- Primary Objectives: To establish a minimum of 6 months of prospective efficacy data of FIX prophylaxis replacement therapy in the usual care setting of hemophilia B subjects, who are negative for NAb to AAV-Spark100.- Secondary Objectives:…
ID
Source
Brief title
Condition
- Coagulopathies and bleeding diatheses (excl thrombocytopenic)
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
- Efficacy endpoints:
Primary Endpoint
* Annualized bleeding rate (ABR).
Secondary Endpoint
* Annualized number of infusions (AIR).
Other Secondary Endpoints
* Dose and total factor consumption.
* Number of bleeding events (spontaneous and/or traumatic).
- Safety Endpoints:
Primary Endpoints
* Incidence of serious adverse events.
* Events of Special Interest:
* FIX inhibitor;
* Thrombotic events;
* FIX hypersensitivity events.
- Exploratory endpoints
* The frequency and percentage of NAb status to AAV-Spark100 (positive,
negative).
Secondary outcome
Evaluate safety (serious adverse events and medically important events of FIX
inhibitor, thrombotic and FIX hypersensitivity reactions) of FIX replacement
therapy in hemophilia B subjects.
Primary Endpoints
* Incidence of serious adverse events.
* Events of Special Interest:
* FIX inhibitor;
* Thrombotic events;
* FIX hypersensitivity events.
Background summary
Hemophilia B (factor IX deficiency or Christmas disease) is an X-linked
recessive disorder caused by a congenital deficiency of coagulation factor IX
clotting activity. Patients with hemophilia B are usually managed by replacing
the missing or defective factor IX for treatment or prevention of hemorrhage.
Current treatment paradigms for hemophilia B rely on replacement of the missing
clotting factor IX through the use of plasma-derived or recombinant factor
administered in the setting of an acute bleed (on-demand) or at regularly
scheduled intervals (prophylaxis). Venous access via peripheral veins remains
the only option for the administration of factor IX replacement therapy. Gene
therapy is a new treatment modality for patients with hemophilia that works via
gene transfer to target cells (hepatocytes in the case of hemophilia B) where
factor IX is then expressed, processed and excreted into the circulation. This
therapy would potentially allow patients to realize the benefit of factor IX
replacement without the need for frequent intravenous infusions.
Study objective
- Primary Objectives: To establish a minimum of 6 months of prospective
efficacy data of FIX prophylaxis replacement therapy in the usual care setting
of hemophilia B subjects, who are negative for NAb to AAV-Spark100.
- Secondary Objectives: Evaluate safety (serious adverse events and medically
important events of FIX inhibitor, thrombotic and FIX hypersensitivity
reactions) of FIX replacement therapy in hemophilia B subjects.
- Exploratory Objective(s): Measure the frequency of NAb against AAV-Spark100
in the population assessed.
Study design
The C0371004 study will be conducted as an open-label, non-investigational
product, prospective, multi-center, lead-in study to assess at least six months
of efficacy and selected safety data of FIX prophylaxis replacement therapy in
the usual care setting of moderately severe to severe adult hemophilia B
subjects (FIX:C[equal or less than than]2%) who are negative for NAb to
AAV-Spark100, prior to the subsequent Phase 3 gene therapy study. The study
consists of
two phases: the screening phase will include laboratory blood draw to determine
neutralizing antibody status to AAV-Spark100 and the second phase will be the
data collection phase for those subjects who are seronegative for NAb to
AAV-Spark100. The data collection phase is designed to provide a minimum of 6
months of prospective efficacy and selected safety data of FIX prophylaxis
replacement therapy in the usual setting of those hemophilia B subjects.
Study burden and risks
For this study the patients will come to the center 3 times. In addition, they
are called every month for 6 months to discuss a diary what they will keep.
This diary is about how much and how severe their bleeding has been.
In addition, up to 3x blood is taken from the patients.
During the screening the researcher will do a physical examination, the
participants will be asked how they feel, whether they take any other
medication and their medical history will be requested.
East 42nd Street 235
New York NY 10017
US
East 42nd Street 235
New York NY 10017
US
Listed location countries
Age
Inclusion criteria
1.Males 18 and <65 years of age with moderate severe to severe hemophilia B and documented FIX activity (* 2%) within the last 12 months prior to baseline visit.;2.Previous experience with FIX therapy (*50 documented exposure days to a FIX protein product such as recombinant, plasma-derived or extended half-life FIX product).;3.Subjects as per usual care setting on FIX prophylaxis replacement therapy (recombinant, plasma-derived or extended half-life FIX product) must have the intention to remain on FIX prophylaxis replacement therapy for the duration of the study.;4.No known hypersensitivity to FIX replacement product.;5.No history of FIX inhibitor (clinical or laboratory-based assessment) defined as a titer 0.6 BU/mL, regardless of the laboratory normal range, or any measured Bethesda inhibitor titer greater than the upper limit of normal for the laboratory performing the assay. Clinically, no signs or symptoms of decreased response to FIX administration.;Subjects will not be required to undergo diagnostic evaluation of inhibitor status to participate in the study.
Exclusion criteria
1.Anti-AAV-Spark100 neutralizing antibodies titer (above the lowest detectable titer) performed by a central laboratory during screening.;2. Lack of patient compliance with documentation of bleeds and/or FIX prophylaxis replacement therapy administration.;3. If there is no documentation regarding hepatitis status, as defined below, within the last 12 months prior to screening for hepatitis B and 6 months prior to screening for hepatitis C, then subjects will be required to have the following hepatitis testing performed at screening:;a. Hepatitis B screening (acute and chronic):;HBsAg (also referred to as Hepatitis B surface antigen), HBV-DNA viral assay (also referred to as a nucleic acid test for Hepatitis B virus DNA), and Anti-HBc (also referred to as Total Hepatitis B core antibody).;-A subject is not eligible if either HbsAg is positive or HBV-DNA is positive/detectable.;-Anti-HBc must be obtained in all subjects for determination of whether the subject had prior hepatitis B. If the anti-HBc is positive and both HBsAg and HBV DNA are negative this would be consistent with a prior infection and the subject would be eligible for the study. Anti-HBc must be obtained in all subjects to discriminate between those with no prior hepatitis B and those with prior infection in the event of reactivation. FDA has noted reactivation of hepatitis B virus exists.;-One documented negative HBV-DNA viral load is sufficient to assess eligibility. A subject who is currently undergoing anti-viral therapy for hepatitis B is not eligible.;b. Hepatitis C (acute or chronic):;-A subject who is currently undergoing anti-viral therapy for chronic hepatitis C is not eligible.;-Subjects treated with anti-viral therapy for chronic hepatitis C, must have completed anti-viral therapy at least 6 months prior to screening and have a negative HCV-RNA at least 6 months prior to screening.;-All subjects (who are not currently undergoing anti-viral therapy for chronic hepatitis C) must have a single HCV-RNA load assay (also referred to as a nucleic acid test [NAT] for HCV RNA) obtained during the 6 months preceding screening. This includes subjects with prior known chronic hepatitis C who have completed treatment with anti-viral therapy.;-A subject is not eligible if his HCV-RNA load assay result is positive/detectable.;4. Currently on antiviral therapy for hepatitis B or C.;5. A subject is not eligible if any of the following pre-existing diagnoses, which are indicative of significant underlying liver disease, are present in the medical record:;- Portal hypertension; or;- Splenomegaly; or;- Hepatic encephalopathy.;All subjects who do not have the listed pre-existing diagnoses above must have the following assessments performed within the last 12 months prior to screening and if not will need to be tested for liver fibrosis status at screening:;-Measurement of serum albumin. A subject is not eligible if the serum albumin level is below the testing laboratory*s lower limit of normal; and;-At least one of the following diagnostic tests for liver fibrosis indicating * stage 3. The following results are indicative of fibrosis * stage 3 and exclude the subject from participation:;-FibroScan, with a score >8.3 kPa units;;-FibroTest/FibroSURE with a result >0.48; or;-AST-to-Platelet Ratio Index (APRI) >1.;6. Documented serological evidence of human immunodeficiency virus HIV-1 or HIV-2 with Cluster of Differentiation 4 positive (CD4+) cell count *200 mm3 within the last 12 months prior to screening. Subjects who are HIV positive and stable, have an adequate CD4 count (>200/mm3 ) and undetectable viral load (<50 gc/mL) documented within the preceding 12 months, and are on an antiretroviral drug regimen are eligible to enroll. Subjects who have not been tested within the prior 12 months of screening will need to be tested for HIV status at screening;7. Any patient who previously received SPK-9001 or any AAV gene based therapy.;8. Any patient with a planned surgical procedure requiring FIX surgical prophylactic factor treatment in the next 24 months.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
Register | ID |
---|---|
EudraCT | EUCTR2017-001271-23-NL |
ClinicalTrials.gov | NCT03587116 |
CCMO | NL66355.042.18 |