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    Summary
    EudraCT Number:2018-003660-31
    Sponsor's Protocol Code Number:B7841005
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-05-24
    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 ConcernedItaly - Italian Medicines Agency
    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
    Studio in aperto in pazienti adolescenti e adulti affetti da grave emofilia A o B (attività del fattore di coagulazione <1%) con o senza inibitori volto a confrontare la terapia standard con la profilassi 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
    Studio su PF-06741086 in profilassi in pazienti emofilici adolescenti e adulti con o senza inibitori
    A.3.2Name or abbreviated title of the trial where available
    -
    -
    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
    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 150 mg/ml
    D.3.2Product code [PF-06741086]
    D.3.4Pharmaceutical form Solution for injection
    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.3.9.4EV 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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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
    Emofilia A o B
    E.1.1.1Medical condition in easily understood language
    Severe Hemophilia A o B
    Emofilia A o B severa
    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 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 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.1.2 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 PF-06741086 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.
    Dimostrare l’efficacia e la sicurezza di PF-06741086 per la profilassi di routine in pazienti con emofilia A o B grave (attività FVIII o FIX < 1%) di età compresa tra 12 e < 75 anni con o senza inibitori.
    E.2.2Secondary objectives of the trial
    To evaluate additional efficacy of PF-06741086
    Valutare l’efficacia aggiuntiva di PF-06741086
    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 with a minimum body weight of 30 kg 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 receiving routine prophylaxis (defined as treatment by IV injection of factor concentrate to prevent 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.
    (OR)
    - Participants with on-demand treatment regimen with >= 6 acute bleeding episodes (spontaneous or traumatic) that required coagulation factor infusion during the 6 months period prior to Enrollment into Observational Phase 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 6 months prior to Enrollment into Observational Phase.
    - Participants who have documented inhibitors while on factor-replacement therapy but who do not meet the quantitative inhibitor criteria described in the prior bullet at the time of Screening (eg, participant with a previously documented high-titer inhibitor (=5 BU/mL) and whose condition precludes re-challenge with FVIII or
    FIX replacement) may be considered for eligibility on a case-by-case basis with prior approval from the Pfizer Medical Monitor.
    - Participants with on-demand treatment regimen with =6 bleeding episodes (spontaneous or traumatic) necessitating treatment with bypass factor during the 6 months prior to Enrollment into Observational Phase 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 legally authorized representative, or participant’s caregiver capable of giving signed informed consent (or minor assent, when applicable) as described in Appendix 1 which includes compliance with the requirements and restrictions listed in the informed consent document (ICD) and in this protocol.
    I partecipanti possono essere inclusi nello studio solo se rispondono a tutti i seguenti criteri:
    Età
    1. Il partecipante deve essere un maschio di età compresa tra i 12 e i < 75 anni, con un peso corporeo minimo di 30 kg al momento della firma del consenso informato.
    Tipo di partecipanti e caratteristiche della malattia
    2. Partecipanti che hanno ricevuto una diagnosi di emofilia A o B grave (attività FVIII o FIX < 1% rispettivamente).
    3. I partecipanti arruolati nella coorte senza inibitori devono soddisfare anche i seguenti criteri:
    • Nessuna anamnesi rilevabile o documentata di inibitori (= 0,6 BU/mL o maggiore del limite superiore di normalità [ULN] per il laboratorio dei test) a fronte di FVIII o FIX prima dell’arruolamento (basale della Fase di osservazione).
    • I partecipanti a cui viene somministrata la terapia profilattica di routine (definita come terapia endovenosa di concentrato di fattori per prevenire il sanguinamento) con prodotti sostitutivi dei fattori FVIII/FIX, hanno dimostrato una conformità pari almeno all’80% con regime profilattico pianificato nei 6 mesi precedenti all’arruolamento e sono disposti a continuare a sottoporsi alla terapia profilattica di routine con prodotti sostitutivi dei fattori FVIII/FIX nel corso della Fase di osservazione.
    (OPPURE)

    • I partecipanti che seguono un regime di terapia al bisogno con >= 6 episodi di sanguinamento acuto (spontaneo o traumatico) che hanno richiesto l’infusione con fattore di coagulazione nel corso dei 6 mesi precedenti all’Arruolamento nella Fase di osservazione e che sono disposti a continuare a sottoporsi alla terapia al bisogno durante la Fase di osservazione. Gli episodi di sanguinamento chirurgico non sono pertinenti per questo criterio.
    4. I partecipanti arruolati nella Coorte con inibitori devono soddisfare anche i seguenti criteri:
    • Documentazione dell’attuale inibitore ad alto titolo (= 5 BU/mL); o dell’attuale inibitore a basso titolo (< 5 BU/mL) refrattario ai prodotti sostitutivi dei fattori FVIII o FIX e con recupero di FVIII o FIX < 60% del previsto entro i precedenti 6 mesi prima dell’arruolamento nella Fase di osservazione.
    • I partecipanti che hanno inibitori documentati durante la terapia a base di prodotti sostitutivi dei fattori ma che, al momento dello Screening, non soddisfano i criteri quantitativi relativi agli inibitori di cui al punto precedente (ad es. i partecipanti con un inibitore ad alto titolo precedentemente documentato (= 5 BU/mL), la cui condizione preclude una risomministrazione dei prodotti sostitutivi dei fattori FVIII o FIX,) possono essere tenuti in considerazione per valutarne l’eleggibilità caso per caso, previa approvazione da parte del responsabile della supervisione dello studio di Pfizer.
    • I partecipanti che seguono un regime di terapia al bisogno con = 6 episodi di sanguinamento (spontaneo o traumatico) che hanno richiesto la terapia con fattore bypassante durante i 6 mesi precedenti all’Arruolamento nella Fase di osservazione e che sono disposti a continuare a sottoporsi alla terapia al bisogno durante la Fase di osservazione. Gli episodi di sanguinamento chirurgico non sono pertinenti per questo criterio.
    Sesso
    5. Maschio
    Consenso informato
    6. Il partecipante, il rappresentante legale o il caregiver del partecipante in grado di sottoscrivere il proprio consenso informato (o assenso del minore, ove pertinente) secondo quanto descritto nell’Appendice 1 del protocollo che include la conformità ai requisiti e alle restrizioni elencati nel documento di consenso informato (ICD) e nel presente protocollo.
    E.4Principal exclusion criteria
    Participants are excluded from the study if any of the following criteria apply:
    Medical Conditions
    1. Previous or current treatment for or history of coronary artery diseases, venous or arterial thrombosis (Common Terminology Criteria for Adverse Events [CTCAE] 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 (see
    Appendix 10.2.1 for formulas used in eGFR calculation).
    5. Abnormal hematology values as defined by the following laboratory tests at Screening:
    a. Platelet count <100,000/uL
    b. Hemoglobin level <10 g/dL
    6. 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.
    7. QTc >450 msec for male participants or QTc >480 msec in participants with bundle branch block.
    8. Individuals with hypersensitivity or an allergic reaction to hamster protein or other components of the study intervention.
    Prior/Concomitant Therapy
    9. Current routine prophylaxis with bypassing agent (eg, aPCC, BYCLOT, Prothrombin Complex Concentrates [PCC], or rFVIIa) or non-coagulation non-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 or during study participation.
    13. Previous exposure to PF-06741086 during to participation in studies B7841002 and B7841003.
    For further details for exclusion criteria please refer to study Protocol.
    I partecipanti sono esclusi dallo studio se rispondono a uno dei seguenti criteri:
    Condizioni mediche
    1. Terapia precedente o in corso per o anamnesi di patologia coronarica, trombosi venosa o arteriosa (Criteri comuni di terminologia per gli eventi avversi [CTCAE] di gradi > 1) o patologia ischemica (esclusa terapia per trombosi da catetere).
    2. Noto intervento chirurgico pianificato durante il periodo programmato dello studio.
    3. Nota anomalia emostatica diversa dall’emofilia A o B.
    4. Anomala funzionalità renale o epatica secondo la definizione dei seguenti risultati di laboratorio allo screening:
    a. Alanina transaminasi (ALT) > 2 volte il limite superiore di normalità (ULN)
    b. Bilirubina > 1,5 volte l’ULN (un valore di bilirubina isolata > 1,5 volte l’ULN è da ritenersi accettabile se la bilirubina è frazionata e la bilirubina diretta è < 35%).
    c. Malattia epatica corrente instabile o patologia biliare, in base alla valutazione dello sperimentatore, stabilita dalla presenza di ascite, encefalopatia, coagulopatia, ipoalbuminemia, varici esofagee o gastriche, itterizia persistente o cirrosi. NOTA: la malattia epatica cronica stabile (incluse sindrome di Gilbert, calcolosi asintomatica ed epatite B o C cronica stabile, ad es. presenza dell’antigene di superficie dell’epatite B [HBsAg] o risultato positivo agli esami degli anticorpi dell’epatite C allo screening o entro i 3 mesi precedenti all’avvio dell’intervento di studio) è accettabile se il partecipante soddisfa comunque i criteri di inclusione.
    d. Sieroalbumina inferiore al limite inferiore di normalità (LLN).
    e. Velocità di filtrazione glomerulare stimata (Estimated Glomerular Filtration Rate, eGFR) < 30 mL/min/1,73 m2 (consultare l’Appendice 10.2.1 per le formule utilizzate nel calcolo dell’eGFR).
    5. Valori di ematologia anomali secondo la definizione dei seguenti test di laboratorio allo screening:
    a. Conta piastrine < 100.000/µL
    b. Livello di emoglobina < 10 g/dL
    6. Altre condizioni psichiatriche o mediche croniche o acute, compresi, siano essi recenti o attivi, idee o comportamenti suicidi o un’anomalia di laboratorio in grado di aumentare il rischio associato alla partecipazione allo studio o alla somministrazione del prodotto sperimentale o di interferire con l’interpretazione dei risultati dello studio e che, secondo l’opinione dello sperimentatore, renderebbe inappropriata la partecipazione della persona al presente studio.
    7. QTc > 450 msec per i partecipanti maschi o QTc > 480 msec per i partecipanti con blocco di branca
    8. Soggetti con ipersensibilità o allergia alle proteine di criceto o ad altri componenti dell’intervento di studio.
    Terapia precedente/concomitante
    9. Attuale profilassi di routine con agente bypassante (ad es. aPCC, BYCLOT, complesso protrombinico concentrato [PCC] o rFVIIa) o terapia non sostitutiva dei fattori di non-coagulazione (ad es. emicizumab).
    10. Terapia regolare concomitante con farmaci immunomodulanti (ad es. immunoglobulina IV [IVIG] e corticosteroidi sistemici di routine, rituximab).
    11. Uso in corso o programmato di induzione della tolleranza immunologica durante la Fase di osservazione o la Fase di trattamento attivo, o profilassi con prodotti sostitutivi dei fattori FVIII e FIX durante la Fase di trattamento attivo.
    Esperienza precedente/concomitante in altri studi clinici
    12. Partecipazione ad altri studi con farmaci sperimentali entro 30 giorni (o secondo quanto stabilito dai requisiti locali) o 5 emivite prima dell’ingresso nello studio o durante la partecipazione allo stesso.
    13. Precedente esposizione a PF 06741086 durante la partecipazione agli studi B7841002 e B7841003.
    Per ulteriori dettagli sui criteri di esclusione si prega di fare riferimento al Protocollo di studio.
    E.5 End points
    E.5.1Primary end point(s)
    Primary Efficacy Endpoints
    The primary efficacy endpoint is the annualized bleeding rate (ABR) of treated bleeding events, which is derived for each participant 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:
    - In all regions, to demonstrate superiority in ABR of PF-06741086 prophylaxis observed over the 12-month Active Treatment Phase versus on demand treatment with bypass therapy during the 6 months prior to
    receiving study intervention.
    Non-Inhibitor Cohort:
    - For regions outside of the EU, superiority in ABR of PF-06741086 prophylaxis observed over the 12-month Active Treatment Phase versus on-demand treatment with FVIII- or FIX- replacement during the Observational Phase prior to receiving study intervention.
    For the EU, non-inferiority in ABR of PF-06741086 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
    Safety Endpoints
    Type I error control would not be applied to the following safety endpoints:
    - Adverse events (AEs) and Serious Adverse Events (SAEs)
    - Incidence and severity of thrombotic events
    - Incidence and severity of thrombotic microangiopathy
    - Disseminated intravascular coagulation/consumption coagulopathy
    - Immunogenicity (incidence of antidrug antibody [ADA] and clinically significantly persistent neutralizing antibody [NAb] against PF-06741086)
    - 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
    Endpoint primari:
    L’endpoint primario di efficacia è il tasso annuale di sanguinamento (ABR) degli eventi di sanguinamento trattati, che si ricava per ogni partecipante e per ciascun periodo terapeutico con la seguente formula: ABR = numero di sanguinamenti che richiedono una terapia/(giorni di terapia/365,25). L’obiettivo statistico e la strategia di dimostrare l’efficacia in ogni coorte sono illustrati di seguito.
    Coorte con inibitori:
    • In tutte le regioni, dimostrare la superiorità nel tasso annuale di sanguinamento della profilassi PF-06741086 osservata sulla Fase di trattamento attivo di 12 mesi rispetto al trattamento al bisogno con terapia bypassante durante i 6 mesi precedenti alla somministrazione dell’intervento di studio.
    Coorte senza inibitori:
    • Per le regioni al di fuori dell’Unione Europea (UE), superiorità nel tasso annuale di sanguinamento della profilassi PF-06741086 osservata sulla Fase di trattamento attivo di 12 mesi rispetto al trattamento al bisogno con prodotti sostitutivi dei fattori FVIII o FIX durante la Fase di osservazione prima della somministrazione dell’intervento di studio.
    • Per l’UE, non inferiorità nel tasso annuale di sanguinamento della profilassi PF 06741086 osservata sulla Fase di trattamento attivo di 12 mesi rispetto al trattamento profilattico con prodotti sostitutivi dei fattori FVIII o FIX durante la Fase di osservazione prima della somministrazione dell’intervento di studio.
    Endpoint di sicurezza
    Il controllo del 6.6 di tipo I non sarà applicato ai seguenti endpoint di sicurezza:
    • Eventi avversi ed eventi avversi gravi
    • Incidenza e gravità degli eventi trombotici
    • Incidenza e gravità di microangiopatie trombotiche
    • Coagulazione intravascolare disseminata/coagulopatia da consumo
    • Immunogenicità (incidenza di anticorpo anti-farmaco [ADA] e anticorpo neutralizzante [NAb] clinicamente significativamente persistente a fronte di PF-06741086)
    • Incidenza e gravità della reazione nel sito dell’iniezione
    • Cambiamenti nell’esame fisico e nei parametri vitali
    • Incidenza delle anomalie dei valori di laboratorio clinicamente significative
    • Incidenza di grave ipersensibilità e reazioni anafilattiche
    E.5.1.1Timepoint(s) of evaluation of this end point
    Timepoints are all listed in the list of primary endpoints.
    Tutti i periodi esaminati sono indicati nell’elenco degli endpoint primari.
    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 regions outside of the EU, and non-inhibitors for the EU). For the Non-Inhibitor Cohort, all the primary and secondary endpoints for regions outside of the EU will be part of the secondary endpoints for the EU and vice versa.
    - Total coagulation factor 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])
    Endpoint secondari:
    I seguenti parametri verranno valutati ai fini del confronto tra la profilassi PF-06741086 osservata sulla Fase di trattamento attivo di 12 mesi rispetto a un gruppo di controllo rispettivo corrispondete a ciascuno dei 3 obiettivi statistici (inibitori, non inibitori per le regioni al di fuori dell’UE e non inibitori per l’UE). Per la coorte senza inibitori, tutti gli endpoint primari e secondari per le regioni al di fuori dell’UE faranno parte degli endpoint secondari per la UE e viceversa.
    • Fattore di coagulazione totale o consumo di prodotti bypassanti
    • Incidenza di sanguinamenti a livello articolare
    • Incidenza di sanguinamenti spontanei
    • Incidenza di sanguinamenti nell’articolazione bersaglio
    • Incidenza di emorragie totali (trattate e non trattate)
    • Percentuale di partecipanti senza episodi di sanguinamento
    • Variazioni nelle articolazioni misurate mediante la scala di punteggio dello stato articolare in caso di emofilia (HJHS, Hemophilia Joint Health Score)
    HRQoL:
    • Questionario sulla qualità della vita per adulti con emofilia (Haem-A-QoL, Hemophilia Quality of Life Questionnaire for Adults ) (= 17 anni di età)/Questionario sulla qualità della vita per minori con emofilia (Haemo-QoL, Hemophilia Quality of Life Questionnaire for Children ) (adolescenti da 12 a < 17 anni di età);

    • Elenco di attività di emofilia (HAL, Hemophilia Activities List) (adulti = 17 anni di età)/Elenco di attività di emofilia pediatrica (pedHAL, Pediatric Hemophilia Activities List) (adolescenti da 12 a < 17 anni di età);
    • Impressione globale di cambiamento dei pazienti - Emofilia (PGIC-H, Patient Global Impression of Change – Hemophilia) (Fase di osservazione e Fase di trattamento attivo)
    • Misura di utilità sanitaria (EuroQol 5 Dimensions 5 Level [EQ-5D-5L])
    E.5.2.1Timepoint(s) of evaluation of this end point
    Timepoints are all listed in the list of primary endpoints.
    Tutti i periodi esaminati sono indicati nell’elenco degli endpoint primari.
    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
    Unidirezionale
    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 per Emofilia A o B
    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 concerned7
    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 Information not present in EudraCT
    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
    Canada
    China
    Hong Kong
    India
    Japan
    Korea, Republic of
    Mexico
    Oman
    Russian Federation
    Saudi Arabia
    Serbia
    Taiwan
    Turkey
    United States
    Bulgaria
    Croatia
    France
    Germany
    Ireland
    Italy
    Spain
    Switzerland
    United Kingdom
    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.
    Si ritiene che un partecipante abbia completato lo studio se ha concluso tutte le sue fasi, inclusa la telefonata di follow-up del Giorno 390 durante la Fase di trattamento attivo.
    La fine dello studio è definita come la data dell’ultima procedura programmata, mostrata nel Programma delle attività, dell’ultimo partecipante allo studio a livello globale.
    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 days0
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months8
    E.8.9.2In all countries concerned by the trial days1
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 Yes
    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
    Minori, 12-18 anni
    F.4 Planned number of subjects to be included
    F.4.1In the member state14
    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.
    L’intervento dello studio non sarà fornito dopo la sua conclusione. Per i partecipanti che completano lo studio B7841005, è disponibile uno studio di estensione della durata di 12 mesi (B7841007) per la valutazione della sicurezza. I partecipanti che prenderanno parte allo studio di estensione a lungo termine B7841007 non devono completare la telefonata di follow-up del Giorno 390 per la Fase di trattamento attivo.
    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 Decision2020-09-24
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2020-07-16
    P. End of Trial
    P.End of Trial StatusOngoing
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