E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Aquired FXIII deficiency following cardiopulmonary bypass surgery (CABG (coronary atery bypass grafting) or CABG plus single heart valve replacement/repairs or planned replacement/repair of a single heart valve) |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10063919 |
E.1.2 | Term | Bypass surgery |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To investigate whether postoperative treatment with either of two doses (17.5 or 35 IU/kg lean body mass (LBM)) of recombinant factor FXIII (rFXIII) is effective in avoiding any allogeneic transfusions in cardio pulmonary bypass (CPB) surgery subjects with a pre-operative transfusion risk score of 2 or 3 (table 1-1). |
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E.2.2 | Secondary objectives of the trial |
To document the safety profile of rFXIII used as replenishment therapy in cardiopulmonary bypass(CPB) surgery. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Informed consent (IC) obtained before any trial-related activities. (Trial related activities are any procedure that would not have been performed during the normal management of the subject). 2. Age: ≥18 - ≤ 80 years 3. Subjects scheduled to undergo cardiac surgery (CS) requiring CPB 4. Planned: CABG or CABG plus single heart valve replacement/repair or planned replacement/repair of a single heart valve 5. Pre-operative transfusion risk score of 2 or 3 (Table 11) 6. Peri-operative use of an antifibrinolytic agent |
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E.4 | Principal exclusion criteria |
1. Known or suspected allergy to trial drug(s) or related products 2. Known intolerance to protamine 3. Known or suspected allergy to the used antifibrinolytic agent 4. Previous randomisation and dosing in this trial 5. The receipt of any investigational drug within 30 days prior to surgery 6. Refusal to receive blood or blood product 7. Planned off pump coronary artery bypass (OPCAB) 8. Planned peri-operative use of Desmopressin (DDAVP) 9. Known heparin induced thrombocytopenia (HIT) 10. Known deficiency of protein C, protein S, antithrombin, or homozygous Factor V Leiden 11. Known congenital bleeding disorders 12. Planned surgery including the aortic arch and/or descending aorta 13. Planned surgery including any implantable ventricular assist device 14. Adult congenital heart diseases 15. Current endocarditis 16. Planned deep hypothermic circulatory arrest (< 28 C) 17. Two or more previous cardiac surgery procedures 18. Emergency cardiac surgery procedures i.e. those that are medically required within 24 hours of presenting with acute symptoms 19. Planned CPB priming with red blood cells (RBC) |
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E.5 End points |
E.5.1 | Primary end point(s) |
The statistical analysis of the primary endpoint, percentage of subjects avoiding any allogeneic transfusions, will be a logistic regression analysis adjusting for trial site, risk markers (risk score 2 or 3), age, redo, pre-TDA fibrinogen, pre-TDA fibrinogen greater than 1.5 (yes/no), pre-TDA thrombocytes, pre-op fibrin-monomer, type of surgery (elective vs. non-elective) and treatment. The primary test will first test 35 IU/kg vs. placebo. If and only if that test is statistically significant 17.5 IU/kg will then be tested against placebo. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 16 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 7 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 7 |