- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT01571934
Inhibitor Development in Patients With Hemophilia A Undergoing Surgery (PASs)
연구 개요
상태
정황
상세 설명
The development of neutralizing anti-factor VIII (fVIII) antibodies, fVIII inhibitor, is the most significant complication affecting patients with hemophilia A (HA). Once an inhibitor develops, treatment is less effective and costly. Although inhibitors occur most commonly in those with severe HA, 25% of new inhibitors occur in those with non-severe HA. In patients with non-severe HA, the development of a fVIII inhibitor can change the course of disease from one that is easily managed to one with the potential for spontaneous life-threatening difficult to treat bleeding. Although significant advances have been made in understanding risk factors for fVIII inhibitor development in patients with severe HA, studies that seek to understand the risk for fVIII inhibitor development in those with non-severe disease have been limited to retrospective analyses. In these retrospective analyses, intensive fVIII treatment and surgery have been identified as risk factors for fVIII inhibitor development in non-severe HA. Additionally, receiving fVIII by continuous infusion has been associated with fVIII inhibitor development in non-severe HA in some but not all studies and may be due in part to a more robust proinflammatory response during continuous infusion. Accordingly, the next logical step to evaluate the risk of inhibitor development associated with continuous fVIII infusion is a prospective observational cohort study. Additionally, knowledge of the immune response to fVIII in the surgical setting is essential for identification of patients at high risk for inhibitor development and development of strategies to prevent inhibitor development and is best evaluated in the setting of an prospective cohort study.
This multicenter prospective observational cohort study will enroll a total of 140 subjects at 10 centers who have mild or moderate hemophilia a (fVIII activity 1-40%) who are scheduled to undergo surgery for which at least 5 consecutive days of fVIII replacement therapy is required. The study will gather clinical data and collect blood specimens on 4 occasions over a 3 month period. Outcomes include: inhibitor development, total fVIII usage, bleeding, and markers of T cell activation.
연구 유형
등록 (실제)
연락처 및 위치
연구 장소
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Colorado
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Aurora, Colorado, 미국, 80045
- University of Colorado, Hemophilia and Thrombosis Center
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Georgia
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Atlanta, Georgia, 미국, 30322
- Emory University Comprehensive Hemophilia Treatment Center
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Indiana
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Indianapolis, Indiana, 미국, 46260
- Indiana Hemophilia and Thrombosis Center
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North Carolina
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Chapel Hill, North Carolina, 미국, 27599-7035
- University of North Carolina
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Oregon
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Portland, Oregon, 미국, 97239
- Oregon Health & Science University
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Pennsylvania
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Pittsburgh, Pennsylvania, 미국, 15213
- University of Pittsburgh and Hemophilia Center of Pennsylvania
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Texas
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Houston, Texas, 미국, 77030
- The University of Texas Health Science Center at Houston
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참여기준
자격 기준
공부할 수 있는 나이
- 어린이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
샘플링 방법
연구 인구
설명
Inclusion Criteria:
- Males with mild/moderate hemophilia A (fVIII activity 1-40%)
- Planned surgical intervention which is anticipated to require 5 consecutive days of fVIII replacement therapy (These can be outpatient or inpatient treatment days.)
- Weight >22.5 kg (To assure that volumes of blood to be drawn for study purposes are safe.)
Exclusion Criteria:
- Past history of an inhibitor (inhibitor titer >0.4 BU/ml)
- HIV infection with CD4 count <400/ul
- Currently receiving immunosuppressive medication(s)
- Unable to tolerate quantity of blood to be drawn
- Current or past diagnosis autoimmune disorder
- Current or past diagnosis of immune deficiency disorder other than HIV
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
코호트 및 개입
그룹/코호트 |
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Mild or moderate hemophilia A
Subjects with mild or moderate hemophilia A (fVIII activity 1-40%) who are scheduled to undergo surgery for which at least 5 consecutive days of fVIII replacement therapy is required.
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
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Inhibitor development (inhibitor titer > 0.4 BU/ml)
기간: postopereratvie date 90
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Primary Study Endpoint: Inhibitor development (inhibitor titer > 0.4 BU/ml) by post-operative (POD) day 90.
Three months or 90 days was selected as the primary end point based on data collected in the case-control study where 17/18 cases had developed their inhibitor within 12 weeks of their intensive fVIII treatment and only 1 case developed the inhibitor >16 weeks after the intensive fVIII treatment.
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postopereratvie date 90
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공동 작업자 및 조사자
스폰서
수사관
- 수석 연구원: Christine Kempton, MD, MSc, Emory University
연구 기록 날짜
연구 주요 날짜
연구 시작
기본 완료 (실제)
연구 완료 (실제)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .
혈우병 A에 대한 임상 시험
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