E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
Haemophilia A is a genetic deficiency in clotting factor VIII, which causes increased bleeding and usually affects males. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Blood and lymphatic diseases [C15] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10018937 |
E.1.2 | Term | Haemophilia A |
E.1.2 | System Organ Class | 100000004850 |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the safety and tolerability of up to 3 dose levels of SIG-001 administered laparoscopically into the intraperitoneal space. |
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E.2.2 | Secondary objectives of the trial |
To evaluate development of FVIII inhibitors after administration of SIG-001 To characterize FVIII activity levels after administration of SIG-001 To assess frequency of bleeding episodes following SIG-001 administration To assess effects of SIG-001 on usage of FVIII products |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Males aged 18 years or older 2. Diagnosis of Haemophilia A as follows: a) Severe (<1% FVIII activity) receiving FVIII prophylaxis or on-demand treatment; or b) Moderately-severe (≥1% - ≤2% FVIII activity) receiving FVIII prophylaxis 3. Greater than 150 exposure days to treatment with FVIII products 4. Fertile males (not surgically sterilized) who have sexual partners that are women of childbearing potential must be willing to use a barrier method of contraception (e.g. condoms) for at least 90 days post-SIG-001 administration 5. Normal levels of von Willebrand factor (VWF) antigen (≥50 IU/dL) 6. Able and willing to provide informed consent 7. Willing to withdraw from FVIII prophylaxis during specified periods in the study |
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E.4 | Principal exclusion criteria |
1. Morbid obesity defined as body mass index (BMI) ≥35 2. Current FVIII inhibitors (>0.6 NBU/mL) or prior Immune Tolerance Induction (ITI) Note: Patients with a history of low and/or transient inhibitors require Sponsor review and approval. 3. History of allergic reaction or anaphylaxis to recombinant FVIII products, alginate (including seaweed and algae), or barium and barium products (including barium contrast agents) 4. Evidence of any bleeding disorder in addition to haemophilia A 5. Abnormal laboratory values, as follows: a) Platelet count <100 × 109/L b) Creatinine ≥1.5 mg/dL c) Haemoglobin <11 g/dL d) Elevated levels (i.e. greater than 2 × upper limit of normal (ULN) of aspartate aminotransferase (AST), alanine aminotransferase (ALT), or total bilirubin Note: Patients with a known history of Gilbert’s disease and bilirubin levels above ULN are not excluded. 6. Active infection with Hepatitis B or Hepatitis C virus, defined as a positive HBsAg, HBeAg, HBV DNA, or HCV RNA results, or currently managed with antiviral medications for Hepatitis B or C 7. Uncontrolled HIV infection, defined as CD4+ counts ≤200/μL or by a viral load of >200 copies/mL 8. Active alcoholism or drug addiction during the 12 months before the screening visit 9. Active malignancy or history of malignancy in the 5 years prior to study entry, exclusive of surgically removed non-melanoma skin cancer 10. Participation in another investigational medicine or device study within 90 days of screening or 5 investigational product half-lives, whichever is longer 11. Prior administration of a gene therapy product 12. Treatment with emicizumab less than 6 months prior to screening. Note: Patients with emicizumab exposure may be eligible before 6 months of prior exposure if FVIII activity assessed by one stage assay is back to pre-emicizumab treatment levels. 13. Unable to tolerate general anaesthesia required for the laparoscopic procedure 14. History of: a) Abdominal adhesions due to prior large, median laparotomy(ies) Note: Uncomplicated prior laparoscopic procedures are not exclusionary (e.g. cholecystectomy, laparoscopic appendectomy or diagnostic laparoscopy). b) Septic peritonitis c) Intraperitoneal mesh d) Inflammatory Bowel Disease (IBD), including ulcerative colitis or Crohn’s disease 15. Other comorbidities that in the opinion of the Investigator increase the risk of abdominal adhesions 16. Any disease or medical condition that in the Investigator’s opinion is a contraindication for anaesthesia or the laparoscopic procedure (e.g. prior significant cardiovascular events) 17. In the Investigator’s judgment, the patient is unlikely to complete all protocol-required study visits, procedures, or comply with the study requirements for participation |
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E.5 End points |
E.5.1 | Primary end point(s) |
Clinically significant changes from baseline in vital signs, clinical laboratory tests, and treatment emergent adverse events (TEAE) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Vitals – Screening, SIG-001 Administration, Follow-Up up to 5 years. TEAEs – Screening, SIG-001 Administration, Follow-Up up to 5 years. See Table 2 Schedule of Assessment in the Clinical Study Protocol for further details. |
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E.5.2 | Secondary end point(s) |
Factor VIII inhibitor titers (Nijmegen Bethesda Units [NBU]) FVIII activity levels (one-stage and chromogenic assays) Bleeding rate (annualized; ABR) Total use of factor VIII therapies (annualized) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
FVIII inhibitor titers - Screening 1, Follow Up up to 5 years. FVIII activity levels - Screening 1, SIG-001 Administration, Follow-Up up to 5 years. ABR and annualized FVIII therapy use - assessed prospectively throughout the study. See Table 2 Schedule of Assessment in the Clinical Study Protocol for further details.
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | Yes |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 5 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Germany |
United Kingdom |
United States |
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E.8.7 | Trial has a data monitoring committee | No |
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
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The End-of-Trial date will be based on the final data collection date for the entire study, which is the date of the last Follow-up visit. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 6 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 6 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |