| E.1 Medical condition or disease under investigation |
| E.1.1 | Medical condition(s) being investigated |
Hemophilia A
Severe hemophilia A
|
|
| E.1.1.1 | Medical condition in easily understood language |
| Hemophilia A is a rare but serious bleeding disorder which affects males and is characterized by a deficiency in the plasma protein known as coagulation Factor VIII. |
|
| E.1.1.2 | Therapeutic area | Diseases [C] - Congenital, Hereditary, and Neonatal Diseases and Abnormalities [C16] |
| MedDRA Classification |
| E.1.2 Medical condition or disease under investigation |
| E.1.2 | Version | 20.0 |
| E.1.2 | Level | LLT |
| E.1.2 | Classification code | 10060613 |
| E.1.2 | Term | Hemophilia A (Factor VIII) |
| E.1.2 | System Organ Class | 100000004850 |
|
| 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 |
Previously treated Patients (PTPs):
• To characterize the long-term safety profile of rVIII-SingleChain with
respect to inhibitor development in PTPs
Previously Untreated Patients (PUPs):
• To characterize the safety with respect to inhibitor development in
PUPs
• To evaluate the efficacy of on-demand and prophylaxis treatment of
rVIII-SingleChain in PUPs |
|
| E.2.2 | Secondary objectives of the trial |
PTPs:
To:
• characterize safety profile of rVIII-SingleChain regarding:
- inhibitor development after 10 EDs and after 50 EDs
- antibodies against rVIII-SC and antibodies to CHO proteins
• collect + evaluate efficacy information on the prophylaxis and treatment of bleeding episodes
• assess the hemostatic efficacy of rVIII-SC for PTPs who undergo surgery
PUPs:
• further characterize the safety profile of rVIII-SC re. inhibitor development
• characterize the safety profile of rVIII-SC re. antibodies against rVIII-SC + antibodies to CHO proteins
• collect + evaluate number of injections required for the treatment of bleeding episodes
• characterize consumption of rVIII-SC in prophylaxis, on-demand treatment, and surgery
• assess the hemostatic efficacy of rVIII-SC for PUPs who undergo surgery, using the 4-point efficacy evaluation of surgical treatment scale
• assess occurrence of clinically significant abnormalities in vital signs after rVIII-SingleChain administration
|
|
| E.2.3 | Trial contains a sub-study | Yes |
| E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
Subjects may participate in a surgical substudy in which rVIII-SingleChain may be administered before, during and after surgery. The substudy objective is to assess the hemostatic efficacy of rVIII-SingleChain for subjects who undergo surgery.
PUPs who develop an inhibitor to rVIII-SingleChain during the main study may participate in an ITI substudy with rVIII-SingleChain. The substudy objective is to investigate the use of rVIII-SingleChain as ITI therapy |
|
| E.3 | Principal inclusion criteria |
PTPs:
• Males of any age who have been diagnosed with severe congenital hemophilia A (FVIII activity levels < 1%) and who participated in a previous CSL-sponsored clinical study with rVIII-SingleChain.
• Males 0 to <65 years age who have been diagnosed with severe congenital hemophilia A (FVIII activity levels < 1%), who have at least 50 EDs to any FVIII product, and who are not currently enrolled in a CSL-sponsored clinical study with rVIII-SingleChain.
PUPs:
• Males 0 to <18 years of who have been diagnosed with severe congenital hemophilia A (FVIII activity levels < 1%).
• No prior exposure to any Factor VIII product (with the exception of short-term use of blood products).
ITI substudy:
• PUPs who have developed a confirmed inhibitor to rVIII-SingleChain in the main study. |
|
| E.4 | Principal exclusion criteria |
• Known or suspected hypersensitivity to rVIII-SingleChain or to any
excipients of rVIII-SingleChain or Chinese hamster ovary (CHO)
proteins.
• Currently receiving a therapy not permitted during the study.
• Serum creatinine > 2 x upper limit of normal, alanine aminotransferase
or aspartate aminotransferase > 5 x upper limit of normal at Screening
(if specified)
• Any first-order family (eg, siblings) history of FVIII inhibitors
• For PTPs not rolling over directly from a CSL-sponsored clinical study
with rVIII-SingleChain: any history of or current FVIII inhibitors |
|
| E.5 End points |
| E.5.1 | Primary end point(s) |
1. Incidence of inhibitor formation to FVIII in PTPs with 100 EDs to
rVIII-SingleChain
2. Incidence of high-titer inhibitor formation to FVIII in PUPs
with at least 50 EDs of rVIII-SingleChain
3. Treatment success for major bleeding episodes in PUPs
4. Annualized spontaneous bleeding rate in PUPs |
|
| E.5.1.1 | Timepoint(s) of evaluation of this end point |
1. At the closest visit after 100 EDs (up to 5 years).
2. At the closest visit after 50 EDs (up to 5 years).
3. Up to 5 years
4. Up to 5 years |
|
| E.5.2 | Secondary end point(s) |
1. Treatment success in PTPs
2. Annualized bleeding rate in PTPs and PUPs
3. Percentage of bleeding episodes requiring 1, 2, 3, or > 3 injections of
rVIII-SingleChain to achieve hemostasis in PTPs and PUPs
4. Consumption of rVIII-SingleChain in PTPs and PUPs - injections
5. Consumption of rVIII-SingleChain in PTPs and PUPs - IU/kg
6. Hemostatic efficacy of rVIII-SingleChain for PTPs and PUPs who
undergo surgery
7. Incidence of inhibitor formation to FVIII after 10 EDs and after 50
EDs in PTPs
8. Percentage of PTPs and PUPs developing antibodies against rVIIISingleChain
9. Percentage of PTPs and PUPs developing antibodies to Chinese
hamster ovary (CHO) proteins
10. Incidence of high-titer inhibitor formation to FVIII in PUPs after 10
EDs with rVIII-SingleChain
11. Incidence of low-titer inhibitor formation to FVIII in PUPs
12. Incidence of total inhibitor formation to FVIII in PUPs
13. Treatment success for non-major bleeding episodes in PUPs
14. Percentage of PUPs with clinically significant abnormal vital signs
values after first rVIII-SingleChain injection
15. Percentage of PUPs with treatment-emergent clinically significant
abnormal vital signs values |
|
| E.5.2.1 | Timepoint(s) of evaluation of this end point |
1, 2, 3, 4, 5: Up to 5 years
6. From the start of surgery through the post-operative recovery
(generally up to 14 days after surgery)
7. After 10 EDs and after 50 EDs
8. PTPs: At the closest visit after 100 EDs (up to 5 years). PUPs: At the
closest visit after 50 EDs (up to 5 years).
9. PTPs: At the closest visit after 100 EDs (up to 5 years). PUPs: At the
closest visit after 50 EDs (up to 5 years)
10. At the closest visit after 10 EDs
11. At the closest visit after 10 and after 50 EDs (up to 5 years)
12. At the closest visit after 10 and after 50 EDs (up to 5 years)
13. Up to 5 years
14. At 1, 2, 3, and 6 hours after first rVIII-SingleChain injection
15. Up to 5 years |
|
| E.6 and E.7 Scope of the trial |
| E.6 | Scope of the trial |
| E.6.1 | Diagnosis | No |
| E.6.2 | Prophylaxis | Yes |
| E.6.3 | Therapy | Yes |
| 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) | No |
| E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
| E.7.4 | Therapeutic use (Phase IV) | No |
| E.8 Design of the trial |
| E.8.1 | Controlled | No |
| E.8.1.1 | Randomised | No |
| E.8.1.2 | Open | Yes |
| E.8.1.3 | Single blind | No |
| E.8.1.4 | Double blind | No |
| E.8.1.5 | Parallel group | No |
| 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) | Information not present in EudraCT |
| E.8.2.2 | Placebo | Information not present in EudraCT |
| E.8.2.3 | Other | Information not present in EudraCT |
| E.8.2.4 | Number of treatment arms in the trial | 2 |
| 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 | 5 |
| E.8.5 | The trial involves multiple Member States | Yes |
| E.8.5.1 | Number of sites anticipated in the EEA | 34 |
| 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 | No |
| 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 |
| Australia |
| Canada |
| European Union |
| Georgia |
| Japan |
| Lebanon |
| Malaysia |
| Philippines |
| South Africa |
| Switzerland |
| Thailand |
| Ukraine |
| United States |
|
| 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
|
|
| E.8.9 Initial estimate of the duration of the trial |
| E.8.9.1 | In the Member State concerned years | 8 |
| E.8.9.1 | In the Member State concerned months | 11 |
| E.8.9.1 | In the Member State concerned days | 0 |
| E.8.9.2 | In all countries concerned by the trial years | 8 |
| E.8.9.2 | In all countries concerned by the trial months | 11 |
| E.8.9.2 | In all countries concerned by the trial days | 0 |