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Acquired Hemophilia APhase 2/3NCT01178294

Study of Modified Recombinant Factor VIII (OBI-1) in Subjects With Acquired Hemophilia A

A Phase 2/3 study testing OBI-1 in people with Acquired Hemophilia A, run by Baxalta now part of Shire at 12 sites in 4 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study is to test whether the study drug (OBI-1) is safe and effective for the treatment of serious bleeding episodes in people with acquired hemophilia A. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Acquired Hemophilia A
What is being tested?
OBI-1
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
29 participants
Where
12 sitesin 4 countries
Study dates
10 Nov 2010to 9 Oct 2013
Phase
Phase 2/3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Written informed consent from subject, trusted person or person who is legally authorized to sign on behalf of the participant (Legal Representative in U.S.), depending on local regulations
  • Participants with acquired hemophilia with autoimmune inhibitory antibodies to human factor VIII with a clinical diagnosis established by the following criteria: a) Prolonged activated partial thromboplastin time (aPTT), b) Prothrombin time (PT) ≤ upper limit of normal (ULN) + 2 seconds and platelet count within normal range, c) Abnormal aPTT mixing study (patient-normal control 1:1) consistent with a factor VIII inhibitors reduced factor VIII activity level (below 10%)
  • Has a serious bleeding episode, as documented by the investigator
  • Be willing and able to follow all instructions and attend all study visits
  • Participants taking anti-thrombotics (such as clopidogrel, heparin or heparin analogue) may be included provided three half-lives of the agent have elapsed since the last dose of the agent
  • Life expectancy, prior to onset of the hemorrhagic episode, of at least 90 days
  • Participants of reproductive age must use acceptable methods of contraception and if female, undergo pregnancy testing as part of the screening process

Who cannot join

  • Hemodynamically unstable after blood transfusion, fluid resuscitation and pharmacologic or volume replacement pressor therapy. This hemodynamic instability is characterized by symptomatic hypotension resulting in vital organ dysfunction, such as cardiac ischemia, oliguria (urine volume <0.5 mL/kg in the previous six hours), central nervous system hypoperfusion manifested by mental status change such as confusion (unless head injury or intracranial hemorrhage is present), pulmonary compromise, and/or acidosis (manifested by pH and lactate levels)
  • Has an established reason for bleeding that is not correctable
  • Bleeding episode assessed likely to resolve on its own if left untreated
  • Anti-OBI-1 inhibitor that exceeds 20 Bethesda Units (BU) (prospectively or retrospectively)
  • Subsequent bleeding episode at the site of the initial qualifying bleeding episode within two weeks following the final OBI-1 dose for the initial qualifying bleeding episode, or subsequent bleeding episode at a different site than the initial qualifying bleeding episode within 1 week following the final OBI-1 dose for the initial qualifying bleeding episode will not be considered "new" qualifying bleeding episodes
  • Prior history of bleeding disorder other than acquired hemophilia.
Show all 14Show fewer
  • Known major sensitivity to therapeutic products of pig or hamster origin; examples include therapeutics of porcine origin (e.g. previously marketed porcine factor VIII, Hyate-C®) and recombinant therapeutics prepared from hamster cells (e.g. Humira®, Advate® and Enbrel®)
  • Use of hemophilia medication: rFVIIa within 3 hours prior to OBI-1 administration or aPCC treatment within 6 hours prior to OBI-1 administration
  • Participation in any other clinical study within 30 days of the first OBI-1 treatment
  • Anticipated need for treatment or device during the study that may interfere with the evaluation of the safety or efficacy of OBI-1, or whose safety or efficacy may be affected by OBI-1
  • Is currently pregnant, breastfeeding, or planning to become pregnant or father a child during the study
  • Abnormal baseline findings, any other medical condition(s) or laboratory findings that, in the opinion of the investigator, might jeopardize the subject's safety or decrease the chance of obtaining satisfactory data needed to achieve the objectives of the study
  • Inability or unwillingness to comply with the study design, protocol requirements, or the follow-up procedures
  • Participant of majority age under legal protection

Trial locations and contacts

12 sites in 4 countries.

12 sites in 4 countries

United States8 sites
  • National Institutes of Health - Warren G. Magnuson Clinical Center

    Bethesda, Maryland, 20892-1508

  • Tufts Medical Center

    Boston, Massachusetts, 02111

  • Brigham and Women's Hospital

    Boston, Massachusetts, 02115

  • University of North Carolina at Chapel Hill Hospital

    Chapel Hill, North Carolina, 27599-7305

  • The Pennsylvania State University and Milton S. Hershey Medical Center

    Hershey, Pennsylvania, 17033

  • Indiana Hemophilia and Thrombosis Center

    Indianapolis, Indiana, 46260

  • Vanderbilt University Medical Center, Hemostasis/Hemophilia Clinic

    Nashville, Tennessee, 37232-9830

  • Louisiana Center for Bleeding & Clotting Disorders

    New Orleans, Louisiana, 70112-2699

Other trials in United States

United Kingdom2 sites
  • Basingstoke and North Hampshire NHS Foundation Trust

    Basingstoke, Hampshire/England, RG249NA

  • Royal Free Hospital-Katharine Dormandy Haemophilia Centre and Thrombosis Unit

    London, England, NW3 2QG

Other trials in United Kingdom

Canada1 site
  • Maisonneuve-Rosemont Hospital

    Montreal, Quebec, H1T 2M4

Other trials in Canada

India1 site
  • Apollo Hospitals

    Chennai, Tamil Nadu, 600006

Other trials in India

About this study

Official title: Efficacy and Safety of B-Domain Deleted Recombinant Porcine Factor VIII (OBI-1) in the Treatment of Acquired Hemophilia A Due to Factor VIII Inhibitory Auto-antibodies

This study is to test whether the study drug (OBI-1) is safe and effective for the treatment of serious bleeding episodes in people with acquired hemophilia A.

Being tested
OBI-1
Keywords
haemophilia A, blood coagulation disorders, coagulation protein disorder, hemophilia A, Acquired Hemophilia A, hematologic diseases, hemorrhagic disorders
Medical subject headings
Factor 8 deficiency, acquired, Hemophilia A, Blood Coagulation Disorders, Coagulation Protein Disorders, Hematologic Diseases, Hemorrhagic Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • OBI-1Biological

    Intravenous infusion

Study groups in NCT01178294
Study groupRoleWhat they receive
OBI-1ExperimentalInitial dose: 200 U/kg - additional doses at the discretion of the investigator based on FVIII activity level and clinical assessment of response to treatment (upper limit: 400 U/kg every 2 hours)
Receives: Biological: OBI-1

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Serious Bleeding Episodes Responsive to OBI-1

    The initial serious ("qualifying") bleeding episode for each subject was analyzed for the primary efficacy outcome measure. A 'positive response' is defined as 'effective' (bleeding stopped with clinical control and FVIII levels of 50% or higher ) or 'partially effective' (bleeding reduced with clinical stabilization and FVIII levels of 20% or higher) control of bleeding, as determined by the investigator using a 4-point rating scale (effective - partially effective - poorly effective - not effective). 'Poorly effective' is defined as 'bleeding slightly reduced or unchanged and FVIII levels of less than 50%'. 'Not effective' is defined as 'bleeding worsening and FVIII levels of less than 50%'.

    Measured: 24 hours after initiation of treatment

Secondary outcomes (16)
  1. Overall Percentage of Serious Bleeding Episodes Successfully Controlled With OBI-1 Therapy, as Assessed by the Investigator

    Treatment success was defined as control of qualifying bleeding episode at the time of final treatment dosing. A serious bleeding episode was considered 'successfully controlled' if the investigator had checked 'completed OBI-1 therapy as treatment success' on the eCRF.

    Measured: At the time of final treatment dosing (varied from participant to participant depending on bleeding episodes)

  2. Percentage of Serious Bleeding Episodes Responsive to OBI-1 Therapy at Designated Assessment Time Points After the Initiation of Therapy, as Assessed by the Investigator

    A 'positive response' is defined as 'effective' (bleeding stopped with clinical control and FVIII levels of 50% or higher ) or 'partially effective' (bleeding reduced with clinical stabilization and FVIII levels of 20% or higher) control of bleeding, as determined by the investigator using a 4-point rating scale (effective - partially effective - poorly effective - not effective). 'Poorly effective' is defined as 'bleeding slightly reduced or unchanged and FVIII levels of less than 50%'. 'Not effective' is defined as 'bleeding worsening and FVIII levels of less than 50%'.

    Measured: 8 hours

  3. Percentage of Serious Bleeding Episodes Responsive to OBI-1 Therapy at Designated Assessment Time Points After the Initiation of Therapy, as Assessed by the Investigator

    A 'positive response' is defined as 'effective' (bleeding stopped with clinical control and FVIII levels of 50% or higher ) or 'partially effective' (bleeding reduced with clinical stabilization and FVIII levels of 20% or higher) control of bleeding, as determined by the investigator using a 4-point rating scale (effective - partially effective - poorly effective - not effective). 'Poorly effective' is defined as 'bleeding slightly reduced or unchanged and FVIII levels of less than 50%'. 'Not effective' is defined as 'bleeding worsening and FVIII levels of less than 50%'.

    Measured: 16 hours

  4. Frequency of Infusions of OBI-1 Required to Successfully Control Qualifying Bleeding Episodes

    'Frequency of infusions' was calculated as the 'average number of infusions per day'. 'Qualifying bleeding episode' was defined as the 'initial, serious bleeding episode'.

    Measured: Time of successful control of qualifying bleeding episode (varied from participant to participant)

  5. Total Dose of OBI-1 Required to Successfully Control 'Qualifying' Bleeding Episodes

    'Qualifying bleeding episode' was defined as the 'initial, serious bleeding episode'.

    Measured: Time of successful control of qualifying bleeding episode (varied from participant to participant)

  6. Total Number of Infusions of OBI-1 Required to Successfully Control 'Qualifying' Bleeding Episodes

    'Qualifying bleeding episode' was defined as the 'initial, serious bleeding episode'. A serious bleeding episode was considered 'successfully controlled' if the investigator had checked 'completed OBI-1 therapy as treatment success' on the eCRF.

    Measured: Time of successful control of qualifying bleeding episode (varied from participant to participant)

  7. Correlation Between Positive Response to OBI-1 Therapy at 8 Hours and Eventual Control of Serious Bleeding Episodes at 24 Hours

    Measured: 24 hours

  8. Correlation Between Response to OBI-1 Therapy at 16 Hours and Eventual Control of Serious Bleeding Episodes at 24 Hours

    Measured: 24 hours

  9. Correlation Between Response to OBI-1 Therapy at Specified Time Points and Eventual Control of Serious Bleeding Episodes at 24 Hours

    Measured: 24 hours

  10. Correlation Between the Pre-infusion Anti-OBI-1 Antibody Titers, the Total Dose of OBI-1, the Outcome at 24 Hours and the Eventual Control of the Bleeding Episode

    Measured: Through 90 days ± 7 days following final OBI-1 dose

  11. Pharmacokinetics (PK) Analysis- Plasma Clearance

    Participation in the PK sampling was optional. PK parameters obtained from the non-bleeding state were summarized with descriptive statistics.

    Measured: Pre-infusion 15-20 minutes, Post-infusion 1, 3, 6, 12, 18, 24 hours

  12. PK Analysis- Volume of Distribution (Vd) at Steady State

    Participation in the PK sampling was optional. PK parameters obtained from the non-bleeding state were summarized with descriptive statistics.

    Measured: Pre-infusion 15-20 minutes, Post-infusion 1, 3, 6, 12, 18, 24 hours

  13. PK Analysis- Area Under the Concentration-time Curve (AUC) From Time 0 to the Last Measurable Concentration

    Participation in the PK sampling was optional. PK parameters obtained from the non-bleeding state were summarized with descriptive statistics. AUC was calculated as area under the percent activity-time curve.

    Measured: Pre-infusion 15-20 minutes, Post-infusion 1, 3, 6, 12, 18, 24 hours

  14. PK Analysis- Terminal Half-life

    Participation in the PK sampling was optional. PK parameters obtained from the non-bleeding state were summarized with descriptive statistics. Half-life was calculated as the time it took to reduce percent activity by half.

    Measured: Pre-infusion 15-20 minutes, Post-infusion 1, 3, 6, 12, 18, 24 hours

  15. Number of Participants Who Developed de Novo Anti-OBI-1 Antibody Titers

    Measured: Through 90 days ± 7 days following final OBI-1 dose

  16. Number of Participants Who Developed an Anti-host Cell Protein Baby Hamster Kidney (BHK) Antibody Titer

    Measured: Through 90 days ± 7 days following final OBI-1 dose

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Aug 2010 (estimated)
  2. Study start10 Nov 2010
  3. Primary completion1 Jul 2013
  4. Study completion9 Oct 2013

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2/3
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
29 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01178294
Sponsor's protocol ID
OBI-1-301
Status last verified
Apr 2021
First submitted
6 Aug 2010
Last updated
13 May 2021
Data monitoring committee
Yes

Publications

  • Kruse-Jarres R, St-Louis J, Greist A, Shapiro A, Smith H, Chowdary P, Drebes A, Gomperts E, Bourgeois C, Mo M, Novack A, Farin H, Ewenstein B. Efficacy and safety of OBI-1, an antihaemophilic factor VIII (recombinant), porcine sequence, in subjects with acquired haemophilia A. Haemophilia. 2015 Mar;21(2):162-170. doi: 10.1111/hae.12627. Epub 2015 Jan 27.

    PubMed 25623166
  • Miesbach W, Curry N, Knobl P, Percy C, Santoro R, Schmaier AH, Trautmann-Grill K, Badejo K, Chen J, Nouri M, Oberai P, Klamroth R. Real-world use of recombinant porcine sequence factor VIII in the treatment of acquired hemophilia A: EU PASS. Ther Adv Hematol. 2024 Sep 2;15:20406207241260332. doi: 10.1177/20406207241260332. eCollection 2024.

    PubMed 39228858

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing OBI-1 in people with Acquired Hemophilia A, run by Baxalta now part of Shire at 12 sites in 4 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 13 May 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in United States, United Kingdom, Canada, India. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 21 Dec 2015). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Serious Bleeding Episodes Responsive to OBI-1 (time frame: 24 hours after initiation of treatment). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01178294, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 May 2021.

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