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Graft Versus Host DiseasePhase 2/3NCT02956122

A Phase 2/3 Study of GLASSIA for the Treatment of Acute GvHD

A Phase 2/3 study testing GLASSIA, methylprednisolone or equivalent steroid and Albumin in people with Graft Versus Host Disease, run by Baxalta now part of Shire at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The purpose of the study is to evaluate the safety and efficacy of GLASSIA as an add-on biopharmacotherapy to standard-of-care steroid treatment as the first-line treatment in participants with acute GvHD with lower GI involvement. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Graft Versus Host Disease
What is being tested?
GLASSIA, methylprednisolone or equivalent steroid and Albumin
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
1 participants
Where
1 siteUnited States
Study dates
26 Apr 2017to 3 May 2018
Phase
Phase 2/3
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female participants aged ≥18 years at the time of screening
  • Recipient of an hematopoietic stem cell transplantation (HSCT)
  • The disease indication for which the participant required HSCT must be in remission
  • Newly diagnosed acute graft-versus-host disease (GvHD), including lower Gastrointestinal (GI) involvement (modified International Bone Marrow Transplant Registry [IBMTR] Severity Stage 1 to 4 [>500 mL diarrhea/day]), with or without other organ system involvement.
  • Willing to undergo or must have had a lower GI biopsy within 7 days of informed consent to confirm GI GvHD. Biopsy results are not needed to initiate treatment; however, if biopsy results are not consistent with aGvHD, treatment with GLASSIA will be discontinued.
  • Participants must be receiving systemic corticosteroids. Treatment with methylprednisolone/systemic steroids must have been initiated within 72 hours prior to the first dose of study treatment after enrollment
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  • Evidence of myeloid engraftment (absolute neutrophil count ≥0.5 x 10^9/L)
  • Lower GI GvHD manifested by diarrhea must have other causes of diarrhea ruled out (eg, negative for Clostridium difficile or cytomegalovirus [CMV] infection or oral magnesium administration)
  • Karnofsky Performance Score ≥50%
  • If female of childbearing potential, participant presents with a negative blood pregnancy test
  • Females of childbearing potential with a fertile male sexual partner must agree to employ adequate contraception for the duration of the study.
  • Males must use adequate contraception and must not donate sperm for the duration of the study.
  • Participant is willing and able to comply with the requirements of the protocol

Who cannot join

  • Participant with manifestations of chronic GvHD
  • Participant with acute/chronic GvHD overlap syndrome
  • Participant whose GvHD developed after donor lymphocyte infusion
  • Participant with myocardial infarction within 6 months prior to enrollment or New York Heart Association Class III or IV heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Prior to the first dose of study treatment, any electrocardiogram (ECG) abnormality at screening must be documented by the investigator as not medically relevant
  • Participant with evidence of recurrent malignancy
  • Participant with veno-occlusive disease (ie, sinusoidal obstruction syndrome)
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  • Participant receiving GvHD treatment other than continued prophylaxis (eg, cyclosporine and/or mycophenolate mofetil, etc) or corticosteroid therapy. In addition, a participant who received the first dose of corticosteroid therapy for acute GvHD with lower GI involvement more than 72 hours before the first dose of study treatment is not eligible for the study
  • Participant with severe sepsis involving at least 1 organ failure
  • Participant who is seropositive or positive in the nucleic acid test for human immunodeficiency virus (HIV)
  • Participant with active hepatitis B or C
  • Participant has participated in another clinical study involving an investigational product (IP) or investigational device within 30 days prior to enrollment or is scheduled to participate in another clinical study involving an IP or investigational device during the course of this study
  • If female, participant is pregnant or lactating at the time of enrollment, or has plans to become pregnant during the study
  • Participant with a serious medical or psychiatric illness likely to interfere with participation in the study
  • Participant is a family member or employee of the investigator

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Georgia Cancer Center

    Augusta, Georgia, 30912

Other trials in United States

About this study

Official title: A Two-Part, Multi-Center, Prospective, Phase 2/3 Clinical Study to Evaluate the Safety and Efficacy of GLASSIA as an Add-On Biopharmacotherapy to Conventional Steroid Treatment in Subjects With Acute Graft-Versus-Host Disease With Lower Gastrointestinal Involvement

The purpose of the study is to evaluate the safety and efficacy of GLASSIA as an add-on biopharmacotherapy to standard-of-care steroid treatment as the first-line treatment in participants with acute GvHD with lower GI involvement.

Being tested
GLASSIA, methylprednisolone or equivalent steroid, Albumin
Medical subject headings
Graft vs Host Disease

What participants receive

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

  • GLASSIABiological

    Also called as alpha-1 antitrypsin, A1PI, alpha-1 proteinase inhibitor

    GLASSIA [Alpha1-Proteinase Inhibitor (Human)]

  • methylprednisolone or equivalent steroidDrug

    The conventional steroid treatment (methylprednisolone or equivalent steroid) will be supplied by the investigators per their institutional practice.

  • AlbuminBiological

    Also called Human Albumin

    The control vials contain human albumin 20% in 50 mL normal saline solution in glass vials (for non-United States (US) Countries), or Flexbumin 25% in 50 mL in normal saline solution in plastic IV bags (for US).

Study groups in NCT02956122
Study groupRoleWhat they receive
Study Part 1 - All Participants - GLASSIAExperimentalParticipants to receive GLASSIA (intravenously) and methylprednisolone or equivalent steroid (either IV or oral per investigator discretion)
Receives: Biological: GLASSIA; Drug: methylprednisolone or equivalent steroid
Study Part 2 - GLASSIAExperimentalParticipants to receive GLASSIA (intravenously) and methylprednisolone or equivalent steroid (either IV or oral per investigator discretion)
Receives: Biological: GLASSIA; Drug: methylprednisolone or equivalent steroid
Study Part 2 - Albumin (Control)Placebo comparatorParticipants to receive control (intravenously) and methylprednisolone or equivalent steroid (either IV or oral per investigator discretion)
Receives: Drug: methylprednisolone or equivalent steroid; Biological: Albumin

What is being measured

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

  1. Percentage of Participants Achieving Overall Response (OR) At Day 28

    OR was defined as graft-versus-host disease (GvHD) complete response (CR) + partial response (PR), defined as: - GvHD CR was complete resolution of all signs and symptoms of acute GvHD in all organs without intervening salvage and GvHD PR was improvement of 1 stage in 1 or more organs involved in GvHD without progression in other organs.

    Measured: Day 28

Secondary outcomes (25)
  1. Percentage of Participants Achieving Gastrointestinal (GI) Response at Day 28

    GI response was defined as complete response (CR) + partial response (PR), defined as: - GI CR was able to eat; not requiring parenteral nutrition, and passing primarily formed stools - GI PR was decrease in need for parenteral nutrition to less than or equal to (<=) 50% of required calories; and reduction of stool volume by greater than or equal to (>=) 50%, without ileus.

    Measured: Day 28

  2. Percentage of Participants Achieving Overall Response at Day 56

    Overall response was defined as graft-versus-host disease (GvHD) complete response (CR) + partial response (PR), defined as: - GvHD CR was complete resolution of all signs and symptoms of acute GvHD in all organs without intervening salvage - GvHD PR was improvement of 1 stage in 1 or more organs involved in GvHD without progression in other organs.

    Measured: Day 56

  3. Acute Graft-versus-host Disease (GvHD) Grading at Days 28, 56 and 180

    Grading of GvHD was performed by the investigator according to the modified International Bone Marrow Transplant Registry (IBMTR) grading system which classifies the degree of involvement of each organ system by stage on a scale of 0 to 4. The degree of skin involvement was staged depending upon degree and severity of the lesions: Stage 1: Maculopapular rash over less than (<) 25% of body area, Stage 2: Maculopapular rash over 25 to 50% of body area, Stage 3: Generalized erythroderma, Stage 4: Generalized erythroderma with bullous formation. Degree of GI involvement was staged based on severity of diarrhoea: Stage 1: 500 to 1000 mL/day,Stage 2: 1000 to 1500 mL/day, Stage 3: 1500 to 2000 mL/day, Stage 4: greater than (>) 2000 mL/day OR pain OR ileus. Degree of liver involvement was staged based upon serum total bilirubin level as follows: Stage 1: 2 to 3 mg/dL, Stage 2: 3 to 6 mg/dL, Stage 3: 6 to 15 mg/dL, Stage 4: >15 mg/dL.

    Measured: Days 28, 56 and 180

  4. Incidence of Chronic Graft-versus-host Disease (GvHD)

    Incidence of chronic GvHD at Days 180 and 365 was reported.

    Measured: Days 180 and 365

  5. Duration of Overall Response (OR)

    OR was defined as GvHD CR + PR, defined as: - GvHD CR was complete resolution of all signs and symptoms of acute GvHD in all organs without intervening salvage - GvHD PR was improvement of 1 stage in 1 or more organs involved in GvHD without progression in other organs. Duration of OR was not assessed due to the termination of the study.

    Measured: Baseline up to Day 365

  6. Duration of Gastrointestinal (GI) Response

    GI response was defined as CR + PR, defined as: - GI CR was able to eat; not requiring parenteral nutrition, and passing primarily formed stools - GI PR was decrease in need for parenteral nutrition to <= 50% of required calories; and reduction of stool volume by >= 50%, without ileus. Duration of GI response was not assessed due to the termination of the study.

    Measured: Baseline up to Day 365

  7. Overall Survival (OS) - Percentage of Participants With an Event

    OS was defined as the time from the date of randomization to the date of death due to any cause.

    Measured: Days 100, 180 and 365

  8. Transplant-related Mortality

    Transplant-related mortality was determined by the investigator (any deaths considered related to the transplant).

    Measured: Days 28, 56, 100 and 180

  9. Failure-free Survival - Percentage of Participants With an Event

    Failure-free survival was defined as the absence of all of the following criteria: Need for second-line treatment for acute GvHD, Non-relapse mortality (death during continuous complete remission) and recurrent malignancy.

    Measured: Days 100 and 180

  10. Graft-versus-host Disease (GvHD)-Free Survival - Percentage of Participants With an Event

    GVHD-free survival was defined as being alive without previous onset of acute GVHD or chronic GVHD requiring immunosuppressive therapy.

    Measured: Days 28, 56, 100, 180 and 365

  11. Infection-related Mortality - Percentage of Participants With an Event

    Infection-related mortality was determined by the investigator (any deaths considered related to infection [including infections related to hematopoietic stem cell transplant {HSCT}]).

    Measured: Days 28, 56, 100 and 180

  12. Graft-versus-host Disease (GvHD)-Related Mortality - Percentage of Participants With an Event

    Graft-versus-host disease (GvHD)-related mortality was determined by the investigator (any deaths considered related to GvHD).

    Measured: Days 28, 56, 100 and 180

  13. All-cause Mortality - Percentage of Participants With an Event

    All-cause mortality was defined as the time from HSCT to death due to any cause.

    Measured: Days 28, 56, 100 and 180

  14. Number of Participants With Adverse Events (AEs), Treatment-related AEs, Serious Adverse Events (SAEs), Treatment-related SAEs and Temporally-associated AEs

    An AE was defined as any untoward medical occurrence in a participant administered an investigational product (IP) that does not necessarily have a causal relationship with the treatment. An SAE was defined as an untoward medical occurrence that at any dose meets one or more of the following criteria: outcome was fatal/results in death, life-threatening, required inpatient hospitalization or resulted in prolongation of an existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect, was a medically important event.

    Measured: From start of study drug administration up to 371 days

  15. Number of Participants With Clinically Significant Changes in Clinical Laboratory Assessments

    Clinical laboratory assessments such as hematology, clinical chemistry, lipid and coagulation panels and urinalysis were performed.

    Measured: Baseline up to Day 56

  16. Number of Participants With Clinically Significant Changes in Vital Signs

    Vital signs included body temperature, respiratory rate, pulse rate and systolic and diastolic blood pressure.

    Measured: Baseline up to Day 56

  17. Number of Participants With Recurrence of Primary Malignancies

    Incidence of recurrence of primary malignancies was reported.

    Measured: Baseline up to Day 365

  18. Area Under the Plasma Concentration Curve (AUC0-inf) From Time Zero to Infinity

    AUC of GLASSIA was reported.

    Measured: Day 1: through 48 hours; Day 13: through 48 hours; Day 22 and Day 50: through approximately 168 hours

  19. Area Under the Plasma Concentration Curve From Time Zero to Time "t" AUC(0-t) of GLASSIA

    AUC(0-t) of GLASSIA was reported.

    Measured: Day 1: through 48 hours, Day 13: through 48 hours, Day 22 and Day 50: through approximately 168 hours

  20. Systemic Clearance at Steady State (CLss) of GLASSIA

    CLss of GLASSIA was reported.

    Measured: Day 1: through 48 hours, Day 13: through 48 hours, Day 22 and Day 50: through approximately 168 hours

  21. Maximum Observed Plasma Concentration (Cmax) of GLASSIA

    Cmax of GLASSIA was reported.

    Measured: Day 1: through 48 hours, Day 13: through 48 hours, Day 22 and Day 50: through approximately 168 hours

  22. Apparent Volume of Distribution at Steady State (Vss) of GLASSIA

    Vss of GLASSIA was reported.

    Measured: Day 1: through 48 hours, Day 13: through 48 hours, Day 22 and Day 50: through approximately 168 hours

  23. Apparent Terminal Half-life (t1/2) of GLASSIA

    Apparent terminal half-life (hour), determined as ln2/lambda-z. lambda-z is the apparent terminal rate constant (one per hour), determined by linear regression of the terminal points of the log-linear concentration-time curve. Visual assessment will be used to identify the terminal linear phase of the concentration-time profile. A minimum of 3 data points will be used for determination. t1/2 of GLASSIA was reported.

    Measured: Day 1: through 48 hours, Day 13: through 48 hours, Day 22 and Day 50: through approximately 168 hours

  24. Mean Residence Time (MRT) of GLASSIA

    MRT of GLASSIA was not calculated.

    Measured: Day 1: through 48 hours, Day 13: through 48 hours, Day 22 and Day 50: through approximately 168 hours

  25. Trough Plasma Concentration at Steady State (Ctrough) of GLASSIA

    Ctrough of GLASSIA was not assessed due to the termination of the study.

    Measured: Day 1: through 48 hours, Day 13: through 48 hours, Day 22 and Day 50: through approximately 168 hours

Timeline

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

  1. First posted7 Nov 2016 (estimated)
  2. Study start26 Apr 2017
  3. Primary completion3 May 2018
  4. Study completion3 May 2018

Why it stopped: The decision to discontinue the study was based on business reasons.

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 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
1 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02956122
Sponsor's protocol ID
471501
Status last verified
Dec 2020
First submitted
24 Oct 2016
Last updated
13 Jan 2021
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No: De-identified individual participant data from this particular study will not be shared as there is a reasonable likelihood that individual patients could be re-identified (due to the low number of study participants).

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing GLASSIA, methylprednisolone or equivalent steroid and Albumin in people with Graft Versus Host Disease, run by Baxalta now part of Shire at 1 site in United States.

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 13 inclusion and 14 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: stopped early, as of the sponsor's last update on 13 Jan 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. 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. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 24 Apr 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?

Percentage of Participants Achieving Overall Response (OR) At Day 28 (time frame: Day 28). 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 13 Jan 2021.

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