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Hemophilia APhase 4NCT04565236

A Post Approval Commitment Study to Gain More Information on How Safe and Effective KOVALTRY is in Chinese Children, Adolescents /Adults With Severe Hemophilia A

A Phase 4 study testing Recombinant Factor VIII (Kovaltry, BAY81-8973) Treatment Group 1, Recombinant Factor VIII (Kovaltry, BAY81-8973) Treatment Group 2 and Recombinant Factor VIII (Kovaltry, BAY81-8973) Treatment Group 3 in people with Hemophilia A, run by Bayer at 10 sites in China.

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 goal of this study is to gather more information on safety and efficacy of Kovaltry for the prevention and treatment of bleeds in Chinese children, adolescents/adults with severe hemophilia A. In addition, pharmacokinetic parameters of Kovaltry will be assessed in a subset of patients. Read more about this study

Who is it for?
Ages 0 to 65 years, men only
Conditions the study is for
Hemophilia A
What is being tested?
Recombinant Factor VIII (Kovaltry, BAY81-8973) Treatment Group 1, Recombinant Factor VIII (Kovaltry, BAY81-8973) Treatment Group 2 and Recombinant Factor VIII (Kovaltry, BAY81-8973) Treatment Group 3
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
45 participants
Where
10 sitesChina
Study dates
22 Sep 2020to 15 Mar 2024
Phase
Phase 4
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 0 to 65 years
  • Men only
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Part A (PTPs):
  • Chinese participants with severe hemophilia A (defined as Factor VIII (FVIII): C < 1% with one- stage clotting assay documented at the time of screening)
  • Currently receiving on-demand or any type of prophylaxis treatment regimen with any FVIII product
  • For participants < 12 years of age, ≥ 50 exposure days (ED); for participants ≥ 12 to 65 years of age, ≥ 150 ED with any FVIII product
  • No current evidence of inhibitor
  • No history of FVIII inhibitor formation
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  • Signed informed consent
  • Part B (PUPs/MTPs):
  • Participants must be <6 years of age at the time of their parent or legal representative's signature of informed consent on the participant's behalf
  • Chinese participants with severe hemophilia A (defined as Factor VIII (FVIII): C < 1% with one- stage clotting assay documented at the time of screening)
  • PUPs must have no previous exposure to any FVIII product. MTPs must have no more than 1 ED with any purified FVIII concentrate or 3 exposures with FFP or cryoprecipitate.
  • MTPs must have no current evidence of inhibitor antibody as measured by the Nijmegen-modified Bethesda assay (<0.6 BU/mL) in 2 consecutive samples and must have absence of clinical signs or symptoms of decreased response to FVIII administration. Testing for the 2 negative samples must be performed by the central laboratory at least 1 week but not more than 2 weeks apart. Participants may not receive FVIII product within 72 hours prior to the collection of samples for inhibitor testing.
  • PUPs and MTPs must observe a 6-month washout period if they have received subcutaneous factor substitution therapy (emicizumab).
  • PUPs may be included if they will receive their first FVIII dose with KOVALTRY for treatment of first bleed and agree to start prophylaxis as part of their care. MTPs may be included if they agree to start prophylaxis as part of their care.

Who cannot join

  • Part A (PTPs):
  • Any other bleeding disease that is different from hemophilia A (e.g. von Willebrand disease, hemophilia B)
  • Platelet count < 100 000/mm^3
  • Impaired renal function (serum creatinine > 2.0 mg/dL) or active liver disease (alanine aminotransferase/aspartate aminotransferase [ALT/AST] > 5x ULN)
  • Human immunodeficiency virus (HIV) positive with an absolute CD4 lymphocyte cell count < 250 cells/μL
  • Known hypersensitivity to the active substance, mouse or hamster protein
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  • Receiving chemotherapy, immune modulatory drugs other than anti-retroviral chemotherapy, or chronic use of oral or intravenous (IV) corticosteroids (> 14 days) within the last 3 months.
  • Requiring any pre-medication to tolerate FVIII infusions (e.g. antihistamines)
  • Currently participating in another investigational drug study, or having previously participated in a clinical study involving an investigational drug within 30 days of signing informed consent or participated in completed interventional clinical studies with BAY81-8973 (Kovaltry)
  • Planned major surgery, defined as surgery with respiratory assistance and/or general anesthesia
  • Part B (PUPs/MTPs):
  • Any other bleeding disease that is different from hemophilia A (e.g. von Willebrand disease, hemophilia B)
  • Platelet count < 100 000/mm^3
  • Impaired renal function (serum creatinine >2× upper limit of normal [ULN]) or active liver disease (alanine aminotransferase [ALT] or aspartate aminotransferase [AST] >5× ULN) based on screening laboratory assessments
  • MTPs with history of FVIII inhibitor formation
  • Known hypersensitivity to the active substance, mouse or hamster protein
  • First treatment with KOVALTRY for high risk bleeding situations (e.g., surgery, intracranial bleed) or requiring intensive or prolonged treatment
  • Receiving chemotherapy, immune modulatory drugs other than anti-retroviral chemotherapy, or chronic use of oral or intravenous (IV) corticosteroids (> 14 days) within the last 3 months.
  • Requiring any pre-medication to tolerate FVIII infusions (e.g. antihistamines)
  • Currently participating in another investigational drug study, or having previously participated in a clinical study involving an investigational drug within 30 days of signing informed consent or participated in completed interventional clinical studies with BAY 81-8973 (Kovaltry)
  • Planned major surgery, defined as surgery with respiratory assistance and/or general anesthesia
  • Unable to tolerate volume of blood draws required for study participation

Trial locations and contacts

10 sites in 1 country.

10 sites in 1 country

China10 sites
  • Beijing Children's Hospital, Capital Medical University

    Beijing, Beijing Municipality, 100045

  • Peking Union Medical College Hospital CAMS

    Beijing, 100730

  • Chengdu Women & Children's Central Hospital

    Chengdu, Sichuan, 610091

  • The Children's Hospital Zhejiang University School of Med

    Hangzhou, Hangzhou Province, 310056

  • Jiangxi Provincial People's Hospital

    Nanchang, Jiangxi, 330006

  • NJ Drum Tower Hospital, the Affil Hos of NJ Univ Med School

    Nanjing, Jiangsu, 210008

  • Childrens Hospital of Shanghai

    Shanghai, TBC

  • Shijiazhuang General Hospital

    Shijiazhuang, Hebei, 50000

  • 1st Affiliated hospital of Soochow University

    Suzhou, Jiangsu, 215000

  • Children's Hospital of Shanxi

    Taiyuan, Shanxi, 30013

Other trials in China

About this study

Official title: A Post Approval Commitment Study to Evaluate the Efficacy, Safety, and Pharmacokinetics of KOVALTRY in Chinese Children, Adolescents /Adults With Severe Hemophilia A

The goal of this study is to gather more information on safety and efficacy of Kovaltry for the prevention and treatment of bleeds in Chinese children, adolescents/adults with severe hemophilia A. In addition, pharmacokinetic parameters of Kovaltry will be assessed in a subset of patients.

Conditions
Hemophilia A
Being tested
Recombinant Factor VIII (Kovaltry, BAY81-8973) Treatment Group 1, Recombinant Factor VIII (Kovaltry, BAY81-8973) Treatment Group 2, Recombinant Factor VIII (Kovaltry, BAY81-8973) Treatment Group 3
Medical subject headings
Hemophilia A

What participants receive

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

  • Recombinant Factor VIII (Kovaltry, BAY81-8973) Treatment Group 1Biological

    25 to 50 IU of Kovaltry per kg body weight given via intravenous (IV) infusion twice weekly, three times weekly, or every other day according to individual requirements for 6 months.

    The dose decisions are at the discretion of the investigator.

  • Recombinant Factor VIII (Kovaltry, BAY81-8973) Treatment Group 2Biological

    12 year-old: 25 to 50 IU of Kovaltry per kg body weight given via intravenous (IV) infusion twice weekly, three times weekly, or every other day for 6 months.

    >12 year-old: 20 to 40 IU of Kovaltry per kg of body weight given via intravenous (IV) infusion two or three times per week for 6 months.

    The dose decisions are at the discretion of the investigator.

  • Recombinant Factor VIII (Kovaltry, BAY81-8973) Treatment Group 3Biological

    15 to 50 IU of Kovaltry per kg body weight (minimum dose: 250 IU) given via intravenous (IV) infusions at least once a week.

    The dose decisions are at the discretion of the investigator.

Study groups in NCT04565236
Study groupRoleWhat they receive
Part A: PTPs <12 years of ageExperimentalPreviously treated severe hemophilia A patients (PTPs) <12 years of age
Receives: Biological: Recombinant Factor VIII (Kovaltry, BAY81-8973) Treatment Group 1
Part A: PTPs ≥12 to 65 years of ageExperimentalPreviously treated severe hemophilia A patients (PTPs) ≥12 to 65 years of age
Receives: Biological: Recombinant Factor VIII (Kovaltry, BAY81-8973) Treatment Group 2
Part B: PUPs/MTPs <6 years of ageExperimentalPreviously untreated/minimally treated severe hemophilia A patients (PUPs/MTPs) <6 years of age
Receives: Biological: Recombinant Factor VIII (Kovaltry, BAY81-8973) Treatment Group 3

What is being measured

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

  1. Annualized Bleeding Rate (ABR) of All Bleeding Episodes During Prophylaxis Treatment in Part A

    Annualized number (mean +/- standard deviation) of all bleeding episodes that occurred during the prophylaxis treatment period is reported for previously treated patients (PTPs). All bleeding episodes: sum of spontaneous bleeds and trauma bleeds exclude bleeding due to surgery.

    Measured: Up to 6 months

  2. Annualized Bleeding Rate (ABR) of All Bleeding Episodes Within 48 Hours of Previous Prophylaxis Infusion in Part B

    Annualized number (mean +/- standard deviation) of all bleeding episodes that occurred within 48 hours of previous prophylaxis infusion is reported for previously untreated/minimally treated patients (PUPs/MTPs). All bleeding episodes: sum of spontaneous bleeds and trauma bleeds exclude bleeding due to surgery.

    Measured: Up to 48 hours post-infusion during 6 months

Secondary outcomes (11)
  1. Annualized Bleeding Rate (ABR) of All Bleeding Episodes Within 48 Hours of Previous Prophylaxis Infusion in Part A

    Annualized number (mean +/- standard deviation) of all bleeding episodes that occurred within 48 hours of previous prophylaxis infusion is reported for previously treated patients (PTPs). All bleeding episodes: sum of spontaneous bleeds and trauma bleeds exclude bleeding due to surgery.

    Measured: Up to 48 hours post-infusion during 6 months

  2. Annualized Bleeding Rate (ABR) of All Bleeding Episodes During Prophylaxis Treatment in Part B

    Annualized number (mean +/- standard deviation) of all bleeding episodes that occurred during the prophylaxis treatment period is reported for previously untreated/minimally treated patients (PUPs/MTPs). All bleeding episodes: sum of spontaneous bleeds and trauma bleeds exclude bleeding due to surgery.

    Measured: Up to 51 exposure days

  3. Number of Infusions Per Bleeding Episode

    The mean value of number of infusions for the treatment of one bleed to achieve hemostasis is reported.

    Measured: Part A: up to 6 months; Part B: up to 51 exposure days

  4. Number of Surgeries Per Physician's Assessment of Adequacy of Hemostasis in Minor Surgery

    For participants who underwent minor surgeries during the study, investigators were ask to assess the adequacy of hemostasis during the surgeries as excellent, good, moderate or poor. Number of surgeries per assessment is reported.

    Measured: Part A: up to 6 months; Part B: up to 51 exposure days

  5. FVIII In-vivo Recovery in Part B

    Incremental recovery of Factor VIII (FVIII) was determined by collecting blood samples pre-infusion and 15-30 minutes after the end of the infusion. Mean recovery values at different time points are reported.

    Measured: At baseline, Visit 6 (ED 20), unscheduled visit and final visit, up to 51 exposure days

  6. Factor VIII Inhibitor Development by the Nijmegen Bethesda Assay

    Number of participants who developed a positive Factor VIII (FVIII) inhibitor level (≥0.6 Bethesda unit [BU/mL]) during the study is reported.

    Measured: Part A: up to 6 months; Part B: up to 51 exposure days

  7. Number of Participants With Treatment-emergent Adverse Events

    An adverse event (AE) was any untoward medical occurrence in a participant, associated with the use of study intervention, whether or not considered related to the study intervention. A serious adverse event (SAE) was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening; persistent or significant disability/incapacity; congenital anomaly/birth defect; another medical important serious event as judged by the investigator. AEs or SAEs were considered to be treatment emergent (TEAEs or TESAEs) if they started after the first KOVALTRY infusion and up to 3 days after the last dose.

    Measured: Part A: up to 6 months; Part B: up to 51 exposure days

  8. FVIII In-vivo Recovery in Part A

    Incremental recovery of Factor VIII (FVIII) was determined by collecting blood samples pre-infusion and 15-30 minutes after the end of the infusion. Mean recovery values at different time points are reported.

    Measured: At baseline, Month 2 and final visit, up to 6 months

  9. Maximum Observed Concentration of FVIII in Plasma (Cmax) in Part A

    For the assessment, participants were administered a dose of 50 IU/kg KOVALTRY. Participants must have no signs or symptoms of an acute bleeding episode. For participants below 12 years, the evaluation was only performed once at baseline. For adolescents/adult participants 12 years or older, the evaluation was performed twice at baseline and at final visit.

    Measured: at baseline for PTPs < 12 Years and at baseline and final visit (month 6) for PTPs >= 12 Years

  10. Area Under the Plasma Concentration of FVIII Versus Time Curve From Zero to Infinity (AUC) in Part A

    For the assessment, participants were administered a dose of 50 IU/kg KOVALTRY. Participants must have no signs or symptoms of an acute bleeding episode. For participants below 12 years, the evaluation was only performed once at baseline. For adolescents/adult participants 12 years or older, the evaluation was performed twice at baseline and at final visit.

    Measured: at baseline for PTPs < 12 Years and at baseline and final visit (month 6) for PTPs >= 12 Years

  11. Half-life (t1/2) of FVIII in Plasma in Part A

    For the assessment, participants were administered a dose of 50 IU/kg KOVALTRY. Participants must have no signs or symptoms of an acute bleeding episode. For participants below 12 years, the evaluation was only performed once at baseline. For adolescents/adult participants 12 years or older, the evaluation was performed twice at baseline and at final visit.

    Measured: at baseline for PTPs < 12 Years and at baseline and final visit (month 6) for PTPs >= 12 Years

Timeline

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

  1. First posted25 Sep 2020
  2. Study start22 Sep 2020
  3. Primary completion15 Mar 2024
  4. Study completion15 Mar 2024

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 4
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
45 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04565236
Sponsor's protocol ID
19855
Other IDs
2021-003537-11
Status last verified
Apr 2025
First submitted
4 Sep 2020
Last updated
18 Apr 2025
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No: Availability of this study's data will later be determined according to Bayer's commitment to the EFPIA/PhRMA "Principles for responsible clinical trial data sharing". This pertains to scope, timepoint and process of data access. As such, Bayer commits to sharing upon request from qualified researchers patient-level clinical trial data, study-level clinical trial data, and protocols from clinical trials in patients for medicines and indications approved in the US and EU as necessary for conducting legitimate research. This applies to data on new medicines and indications that have been approved by the EU and US regulatory agencies on or after January 01, 2014. Interested researchers can use www.vivli.org to request access to anonymized patient-level data and supporting documents from clinical studies to conduct research. Information on the Bayer criteria for listing studies and other relevant information is provided in the member section of the portal.

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Recombinant Factor VIII (Kovaltry, BAY81-8973) Treatment Group 1, Recombinant Factor VIII (Kovaltry, BAY81-8973) Treatment Group 2 and Recombinant Factor VIII (Kovaltry, BAY81-8973) Treatment Group 3 in people with Hemophilia A, run by Bayer at 10 sites in China.

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 14 inclusion and 22 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 18 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 10 sites in China. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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 18 Apr 2025). 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?

Annualized Bleeding Rate (ABR) of All Bleeding Episodes During Prophylaxis Treatment in Part A (time frame: Up to 6 months). The study lists 2 primary outcomes in all. 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 18 Apr 2025.

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