Clinical Trial Results:
An Open-Label, Single-Arm, Post-Authorization Pragmatic Clinical Trial on the Safety and Efficacy of Xyntha (Moroctocog-Alfa (AF CC), Recombinant FVIII) in Subjects With Hemophilia A in Usual Care Settings in China
Summary
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EudraCT number |
2015-005040-33 |
Trial protocol |
Outside EU/EEA |
Global end of trial date |
22 Aug 2016
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Results information
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Results version number |
v1(current) |
This version publication date |
04 Jan 2017
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First version publication date |
04 Jan 2017
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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 |
B1831083
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
- | ||
WHO universal trial number (UTN) |
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Sponsors
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Sponsor organisation name |
Pfizer, Inc.
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Sponsor organisation address |
235 E 42nd Street, New York, United States, NY 10017
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Public contact |
Pfizer ClinicalTrials.gov Call Center, Pfizer, Inc., 001 8007181021, ClinicalTrials.gov_Inquiries@pfizer.com
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Scientific contact |
Pfizer ClinicalTrials.gov Call Center, Pfizer, Inc., 001 8007181021, ClinicalTrials.gov_Inquiries@pfizer.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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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? |
Yes
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
14 Oct 2016
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
25 Jul 2016
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Global end of trial reached? |
Yes
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Global end of trial date |
22 Aug 2016
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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 |
The main objective of the trial was to evaluate the product medically important event (MIE) (FVIII inhibitor development during the study) of Xyntha in subjects with hemophilia A in usual care settings in China.
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Protection of trial subjects |
This study used an External Data Monitoring Committee (E-DMC). The E-DMC periodically reviewed data from the study to ensure patient safety according to the Charter. The recommendations made by the E DMC to continue or alter the conduct of the study were forwarded to Pfizer for final decision.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
15 Apr 2015
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
Yes
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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 |
China: 85
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Worldwide total number of subjects |
85
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EEA total number of subjects |
0
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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) |
4
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Children (2-11 years) |
64
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Adolescents (12-17 years) |
7
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Adults (18-64 years) |
10
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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 |
- | |||||||||||||||||||||
Pre-assignment
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Screening details |
As there were 2 subjects who rolled over from the surgical prophylaxis group to the on-demand group should be counted once in total column, the total number of baseline subjects was 85. | |||||||||||||||||||||
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 | |||||||||||||||||||||
Arms
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Are arms mutually exclusive |
No
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Arm title
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On-Demand Group | |||||||||||||||||||||
Arm description |
Subjects were treated with intravenous infusions of Xyntha 500 International Unit (IU)/vial at a dose and frequency prescribed by the subject's treating physician in accordance with the China Xyntha Package Insert for approximately 6 months or approximately 50 exposure days (EDs). | |||||||||||||||||||||
Arm type |
Experimental | |||||||||||||||||||||
Investigational medicinal product name |
Xyntha
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Powder and solution for solution for injection
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Routes of administration |
Intravenous use
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Dosage and administration details |
Subjects were treated with intravenous infusions of Xyntha 500 IU/vial at a dose and frequency prescribed by the subject’s treating physician in accordance with the China Xyntha Package Insert.
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Arm title
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Surgical Prophylaxis Group | |||||||||||||||||||||
Arm description |
Subjects were treated with intravenous infusions of Xyntha 500 IU/vial. The treatment duration for surgical prophylaxis was decided by the investigator depending on surgery nature and subject conditions. | |||||||||||||||||||||
Arm type |
Experimental | |||||||||||||||||||||
Investigational medicinal product name |
Xyntha
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Powder and solution for solution for injection
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Routes of administration |
Intravenous use
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Dosage and administration details |
Subjects were treated with intravenous infusions of Xyntha 500 IU/vial. The treatment duration for surgical prophylaxis was decided by the investigator depending on surgery nature and subject conditions.
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Baseline characteristics reporting groups
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Reporting group title |
On-Demand Group
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Reporting group description |
Subjects were treated with intravenous infusions of Xyntha 500 International Unit (IU)/vial at a dose and frequency prescribed by the subject's treating physician in accordance with the China Xyntha Package Insert for approximately 6 months or approximately 50 exposure days (EDs). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Surgical Prophylaxis Group
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Reporting group description |
Subjects were treated with intravenous infusions of Xyntha 500 IU/vial. The treatment duration for surgical prophylaxis was decided by the investigator depending on surgery nature and subject conditions. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
On-Demand Group
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Reporting group description |
Subjects were treated with intravenous infusions of Xyntha 500 International Unit (IU)/vial at a dose and frequency prescribed by the subject's treating physician in accordance with the China Xyntha Package Insert for approximately 6 months or approximately 50 exposure days (EDs). | ||
Reporting group title |
Surgical Prophylaxis Group
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Reporting group description |
Subjects were treated with intravenous infusions of Xyntha 500 IU/vial. The treatment duration for surgical prophylaxis was decided by the investigator depending on surgery nature and subject conditions. |
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End point title |
Percentage of Subjects With Factor VIII (FVIII) Inhibitors [1] | ||||||||||||
End point description |
Percentage of subjects with the product medically important event (MIE) (FVIII inhibitor development during the study).
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End point type |
Primary
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End point timeframe |
From Day 1 up to 28 calendar days after End of Treatment (subjects had received treatment for 6 months or when subjects had achieved 50 exposure days [EDs] whichever occurred first).
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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: No statistical analysis was planned for this endpoint. |
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No statistical analyses for this end point |
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End point title |
Number of Subjects with All Causality Treatment-Emergent Adverse Events (AEs) or Serious Adverse Events (SAEs) | |||||||||||||||
End point description |
An AE was any untoward medical occurrence without regard to causality in a subject who received study drug. An SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. An AE was considered treatment emergent if it started for the first time in a subject on or after the first day of active treatment, or the event started before the first day of active treatment but increased in severity during active treatment. AEs included both SAEs and non-serious AEs.
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End point type |
Secondary
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End point timeframe |
From Day 1 up to 28 calendar after End of Treatment (subjects had received treatment for 6 months or when subjects had achieved 50 EDs whichever occurred first).
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No statistical analyses for this end point |
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End point title |
Response Assessment of On-Demand Treatment of Bleeds [2] | ||||||||||||||||||
End point description |
The proportion of infusions (initial and subsequent for a bleed) in each response category (excellent, good, moderate, no response) was reported. Excellent: Definite pain relief and/or improvement in signs of bleeding starting within 8 hours after an infusion, with no additional infusion administered. Good: Definite pain relief and/or improvement in signs of bleeding starting within 8 hours after an infusion, with at least 1 additional infusion administered for complete resolution of the bleeding episode or definite pain relief and/or improvement in signs of bleeding starting after 8 hours following the infusion, with no additional infusion administered. Moderate: Probable or slight improvement starting after 8 hours following the infusion, with at least 1 additional infusion administered for complete resolution of the bleeding episode. No Response: No improvement at all between infusions or during the 24 hour interval following an infusion, or condition worsens.
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End point type |
Secondary
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End point timeframe |
From Day 1 up to subjects had received treatment for 6 months or when subjects had achieved 50 EDs whichever occurred first.
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Notes [2] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period. Justification: No statistical analysis was planned for this endpoint. |
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No statistical analyses for this end point |
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End point title |
Number of Infusions Needed to Treat Each New Bleed for On-Demand Treatment [3] | ||||||||
End point description |
The number of Xyntha infusions administered to treat a bleed was determined. This was calculated by adding the on-demand initial treatment and any on-demand follow-up infusions for the same bleed (same bleed start date/time).
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End point type |
Secondary
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End point timeframe |
From Day 1 up to subjects had received treatment for 6 months or when subjects had achieved 50 EDs whichever occurred first.
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Notes [3] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period. Justification: No statistical analysis was planned for this endpoint. |
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No statistical analyses for this end point |
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End point title |
Frequency of Xyntha Infusions to Treat Each New Bleed for On-Demand Group [4] | ||||||||||||||||||
End point description |
The number of bleeds resolved with 1, 2, 3, 4, or >4 infusions was reported for each of the categories (1, 2, 3, 4, or >4 infusions needed to treat the bleed), in which the numerator was the number of bleeds falling into each category, and the denominator was the total number of new bleeds across all subjects.
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End point type |
Secondary
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End point timeframe |
From Day 1 up to subjects had received treatment for 6 months or when subjects had achieved 50 EDs whichever occurred first.
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Notes [4] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period. Justification: No statistical analysis was planned for this endpoint. |
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No statistical analyses for this end point |
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End point title |
Hemostatic Efficacy for Surgical Prophylaxis Treatment [5] | ||||||||||||||||||||||||
End point description |
Assessment of hemostatic efficacy was determined by the investigator and/or surgeon using the 4 point Surgical Hemostasis Efficacy Rating Scale. Excellent: Achieved hemostasis comparable to that expected after similar surgery in a non hemophilic subject. Good: Prolonged time to hemostasis, with somewhat increased bleeding compared to that expected after similar surgery in a non hemophilic subject. Moderate: Obviously delayed hemostasis, but manageable with additional infusions. No Response: No hemostatic response. The percentage of observations in each hemostatic efficacy response category (excellent, good, moderate, none) was reported.
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End point type |
Secondary
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End point timeframe |
From day of surgery to postoperative period
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Notes [5] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period. Justification: No statistical analysis was planned for this endpoint. |
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No statistical analyses for this end point |
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End point title |
Actual Estimated Blood Loss for Surgical Prophylaxis Treatment [6] | ||||||||||||
End point description |
Number of subjects with blood loss in each category (Abnormal, Normal, and Absence). Blood loss during the intraoperative and the postoperative period were assessed by investigator or surgeon, which were rated as Abnormal, Normal, and Absence. Abnormal blood loss meant the blood loss was higher over the expectation for the non hemophilic subject.
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End point type |
Secondary
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End point timeframe |
From day of surgery to postoperative period
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Notes [6] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period. Justification: No statistical analysis was planned for this endpoint. |
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No statistical analyses for this end point |
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End point title |
Number of Units Transfused and Transfusion Type for Surgical Prophylaxis Treatment [7] | ||||||||||
End point description |
The number of units and types of blood products transfused during the intraoperative and the postoperative period were recorded.
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End point type |
Secondary
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End point timeframe |
From day of surgery to postoperative period.
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Notes [7] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period. Justification: No statistical analysis was planned for this endpoint. |
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No statistical analyses for this end point |
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End point title |
Average Infusion Dose and Total Factor VIII Consumption for On-Demand Treatment and Surgical Prophylaxis Treatment | ||||||||||||||||||
End point description |
The total amount (IU) infused for each Xyntha infusion recorded in the study drug infusion log case report form (CRF) was summed to calculate the total factor VIII consumption for each subject. The average infusion dose for each subject was calculated as his total factor VIII consumption (in IU) divided by the number of infusions administered. The total factor VIII consumption, divided by number of infusions, was summarized similarly to average infusion dose (IU).
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End point type |
Secondary
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End point timeframe |
Day 1 up to 6 months or 50 EDs whichever occurred first for On-Demand Group and Day of surgery to postoperative period for Surgical Prophylaxis Group
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No statistical analyses for this end point |
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End point title |
Percentage of Less Than Expected Therapeutic Effect (LETE) in the On-Demand Setting [8] | ||||||||
End point description |
LETE occurred in the on demand setting if 2 successive “No Response” ratings were recorded after 2 successive Xyntha drug infusions, respectively.The infusions must have been administered within 24 hours (less than or equal to 24 hours) of each other for treatment of the same bleeding event in the absence of confounding factors (prespecified). Therefore, LETE in the on demand setting was based on the response to treatment of a bleeding episode (including those occurring during the surgical prophylaxis period). Note that on-demand treatments administered during the surgical prophylaxis period were also to be included.
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End point type |
Secondary
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End point timeframe |
From Day 1 up to subjects had received treatment for 6 months or subjects had achieved 50 EDs whichever occurred first.
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Notes [8] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period. Justification: No statistical analysis was planned for this endpoint. |
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No statistical analyses for this end point |
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End point title |
Number of Confirmed LETE in the Low Recovery Setting | |||||||||
End point description |
LETE could also be lower than expected recovery of FVIII in the opinion of the investigator following infusion of Xyntha in the absence of confounding factors. The only confounding factors for low recovery were: known presence or subsequent identification of a FVIII inhibitor; known compromised Xyntha; faulty administration of Xyntha, including inadequate dosing.
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End point type |
Secondary
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End point timeframe |
From Day 1 up to subjects had received treatment for approximately 6 months or when subjects had achieved approximately 50 EDs whichever occurred first.
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No statistical analyses for this end point |
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Adverse events information
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Timeframe for reporting adverse events |
From Day 1 up to 28 calendar days after End of Treatment (subjects had received treatment for 6 months or when subjects had achieved 50 EDs whichever occurred first).
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Assessment type |
Non-systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
19.0
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Reporting groups
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Reporting group title |
On-Demand Group
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Reporting group description |
Subjects were treated with intravenous infusions of Xyntha 500 International Unit (IU)/vial at a dose and frequency prescribed by the subject's treating physician in accordance with the China Xyntha Package Insert for approximately 6 months or approximately 50 exposure days (EDs). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Surgical Prophylaxis Group
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Reporting group description |
Subjects were treated with intravenous infusions of Xyntha 500 IU/vial. The treatment duration for surgical prophylaxis was decided by the investigator depending on surgery nature and subject conditions. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 5% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? No | |||
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 |