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    Clinical Trial Results:
    A Multi-Centre, Multinational, Open-Label, Single-Arm and Multiple Dosing Trial on Safety and Efficacy of Monthly Replacement Therapy with Recombinant Factor XIII (rFXIII) in Paediatric Subjects with Congenital Factor XIII A-subunit Deficiency - Safety Extension Trial to F13CD-3760.

    Summary
    EudraCT number
    2010-020192-23
    Trial protocol
    GB  
    Global end of trial date
    29 Mar 2015

    Results information
    Results version number
    v1(current)
    This version publication date
    14 Apr 2016
    First version publication date
    14 Apr 2016
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    F13CD-3835
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01253811
    WHO universal trial number (UTN)
    U1111-1117-1063
    Sponsors
    Sponsor organisation name
    Novo Nordisk A/S
    Sponsor organisation address
    Novo Allé, Bagsvaerd, Denmark, 2880
    Public contact
    Global Clinical Registry (GCR, 1452), Novo Nordisk A/S, clinicaltrials@novonordisk.com
    Scientific contact
    Global Clinical Registry (GCR, 1452), Novo Nordisk A/S, clinicaltrials@novonordisk.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    11 Sep 2015
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    29 Mar 2015
    Global end of trial reached?
    Yes
    Global end of trial date
    29 Mar 2015
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate the long term safety of monthly replacement therapy with rFXIII when used for prevention of bleeding episodes in paediatric subjects with congenital FXIII A-subunit deficiency.
    Protection of trial subjects
    The trial was conducted in accordance with the Declaration of Helsinki (2008) and ICH Good Clinical Practice (1996) and 21 Code of Federal Regulations parts 321, 50, and 56.
    Background therapy
    Previous participation (means up to and including end of trial visit) in F13CD-3760 (EudraCT no: 2009-016869-28).
    Evidence for comparator
    Not applicable.
    Actual start date of recruitment
    07 Jan 2011
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United Kingdom: 3
    Country: Number of subjects enrolled
    Israel: 1
    Country: Number of subjects enrolled
    United States: 2
    Worldwide total number of subjects
    6
    EEA total number of subjects
    3
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    1
    Children (2-11 years)
    5
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    0
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    The trial was conducted at 5 sites in 3 countries as follows: Israel (IS): 1 site; United Kingdom (UK): 2 sites; and United States (US): 2 sites.

    Pre-assignment
    Screening details
    Subjects who completed the F13CD-3760 trial were eligible to enroll in this trial.

    Period 1
    Period 1 title
    Overall study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded
    Blinding implementation details
    The trial was an open-label phase 3b trial.

    Arms
    Arm title
    Recombinant factor XIII
    Arm description
    Each subject received one single dose of 35 IU/kg rFXIII was administered as a slow intravenous (i.v.) injection preventive treatment of bleeding episodes. The dose was identical to the dose administered in F13CD-3760. The correct dosing was calculated based on subject's body weight and the trial dose was scheduled at visit 1 and for every 4th week (28 ± 2 days).
    Arm type
    Experimental

    Investigational medicinal product name
    Recombinant factor XIII (rFXIII)
    Investigational medicinal product code
    Other name
    Catridecacog
    Pharmaceutical forms
    Powder and solvent for solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    Each single dose included intravenous injection of recombinant factor XIII, 35 IU/kg bodyweight. The rFXIII was reconstituted and diluted with saline, administered as a slow i.v. injection at a rate not exceeding 1-2 mL min-1.

    Number of subjects in period 1
    Recombinant factor XIII
    Started
    6
    Completed
    5
    Not completed
    1
         Withdrawal criteria
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall study
    Reporting group description
    Each subject received one single dose of 35 IU/kg rFXIII was administered as a slow intravenous (i.v.) injection preventive treatment of bleeding episodes. The dose was identical to the dose administered in F13CD-3760. The correct dosing was calculated based on subject's body weight and the trial dose was scheduled at visit 1 and for every 4th week (28 ± 2 days).

    Reporting group values
    Overall study Total
    Number of subjects
    6 6
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    1 1
        Children (2-11 years)
    5 5
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    0 0
        From 65-84 years
    0 0
        85 years and over
    0 0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    3 ( 1.3 ) -
    Gender categorical
    Units: Subjects
        Female
    3 3
        Male
    3 3
    Ethnicity
    Units: Subjects
        Not hispanic or latino
    6 6
    Race
    Units: Subjects
        Asian
    3 3
        Black or african american
    1 1
        White
    2 2

    End points

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    End points reporting groups
    Reporting group title
    Recombinant factor XIII
    Reporting group description
    Each subject received one single dose of 35 IU/kg rFXIII was administered as a slow intravenous (i.v.) injection preventive treatment of bleeding episodes. The dose was identical to the dose administered in F13CD-3760. The correct dosing was calculated based on subject's body weight and the trial dose was scheduled at visit 1 and for every 4th week (28 ± 2 days).

    Primary: Treatment emergent adverse events (serious and non-serious), defined as adverse events occurring from first trial product administration to the end of the subject’s participation in the trial.

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    End point title
    Treatment emergent adverse events (serious and non-serious), defined as adverse events occurring from first trial product administration to the end of the subject’s participation in the trial. [1]
    End point description
    An adverse event was described as any untoward medical occurrence in a subject or clinical investigation subject administered a pharmaceutical product, and which does not necessarily have a causal relationship with this treatment. Treatment emergent adverse events (serious and non-serious), defined as adverse events occurring from first trial product administration to the end of the subject’s participation in the trial. The safety analysis set (SAS) included all subjects exposed to trial drug (rFXIII).
    End point type
    Primary
    End point timeframe
    All adverse events were collected and reported from screening (visit 1) and until the end of trial visit for a minimum period of 52 weeks.
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The primary endpoint investigated safety and was analysed using descriptive statistics, and thus no statistical analysis was performed.
    End point values
    Recombinant factor XIII
    Number of subjects analysed
    6
    Units: Events
        All adverse events
    100
        Serious adverse events
    2
        Non-serious adverse events
    98
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All adverse events were collected and reported from screening (visit 1) and until the end of trial visit for a minimum period of 52 weeks.
    Adverse event reporting additional description
    The SAS included all subjects who received at least one dose of the trial product.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    16.1
    Reporting groups
    Reporting group title
    Recombinant factor XIII (rFXIII) 35 IU/kg
    Reporting group description
    Each subject received one single dose of 35 IU/kg rFXIII was administered as a slow intravenous (i.v.) injection preventive treatment of bleeding episodes. The dose was identical to the dose administered in F13CD-3760. The correct dosing was calculated based on subject's body weight and the trial dose was scheduled at visit 1 and for every 4th week (28 ± 2 days).

    Serious adverse events
    Recombinant factor XIII (rFXIII) 35 IU/kg
    Total subjects affected by serious adverse events
         subjects affected / exposed
    1 / 6 (16.67%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    0
    Injury, poisoning and procedural complications
    Head injury
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Recombinant factor XIII (rFXIII) 35 IU/kg
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    6 / 6 (100.00%)
    Investigations
    Bacterial test positive
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Injury, poisoning and procedural complications
    Arthropod bite
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Contusion
         subjects affected / exposed
    3 / 6 (50.00%)
         occurrences all number
    3
    Fall
         subjects affected / exposed
    3 / 6 (50.00%)
         occurrences all number
    7
    Incorrect dose administered
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Joint injury
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Laceration
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    2
    Limb injury
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Skin abrasion
         subjects affected / exposed
    2 / 6 (33.33%)
         occurrences all number
    2
    Thermal burn
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Traumatic haematoma
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Traumatic haemorrhage
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Vascular disorders
    Haematoma
         subjects affected / exposed
    2 / 6 (33.33%)
         occurrences all number
    2
    Nervous system disorders
    Headache
         subjects affected / exposed
    3 / 6 (50.00%)
         occurrences all number
    3
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Infusion site extravasation
         subjects affected / exposed
    2 / 6 (33.33%)
         occurrences all number
    2
    Infusion site rash
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Pain
         subjects affected / exposed
    2 / 6 (33.33%)
         occurrences all number
    2
    Pyrexia
         subjects affected / exposed
    4 / 6 (66.67%)
         occurrences all number
    6
    Blood and lymphatic system disorders
    Lymphopenia
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Gastrointestinal disorders
    Abdominal pain upper
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Diarrhoea
         subjects affected / exposed
    3 / 6 (50.00%)
         occurrences all number
    5
    Nausea
         subjects affected / exposed
    2 / 6 (33.33%)
         occurrences all number
    2
    Tooth loss
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Vomiting
         subjects affected / exposed
    2 / 6 (33.33%)
         occurrences all number
    4
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    2 / 6 (33.33%)
         occurrences all number
    3
    Epistaxis
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Nasal congestion
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    2
    Oropharyngeal pain
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Respiratory disorder
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Rhinitis allergic
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Rhinorrhoea
         subjects affected / exposed
    2 / 6 (33.33%)
         occurrences all number
    7
    Sneezing
         subjects affected / exposed
    2 / 6 (33.33%)
         occurrences all number
    3
    Snoring
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Skin and subcutaneous tissue disorders
    Dry skin
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Rash
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    3
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Infections and infestations
    Acute tonsillitis
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Gastroenteritis
         subjects affected / exposed
    2 / 6 (33.33%)
         occurrences all number
    3
    Gastroenteritis viral
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Influenza
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Nasopharyngitis
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Otitis media acute
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    2
    Pharyngitis streptococcal
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Upper respiratory tract infection
         subjects affected / exposed
    3 / 6 (50.00%)
         occurrences all number
    7
    Varicella
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Viral infection
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    1 / 6 (16.67%)
         occurrences all number
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    10 Sep 2010
    Additions made to data collection in relation to bleeding episodes and in case of surgery; revision of an exclusion criteria; clarification of water and sodium supply; change in trial title.
    13 Apr 2011
    Date for LSLV was moved up; additional analyses were permitted to be reported to the investigator by the local laboratory.
    10 Oct 2013
    Date for LSLV was postponed
    01 Apr 2014
    Date for LSLV was postponed.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    Limitations of the trial included the small number of subjects analysed and the sensitivity of the Berichrom® FXIII activity assay. However, congenital FXIII deficiency is a rare disease and there were no bleeds requiring haemostatic treatment.
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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