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    Clinical Trial Results:
    Extension Study for Patients who completed GENA-05 (NuProtect) – to Investigate Immunogenicity, Efficacy and Safety of Treatment with Human-cl rhFVIII

    Summary
    EudraCT number
    2013-003997-28
    Trial protocol
    GB   DE   FR  
    Global end of trial date
    27 Dec 2018

    Results information
    Results version number
    v1(current)
    This version publication date
    18 Jul 2019
    First version publication date
    18 Jul 2019
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    GENA-15
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01992549
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Octapharma Pharmazeutika Produktionsges.m.b.H.
    Sponsor organisation address
    Oberlaaer Strasse 235, Vienna, Austria, 1100
    Public contact
    sigurd.knaub@octapharma.com, Octapharma AG, +41 554512141, sigurd.knaub@octapharma.com
    Scientific contact
    sigurd.knaub@octapharma.com, Octapharma AG, +41 554512141, sigurd.knaub@octapharma.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 Jun 2019
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    27 Dec 2018
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    • To investigate the immunogenicity of Human-cl rhFVIII in patients who completed GENA-05 in accordance with the study protocol • To assess the efficacy of Human-cl rhFVIII during prophylactic treatment (based on the frequency of spontaneous break-through bleeds) • To assess the efficacy of Human-cl rhFVIII during treatment of bleeds • To assess the efficacy of Human-cl rhFVIII in surgical prophylaxis • To assess the safety and tolerability of Human-cl rhFVIII
    Protection of trial subjects
    This trial was conducted in accordance to the principles of ICH- GCP (Note for Guidance CPMP/ICH/135/95 and national regulatory requirements, ensuring that the rights, safety and well-being of patients are protected and in consistency with the Declaration of Helsinki. Inclusion and exclusion criteria were carefully defined in order to protect subjects from contraindications, interactions with other medication and risk factors associated with the investigational medicinal product. Safety and tolerability was assessed by monitoring vital signs, standard laboratory parameters, and by monitoring adverse events (AEs)
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    19 Mar 2014
    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
    Poland: 1
    Country: Number of subjects enrolled
    United Kingdom: 2
    Country: Number of subjects enrolled
    France: 2
    Country: Number of subjects enrolled
    India: 9
    Country: Number of subjects enrolled
    Canada: 5
    Country: Number of subjects enrolled
    Georgia: 4
    Country: Number of subjects enrolled
    Moldova, Republic of: 3
    Country: Number of subjects enrolled
    Ukraine: 21
    Country: Number of subjects enrolled
    United States: 1
    Worldwide total number of subjects
    48
    EEA total number of subjects
    5
    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)
    11
    Children (2-11 years)
    37
    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
    -

    Pre-assignment
    Screening details
    Only patients who completed the clinical study GENA-05 in accordance with the study protocol could be enrolled.

    Period 1
    Period 1 title
    Overall Trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Human-cl rhFVIII
    Arm description
    Patients with Severe Haemophilia A were to be treated prophylactically or on-demand. Upon discretion of the investigator patients could be switched from on-demand to prophylactic treatment, or from prophylactic to on-demand treatment during the course of the study.
    Arm type
    Experimental

    Investigational medicinal product name
    Human cell line recombinant factor VIII
    Investigational medicinal product code
    Human-cl rhFVIII
    Other name
    Pharmaceutical forms
    Powder and solvent for solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    PROPHYLACTIC TREATMENT: recommended dose of >20 IU FVIII/kg body weight. Frequency or dose adjustments could be done on Investigator’s discretion. ON-DEMAND TREATMENT: recommended dose depending on location, extent of bleeding & clinical situation of the patient; for minor haemorrhage: 20-30 IU FVIII/kg BW, moderate to major haemorrhage 30-40 IU FVIII/kg BW, major to life-threatening haemorrage initial dose 50-80 IU FVIII/kg BW to achieve an intended target peak level of 100-120%. Repeat dose of >20 IUFVIII/kg BW every 6-12 hr until BE is resolved. SURGICAL PROPHYLAXIS: for minor surgeries incl. tooth extractions recommended dose: 25-30 IU FVIII/kg BW, for major surgeries: > 50 IU FVIII/kg BW within 3 hr prior to surgery to achieve an intended target peak level of approximately 100%. Repeat if necessary after 6-12 hr initially and for at least 6 -14 days until healing is complete and recurrence to regular prophylactic treatment is possible. Trough levels should be maintained at >50%.

    Number of subjects in period 1
    Human-cl rhFVIII
    Started
    48
    Completed
    44
    Not completed
    4
         Serious adverse event, non-fatal
    1
         Lost to follow-up
    2
         Protocol deviation
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall Trial
    Reporting group description
    -

    Reporting group values
    Overall Trial Total
    Number of subjects
    48 48
    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)
    11 11
        Children (2-11 years)
    37 37
        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
        median (full range (min-max))
    2.8 (1.3 to 11.9) -
    Gender categorical
    Units: Subjects
        Female
    0 0
        Male
    48 48

    End points

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    End points reporting groups
    Reporting group title
    Human-cl rhFVIII
    Reporting group description
    Patients with Severe Haemophilia A were to be treated prophylactically or on-demand. Upon discretion of the investigator patients could be switched from on-demand to prophylactic treatment, or from prophylactic to on-demand treatment during the course of the study.

    Primary: Immunogenicity: determination of patients with positive inhibitor activity

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    End point title
    Immunogenicity: determination of patients with positive inhibitor activity [1]
    End point description
    FVIII inhibitor development was determined in BU/mL (Bethesda Units) by the modified Bethesda assay (Nijmegen modification), using congenital FVIII-deficient human plasma spiked with Human-cl rhFVIII at the timepoints described above. No patient tested positive for inhibitors in this study.
    End point type
    Primary
    End point timeframe
    FVIII inhibitor development determined at: • Screening Visit • Once every 6 months during treatment phase • Study completion • Any time in case of suspicion of inhibitor development.
    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: Trial includes one arm only. For statistical analysis at least 2 arms are required, so no statistical analysis can be provided. Therefore, only results for this endpoint are provided.
    End point values
    Human-cl rhFVIII
    Number of subjects analysed
    48 [2]
    Units: Number of patients
    0
    Notes
    [2] - No patient tested positive for inhibitors in this study.
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All AEs and SAEs will be monitored and recorded at each visit, whether scheduled or unscheduled throughout the study.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    22.0
    Reporting groups
    Reporting group title
    Safety Population
    Reporting group description
    Patients with Severe Haemophilia A were treated prophylactically or on-demand. Upon discretion of the investigator patients could be switched from on-demand to prophylactic treatment, or from prophylactic to on-demand treatment during the course of the study.

    Serious adverse events
    Safety Population
    Total subjects affected by serious adverse events
         subjects affected / exposed
    5 / 48 (10.42%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Neuroblastoma
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Haemorrhage
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Gastritis
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Epistaxis
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Cellulitis
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    2 / 48 (4.17%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Varicella
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 2.08%
    Non-serious adverse events
    Safety Population
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    29 / 48 (60.42%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Skin papilloma
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    10 / 48 (20.83%)
         occurrences all number
    16
    Respiratory, thoracic and mediastinal disorders
    Adenoidal hypertrophy
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Cough
         subjects affected / exposed
    7 / 48 (14.58%)
         occurrences all number
    10
    Rhinorrhoea
         subjects affected / exposed
    2 / 48 (4.17%)
         occurrences all number
    2
    Injury, poisoning and procedural complications
    Bite
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Hand fracture
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Procedural pain
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    4 / 48 (8.33%)
         occurrences all number
    5
    Ear and labyrinth disorders
    Tympanic membrane perforation
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Gastrointestinal disorders
    Abdominal discomfort
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Diarrhoea
         subjects affected / exposed
    2 / 48 (4.17%)
         occurrences all number
    2
    Glossodynia
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Stomatitis
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Vomiting
         subjects affected / exposed
    2 / 48 (4.17%)
         occurrences all number
    2
    Vomiting projectile
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Hepatobiliary disorders
    Biliary dyskinesia
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Skin and subcutaneous tissue disorders
    Acne
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Rash
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    2
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    4 / 48 (8.33%)
         occurrences all number
    4
    Conjunctivitis
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Ear infection
         subjects affected / exposed
    4 / 48 (8.33%)
         occurrences all number
    4
    Enterovirus infection
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Eye infection
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Nasopharyngitis
         subjects affected / exposed
    10 / 48 (20.83%)
         occurrences all number
    12
    Otitis media
         subjects affected / exposed
    2 / 48 (4.17%)
         occurrences all number
    2
    Periodontitis
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    2
    Pharyngitis
         subjects affected / exposed
    4 / 48 (8.33%)
         occurrences all number
    4
    Pharyngotonsillitis
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Pulpitis dental
         subjects affected / exposed
    2 / 48 (4.17%)
         occurrences all number
    2
    Respiratory tract infection
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Respiratory tract infection viral
         subjects affected / exposed
    2 / 48 (4.17%)
         occurrences all number
    2
    Rhinitis
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    3
    Skin bacterial infection
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Staphylococcal skin infection
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Tonsillitis
         subjects affected / exposed
    3 / 48 (6.25%)
         occurrences all number
    3
    Tracheitis
         subjects affected / exposed
    2 / 48 (4.17%)
         occurrences all number
    8
    Tracheobronchitis
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Viral infection
         subjects affected / exposed
    1 / 48 (2.08%)
         occurrences all number
    1
    Varicella
         subjects affected / exposed
    4 / 48 (8.33%)
         occurrences all number
    4
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    1 / 48 (2.08%)
         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
    23 Apr 2018
    • General clinical end date was fixed with 31Dec2018 • Further minor changes were implemented

    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.
    None reported
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    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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