Efficacy of Atenativ in Patients With Congenital Antithrombin Deficiency Undergoing Surgery or Delivery

September 25, 2026 updated by: Octapharma

A Multicenter, Prospective, Open-label, Uncontrolled Phase 3 Study to Assess the Efficacy, Safety and Pharmacokinetics of Atenativ in Patients With Congenital Antithrombin Deficiency Undergoing Surgery or Delivery

The goal of this study is to assess the incidence of the composite of thrombotic events (TEs) and thromboembolic events (TEEs) in patients with congenital antithrombin deficiency under when they receive Atenativ for surgical procedures or parturition.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
38

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Armenia
      • Yerevan, Armenia
        • Recruiting
        • Yeolyan Hematology and Oncology Centre
  • Austria
      • Vienna, Austria
        • Recruiting
        • Medizinische Universität Wien. Universitätsklinik für Innere Medizin Klinische Abteilung für Hämatologie und Hämostaseologie
  • Czechia
      • Nymburk, Czechia
        • Recruiting
        • Centre for Thrombosis and Haemaostasis Nemocnice
  • France
      • Bron, France
        • Recruiting
        • Centre de Référence de l'Hémophilie Unité d'Hémostase Clinique Hôpital Cardiologique Louis Pradel
      • Reims, France
        • Recruiting
        • University Hospital of Reims
      • Rouen, France
        • Recruiting
        • Centre Hospitalier Universitaire de Rouen (CHU de Rouen) - Centre de Traitement des Maladies Hemorragiques (CRTH) (Centre d'Hemophiles)
  • Georgia
      • Tbilisi, Georgia
        • Recruiting
        • Aversi Clinic
  • Germany
      • Berlin, Germany
        • Recruiting
        • Vivantes Klinikum Friedrichshain Klinik für Angiologie Hämostaseologie
      • Bonn, Germany
        • Recruiting
        • UKB Bonn Institut für Experimentelle Hämatologie und Transfusionsmedizin
      • Duisburg, Germany
        • Recruiting
        • Gerinnungszentrum Rhein-Ruhr
  • Hungary
      • Debrecen, Hungary
        • Recruiting
        • University of Debrecen, Medical and Health Science Centre
  • Israel
      • Petah Tikva, Israel
        • Recruiting
        • Rabin Medical Centre, Institute of Haematology
      • Ramat Gan, Israel
        • Recruiting
        • Sheba Medical Centre
  • Italy
      • Bergamo, Italy, 24127
        • Recruiting
        • Unita Strutturale Complessa di Immunoematologia e Medicina Trasfusionale -Dipartimento Interaziendale di Medicina Trasfusionale ed Ematologia - ASST Papa Giovanni XXIII ematologia Piazza OMS, 1
      • Milan, Italy
        • Recruiting
        • Universita degli Studi di Milano - IRCCS Ospedale Maggiore Policlinico - Centro Emofilia e Trombosi Angelo Bianchi Bonomi
      • Padua, Italy
        • Recruiting
        • University of Padua Medical School
      • Roma, Italy
        • Recruiting
        • Fondazione Policlinico Universitario Agostino Gemelli IRCCS
  • Romania
      • Craiova, Romania
        • Recruiting
        • Emergency County Hospital Craiova
  • Serbia
      • Belgrade, Serbia
        • Recruiting
        • Clinical Center of Serbia
  • Spain
      • Madrid, Spain, 28046
        • Recruiting
        • Hospital Universitario La Paz
      • Murcia, Spain
        • Recruiting
        • Hospital Universitario Morales Meseguer
      • Ourense, Spain, 32005
        • Recruiting
        • Ourense University Hospital
    • Principality of Asturias
      • Oviedo, Principality of Asturias, Spain, 33011
        • Recruiting
        • Central University Hospital of Asturias
  • United Kingdom
      • London, United Kingdom
        • Recruiting
        • Royal-free Hospital-Katherine Dormandy Haemophilia and Thrombosis Centre
      • London, United Kingdom
        • Recruiting
        • St. Thomas Hospital, Guy's and St. Thomas' NHS Foundation Trust
  • United States
    • District of Columbia
      • Washington D.C., District of Columbia, United States, 20057
        • Recruiting
        • Georgetown University Hospital
    • Florida
      • Miami, Florida, United States, 33124
        • Recruiting
        • University of Miami, Miller School of Medicine
    • Illinois
      • Peoria, Illinois, United States, 61615
        • Recruiting
        • Bleeding and Clotting Disorders Institute
    • New York
      • New York, New York, United States, 10065
        • Recruiting
        • Weill Cornell Medicine, New York Presbyterian Hospital
    • North Carolina
      • Durham, North Carolina, United States, 27708
        • Recruiting
        • Duke University School of Medicine, Division of Hematology

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

12 years to 80 years (Child, Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Adult male or female patients ≥18 and ≤80 years of age. Solely in the US, 4 male or female patients between ≥12 and <17 years of age will be enrolled into the PK phase, and subsequently in the treatment phase, if applicable
  2. Documented congenital antithrombin deficiency, defined by plasma activity level of antithrombin ≤60% from medical history
  3. Personal or family history of TEs or TEEs (except for PK patients)
  4. For the Treatment Phase: either a) non-pregnant surgical patients scheduled for elective surgical procedure(s) known to be associated with a high risk for occurrence of TEs or TEEs, or b) pregnant patients of at least 27 weeks gestational age who are scheduled for caesarean section or delivery
  5. For female patients of childbearing potential entering the PK Phase who are not known to be pregnant, and for female surgical patients of childbearing potential entering the Treatment Phase for any procedure other than caesarean section or delivery, a negative urine pregnancy test at screening and at baseline
  6. Patient has provided informed consent

Exclusion Criteria:

  1. Requires emergency surgery or emergency caesarean section

  2. Has undergone surgery within the last 6 weeks

  3. History or suspicion of another hereditary thrombophilic disorder other than antithrombin deficiency (e.g., activated protein C [APC] resistance/Factor V Leiden, Protein S or C deficiency, prothrombin gene mutation [G20210A], or acquired [lupus anticoagulant] thrombophilic disorder)

  4. Malignancies, renal failure (patients on renal replacement therapy), or severe liver disease (aspartate aminotransferase [ASAT] >5 times the upper limit of normal)

  5. Body mass index >40 kg/m2 (for non-pregnant patients, only)

  6. Known hypersensitivity or allergic reaction to antithrombin or any of the excipients in Atenativ

  7. History of anaphylactic reaction(s) to blood or blood components

  8. Refusal to receive transfusion of blood-derived products

  9. Administration of any antithrombin concentrate or antithrombin-containing blood product within 14 days of either of the two phases of the study

  10. Prior diagnosis of heparin-induced thrombocytopenia

  11. TE or TEE within the last 6 months

  12. Female patients who are nursing at the time of screening*

  13. Have participated in another investigational study within the last 30 days

  14. Persons dependent on the sponsor, the investigator or the centre of investigation

  15. Persons placed in an institution by administrative or judicial order

    • criterion does not include female patients who plan to breastfeed after giving birth

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Atenativ treatment

During the PK phase, patients will receive a 60 IU/kg Atenativ as a single intravenous infusion for PK analysis.

During the treatment phase, patients will receive a single intravenous loading dose followed by maintenance doses administered every 24 hours for approximately 2-7 days for surgical patients and approximately 5 days for parturients
Drug: Atenativ

Antithrombin concentrate

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Thrombotic event incidence
Time Frame: Up to day 30 post treatment initiation

The primary objective of this study is to assess the incidence of the composite of TEs and TEEs in patients with congenital antithrombin deficiency under cover of Atenativ for surgical procedures or parturition
Up to day 30 post treatment initiation

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Single dose Pharmacokinetics of Atenativ: Area under the curve (AUCnorm(0-∞))
Time Frame: Up to day 14 post PK infusion

Assess the area under the curve (AUCnorm(0-∞)) of Atenativ in patients with congenital antithrombin deficiency
Up to day 14 post PK infusion
Single dose Pharmacokinetics of Atenativ: Maximum plasma concentration (Cmax)
Time Frame: Before first infusion, 20 minutes, 1 hour, 3 hours, 8 hrs, 1 day, 2 days, 3, days, 4 days, 5 days, 6 days, 7 days, 8 days, 10 days, 12 days and 14 days post-infusion

Assess the maximum plasma concentration (Cmax) after a single dose of Atenativ in patients with congenital antithrombin deficiency
Before first infusion, 20 minutes, 1 hour, 3 hours, 8 hrs, 1 day, 2 days, 3, days, 4 days, 5 days, 6 days, 7 days, 8 days, 10 days, 12 days and 14 days post-infusion
Single dose Pharmacokinetics of Atenativ: Half-life (t1/2)
Time Frame: Before first infusion, 20 minutes, 1 hour, 3 hours, 8 hrs, 1 day, 2 days, 3, days, 4 days, 5 days, 6 days, 7 days, 8 days, 10 days, 12 days and 14 days post-infusion

Assess the half-life (t1/2) after a single dose of Atenativ in patients with congenital antithrombin deficiency
Before first infusion, 20 minutes, 1 hour, 3 hours, 8 hrs, 1 day, 2 days, 3, days, 4 days, 5 days, 6 days, 7 days, 8 days, 10 days, 12 days and 14 days post-infusion
Single dose Pharmacokinetics of Atenativ: Mean residence time (MRT)
Time Frame: Before first infusion, 20 minutes, 1 hour, 3 hours, 8 hrs, 1 day, 2 days, 3, days, 4 days, 5 days, 6 days, 7 days, 8 days, 10 days, 12 days and 14 days post-infusion

Assess the mean residence time (MRT) after a single dose of Atenativ in patients with congenital antithrombin deficiency
Before first infusion, 20 minutes, 1 hour, 3 hours, 8 hrs, 1 day, 2 days, 3, days, 4 days, 5 days, 6 days, 7 days, 8 days, 10 days, 12 days and 14 days post-infusion
Single dose Pharmacokinetics of Atenativ: Clearance (CL)
Time Frame: Before first infusion, 20 minutes, 1 hour, 3 hours, 8 hrs, 1 day, 2 days, 3, days, 4 days, 5 days, 6 days, 7 days, 8 days, 10 days, 12 days and 14 days post-infusion

Assess the clearance (CL) after a single dose of Atenativ in patients with congenital antithrombin deficiency
Before first infusion, 20 minutes, 1 hour, 3 hours, 8 hrs, 1 day, 2 days, 3, days, 4 days, 5 days, 6 days, 7 days, 8 days, 10 days, 12 days and 14 days post-infusion
Single dose Pharmacokinetics of Atenativ: Incremental in vivo recovery (IVR)
Time Frame: Before first infusion, 20 minutes, 1 hour, 3 hours, 8 hrs, 1 day, 2 days, 3, days, 4 days, 5 days, 6 days, 7 days, 8 days, 10 days, 12 days and 14 days post-infusion

Assess the Incremental in vivo recovery after a single dose of Atenativ in patients with congenital antithrombin deficiency
Before first infusion, 20 minutes, 1 hour, 3 hours, 8 hrs, 1 day, 2 days, 3, days, 4 days, 5 days, 6 days, 7 days, 8 days, 10 days, 12 days and 14 days post-infusion
Single dose Pharmacokinetics of Atenativ: Volume of distribution at steady state (Vss)
Time Frame: Before first infusion, 20 minutes, 1 hour, 3 hours, 8 hrs, 1 day, 2 days, 3, days, 4 days, 5 days, 6 days, 7 days, 8 days, 10 days, 12 days and 14 days post-infusion

Assess the volume of distribution at steady state (Vss) after a single dose of Atenativ in patients with congenital antithrombin deficiency
Before first infusion, 20 minutes, 1 hour, 3 hours, 8 hrs, 1 day, 2 days, 3, days, 4 days, 5 days, 6 days, 7 days, 8 days, 10 days, 12 days and 14 days post-infusion
Single dose Pharmacokinetics of Atenativ: Maximum Plasma Concentration (Tmax)
Time Frame: Before first infusion, 20 minutes, 1 hour, 3 hours, 8 hrs, 1 day, 2 days, 3, days, 4 days, 5 days, 6 days, 7 days, 8 days, 10 days, 12 days and 14 days post-infusion

Assess the time to reach Maximum Plasma Concentration (Tmax) after a single dose of Atenativ in patients with congenital antithrombin deficiency
Before first infusion, 20 minutes, 1 hour, 3 hours, 8 hrs, 1 day, 2 days, 3, days, 4 days, 5 days, 6 days, 7 days, 8 days, 10 days, 12 days and 14 days post-infusion
10. Coagulation parameters: Activated partial thromboplastin time [aPTT]
Time Frame: Up to day 7 post treatment initiation

Assess activated partial thromboplastin time [aPTT] in patients with congenital antithrombin deficiency undergoing surgical procedures or parturition
Up to day 7 post treatment initiation
Coagulation parameters: Prothrombin time [PT]
Time Frame: Up to day 7 post treatment initiation

Assess prothrombin time [PT] in patients with congenital antithrombin deficiency undergoing surgical procedures or parturition
Up to day 7 post treatment initiation
Coagulation parameters: International normalised ratio [INR]
Time Frame: Up to day 7 post treatment initiation

Assess international normalised ratio [INR] in patients with congenital antithrombin deficiency undergoing surgical procedures or parturition
Up to day 7 post treatment initiation
Coagulation parameters: Fibrinogen level
Time Frame: Up to day 7 post treatment initiation

Assess fibrinogen in patients with congenital antithrombin deficiency undergoing surgical procedures or parturition
Up to day 7 post treatment initiation
Safety and tolerability: Number of adverse events (AEs)
Time Frame: Up to day 30 post treatment initiation

Number of adverse events (AEs) following treatment with Atenativ in patients with congenital antithrombin deficiency
Up to day 30 post treatment initiation

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Octapharma

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
July 1, 2022

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 1, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 1, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
May 18, 2021

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 4, 2021

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
June 8, 2021

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
September 28, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
September 25, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
September 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • ATN-106

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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