Pharmacokinetic, Efficacy, and Safety Study of Octafibrin Compared to Haemocomplettan/Riastap
A Prospective, Controlled, Randomised, Crossover Study Investigating the Pharmacokinetic Properties, Surrogate Efficacy and Safety of Octafibrin Compared to Haemocomplettan® P/RiaSTAPTM in Patients With Congenital Fibrinogen Deficiency
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
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Sofia, Bulgaria
- Specialized Hospital for Active Treatment "Joan Pavel"
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Bangalore, India
- Department of Hematology St. John's Medical College Hospital
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Prune, India
- Sahyadri Speciality Hospital
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Vellore, India
- Department of Hematology Christian Medical College
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Shiraz, Iran, Islamic Republic of
- Nemazee Hospital Shiraz University of Medical Sciences
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Tehran, Iran, Islamic Republic of
- Tehran University of Medical Sciences
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Zurich, Switzerland
- Department of Hematology University Hospital
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London, United Kingdom
- The Centre for Haemostatis and Thrombosis
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Colorado
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Aurora, Colorado, United States, 80045
- University of Colorado Hemophilia & Thrombosis Center
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New York
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New Hyde Park, New York, United States, 11040
- Cohen Children's Medical Center of New York
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age ≥ 12 years.
- Documented congenital fibrinogen deficiency (afibrinogenemia).
Exclusion Criteria:
- Life expectancy > 6 month.
- Bleeding disorder other than congenital fibrinogen deficiency.
- Presence or history of hypersensitivity to study medication.
- Presence or history of deep vein thrombosis or pulmonary embolism within 1 year prior to enrollment.
- Presence or history of arterial thrombosis with 1 year prior to enrollment.
- Hypersensitivity to human plasma products.
- Acute bleeding.
- Pregnant or currently breast-feeding women.
- Suspicion of an anti-fibrinogen inhibitor as indicated by previous in vivo recovery (if available).
- Blood or plasma donation in the 3 months prior to enrollment.
- Human immunodeficiency virus (HIV) positive with a viral load > 200 particles/µl or > 400000 copies/mL.
- End-stage liver disease.
- History of oesophageal varicose bleeding.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Experimental: Octafibrin followed by Haemocomplettan® P or RiaSTAPTM
Participants received Octafibrin 70 mg/kg intravenously once followed by Haemocomplettan® P or RiaSTAPTM 70 mg/kg intravenously once 45 days later.
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Octafibrin was supplied as a powder for reconstitution with water for injection.
Other Names:
Commercially available Haemocomplettan® P or RiaSTAPTM (same product with different names in different markets) were supplied as powders for reconstitution with water for injection.
Other Names:
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Experimental: Haemocomplettan® P or RiaSTAPTM followed by Octafibrin
Participants received Haemocomplettan® P or RiaSTAPTM 70 mg/kg intravenously once followed by Octafibrin 70 mg/kg intravenously once 45 days later.
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Octafibrin was supplied as a powder for reconstitution with water for injection.
Other Names:
Commercially available Haemocomplettan® P or RiaSTAPTM (same product with different names in different markets) were supplied as powders for reconstitution with water for injection.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Ratio of Octafibrin/FIBRYGA® to Haemocomplettan® P/RiaSTAP(TM) for Fibrinogen Activity Normalized Area Under the Curve Unstandardized
Time Frame: Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Fibrinogen activity was determined via a validated Clauss assay (fibrinogen activity) and fibrinogen-specific enzyme-linked immunosorbent assay (ie, fibrinogen antigen) using paired antibodies for fibrinogen antigen.
All determinations were performed on frozen plasma samples in a central laboratory.
The Clauss assay was modified and validated to achieve a limit of quantification of 0.2 g/L.
The pharmacokinetic analysis was assessed individually using a non-compartmental model.
Plasma levels were measured at Baseline, and at 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment.
The mean ratio of normalized area under the curve was calculated as Octafibrin/FIBRYGA® over Haemocomplettan® P/RiaSTAP(TM)
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Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Comparison of Maximum Clot Firmness Between Octafibrin/FIBRYGA® and Haemocomplettan® P/RiaSTAP(TM) at 1 hr Post Infusion
Time Frame: 1 hour post-treatment
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Thromboelastometry (ROTEM®) was used to measure maximum clot firmness.
Thromboelastometry is a method for the continuous measurement of clot formation.
Maximum clot firmness is a functional parameter that depends on the activation of coagulation, the platelet and fibrinogen content of the blood sample, and the polymerisation and cross-linking of the fibrin network.
In order to obtain comparable results from all study centres, maximum clot firmness data were assessed from frozen citrated plasma samples in a central laboratory.
As these samples did not contain platelets that would be found in the whole blood assay, the fibrinogen content primarily defined the maximum clot firmness.
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1 hour post-treatment
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Fibrinogen Activity Normalized Area Under the Curve Unstandardized
Time Frame: Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Fibrinogen activity was determined via a validated Clauss assay (fibrinogen activity) and fibrinogen-specific enzyme-linked immunosorbent assay (ie, fibrinogen antigen) using paired antibodies for fibrinogen antigen.
All determinations were performed on frozen plasma samples in a central laboratory.
The Clauss assay was modified and validated to achieve a limit of quantification of 0.2 g/L.
The pharmacokinetic analysis was assessed individually using a non-compartmental model.
Plasma levels were measured at Baseline, and at 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment.
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Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Fibrinogen Activity Normalized Area Under the Curve Standardized
Time Frame: Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Fibrinogen activity was determined via a validated Clauss assay (fibrinogen activity) and fibrinogen-specific enzyme-linked immunosorbent assay (ie, fibrinogen antigen) using paired antibodies for fibrinogen antigen.
All determinations were performed on frozen plasma samples in a central laboratory.
The Clauss assay was modified and validated to achieve a limit of quantification of 0.2 g/L.
The pharmacokinetic analysis was assessed individually using a non-compartmental model.
Plasma levels were measured at Baseline, and at 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment.
The normalized area under the curve was standardized to a dose of 70 mg/kg.
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Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Maximum Plasma Concentration Normalized (Cmaxnorm)
Time Frame: Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Fibrinogen activity was determined via a validated Clauss assay (fibrinogen activity) and fibrinogen-specific enzyme-linked immunosorbent assay (ie, fibrinogen antigen) using paired antibodies for fibrinogen antigen.
All determinations were performed on frozen plasma samples in a central laboratory.
The Clauss assay was modified and validated to achieve a limit of quantification of 0.2 g/L.
The pharmacokinetic analysis was assessed individually using a non-compartmental model.
Plasma levels were measured at Baseline, and at 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment.
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Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Maximum Plasma Concentration (Cmax) Unstandardized
Time Frame: Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Fibrinogen activity was determined via a validated Clauss assay (fibrinogen activity) and fibrinogen-specific enzyme-linked immunosorbent assay (ie, fibrinogen antigen) using paired antibodies for fibrinogen antigen.
All determinations were performed on frozen plasma samples in a central laboratory.
The Clauss assay was modified and validated to achieve a limit of quantification of 0.2 g/L.
The pharmacokinetic analysis was assessed individually using a non-compartmental model.
Plasma levels were measured at Baseline, and at 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment.
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Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Maximum Plasma Concentration (Cmax) Standardized
Time Frame: Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Fibrinogen activity was determined via a validated Clauss assay (fibrinogen activity) and fibrinogen-specific enzyme-linked immunosorbent assay (ie, fibrinogen antigen) using paired antibodies for fibrinogen antigen.
All determinations were performed on frozen plasma samples in a central laboratory.
The Clauss assay was modified and validated to achieve a limit of quantification of 0.2 g/L.
The pharmacokinetic analysis was assessed individually using a non-compartmental model.
Plasma levels were measured at Baseline, and at 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment.
The maximum plasma concentration was standardized to a dose of 70 mg/kg.
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Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Incremental in Vivo Recovery
Time Frame: Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Incremental in vivo recovery was calculated as the maximum increase in plasma fibrinogen (fibrinogen activity assay data) within 4 hours post-treatment as compared with pre-treatment (expressed as an absolute mg/dL concentration in plasma), divided by the exact dose of Octafibrin/FIBRYGA® or Haemocomplettan® P/RiaSTAP(TM) (expressed as mg/kg dosed).
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Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Classical in Vivo Recovery
Time Frame: Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Classical in vivo recovery was calculated as: 100 x the maximum increase in plasma fibrinogen (fibrinogen activity assay data) within 4 hours post-treatment as compared with pre-treatment (expressed as an absolute mg/dL concentration in plasma) x the plasma volume (mL), divided by the exact dose of Octafibrin/FIBRYGA® or Haemocomplettan® P/RiaSTAP(TM) (expressed as mg).
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Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Time to Reach Maximum Plasma Concentration (Tmax)
Time Frame: Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Fibrinogen activity was determined via a validated Clauss assay (fibrinogen activity) and fibrinogen-specific enzyme-linked immunosorbent assay (ie, fibrinogen antigen) using paired antibodies for fibrinogen antigen.
All determinations were performed on frozen plasma samples in a central laboratory.
The Clauss assay was modified and validated to achieve a limit of quantification of 0.2 g/L.
The pharmacokinetic analysis was assessed individually using a non-compartmental model.
Plasma levels were measured at Baseline, and at 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment.
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Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Terminal Half-life (t½)
Time Frame: Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Fibrinogen activity was determined via a validated Clauss assay (fibrinogen activity) and fibrinogen-specific enzyme-linked immunosorbent assay (ie, fibrinogen antigen) using paired antibodies for fibrinogen antigen.
All determinations were performed on frozen plasma samples in a central laboratory.
The Clauss assay was modified and validated to achieve a limit of quantification of 0.2 g/L.
The pharmacokinetic analysis was assessed individually using a non-compartmental model.
Plasma levels were measured at Baseline, and at 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment.
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Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Mean Residence Time (MRT)
Time Frame: Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Fibrinogen activity was determined via a validated Clauss assay (fibrinogen activity) and fibrinogen-specific enzyme-linked immunosorbent assay (ie, fibrinogen antigen) using paired antibodies for fibrinogen antigen.
All determinations were performed on frozen plasma samples in a central laboratory.
The Clauss assay was modified and validated to achieve a limit of quantification of 0.2 g/L.
The pharmacokinetic analysis was assessed individually using a non-compartmental model.
Plasma levels were measured at Baseline, and at 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment.
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Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Clearance
Time Frame: Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Fibrinogen activity was determined via a validated Clauss assay (fibrinogen activity) and fibrinogen-specific enzyme-linked immunosorbent assay (ie, fibrinogen antigen) using paired antibodies for fibrinogen antigen.
All determinations were performed on frozen plasma samples in a central laboratory.
The Clauss assay was modified and validated to achieve a limit of quantification of 0.2 g/L.
The pharmacokinetic analysis was assessed individually using a non-compartmental model.
Plasma levels were measured at Baseline, and at 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment.
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Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Volume of Distribution at Steady State (Vss)
Time Frame: Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Fibrinogen activity was determined via a validated Clauss assay (fibrinogen activity) and fibrinogen-specific enzyme-linked immunosorbent assay (ie, fibrinogen antigen) using paired antibodies for fibrinogen antigen.
All determinations were performed on frozen plasma samples in a central laboratory.
The Clauss assay was modified and validated to achieve a limit of quantification of 0.2 g/L.
The pharmacokinetic analysis was assessed individually using a non-compartmental model.
Plasma levels were measured at Baseline, and at 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment.
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Baseline to 0.5, 1, 2, 4, 8, 24, 48, 96, 144, 216, and 312 hours post-treatment
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Sigurd Knaub, PhD, Octapharma
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- FORMA-01
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