Clinical Trial Results:
A Multinational, Open-Label, Non-Controlled Trial on Safety, Efficacy and Pharmacokinetics of NNC 0129-0000-1003 in Previously Treated Paediatric Patients with Severe Haemophilia A
Summary
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EudraCT number |
2012-001711-23 |
Trial protocol |
DE PT GB IT GR LT |
Global end of trial date |
28 Sep 2018
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Results information
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Results version number |
v1(current) |
This version publication date |
12 Apr 2019
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First version publication date |
12 Apr 2019
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Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
NN7088-3885
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT01731600 | ||
WHO universal trial number (UTN) |
U1111-1129-6009 | ||
Other trial identifiers |
Japanese trial registration: 132214 | ||
Sponsors
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Sponsor organisation name |
Novo Nordisk A/S
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Sponsor organisation address |
Novo Allé, Bagsvaerd, Denmark, 2880
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Public contact |
Clinical Reporting Anchor and Disclosure (1452), Novo Nordisk A/S, clinicaltrials@novonordisk.com
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Scientific contact |
Clinical Reporting Anchor and Disclosure (1452), Novo Nordisk A/S, clinicaltrials@novonordisk.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
Yes
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EMA paediatric investigation plan number(s) |
EMEA-001174-PIP02-12 | ||
Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
13 Mar 2019
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
15 Sep 2014
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Global end of trial reached? |
Yes
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Global end of trial date |
28 Sep 2018
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
To evaluate immunogenicity of NNC 0129-0000-1003 (hereafter referred to as N8-GP)
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Protection of trial subjects |
The trial was conducted in accordance with the Declaration of Helsinki (Seoul, October 2008), ICH Good Clinical Practice (Geneva, May 1996), and FDA 21 CFR 312.120.
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Background therapy |
Not applicable | ||
Evidence for comparator |
Not applicable | ||
Actual start date of recruitment |
20 Feb 2013
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
No
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Canada: 2
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Country: Number of subjects enrolled |
France: 7
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Country: Number of subjects enrolled |
Germany: 1
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Country: Number of subjects enrolled |
Greece: 1
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Country: Number of subjects enrolled |
Israel: 2
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Country: Number of subjects enrolled |
Italy: 1
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Country: Number of subjects enrolled |
Japan: 2
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Country: Number of subjects enrolled |
Lithuania: 5
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Country: Number of subjects enrolled |
Malaysia: 2
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Country: Number of subjects enrolled |
Portugal: 2
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Country: Number of subjects enrolled |
Switzerland: 4
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Country: Number of subjects enrolled |
Turkey: 6
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Country: Number of subjects enrolled |
Ukraine: 6
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Country: Number of subjects enrolled |
United Kingdom: 6
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Country: Number of subjects enrolled |
United States: 21
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Worldwide total number of subjects |
68
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EEA total number of subjects |
23
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
6
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Children (2-11 years) |
62
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
0
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From 65 to 84 years |
0
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85 years and over |
0
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Recruitment
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Recruitment details |
The trial was conducted at 36 sites in 15 countries as follows: Canada (1), France (2), Germany (1), Greece (2 sites screened/1 site randomised subjects), Israel (1), Italy (1), Japan (2), Lithuania (1), Malaysia (1), Portugal (1), Switzerland (3), Turkey (3), Ukraine (2), United Kingdom (3), and United States (12). | |||||||||||||||||||||
Pre-assignment
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Screening details |
Not applicable | |||||||||||||||||||||
Period 1
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Period 1 title |
Overall study (overall period)
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Is this the baseline period? |
Yes | |||||||||||||||||||||
Allocation method |
Not applicable
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Blinding used |
Not blinded | |||||||||||||||||||||
Blinding implementation details |
Not applicable
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Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Younger children (0 - 5 years) | |||||||||||||||||||||
Arm description |
Subjects (0 - 5 years) previously treated with FVIII received N8-GP (prophylaxis or treatment of bleeding episodes). The trial consisted of main and extension phase. Duration of main phase for each subject was approximately 26 weeks (50 exposure days). After completion of main phase, subjects could continue until the end of the extension phase, which was defined as last patient last visit (LPLV). All subjects continued twice weekly or every third day prophylaxis regimen in extension phase as prescribed for main phase. However, after 12 months' treatment with N8-GP (main phase+extension phase) the investigator was permitted to prescribe extra coverage before physical activities. | |||||||||||||||||||||
Arm type |
Experimental | |||||||||||||||||||||
Investigational medicinal product name |
N8-GP rFVIII
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Powder and solvent for solution for injection
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Routes of administration |
Intravenous use
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Dosage and administration details |
Prophylaxis: N8-GP was administered as a single intravenous (iv) bolus injection 60 IU/kg twice weekly. There were two vials which were used (500 U/vial 53μg/vial, 2000 U/vial 211 μg/vial). An increase in dose frequency from twice weekly to every third day was permitted at investigator’s discretion (based on bleeding pattern). Extra doses of N8-GP were administered, if the subject experienced a treatment-requiring bleeding episode or in case of minor surgery. Treatment of bleeding episodes: Treatment-requiring bleeding episodes were treated with doses of N8-GP ranging from 20−75 IU/kg, according to the severity and location of the bleeding episode. Bleeding episodes due to abdominal, head trauma, surgery were treated with extra dose of N8-GP similar to that used for severe bleeding episodes.
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Arm title
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Older children (6 - 11 years) | |||||||||||||||||||||
Arm description |
Subjects (6 - 11 years) previously treated with FVIII received N8-GP (prophylaxis or treatment of bleeding episodes). The trial consisted of main and extension phase. Duration of main phase for each subject was approximately 26 weeks (50 exposure days). After completion of main phase, subjects could continue until the end of the extension phase, which was defined as LPLV. All subjects continued twice weekly or every third day prophylaxis regimen in extension phase as prescribed for main phase. However, after 12 months' treatment with N8-GP (main phase+extension phase) the investigator was permitted to prescribe extra coverage before physical activities. | |||||||||||||||||||||
Arm type |
Experimental | |||||||||||||||||||||
Investigational medicinal product name |
N8-GP rFVIII
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Powder and solvent for solution for injection
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Routes of administration |
Intravenous use
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Dosage and administration details |
Prophylaxis: N8-GP was administered as a single iv bolus injection 60 IU/kg twice weekly. There were two vials which were used (500 U/vial 53μg/vial, 2000 U/vial 211 μg/vial). An increase in dose frequency from twice weekly to every third day was permitted at investigator’s discretion (based on bleeding pattern). Extra doses of N8-GP were administered, if the subject experienced a treatment-requiring bleeding episode or in case of minor surgery. Treatment of bleeding episodes: Treatment-requiring bleeding episodes were treated with doses of N8-GP ranging from 20−75 IU/kg, according to the severity and location of the bleeding episode. Bleeding episodes due to abdominal, head trauma, surgery were treated with extra dose of N8-GP similar to that used for severe bleeding episodes.
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Baseline characteristics reporting groups
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Reporting group title |
Younger children (0 - 5 years)
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Reporting group description |
Subjects (0 - 5 years) previously treated with FVIII received N8-GP (prophylaxis or treatment of bleeding episodes). The trial consisted of main and extension phase. Duration of main phase for each subject was approximately 26 weeks (50 exposure days). After completion of main phase, subjects could continue until the end of the extension phase, which was defined as last patient last visit (LPLV). All subjects continued twice weekly or every third day prophylaxis regimen in extension phase as prescribed for main phase. However, after 12 months' treatment with N8-GP (main phase+extension phase) the investigator was permitted to prescribe extra coverage before physical activities. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Older children (6 - 11 years)
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Reporting group description |
Subjects (6 - 11 years) previously treated with FVIII received N8-GP (prophylaxis or treatment of bleeding episodes). The trial consisted of main and extension phase. Duration of main phase for each subject was approximately 26 weeks (50 exposure days). After completion of main phase, subjects could continue until the end of the extension phase, which was defined as LPLV. All subjects continued twice weekly or every third day prophylaxis regimen in extension phase as prescribed for main phase. However, after 12 months' treatment with N8-GP (main phase+extension phase) the investigator was permitted to prescribe extra coverage before physical activities. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Subject analysis sets
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Subject analysis set title |
Younger children (0 - 5 years) [Main trial]
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Subject analysis set type |
Full analysis | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Subject analysis set description |
Subjects (0 - 5 years) previously treated with FVIII received N8-GP (prophylaxis or treatment of bleeding episodes). The trial consisted of main and extension phase. Duration of main phase for each subject was approximately 26 weeks (50 exposure days).
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Subject analysis set title |
Older children (6 - 11 years) [Main trial]
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Subject analysis set type |
Full analysis | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Subject analysis set description |
Subjects (6 - 11 years) previously treated with FVIII received N8-GP (prophylaxis or treatment of bleeding episodes). The trial consisted of main and extension phase. Duration of main phase for each subject was approximately 26 weeks (50 exposure days).
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Subject analysis set title |
Younger children (0 - 5 years) [Full trial]
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Subject analysis set type |
Full analysis | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Subject analysis set description |
Subjects (0 - 5 years) previously treated with FVIII received N8-GP (prophylaxis or treatment of bleeding episodes). The trial consisted of main and extension phase. Duration of main phase for each subject was approximately 26 weeks (50 exposure days). After completion of main phase, subjects could continue until the end of the extension phase, which was defined as LPLV. All subjects continued twice weekly or every third day prophylaxis regimen in extension phase as prescribed for main phase. However, after 12 months treatment with N8-GP (main phase+extension phase) the investigator was permitted to prescribe extra coverage before physical activities.
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Subject analysis set title |
Older children (6 - 11 years) [Full trial]
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Subject analysis set type |
Full analysis | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Subject analysis set description |
Subjects (6 - 11 years) previously treated with FVIII received N8-GP (prophylaxis or treatment of bleeding episodes). The trial consisted of main and extension phase. Duration of main phase for each subject was approximately 26 weeks (50 exposure days). After completion of main phase, subjects could continue until the end of the extension phase, which was defined as LPLV. All subjects continued twice weekly or every third day prophylaxis regimen in extension phase as prescribed for main phase. However, after 12 months treatment with N8-GP (main phase+extension phase) the investigator was permitted to prescribe extra coverage before physical activities.
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End points reporting groups
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Reporting group title |
Younger children (0 - 5 years)
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Reporting group description |
Subjects (0 - 5 years) previously treated with FVIII received N8-GP (prophylaxis or treatment of bleeding episodes). The trial consisted of main and extension phase. Duration of main phase for each subject was approximately 26 weeks (50 exposure days). After completion of main phase, subjects could continue until the end of the extension phase, which was defined as last patient last visit (LPLV). All subjects continued twice weekly or every third day prophylaxis regimen in extension phase as prescribed for main phase. However, after 12 months' treatment with N8-GP (main phase+extension phase) the investigator was permitted to prescribe extra coverage before physical activities. | ||
Reporting group title |
Older children (6 - 11 years)
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Reporting group description |
Subjects (6 - 11 years) previously treated with FVIII received N8-GP (prophylaxis or treatment of bleeding episodes). The trial consisted of main and extension phase. Duration of main phase for each subject was approximately 26 weeks (50 exposure days). After completion of main phase, subjects could continue until the end of the extension phase, which was defined as LPLV. All subjects continued twice weekly or every third day prophylaxis regimen in extension phase as prescribed for main phase. However, after 12 months' treatment with N8-GP (main phase+extension phase) the investigator was permitted to prescribe extra coverage before physical activities. | ||
Subject analysis set title |
Younger children (0 - 5 years) [Main trial]
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Subject analysis set type |
Full analysis | ||
Subject analysis set description |
Subjects (0 - 5 years) previously treated with FVIII received N8-GP (prophylaxis or treatment of bleeding episodes). The trial consisted of main and extension phase. Duration of main phase for each subject was approximately 26 weeks (50 exposure days).
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Subject analysis set title |
Older children (6 - 11 years) [Main trial]
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Subject analysis set type |
Full analysis | ||
Subject analysis set description |
Subjects (6 - 11 years) previously treated with FVIII received N8-GP (prophylaxis or treatment of bleeding episodes). The trial consisted of main and extension phase. Duration of main phase for each subject was approximately 26 weeks (50 exposure days).
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Subject analysis set title |
Younger children (0 - 5 years) [Full trial]
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Subject analysis set type |
Full analysis | ||
Subject analysis set description |
Subjects (0 - 5 years) previously treated with FVIII received N8-GP (prophylaxis or treatment of bleeding episodes). The trial consisted of main and extension phase. Duration of main phase for each subject was approximately 26 weeks (50 exposure days). After completion of main phase, subjects could continue until the end of the extension phase, which was defined as LPLV. All subjects continued twice weekly or every third day prophylaxis regimen in extension phase as prescribed for main phase. However, after 12 months treatment with N8-GP (main phase+extension phase) the investigator was permitted to prescribe extra coverage before physical activities.
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Subject analysis set title |
Older children (6 - 11 years) [Full trial]
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Subject analysis set type |
Full analysis | ||
Subject analysis set description |
Subjects (6 - 11 years) previously treated with FVIII received N8-GP (prophylaxis or treatment of bleeding episodes). The trial consisted of main and extension phase. Duration of main phase for each subject was approximately 26 weeks (50 exposure days). After completion of main phase, subjects could continue until the end of the extension phase, which was defined as LPLV. All subjects continued twice weekly or every third day prophylaxis regimen in extension phase as prescribed for main phase. However, after 12 months treatment with N8-GP (main phase+extension phase) the investigator was permitted to prescribe extra coverage before physical activities.
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End point title |
Incidence of inhibitory antibodies against coagulation factor VIII (FVIII) ≥0.6 Bethesda units | |||||||||
End point description |
The incidence of inhibitory antibodies was calculated as number of patients with inhibitors during the main phase of the trial divided by number of patients in the main phase of the trial. Results were based on safety analysis set (SAS). The SAS consists of all patients exposed to at least one dose of turoctocog alfa pegol.
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End point type |
Primary
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End point timeframe |
During the main phase of the trial (from 0-26 weeks of treatment)
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Statistical analysis title |
Statistical analysis 1 | |||||||||
Statistical analysis description |
A one-sided, upper 97.5% confidence limit was provided based on an exact calculation in the binomial distribution.
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Comparison groups |
Older children (6 - 11 years) [Main trial] v Younger children (0 - 5 years) [Main trial]
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Number of subjects included in analysis |
68
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Analysis specification |
Pre-specified
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Analysis type |
other | |||||||||
Method |
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Parameter type |
Incidence rate | |||||||||
Point estimate |
0
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Confidence interval |
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level |
97.5% | |||||||||
sides |
1-sided
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lower limit |
- | |||||||||
upper limit |
0.067 |
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End point title |
Frequency of adverse events including serious adverse events reported during the trial period | ||||||||||||||||||||
End point description |
The frequency of adverse events including serious adverse events reported during the main and extension phase of the trial. Results were based on SAS.
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End point type |
Secondary
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End point timeframe |
Main phase: (from 0-26 weeks of treatment) and full trial: (0 weeks to last patient’s completion of the trial)
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No statistical analyses for this end point |
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End point title |
Haemostatic effect of N8-GP when used for treatment of bleeding episodes and assessed as: Excellent, Good, Moderate, or None | ||||||||||||||||||||||||||||||||||||||||
End point description |
Haemostatic effect of turoctocog alfa pegol for treatment of bleeding episodes was assessed by 4-point response scale: none, moderate, good or excellent. Evaluation during trial was done by patient and/or parent(s)/caregiver 8 hours after first injection as follows: Excellent: Abrupt pain relief and/or clear improvement in objective signs of bleeding within approximately 8 hours after a single injection; Good: Definite pain relief and/or improvement in signs of bleeding within approximately 8 hours after a single injection, but possibly requiring more than one injection for complete resolution; Moderate: Probable or slight beneficial effect within approximately 8 hours after the first injection, but usually requiring more than one injection; None: No improvement, or worsening of symptoms. Results were based on full analysis set (FAS). All trial patients allocated to treatment, for which at least one of the pharmacokinetic or efficacy endpoints was assessed, were included in the FAS.
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End point type |
Secondary
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End point timeframe |
Main phase: (from 0-26 weeks of treatment) and full trial: (0 weeks to last patient’s completion of the trial)
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Notes [1] - "Number of subjects analyzed” = number of bleeds in subjects [2] - "Number of subjects analyzed” = number of bleeds in subjects [3] - "Number of subjects analyzed” = number of bleeds in subjects [4] - "Number of subjects analyzed” = number of bleeds in subjects |
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No statistical analyses for this end point |
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End point title |
Number of bleeding episodes during prophylactic treatment with N8-GP (annualised bleeding rate) | ||||||||||||||||||||
End point description |
The number of bleeding episodes per year reported during the prophylactic treatment with N8-GP. Results were based on FAS.
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End point type |
Secondary
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End point timeframe |
Main phase: (from 0-26 weeks of treatment) and full trial: (0 weeks to last patient’s completion of the trial)
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No statistical analyses for this end point |
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End point title |
Consumption of N8-GP per bleeding episode (number of injections) | ||||||||||||||||||||
End point description |
The mean number of injections of turoctocog alfa pegol used for treatment of a bleed from start to stop of a bleed. Results were based on FAS.
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End point type |
Secondary
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End point timeframe |
Main phase: (from 0-26 weeks of treatment) and full trial: (0 weeks to last patient’s completion of the trial)
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Notes [5] - "Number of subjects analyzed"=number of bleeds [6] - "Number of subjects analyzed"=number of bleeds [7] - "Number of subjects analyzed"=number of bleeds [8] - "Number of subjects analyzed"=number of bleeds |
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No statistical analyses for this end point |
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End point title |
Consumption of N8-GP per bleeding episode (U/kg) | ||||||||||||||||||||
End point description |
The mean consumption of turoctocog alfa pegol used for treatment of a bleed from start to stop of a bleed. Results were based on FAS.
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End point type |
Secondary
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End point timeframe |
Main phase: (from 0-26 weeks of treatment) and full trial: (0 weeks to last patient’s completion of the trial)
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No statistical analyses for this end point |
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End point title |
Consumption of N8-GP during prophylaxis (number of injections) | ||||||||||||||||||||
End point description |
The mean number of injections of turoctocog alfa pegol used for treatment of a bleed from start to stop of a bleed during prophylaxis. Results were based on FAS.
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End point type |
Secondary
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End point timeframe |
Main phase: (from 0-26 weeks of treatment) and full trial: (0 weeks to last patient’s completion of the trial)
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Notes [9] - "Number of subjects analyzed"=Number of injections" [10] - "Number of subjects analyzed"=Number of injections" [11] - "Number of subjects analyzed"=Number of injections" [12] - "Number of subjects analyzed"=Number of injections" |
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No statistical analyses for this end point |
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End point title |
Consumption of N8-GP during prophylaxis (U/kg per month) | ||||||||||||||||||||
End point description |
The mean consumption of turoctocog alfa pegol used for treatment of a bleed from start to stop of a bleed during prophylaxis (per month per subject). Results were based on FAS. Consumption used for treatment includes all doses given (prophylaxis, treatment of bleed, minor surgery and pharmacokinetics [PK])
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End point type |
Secondary
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End point timeframe |
Main phase: (from 0-26 weeks of treatment) and full trial: (0 weeks to last patient’s completion of the trial)
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No statistical analyses for this end point |
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End point title |
Consumption of N8-GP during prophylaxis (U/kg per year) | ||||||||||||||||||||
End point description |
The mean consumption of turoctocog alfa pegol used for treatment of a bleed from start to stop of a bleed during prophylaxis (per year per subject). Results were based on FAS. Consumption used for treatment includes all doses given (prophylaxis, treatment of bleed, minor surgery and pharmacokinetics)
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End point type |
Secondary
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End point timeframe |
Main phase: (from 0-26 weeks of treatment) and full trial: (0 weeks to last patient’s completion of the trial).
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||||||||||||||||||||
|
|||||||||||||||||||||
No statistical analyses for this end point |
|
|||||||||||||
End point title |
Incremental recovery (defined as the peak level recorded 60 min after end of injection) evaluated for previous FVIII product | ||||||||||||
End point description |
The incremental recovery was defined as the increase in plasma FVIII activity per IU/kg of factor administered recorded 60 minutes after end of injection. It was calculated as (Factor VIII procoagulant [FVIII:C] activity measured in plasma 60 min after dosing - FVIII:C activity measured in plasma immediately before dosing) / (dose injected at time 0 min), where the dose was expressed as U FVIII product per kg body weight. A chromogenic assay with normal human plasma (NHP) as calibrator was used. Results were based on FAS.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
2-6 weeks prior to initial dosing with N8-GP and up to 30 hours after administration of previous FVIII product
|
||||||||||||
|
|||||||||||||
Notes [13] - "Number of subjects analysed"=subjects with available data [14] - "Number of subjects analysed"=subjects with available data |
|||||||||||||
No statistical analyses for this end point |
|
|||||||||||||
End point title |
Incremental recovery (defined as the peak level recorded 60 min after end of injection) evaluated for N8-GP | ||||||||||||
End point description |
The incremental recovery was defined as the peak level recorded 60 min after end of injection and dose-normalised. It was calculated as (FVIII:C activity measured in plasma 60 min after dosing - FVIII:C activity measured in plasma immediately before dosing) / (dose injected at time 0 min), where the dose was expressed as U FVIII product per kg body weight. A chromogenic assay with product specific calibrator (PSS) as calibrator was used. Results were based on FAS.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
From 1 hour prior to and up to 96 hours after initial administration of N8-GP.
|
||||||||||||
|
|||||||||||||
Notes [15] - "Number of subjects analyzed"=subjects with available data [16] - "Number of subjects analyzed"=subjects with available data |
|||||||||||||
No statistical analyses for this end point |
|
|||||||||||||
End point title |
Area under the curve evaluated for previous FVIII product | ||||||||||||
End point description |
Area under the curve (AUC) versus time from zero to infinity. This is calculated as AUC = AUClast + (C(t) / λz), where C(t) is the last measurable concentration. A chromogenic assay with NHP as calibrator was used. Results were based on FAS.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
2-6 weeks prior to initial dosing with N8-GP and up to 30 hours after administration of previous FVIII product
|
||||||||||||
|
|||||||||||||
Notes [17] - "Number of subjects analyzed"=subjects with available data [18] - "Number of subjects analyzed"=subjects with available data |
|||||||||||||
No statistical analyses for this end point |
|
|||||||||||||
End point title |
Area under the curve evaluated for N8-GP | ||||||||||||
End point description |
Area under the curve versus time from zero to infinity. This is calculated as AUC = AUClast + (C(t) / λz), where C(t) is the last measurable concentration. A chromogenic assay with PSS as calibrator was used. Results were based on FAS.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
From 1 hour prior to and up to 96 hours after initial administration of N8-GP
|
||||||||||||
|
|||||||||||||
Notes [19] - "Number of subjects analyzed"=subjects with available data [20] - "Number of subjects analyzed"=subjects with available data |
|||||||||||||
No statistical analyses for this end point |
|
|||||||||||||
End point title |
Terminal half-life evaluated for previous FVIII product | ||||||||||||
End point description |
t½ = ln(2) / λz, where λz is the terminal elimination rate. The terminal elimination rate was planned estimated using linear regression on the terminal part of the time versus log(concentration) curve. A population-based method simultaneously estimating individual t½ values for all patients was applied, including patients with few values above the lower limit of quantification (LLOQ). This was estimated using time points from 1h to 30h. A chromogenic assay with PSS as calibrator was used. Results were based on FAS.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
2-6 weeks prior to initial dosing with N8-GP and up to 30 hours after administration of previous FVIII product
|
||||||||||||
|
|||||||||||||
Notes [21] - "Number of subjects analyzed"=subjects with available data [22] - "Number of subjects analyzed"=subjects with available data |
|||||||||||||
No statistical analyses for this end point |
|
|||||||||||||
End point title |
Terminal half-life evaluated for N8-GP | ||||||||||||
End point description |
t½ = ln(2) / λz, where λz is the terminal elimination rate. The terminal elimination rate was planned estimated using linear regression on the terminal part of the time versus log(concentration) curve. A population-based method simultaneously estimating individual t½ values for all patients was applied, including patients with few values above the LLOQ. This was estimated using time points from 6h to 96h. A chromogenic assay with PSS as calibrator was used. Results were based on FAS.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
From 1 hour prior to and up to 96 hours after initial administration of N8-GP
|
||||||||||||
|
|||||||||||||
Notes [23] - "Number of subjects analyzed"=subjects with available data [24] - "Number of subjects analyzed"=subjects with available data |
|||||||||||||
No statistical analyses for this end point |
|
|||||||||||||
End point title |
Clearance evaluated for previous FVIII product | ||||||||||||
End point description |
Total plasma clearance of drug after intravenous administration measured as actual dose/AUC. A chromogenic assay with NHP as calibrator was used. Results were based on FAS.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
2-6 weeks prior to initial dosing with N8-GP and up to 30 hours after administration of previous FVIII product
|
||||||||||||
|
|||||||||||||
Notes [25] - "Number of subjects analyzed"=subjects with available data [26] - "Number of subjects analyzed"=subjects with available data |
|||||||||||||
No statistical analyses for this end point |
|
|||||||||||||
End point title |
Clearance evaluated for N8-GP | ||||||||||||
End point description |
Total plasma clearance of drug after intravenous administration measured as actual dose/AUC. A chromogenic assay with PSS as calibrator was used. Results were based on FAS.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
From 1 hour prior to and up to 96 hours after initial administration of N8-GP.
|
||||||||||||
|
|||||||||||||
No statistical analyses for this end point |
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adverse events information
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Timeframe for reporting adverse events |
From first exposure to N8-GP (visit 2) of main phase to end of extension phase (>=4 days after last dose of N8-GP).
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adverse event reporting additional description |
The safety analysis set consists of all patients exposed to at least one dose of N8-GP.
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Assessment type |
Systematic | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
|
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Dictionary name |
MedDRA | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
21
|
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Reporting groups
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Younger children (0-5 years)
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Subjects (0 - 5 years) previously treated with FVIII received N8-GP (prophylaxis or treatment of bleeding episodes). The trial consisted of main and extension phase. Duration of main phase for each subject was approximately 26 weeks (50 exposure days). After completion of main phase, subjects could continue until the end of the extension phase, which was defined as LPLV. All subjects continued twice weekly or every third day prophylaxis regimen in extension phase as prescribed for main phase. However, after 12 months treatment with N8-GP (main phase+extension phase) the investigator was permitted to prescribe extra coverage before physical activities. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Older children (6-11 years)
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Subjects (6 - 11 years) previously treated with FVIII received N8-GP (prophylaxis or treatment of bleeding episodes). The trial consisted of main and extension phase. Duration of main phase for each subject was approximately 26 weeks (50 exposure days). After completion of main phase, subjects could continue until the end of the extension phase, which was defined as LPLV. All subjects continued twice weekly or every third day prophylaxis regimen in extension phase as prescribed for main phase. However, after 12 months treatment with N8-GP (main phase+extension phase) the investigator was permitted to prescribe extra coverage before physical activities. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 5% | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
|||
Substantial protocol amendments (globally) |
|||
Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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14 Dec 2012 |
1) Changes introduced to the dose table in order to extend weight predictions. 2) Port restrictions text in connection with blood samplings removed. Included together with detailed instructions for laboratory sampling in other trial documents (e.g., in the laboratory manual). 3) Inconsistencies and typing errors corrected. |
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11 Mar 2014 |
1) Withdrawal criteria amended to allow patients with a low titre inhibitor (≤ 5 BU), that does not result in clinically ineffective treatment with N8-GP, to continue in the trial. 2) Reference unit for inhibitors has been aligned to BU. 3) Lupus anticoagulant added to flowchart main and extension phase. 4) Patients allowed continuing in the extension phase as soon as minimum 25 patients for each cohort had completed the main phase. 5) List of participating countries updated. 6) FVIII results to investigators changed to one-stage clotting assay to align across N8-GP project. 7) Inclusion of an assay to analyse for antibodies towards polyethylene glycol (PEG). 8) Clarification that FVIII activity should be analysed in case of severe allergic reaction. 9) Labelling allowed by third party vendors. 10) Section added: suspected transmission of infectious agents to the serious adverse event (SAE) definition. 11) Extension of monitoring window during extension phase to reflect the visit scheduled. 12) Multiple bleeding from the same event or time point counted as one bleeding episode. 13) Minor updates to the interim analysis |
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14 Apr 2014 |
1) Patients with low titre inhibitors who continue on N8-GP treatment are followed systematically and should attend an unscheduled visit monthly. 2) Novo Nordisk safety committee consulted by the investigator to determine the best management of individual patients with low titre inhibitors. |
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |