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    Summary
    EudraCT Number:2018-003660-31
    Sponsor's Protocol Code Number:B7841005
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Restarted
    Date on which this record was first entered in the EudraCT database:2019-12-20
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2018-003660-31
    A.3Full title of the trial
    An Open-Label Study in Adolescent and Adult Severe (Coagulation Factor Activity <1%) Hemophilia A or B Patients With or Without Inhibitors Comparing Standard Treatment to PF-06741086 Prophylaxis
    Estudio abierto en pacientes adolescentes y adultos con hemofilia A o B grave (actividad del factor de coagulación <1 %) con o sin inhibidores para comparar el tratamiento estándar con la profilaxis con PF-06741086
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    PROPHYLAXIS STUDY OF PF-06741086 IN ADOLESCENT AND ADULT HEMOPHILIA PATIENTS WITH OR WITHOUT INHIBITORS
    ESTUDIO DE PROFILAXIA DE PF-06741086 EN PACIENTES ADOLESCENTES Y ADULTOS CON HEMOFILIA CON O SIN INHIBIDORES
    A.4.1Sponsor's protocol code numberB7841005
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorPfizer Inc., 235 East 42nd Street, New York, NY 10017
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportPfizer Inc, 235 East 42nd Street, New York, NY 10017
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationPfizer Inc.
    B.5.2Functional name of contact pointClinical Trials.gov Call Centre
    B.5.3 Address:
    B.5.3.1Street Address235 East 42nd Street,
    B.5.3.2Town/ cityNew York
    B.5.3.3Post codeNY 10017
    B.5.3.4CountryUnited States
    B.5.4Telephone number+18007181021
    B.5.6E-mailClinicalTrials.gov_Inquiries@pfizer.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community Yes
    D.2.5.1Orphan drug designation numberEU/3/16/1752
    D.3 Description of the IMP
    D.3.1Product namePF-06741086, MARSTACIMAB 150mg/ml
    D.3.2Product code PF-06741086
    D.3.4Pharmaceutical form Solution for injection in pre-filled syringe
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNMarstacimab
    D.3.9.2Current sponsor codePF-06741086
    D.3.9.3Other descriptive nameanti-TFPI mAb, , BLU-C002
    D.3.9.4EV Substance CodeSUB187130
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number150
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Hemophilia A or B
    Hemofilia A o B
    E.1.1.1Medical condition in easily understood language
    Severe Hemophilia A or B
    Hemofilia A o B grave
    E.1.1.2Therapeutic area Diseases [C] - Blood and lymphatic diseases [C15]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level LLT
    E.1.2Classification code 10060613
    E.1.2Term Hemophilia A (Factor VIII)
    E.1.2System Organ Class 100000004850
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level LLT
    E.1.2Classification code 10060612
    E.1.2Term Hemophilia A
    E.1.2System Organ Class 100000004850
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level LLT
    E.1.2Classification code 10060614
    E.1.2Term Hemophilia B (Factor IX)
    E.1.2System Organ Class 100000004850
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To demonstrate the efficacy and safety of PF06741086 for routine prophylaxis in severe (FVIII or FIX activity <1%) hemophilia A or B patients 12 to <75 years of age with or without inhibitors
    Demostrar la eficacia y la seguridad de PF06741086 para la profilaxis de rutina en pacientes con hemofilia A o B grave (actividad FVIII o FIX de <1 %) que tengan entre 12 y <75 años con o sin inhibidores.
    E.2.2Secondary objectives of the trial
    To evaluate additional efficacy of PF06741086
    Evaluar la eficacia adicional de PF06741086.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Participants are eligible to be included in the study only if all of the following criteria apply:
    Age
    1. Participant must be male and 12 to <75 years of age inclusive, at the time of signing the informed consent.
    Type of Participant and Disease Characteristics
    2. Participants with a diagnosis of severe hemophilia A or B (FVIII or FIX activity <1%, respectively).
    3. Participants who are enrolled into the Non-Inhibitor Cohort must also meet the following criteria:
    • No detectable or documented history of inhibitors (≥0.6 BU/mL or greater than the upper limit of normal [ULN] for the testing laboratory) against FVIII or FIX prior to enrollment (Baseline of Observational Phase).
    • Participants outside the US and Canada receiving routine prophylaxis (defined as treatment by IV injection of factor concentrate to prevent anticipated bleeding) treatment with FVIII/FIX replacement, have demonstrated at least 80% compliance with scheduled prophylaxis regimen during 6 months prior to enrollment, and willing to continue to receive routine prophylaxis treatment with FVIII/FIX replacement during the Observational Phase (For investigator sites in the US and Canada only: See Appendix 7 of the protocol for details).
    OR
    • Participants with on-demand treatment regimen with ≥6 acute bleeding episodes (spontaneous and/or traumatic) that required coagulation factor infusion during the 6 months period prior to Screening and willing to continue to receive on demand treatment during the Observational Phase. Surgical bleeding episodes do not apply to this criterion.
    4. Participants who are enrolled into the Inhibitor Cohort must also meet the following criteria:
    • Documentation of current high titer inhibitor (≥5 BU/mL) or current low titer inhibitor (<5 BU/mL) refractory to FVIII or FIX replacement and with FVIII or FIX recovery <60% of expected within previous 30 days prior to Baseline of Observational Phase, Enrollment into Observational Phase.
    • Participants with on-demand treatment regimen with ≥6 bleeding episodes (spontaneous and/or traumatic) necessitating treatment with bypass factor for at least 6 months prior to screening and willing to continue to receive on-demand treatment during the Observational Phase. Surgical bleeding episodes do not apply to this criterion.
    Sex
    5. Male
    Informed Consent
    6. Participant or caregiver capable of giving signed informed consent (or minor assent, when applicable) as described in Appendix 1 of the protocol which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol
    Los participantes son elegibles para participar en el estudio solo si se aplican todos los siguientes criterios:
    Edad
    1. El participante debe ser de sexo masculino y tener entre 12 y <75 años al momento de firmar el consentimiento informado.
    Tipo de participante y características de la enfermedad
    2. Participantes con un diagnóstico de hemofilia A o B grave (actividad FVIII o FIX <1 %, respectivamente).
    3. Los participantes inscritos en la cohorte sin inhibidor también deben cumplir con los siguientes criterios:
    • No tener historial detectable o documentado de inhibidores (≥0,6 BU/ml o por encima del límite superior normal [LSN] para el laboratorio de pruebas) frente a FVIII o FIX previo a la inscripción (valor inicial de la fase de observación).
    • Participantes fuera de EE. UU. y Canadá que reciban tratamiento de profilaxis (definido como tratamiento por inyección intravenosa de concentrado de factor para prevenir el sangrado anticipado) de rutina con reemplazo FVIII/FIX, que demuestren al menos un 80 % de cumplimiento con el régimen de profilaxis programada durante 6 meses previos a la inscripción y manifiesten la voluntad de seguir recibiendo el tratamiento de profilaxis de rutina con reemplazo FVIII/FIX durante la fase de observación. (Únicamente para centros de investigación en EE. UU. y Canadá: para obtener más detalles, consulte el Apéndice 7 del Protocolo).
    O)
    • Participantes con un régimen de tratamiento a demanda con ≥6 episodios de sangrado agudo (espontáneo o traumático) que hayan requerido la infusión del factor de coagulación durante el período de 6 meses previo a la selección y manifiesten la voluntad de seguir recibiendo el tratamiento a demanda durante la fase de observación. Los episodios de sangrado quirúrgico no se aplican en este criterio.
    4. Los participantes inscritos en la cohorte con inhibidor también deben cumplir con los siguientes criterios:
    • Documentación de refractario de alto (≥5 BU/ml) o bajo título de inhibidor actual (<5 BU/ml) a reemplazo de FVIII o FIX y con recuperación de FVIII o FIX del <60 % de lo esperado dentro de los 30 días previos a la visita inicial y la inscripción en la fase de observación.
    • Participantes con un régimen de tratamiento a demanda con ≥6 episodios de sangrado (espontáneo o traumático) que requieran tratamiento con factor bypass durante al menos 6 meses previos a la selección y manifiesten la voluntad de seguir recibiendo el tratamiento a demanda durante la fase de observación. Los episodios de sangrado quirúrgico no se aplican en este criterio.
    Sexo
    5.Masculino
    Consentimiento informado
    6.Participante o cuidador con la capacidad de otorgar el consentimiento informado firmado (o la autorización del menor, si corresponde) según lo descrito en el protocolo, que incluye el cumplimiento con los requisitos y las restricciones mencionadas en el formulario de consentimiento informado (FCI) y en este protocolo.
    E.4Principal exclusion criteria
    Medical Conditions
    1. Previous or current treatment for and/or history of coronary artery diseases, venous or arterial thrombosis (Common Terminology Criteria for Adverse Events [CTCAE]13 Grade >1), or ischemic disease (except treatment for catheter associated thrombosis).
    2. Known planned surgical procedure during the planned study period.
    3. Known hemostatic defect other than hemophilia A or B.
    4. Abnormal renal or hepatic function as defined by the following laboratory results at Screening:
    a. Alanine transaminase (ALT) >2 × upper limit of normal (ULN)
    b. Bilirubin >1.5 × ULN (isolated bilirubin >1.5 × ULN is acceptable if bilirubin is fractionated and direct bilirubin <35%)
    c. Current unstable liver or biliary disease per investigator assessment defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminaemia, oesophageal or gastric varices, persistent jaundice, or cirrhosis. NOTE: Stable chronic liver disease (including Gilbert’s syndrome, asymptomatic gallstones, and chronic stable hepatitis B or C -eg, presence of hepatitis B surface antigen [HBsAg] or positive hepatitis C antibody test result at screening or within 3 months prior to starting study intervention) is acceptable if the participant otherwise meets entry criteria
    d. Serum albumin less than the lower limit of normal (LLN).
    e. Estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2.
    5. Abnormal hematology values as defined by the following laboratory tests at Screening:
    a. Platelet count <100,000/uL
    b. Fibrinogen level <LLN
    c. Hemoglobin level <10 g/dL
    6. Abnormal coagulation activity as defined by the following laboratory results at Screening:
    a. Prothrombin time (PT) >1.25 × ULN.
    7. Other acute or chronic medical or psychiatric condition including recent (within the past year) or active suicidal ideation or behavior or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the participant inappropriate for entry into this study.
    8. QTc >450 msec for male participants or QTc >480 msec in participants with bundle branch block
    Prior/Concomitant Therapy
    9. Current routine prophylaxis with bypassing agent (eg, aPCC, Prothrombin Complex Concentrates [PCC], and/or rFVIIa) or no coagulation factor-replacement therapy (eg, emicizumab).
    10. Regular, concomitant therapy with immunomodulatory drugs (eg, IV immunoglobulin [IVIG], and routine systemic corticosteroids, rituximab).
    11. Ongoing or planned use of immune tolerance induction during the Observational Phase or Active Treatment Phase, or prophylaxis with FVIII or FIX replacement during the Active Treatment Phase.
    Prior/Concurrent Clinical Study Experience
    12. Participation in other studies involving investigational drug(s) within 30 days (or as determined by local requirements) or 5 half-lives prior to study entry and/or during study participation.
    Diagnostic assessments
    13. CD4 cell count ≤200/uL if human immunodeficiency virus (HIV)-positive
    14. Baseline 12-lead ECG that demonstrates clinically relevant abnormalities that may affect participant safety or interpretation of study results.
    Other Exclusions
    15. Investigator site staff members directly involved in the conduct of the study and their family members, site staff members otherwise supervised by the investigator, or participants who are Pfizer employees, including their family members, directly involved in the conduct of the study.
    Enfermedades
    1. Tratamientos previos o actuales o historial de enfermedades de la arteria coronaria, trombosis venosa o arterial (Terminología Frecuente de Criterios para Eventos Adversos [Common Terminology Criteria for Adverse Events, CTCAE]13 Grado >1) o enfermedad isquémica (con la excepción del tratamiento para trombosis asociada al uso de catéteres).
    2. Procedimiento quirúrgico programado conocido durante el período del estudio planificado.
    3. Defecto hemostático conocido aparte de la hemofilia A o B.
    4. Función renal o hepática anormal, según lo definido por los siguientes resultados del laboratorio en la selección:
    a. Alanina aminotransferasa (ALT) >2 veces por encima del límite superior normal (LSN)
    b. Bilirrubina >1,5 veces por encima del LSN (la bilirrubina aislada >1,5 veces por encima del LSN es aceptable si es bilirrubina fraccionada y directa <35 %)
    c. Enfermedad inestable actual del hígado o de la vesícula biliar según la evaluación del investigador, definida por la presencia de ascitis, encefalopatía, coagulopatía, hipoalbuminemia, várices esofágicas o gástricas, ictericia persistente o cirrosis. NOTA: La enfermedad crónica y estable del hígado (incluidos el síndrome de Gilbert, cálculos biliares asintomáticos y la hepatitis B o C crónica, p. ej., presencia del antígeno de superficie de la hepatitis B [HBsAg] o un resultado positivo del anticuerpo de la hepatitis C durante la selección o dentro de los 3 meses previos al comienzo de la intervención del estudio) es aceptable si el participante igualmente cumple con los criterios de entrada.
    d. Albúmina sérica por debajo del límite inferior normal (LIN).
    e. Tasa de filtración glomerular estimada (TFGe) <30 ml/min/1,73 m2.
    5. Valores hematológicos anormales según lo definido por las siguientes pruebas del laboratorio en la selección:
    a. Recuento de plaquetas <100 000/µl
    b. Nivel de fibrinógeno <LIN
    c. Niveles de hemoglobina <10 g/dl
    6. Actividad de coagulación anormal según lo definido por los siguientes resultados del laboratorio en la selección:
    a. Tiempo de protrombina (TP) >1,25 × LSN
    7. Cualquier otra afección médica o psiquiátrica, aguda o crónica, incluidas ideación o conducta suicidas recientes (en el año anterior) o anomalías en los análisis clínicos que pudieran aumentar el riesgo asociado a la participación en el estudio o a la administración del producto en fase de investigación, o que pudieran interferir en la interpretación de los resultados del estudio y que, en la opinión del investigador, harían que el participante fuera inapropiado para ingresar en este estudio.
    8. QTc >450 ms para participantes masculinos o QTc >480 ms en participantes con bloqueo de rama.
    Tratamiento anterior/concomitante
    9. Profilaxis de rutina actual con agente bypass (p. ej., CCPa, concentrados de complejo de protrombina [CCP] o rFVIIa) o sin terapia de reemplazo de factor de coagulación (p. ej., emicizumab).
    10. Terapia regular y concomitante con medicamentos inmunomoduladores (p. ej., inmunoglobina intravenosa [IGIV] y corticosteroides sistémicos de rutina, rituximab).
    11. Uso en curso o planificado de inducción de la tolerancia inmune durante la fase de observación o la fase de tratamiento activo, o profilaxis con reemplazo de FVIII o FIX durante la fase de tratamiento activo.
    Experiencia anterior/concurrente en estudios clínicos
    12. Participación en otros estudios con fármacos en fase de investigación en los 30 días (o según lo determinado por los requisitos locales) o 5 semividas previos a la entrada en el estudio o durante la participación en este.
    Evaluaciones diagnósticas
    13. Recuento de células CD4 ≤200/µl si es virus de la inmunodeficiencia humana (VIH) positivo.
    14. Electrocardiograma de 12 derivaciones inicial que demuestra anormalidades clínicamente relevantes que pueden afectar la seguridad del participante o la interpretación de los resultados del estudio.
    Otras exclusiones
    15. Miembros del personal del centro del investigador implicados directamente en la realización del estudio y sus familiares; miembros del personal del centro que tengan la supervisión del investigador, o participantes que sean empleados de Pfizer (incluidos sus familiares) implicados directamente en la realización del estudio.
    E.5 End points
    E.5.1Primary end point(s)
    Primary Endpoints
    - The primary efficacy endpoint is the annualized bleeding rate (ABR) of treated bleeding events, which is derived for each subject for each treatment period by using the following formula: ABR = number of bleeds requiring treatments/ (days on treatment period / 365.25). The statistical objective and strategy of demonstrating the efficacy in each cohort is shown below.
    - Inhibitor Cohort:
    - Superiority in ABR of PF-06741086 prophylaxis observed over the 12 month Active Treatment Phase versus ondemand treatment with bypass therapy during the 6 months prior to receiving study intervention, using within-subject comparison
    - Non-Inhibitor Cohort:
    - For the European Union (EU), non-inferiority in ABR of PF06741086 prophylaxis observed over the 12 month Active Treatment Phase versus prophylaxis treatment with FVIII- or FIX-replacement during the Observational Phase prior to receiving study intervention, using within-subject comparison
    - Adverse events (AEs) and SAEs
    - Incidence and severity of thrombotic events
    - Immunogenicity (incidence of antidrug antibody [ADA] and clinically significantly persistent neutralizing antibody [NAb] against PF06741086)
    - Incidence and severity of injection site reaction
    - Changes in physical examination and vital signs
    - Incidence of clinically significant laboratory value abnormalities
    - Incidence of severe hypersensitivity and anaphylactic reactions
    Criterios de valoración principales
    - El criterio principal de valoración de eficacia es la tasa anualizada de sangrados (Annualized Bleeding Rate, ABR) de los eventos de sangrado tratados, que se deriva para cada sujeto por cada período de tratamiento mediante el uso de la siguiente fórmula: ABR = número de sangrados que requieren tratamiento/(días de tratamiento/365,25). El objetivo y la estrategia estadísticos de la demostración de la eficacia en cada cohorte se muestra a continuación.
    - Cohorte con inhibidor:
    - Superioridad en la ABR de la profilaxis PF 06741086 observada durante la fase de tratamiento activo de 12 meses en comparación con el tratamiento a demanda con terapia de bypass durante los 6 meses previos a recibir la intervención del estudio, mediante la comparación dentro de los parámetros propios del sujeto.
    - Cohorte sin inhibidor:
    - Para EE. UU., superioridad en la ABR de la profilaxis PF-06741086 observada durante la fase de tratamiento activo de 12 meses en comparación con el tratamiento a demanda con sustitución FVIII o FIX durante la fase de observación previa a recibir la intervención del estudio, mediante la comparación dentro de los parámetros propios del sujeto.
    - Para la Unión Europea (UE), no inferioridad en la ABR de la profilaxis PF06741086 observada durante la fase de tratamiento activo de 12 meses en comparación con el tratamiento de profilaxis con sustitución FVIII o FIX durante la fase de observación previa a recibir la intervención del estudio, mediante la comparación dentro de los parámetros propios del sujeto.
    - Efectos adversos (EA) y efectos adversos significativos (EAS).
    - Incidencia y gravedad de los eventos trombóticos.
    - Inmunogenicidad (incidencia de anticuerpos antidroga [Antidrug Antibody, ADA] y anticuerpos neutralizantes [Neutralizing Antibody, NAb] persistentes clínicamente significativos en comparación con PF06741086).
    - Incidencia y gravedad de la reacción en el sitio de inyección.
    - Cambios en el examen físico y los signos vitales.
    - Incidencia de anormalidades en los valores de laboratorio clínicamente significativas.
    - Incidencia de hipersensibilidad grave y reacciones anafilácticas.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Timepoints are all listed in the list of primary endpoints.
    Todos los tiempos se han incluido en la lista de los criterios de valoración principales.
    E.5.2Secondary end point(s)
    Secondary Endpoints
    - The following parameters will be assessed for comparison between PF-06741086 prophylaxis observed over the 12-month Active Treatment Phase versus a respective control group corresponding to each of the 3 statistical objectives (inhibitors, non-inhibitors for the US, and non-inhibitors for the EU), using within-subject comparison. For the Non-Inhibitor Cohort, all the primary and secondary endpoints for the US will be part of the secondary endpoints for the EU and vice versa.
    - Total coagulation factor and/or bypass product consumption
    - Incidence of joint bleeds
    - Incidence of spontaneous bleeds
    - Incidence of target joint bleeds
    - Incidence of total bleeds (treated and untreated).
    - Percentage of participants with no bleeding episodes
    - Change in joints as measured by the Hemophilia Joint Health Score (HJHS)
    - HRQoL:
    - Hemophilia Quality of Life Questionnaire for Adults (Haem-A-QoL) (≥17 years of age)/Hemophilia Quality of Life Questionnaire for Children (Haemo-QoL); (Adolescents 12 to <17 years of age);
    - Hemophilia Activities List (HAL) (Adult ≥17 years of age)/Pediatric Hemophilia Activities List (pedHAL) (Adolescents 12 to <17 years of age);
    - Patient Global Impression of Change – Hemophilia (PGIC-H) (Observational Phase and Active Treatment Phase)
    - Health Utilities Measure (EuroQol 5 Dimensions 5 Level [EQ-5D-5L])
    Tertiary/Exploratory Endpoints
    - Analysis of trough concentrations over the duration of the study
    - Analysis of changes in biomarkers: TFPI, peak thrombin generation [PKT], prothrombin fragment 1+2 [PF1+2], and dilute prothrombin time over duration of the study
    - Se evaluarán los siguientes parámetros para comparar la profilaxis PF-06741086 observada durante la fase de tratamiento activo de 12 meses frente al grupo de control respectivo correspondiente a cada uno de los tres objetivos estadísticos (con inhibidor, sin inhibidor para EE. UU. y sin inhibidor para la UE), mediante la comparación dentro de los parámetros propios del sujeto. Con respecto a la cohorte sin inhibidor, todos los criterios de valoración principales y secundarios para EE. UU. formarán parte de los criterios de valoración secundarios para la UE y viceversa.
    - Factor de coagulación total o consumo de productos de bypass.
    - Incidencia de sangrados articulares.
    - Incidencia de sangrados espontáneos.
    - Incidencia de sangrados de articulaciones específicas.
    - Incidencia de sangrados totales (tratados y sin tratar).
    - Porcentaje de participantes sin episodios de sangrado.
    - Cambio en articulaciones según lo medido por el Puntaje de salud articular en la hemofilia (Hemophilia Joint Health Score, HJHS).
    - CVRS:
    - Cuestionario sobre la calidad de vida en pacientes adultos con hemofilia (Haem A QoL) (≥17 años)/Cuestionario sobre la calidad de vida en pacientes pediátricos con hemofilia (Haemo-QoL); (adolescentes de 12 a <17 años).
    - Lista de actividades para personas con hemofilia (Hemophilia Activities List, HAL) (adultos ≥17 años)/lista de actividades para pacientes pediátricos con hemofilia (Pediatric Hemophilia Activities List, pedHAL) (adolescentes de 12 a <17 años).
    - Impresión global de cambio del paciente – hemofilia (PGIC-H) (fase de observación y fase de tratamiento activo).
    - Medición de las utilidades relacionadas con la salud (EuroQol 5 Dimensions 5 Level, EQ-5D-5L).
    Criterios de valoración terciarios/exploratorios
    - Análisis de las concentraciones mínimas durante el estudio.
    - Análisis de cambios en biomarcadores: TFPI, pico de generación de trombina [PKT], fragmento de protrombina 1+2 [PF1+2], tiempo de protrombina diluido durante el estudio.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Timepoints are all listed in the list of primary endpoints.
    Todos los tiempos se han incluido en la lista de los criterios de valoración secundarios.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis Yes
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised No
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    E.8.1.6Cross over Yes
    E.8.1.7Other Yes
    E.8.1.7.1Other trial design description
    one way
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    Standard of Care for Hemophilia A or B
    E.8.2.4Number of treatment arms in the trial1
    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.8.4.1Number of sites anticipated in Member State concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA22
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Australia
    Brazil
    Bulgaria
    Canada
    China
    Croatia
    France
    Germany
    Hong Kong
    India
    Ireland
    Italy
    Japan
    Korea, Republic of
    Mexico
    Oman
    Russian Federation
    Saudi Arabia
    Serbia
    Spain
    Switzerland
    Taiwan
    Turkey
    United Kingdom
    United States
    E.8.7Trial 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
    A participant is considered to have completed the study if he has completed all phases of the study including the Day 390 Follow-up phone call during the Active Treatment Phase.
    The end of the study is defined as the date of the last scheduled procedure shown in the Schedule of Activities for the last participant in the trial globally.
    Un participante se considera que ha completado el estudio si ha completado todas las fases del estudio incluyendo el día 390 - llamada de seguimiento durante la fase activa del tratamiento.
    El final del estudio se define como la fecha del último procedimiento programado según se incluye en el calendario de actividades para el último participante del estudio globalmente.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months11
    E.8.9.1In the Member State concerned days6
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months6
    E.8.9.2In all countries concerned by the trial days14
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 Yes
    F.1.1Number of subjects for this age range: 29
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) Yes
    F.1.1.6.1Number of subjects for this age range: 29
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 104
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 12
    F.2 Gender
    F.2.1Female No
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception No
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others Yes
    F.3.3.7.1Details of other specific vulnerable populations
    Minors 12-18 years old
    F.4 Planned number of subjects to be included
    F.4.1In the member state6
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 39
    F.4.2.2In the whole clinical trial 106
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    Study intervention will not be provided after conclusion of this study. A 12-month extension study (B7841007) to assess safety is available for participants who complete the B7841005 study. Participants who will participate in the B7841007 long-term extension study are not required to complete the Active Treatment Phase Day 390 Follow-up Phone Call.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2020-03-02
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2020-02-28
    P. End of Trial
    P.End of Trial StatusRestarted
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