee, Wisconsin, 53226

  • Research Site

    Minneapolis, Minnesota, 55404

  • Research Site

    New York, New York, 10065

  • Research Site

    Philadelphia, Pennsylvania, 19104

  • Research Site

    Portland, Oregon, 97239

  • Research Site

    Rochester, New York, 14621

  • Research Site

    Sacramento, California, 95817

  • Research Site

    San Francisco, California, 94143

  • Research Site

    St Louis, Missouri, 63104

  • Research Site

    Torrance, California, 90509

Other trials in United States

Italy9 sites
  • Research Site

    Bari, 70123

  • Research Site

    Florence, 50134

  • Research Site

    Genova, 16148

  • Research Site

    Milan, 20122

  • Research Site

    Naples, 80123

  • Research Site

    Padova, 35128

  • Research Site

    Rome, 161

  • Research Site

    Rome, 165

  • Research Site

    Vicenza, VI, 36100

Other trials in Italy

France7 sites
  • Research Site

    Caen, 14033

  • Research Site

    Le Kremlin-Bicêtre, 94270

  • Research Site

    Lille, 59037

  • Research Site

    Nantes, 44093

  • Research Site

    Strasbourg, 67200

  • Research Site

    Toulouse, 31059

  • Research Site

    Tours, 37044

Other trials in France

United Kingdom6 sites
  • Research Site

    Basingstoke, Hampshire, RG24 9NA

  • Research Site

    Cambridge, Cambridgeshire, CB2 0QQ

  • Research Site

    Cardiff, CF14 4XW

  • Research Site

    London, WC1N3JH

  • Research Site

    Sheffield, S10 2TH

  • Research Site

    Whitechapel, London, E1 1BB

Other trials in United Kingdom

Brazil5 sites
  • Research Site

    Campinas, 13083-878

  • Research Site

    Canoas, 92425-900

  • Research Site

    Ribeirão Preto, 14048-900

  • Research Site

    Rio de Janeiro, 20211-030

  • Research Site

    São Paulo, 01227-200

Other trials in Brazil

Germany5 sites
  • Research Site

    Berlin, 13353

  • Research Site

    Bonn, 53127

  • Research Site

    Düsseldorf, 40225

  • Research Site

    Frankfurt, 60590

  • Research Site

    Hannover, 30625

Other trials in Germany

Australia4 sites
  • Research Site

    Brisbane, 4029

  • Research Site

    Parkville, 3052

  • Research Site

    Perth, 6008

  • Research Site

    Westmead, 2145

Other trials in Australia

Poland4 sites
  • Research Site

    Gdansk, 80-952

  • Research Site

    Krakow, 30-663

  • Research Site

    Lublin, 20-093

  • Research Site

    Warsaw, 02-091

Other trials in Poland

Canada3 sites
  • Research Site

    Hamilton, L8S 4K1

  • Research Site

    London, N6A 4G5

  • Research Site

    Toronto, M5G 1X8

Other trials in Canada

Netherlands2 sites
  • Research Site

    Leiden, 2333 ZA

  • Research Site

    Utrecht, 3584 CX

Other trials in Netherlands

New Zealand2 sites
  • Research Site

    Auckland, 1023

  • Research Site

    Christchurch, 8011

Other trials in New Zealand

Spain2 sites
  • Research Site

    Barcelona, 08035

  • Research Site

    Madrid, 28046

Other trials in Spain

Ireland1 site
  • Research Site

    Dublin, D12 N512

Other trials in Ireland

Sweden1 site
  • Research Site

    Stockholm, 171 76

Other trials in Sweden

About this study

Official title: An Open-Label, Multicenter Evaluation of the Safety and Efficacy of Recombinant Coagulation Factor VIII Fc Fusion Protein (rFVIIIFc; BIIB031) in the Prevention and Treatment of Bleeding in Previously Untreated Patients With Severe Hemophilia A

The primary objective of the study was to evaluate the safety of rFVIIIFc (BIIB031) in previously untreated participants (PUPs) with severe hemophilia A. The secondary objectives were to evaluate the efficacy of rFVIIIFc in the prevention and treatment of bleeding episodes in PUPs, to evaluate rFVIIIFc consumption for the prevention and treatment of bleeding episodes in PUPs, and to describe experience with the use of rFVIIIFc for immune tolerance induction (ITI) in participants with inhibitors.

Conditions
Hemophilia A
Being tested
rFVIIIFc
Keywords
prophylaxis treatment, Hemophilia A, Hemophilia, episodic treatment
Medical subject headings
Hemophilia A

What participants receive

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

  • rFVIIIFcBiological

    Also called Eloctate; BIIB031; efmoroctocog alfa; recombinant coagulation factor VIII Fc fusion protein; antihemophilic factor [recombinant], Fc fusion protein

    Administered as specified in arm description

Study groups in NCT02234323
Study groupRoleWhat they receive
rFVIIIFcExperimentalParticipants were to receive rFVIIIFc as follows- Prophylaxis regimen (PR): rFVIIIFc 25-80 international units per kilogram (IU/kg), at 3- to 5-day intervals until participant reached greater than or equal to (>=) 50 exposure days (ED: 24-hour period in which >=1 injection/dose of rFVIIIFc was given), or study withdrawal/end of study. Adjustments to dose/dosing interval was done as needed by investigator; Treatment with an optional ER (Episodic regimen) can be initiated before PR at investigators discretion; ITI: rFVIIIFc 200 IU/kg, daily for participants who, after exposure to rFVIIIFc, had positive high titer inhibitor (>=5.00 Bethesda Units per milliliter [BU/mL]) or positive low titer inhibitor (>=0.60 and <5.00 BU/mL) and had poorly controlled bleeding despite increased rFVIIIFc doses, or required bypassing agent to treat bleeding.
Receives: Biological: rFVIIIFc

What is being measured

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

  1. Percentage of Participants With Confirmed Inhibitor Development as Measured by the Nijmegen-Modified Bethesda Assay

    A positive/confirmed inhibitor result occurs when a participant has a value >=0.6 BU/mL by central laboratory testing using Nijmegen-modified Bethesda assay, that is confirmed on re-testing of a separate sample collected >=2 weeks after the initial sample. Confirmed inhibitor development was based on all participants who had reached >=10 EDs and had >=1 inhibitor test performed at or beyond this milestone or who had an inhibitor. Exposure day (ED) is a 24-hour period in which participant received >=1 dose of rFVIIIFc injections. Participants who did not develop an inhibitor but reached the milestone number of EDs were included in the denominator during calculation of percentage. Additionally, any participant who developed an inhibitor following the initial rFVIIIFc administration was included in the numerator and denominator during calculation of percentage.

    Measured: Up to 3 years

Secondary outcomes (9)
  1. Annualized Number of Bleeding Episodes (Spontaneous and Traumatic) Per Participant (Annualized Bleeding Rate [ABR])

    ABR was annualized number of bleeding episodes during efficacy period (EP) per participant annualized to a 1-year interval of time. Bleeding episodes were classified as spontaneous if parent/caregiver/participant records bleeding event when there is no known contributing factor such as definite trauma or antecedent "strenuous" activity and as traumatic when there is known reason for bleed. ABR=(Number of bleeding episodes during EP divided by total number of days during EP)*365.25. EP was sum of all intervals of time during which participants were treated with rFVIIIFc per treatment regimens of study excluding surgical/rehabilitation periods and large injection intervals (greater than [>]28 days). Participants were included in summary of more than 1 treatment regimen if their regimen changed during study.

    Measured: Up to 3 years

  2. Annualized Number of Spontaneous Joint Bleeding Episodes

    Bleeding episodes were classified as spontaneous if parent/caregiver/participant records a bleeding event when there was no known contributing factor such as a definite trauma or antecedent "strenuous" activity. Annualized spontaneous joint bleeding episodes = (Total number of spontaneous joint bleeding episodes during EP divided by total number of days during EP)*365.25. EP reflects sum of all intervals of time during which participants were treated with rFVIIIFc per treatment regimen excluding major and minor surgical/rehabilitation periods and large injection intervals (> 28 days). Bleeding episodes were summarized by treatment regimen. Participants were included in summary of more than 1 treatment regimen if their regimen changed during study.

    Measured: Up to 3 years

  3. Number of rFVIIIFc Injections With Excellent or Good, Moderate or None Treatment Response Assessed Using a 4-Point Scale

    Using e-diary, each participant's parent/caregiver rated treatment response to any bleeding episode at approximately 8-12 hours from time of injection and prior to additional doses of rFVIIIFc given for same bleeding episodes, using 4-point scale: 1=Excellent: abrupt pain relief and/or improvement in signs of bleeding within approximately 8 hour after initial injection; 2=Good: definite pain relief and/or improvement in signs of bleeding within approximately 8 hour after injection, but possibly requiring more than 1 injection after 24-48 hour for complete resolution; 3=Moderate: Probable/slight beneficial effect within 8 hour after initial injection and requires more than 1 injection and 4=None: No improvement or condition worsens within approximately 8 hour after initial injection. Participants included in more than 1 treatment regimen if their regimen changed during study.

    Measured: Up to 3 years

  4. Total Number of Exposure Days (EDs)

    An ED was defined as a 24-hour period in which a participant received one or more doses of rFVIIIFc injections, with the time of the first injection of rFVIIIFc defined as the start of the ED. Participants who did not have a particular injection type were counted as having zero injections for that type.

    Measured: Up to 3 years

  5. Total Annualized rFVIIIFc Consumption Per Participant for the Prevention and Treatment of Bleeding Episodes

    Total annualized rFVIIIFc consumption (in IU/kg) was calculated for each participant as: Annualized consumption = (Total IU/kg of rFVIIIFc during EP divided by total number of days during EP)*365.25. EP reflects the sum of all intervals of time during which participants are treated with rFVIIIFc according to the treatment regimens of the study excluding surgical/rehabilitation periods and large injection intervals (>28 days). Participants were included in summary of more than 1 treatment regimen if their regimen changed during study.

    Measured: Up to 3 years

  6. Number of Injections of rFVIIIFc Required to Resolve a Bleeding Episode

    Number of Injections of rFVIIIFc required to resolve a bleeding episode during EP were reported. EP reflects the sum of all intervals of time during which participants were treated with rFVIIIFc according to the treatment regimens of the study excluding surgical/rehabilitation periods and large injection intervals (>28 days). All injections given from the initial sign of a bleed, until the last date/time within the bleed window were counted. Participants were included in summary of more than 1 treatment regimen if their regimen changed during study.

    Measured: Up to 3 years

  7. Average Dose Per Injection of rFVIIIFc Required to Resolve a Bleeding Episode

    The average dose of rFVIIIFc per injection per bleeding episode was calculated as the average of all doses (IU/kg) administered to treat the bleeding episode during EP. EP begins with the first treatment regimen dose of rFVIIIFc and ends with the last dose (regardless of the reason for dosing). Surgery/rehabilitation periods were not included in the EP. Participants were included in summary of more than 1 treatment regimen if their regimen changed during study.

    Measured: Up to 3 years

  8. Change From Baseline in rFVIIIFc Incremental Recovery (IR)

    Blood samples were taken at trough (predose) and Cmax (maximum concentration) for assessment of incremental recovery, measured by the one-stage clotting assay. IR (International Units per deciliter [IU/dL] per IU/kg) = (Cmax for FVIII activity - Pre-dose FVIII activity) (IU/dL) divided by actual dose (IU/kg), where Cmax (maximum concentration) is 30-minute FVIII activity post-dose and FVIII activity less than (<)0.5 IU/dL was set to 0 IU/dL for calculation of IR.

    Measured: Baseline, Weeks 12, 24, 36, 48, 60, 72, 84, 96, 108 and 120

  9. Number of Participants With Response to Immune Tolerance Induction (ITI)

    Complete Success was defined as meeting all of the following criteria: Negative inhibitor titers in 2 consecutive determinations at least 4 weeks apart; IR >=66% of baseline in 2 consecutive determinations at least 4 weeks apart; Half life >=6 hours. Partial Success was defined as meeting the first criteria for complete success and one of the other 2 after 33 months of ITI.

    Measured: Up to 3 years

Timeline

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

  1. First posted9 Sep 2014 (estimated)
  2. Study start12 Jan 2015
  3. Primary completion23 Sep 2019
  4. Study completion23 Sep 2019

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
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
108 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02234323
Sponsor's protocol ID
997HA306
Other IDs
2013-005512-10
Status last verified
Mar 2022
First submitted
29 Aug 2014
Last updated
11 Apr 2022
Data monitoring committee
Yes
Individual data sharing
Yes: Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org

Publications

  • Carcao M, Schiavulli M, Kulkarni R, Rendo P, Foster M, Santagostino E, Casiano S, Konigs C. A post hoc analysis of previously untreated patients with severe hemophilia A who developed inhibitors in the PUPs A-LONG trial. Blood Adv. 2024 Mar 26;8(6):1494-1503. doi: 10.1182/bloodadvances.2023011475.

    PubMed 38266154
  • Konigs C, Ozelo MC, Dunn A, Kulkarni R, Nolan B, Brown SA, Schiavulli M, Gunawardena S, Mukhopadhyay S, Jayawardene D, Winding B, Carcao M. First study of extended half-life rFVIIIFc in previously untreated patients with hemophilia A: PUPs A-LONG final results. Blood. 2022 Jun 30;139(26):3699-3707. doi: 10.1182/blood.2021013563.

    PubMed 35421219

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing rFVIIIFc in people with Hemophilia A, run by Bioverativ, a Sanofi company at 71 sites in 14 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 3 inclusion and 7 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 Apr 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 71 sites in United States, Italy, France, United Kingdom, Brazil and 9 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 13 Aug 2020). 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?

Percentage of Participants With Confirmed Inhibitor Development as Measured by the Nijmegen-Modified Bethesda Assay (time frame: Up to 3 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02234323, which also lists 2 linked publications.

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 Apr 2022.

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