Congenital Bleeding DisorderPhase 3paradigm™6NCT02141074
Safety and Efficacy of Nonacog Beta Pegol (N9-GP) in Previously Untreated Patients With Haemophilia B
A Phase 3 study testing nonacog beta pegol in people with Congenital Bleeding Disorder and Haemophilia B, run by Novo Nordisk A/S at 93 sites in 24 countries.
Trial summary
This trial is conducted globally. The aim of the trial is to investigate the safety and efficacy of nonacog beta pegol (N9-GP) in previously untreated patients with Haemophilia B. Read more about this study
- Who is it for?
- Ages 0 to 6 years, men only
- Conditions the study is for
- Congenital Bleeding Disorder, Haemophilia B
- What is being tested?
- nonacog beta pegol
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 54 participants
- Where
- 93 sitesin 24 countries
- Study dates
- 2 Jul 2014to 27 Oct 2022
- Phase
- Phase 3
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 0 to 6 years
- Men only
- No healthy volunteers
- Child
Who may be able to join
- Informed consent obtained before any trial-related activities. Trial-related activities are any procedures that are carried out as part of the trial, including activities to determine suitability for the trial
- Male, age below 6 years at the time of signing informed consent
- Patients with the diagnosis of haemophilia B (FIX (coagulation factor IX) activity level below or equal to 2%) based on medical records or central laboratory results
- Previously untreated or exposed to FIX containing products less than or equal to 3 exposure days (5 previous exposures to blood components is acceptable)
Who cannot join
- Any history of FIX inhibitors (defined by medical records)
- Known or suspected hypersensitivity to trial product or related products
- Previous participation in this trial. Participation is defined as first dose administered of trial product
- Receipt of any investigational medicinal product within 30 days before screening
- Congenital or acquired coagulation disorder other than haemophilia B
- Any chronic disorder or severe disease which, in the opinion of the Investigator, might jeopardise the patient's safety or compliance with the protocol
- Patient's parent(s)/LAR(s) (legally acceptable representative) mental incapacity, unwillingness to cooperate, or a language barrier precluding adequate understanding and cooperation
Trial locations and contacts
93 sites in 24 countries.
93 sites in 24 countries
United States23 sites
Augusta University
Augusta, Georgia, 30912
Johns Hopkins University_Baltimore_3
Baltimore, Maryland, 21205
St. Luke's Mountain States Tumor Institute
Boise, Idaho, 83712
University of North Carlolina-Chapel Hill
Chapel Hill, North Carolina, 27514
Medical University Of SC
Charleston, South Carolina, 29425
Novant Hlth Vasc Ins Charlotte
Charlotte, North Carolina, 28204
University of Virginia Children's Hospital
Charlottesville, Virginia, 22903
Univ Hosp Cleveland Med Ctr
Cleveland, Ohio, 44106
Dayton Children Hemostati Ctr
Dayton, Ohio, 45404
Shands Hospital at the University of Florida
Gainesville, Florida, 32610
Penn State MS Hershey Med Ctr
Hershey, Pennsylvania, 17033
University Of Iowa
Iowa City, Iowa, 52242
Nemours Chld Clnc Jacksonville
Jacksonville, Florida, 32207
Miller Children's Hospital Long Beach
Long Beach, California, 90806
Children's Hospital Los Angeles - Endocrinology
Los Angeles, California, 90027
Hope for Kids
Macon, Georgia, 31201
Vanderbilt Hemostasis Thrombosis Clinic
Nashville, Tennessee, 37232
North Shore Long Island Jewish Medical Center
New Hyde Park, New York, 11040
Children's Hosp-New Orleans
New Orleans, Louisiana, 70118-5720
Children's Hsptl Of The Kings
Norfolk, Virginia, 23507
Univ of NE Med Center_Omaha
Omaha, Nebraska, 68198-6828
St Christopher Hosp for Child
Philadelphia, Pennsylvania, 19134
Univ of Utah Primary Children's Hospital
Salt Lake City, Utah, 84113
Austria7 sites
Med. Univ. Graz -Klinische Abteilung f. Allgemeine Pädiatrie
Graz, 8036
Universitätsklinik Kinder-Jugendheilkunde Innsbruck
Innsbruck, 6020
Klinikum Klagenfurt am Wörthersee (LKH Klagenfurt)
Klagenfurt, 9020
Landes-Frauen und Kinderklinik Linz
Linz, 4020
LKH Salzburg- Univ. Klinik f. Kinder- und Jugendheilkunde
Salzburg, 5020
Ordination Prof. Zwiauer
Sankt Pölten, A 3100
Universitätsklinik für Kinder- und Jugendheilkunde
Vienna, A 1090
United Kingdom7 sites
Birmingham Children's Hospital
Birmingham, B4 6NH
Kent and Canterbury Hospital - Kent Haemophilia and Thrombosis Centre
Canterbury, CT1 3NG
Royal Hospital for Children
Glasgow, G51 4TF
Leicester Royal Infirmary - Haemostasis & Thrombosis Unit
Leicester, LE1 5WW
St Thomas' Hospital - Haemostasis and Thrombosis Centre
London, SE1 7EH
Royal Manchester Children's Hospital
Manchester, M13 9WL
John Radcliffe Hospital
Oxford, OX3 9DU
Japan6 sites
Nagoya University Hospital_Blood Transfusion
Aichi, 466-8560
Kanagawa Children's Medical Center _ Hematology / Oncology
Kanagawa, 232-8555
Saitama Children's Med Centre_Hematology-Oncology
Saitama, 330-8777
Shizuoka Children's Hospital, Hematology-Oncology
Shizuoka, 420-8660
National Center for Child Health and Development_Hematology
Tokyo, 157-8535
Ogikubo Hospital_Pediatries & Blood
Tokyo, 167-0035
Taiwan6 sites
Changhua Christian Hospital_Hematology Dept.
Changhua, 500
Changhua Christian Hospital
Changhua, 500
Kaohsiung Medical University Chung-Ho Memorial Hospital_Dept of Pediatrics
Kaohsiung City, 807
China Medical University Children's Hospital
Taichung, 40447
China Medical University Hospital - Children Building
Taichung, 40447
National Taiwan University Children's Hospital
Taipei, 100
France5 sites
CHU Estaing
Clermont-Ferrand, 63003
Ap-Hp-Hopital de Bicetre-1
Le Kremlin-Bicêtre, 94275
Centre Hospitalier Universitaire de Nantes-Hopital Hotel-Dieu
Nantes, 44093
Centre Hospitalier Universitaire de Rennes - Hopital Pontchaillou
Rennes, 35033
CHU Haute Pierre
Strasbourg, 67098
Germany4 sites
Universitätsklinikum Bonn - Institut für Experimentelle Hämatologie
Bonn, 53127
Coagulation Research Center
Duisburg, 47051
HZRM Haemophilie-Zentrum Rhein Main GmbH
Frankfurt am Main, 60596
Werlhof-Institut
Hanover, 30159
Malaysia4 sites
Hospital Pulau Pinang_Georgetown, Penang
George Town, Pulau Pinang, 10450
Hospital Tengku Ampuan Rahimah
Klang, Selangor, 41200
National Blood Centre
Kuala Lumpur, 50400
Hospital Tengku Ampuan Afzan
Kuantan, Pahang, 25100
Spain3 sites
Hospital Sant Joan de Déu
Esplugues Llobregat, 08950
Hospital Universitario La Paz
Madrid, 28046
Hospital La Fe - Endocrinología y Nutrición
Valencia, 46026
Thailand3 sites
King Chulalongkorn Memorial Hospital_Pediatric Hematology-Oncology
Bangkok, 10330
Ramathibodi Hospital_Paediatrics
Bangkok, 10400
Maharaj Nakorn Chiang Mai Hospital _Pediatric Hematology and Oncology
Chiang Mai, 50200
Algeria2 sites
Beni Messous Hospital Issaad Hassani
Algiers, 16000
University Hospital Saadna Abdenour of Setif
Sétif, 19000
Argentina2 sites
Hospital de Pediatría S.A.M.I.C. "Prof. Dr. Juan P. Garrahan
CABA, C1245AAM
Sanatorio Mayo Privado S.A
Córdoba, X5000FAL
Australia2 sites
Royal Children's Hospital
Parkville, Victoria, 3052
Lady Cilento Children's Hospital
South Brisbane, Queensland, 4101
Canada2 sites
Hamltn Hth Sci/McMstr Child Hosp
Hamilton, Ontario, L8N 3Z5
The Hospital for Sick Children
Toronto, Ontario, M5G 1X8
Greece2 sites
Aghia Sophia Childrens' Hospital
Athens, GR-11527
'Ippokrateio' General Hospital of Thessaloniki
Thessaloniki, 54642
Italy2 sites
Dipartimento di Ematologia Univ. Firenze
Florence, 50134
IRCCS Meyer Firenze
Florence, 50139
Mexico2 sites
Centro Medico Nacional SXXI-Hospital de Pediatria, IMSS
Mexico City, México, D.F., 06720
Hospital Universitario Dr. José Eleuterio González_Monterrey
Monterrey, Nuevo León, 64460
Portugal2 sites
Centro Hospitalar Lisboa Norte-HSM
Lisbon, 1649-035
ULS São João, E.P.E.
Porto, 4200-319
Romania2 sites
1st Paediatric Department, Fundeni Clinical Institute
Bucharest, 022328
,,Louis Ţurcanu'' Emergency Hospital for Children
Timișoara, Timiș County, 300011
Serbia2 sites
University Children's Hospital Tirsova
Belgrade, 11000
Institute for Mother and Child Health Care of Serbia
Belgrade, 11070
Ukraine2 sites
SI Institute of Urgent and Recovery Surgery - Haematology
Donetsk, 83045
Institute of blood pathology and transfusion medicine of NAMSU - General and haematol. surgery
Lviv, 79044
Bulgaria1 site
UMHAT Sveti Georgi EAD, Plovdiv, Clinic of Pediatrics
Plovdiv, 4002
Israel1 site
Sheba MC - The Israeli National Hemophilia Center
Tel Litwinsky, 52621
About this study
Official title: An Open-label Single-arm Multicentre Non-controlled Phase 3 a Trial Investigating Safety and Efficacy of Nonacog Beta Pegol (N9-GP) in Prophylaxis and Treatment of Bleeding Episodes in Previously Untreated Patients With Haemophilia B (FIX Activity Below or Equal to 2 Percent)
This trial is conducted globally. The aim of the trial is to investigate the safety and efficacy of nonacog beta pegol (N9-GP) in previously untreated patients with Haemophilia B.
- Conditions
- Congenital Bleeding Disorder, Haemophilia B
- Being tested
- nonacog beta pegol
- Medical subject headings
- Hemophilia B
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
nonacog beta pegolDrug
For intravenous (i.v.) injection. A single dose of 40 U/kg, unless the bleeding episode is severe in which case it should be treated with 80 U/kg.
| Study group | Role | What they receive |
|---|---|---|
| 50 EDs (exposure days) | Experimental | Not described Receives: Drug: nonacog beta pegol |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants With Incidence of Inhibitory Antibodies Against Coagulation Factor IX (FIX) (50 Exposure Days)
Number of participants with incidence of inihibitory antibodies against FIX after 50 ED is presented and defined as an inhibitory antibody titre greater than equal to 0.6 Bethesda unit (BU) at two consecutive tests performed at the central laboratory and also tested positive for nonacog beta pegol binding antibodies.
Measured: When minimum 20 previously untreated patients (PUPs) have reached at least 50 exposure days (ED) (up to 156 weeks)
Number of Participants With Incidence of Inhibitory Antibodies Against FIX (100 ED)
Number of participants with incidence of inihibitory antibodies against FIX after 100 ED is presented and defined as an inhibitory antibody titre greater than equal to 0.6 Bethesda unit (BU) at two consecutive tests performed at the central laboratory and also tested positive for nonacog beta pegol binding antibodies.
Measured: When minimum 40 PUPs have reached at least 100 ED (up to 208 weeks)
Number of Participants With Incidence of Inhibitory Antibodies Against FIX (At End of Trial)
Number of participants with incidence of inihibitory antibodies against FIX at end of trial is presented and defined as an inhibitory antibody titre greater than equal to 0.6 Bethesda unit (BU) at two consecutive tests performed at the central laboratory and also tested positive for nonacog beta pegol binding antibodies.
Measured: At end of trial (up to 434 weeks)
Secondary outcomes (13)
Number of Adverse Events
Number of adverse events after 50 ED, after 100 ED, and at end of trial is presented. An adverse event was defined as any untoward medical occurrence in a participant who was administered a product, and which does not necessarily have a causal relationship with this treatment. All presented adverse events are treatment emergent adverse events, defined as an event that occured while the participant was on treatment in the period from first dosing with nonacog beta pegol to the end of trial/discontinuation of treatment.
Measured: When minimum 20 PUPs have reached at least 50 ED (up to 156 weeks); when minimum 40 PUPs have reached at least 100 ED (up to 208 weeks); at end of trial (up to 434 weeks)
Frequency of Adverse Events
Frequency of adverse events after 50 ED, after 100 ED, and at end of trial is presented. Frequency of adverse events was expressed as number of adverse events per participant years of exposure (total number of events /total time in trial). An adverse event was defined as any untoward medical occurrence in a participant who was administered a product, and which does not necessarily have a causal relationship with this treatment. All presented adverse events are treatment emergent adverse events, defined as an event that occured while the participant was on treatment in the period from first dosing with nonacog beta pegol to the end of trial/discontinuation of treatment.
Measured: When minimum 20 PUPs have reached at least 50 ED (up to 156 weeks); when minimum 40 PUPs have reached at least 100 ED (up to 208 weeks); at end of trial (up to 434 weeks)
Number of Serious Adverse Events
Number of serious adverse events after 50 ED, after 100 ED, and at end of trial is presented. A serious adverse event was an experience that at any dose resulted in: death; life-threatening experience; in-patient hospitalisation or prolongation of existing hospitalisation; a persistent or significant disability/incapacity; congenital anomaly/birth defect; important medical events that may not result in death, be life-threatening/require hospitalisation could be considered a serious adverse event based upon appropriate medical judgement.
Measured: When minimum 20 PUPs have reached at least 50 ED (up to 156 weeks); when minimum 40 PUPs have reached at least 100 ED (up to 208 weeks); at end of trial (up to 434 weeks)
Frequency of Serious Adverse Events
Frequency of serious adverse events after 50 ED, after 100 ED, and at end of trial is presented. Frequency of serious adverse events was expressed as number of serious adverse events per participant years of exposure (total number of events /total time in trial). A serious adverse event was an experience that at any dose resulted in: death; life-threatening experience; in-patient hospitalisation or prolongation of existing hospitalisation; a persistent or significant disability/incapacity; congenital anomaly/birth defect; important medical events that may not result in death, be life-threatening/require hospitalisation could be considered a serious adverse event based upon appropriate medical judgement.
Measured: When minimum 20 PUPs have reached at least 50 ED (up to 156 weeks); when minimum 40 PUPs have reached at least 100 ED (up to 208 weeks); at end of trial (up to 434 weeks)
Number of Medical Events of Special Interest
Number of medical events of special interest after 50 ED, after 100 ED, and at end of trial is presented. A medical event of special interest (MESI) was an event that, in the evaluation of safety, has a special focus. A MESI was an adverse event (serious or non-serious adverse event) that fulfils one or more of the following MESI criteria: 1. Medication errors concerning the trial product; 2. Inhibitor formation against FIX; 3. Thromboembolic events; 4. Anaphylactic reaction; 5. Allergic reaction including, but not limited to, any acute immunoglobulin E mediated reaction of delayed-type hypersensitivity (clinical signs may include various types of skin rashes) that does not meet the definition of anaphylaxis; 6. CNS-related adverse events including, but not limited to, any learning and behavioral deficits; 7. Renal adverse events including new onset of renal disorder or renal impairment or acute and chronic renal failure.
Measured: When minimum 20 PUPs have reached at least 50 ED (up to 156 weeks); when minimum 40 PUPs have reached at least 100 ED (up to 208 weeks); at end of trial (up to 434 weeks)
Frequency of Medical Events of Special Interest
Frequency of medical events of special interest after 50 ED, after 100 ED, and at end of trial is presented. It was expressed as number of MESI per participant years of exposure (total number of events/total time in trial). A MESI was an event that, in the evaluation of safety, has a special focus. A MESI was an adverse event that fulfils one or more of the MESI criteria: 1. Medication errors concerning the trial product; 2. Inhibitor formation against FIX; 3. Thromboembolic events; 4. Anaphylactic reaction; 5. Allergic reaction including, but not limited to, any acute immunoglobulin E mediated reaction of delayed-type hypersensitivity (clinical signs may include various types of skin rashes) that does not meet the definition of anaphylaxis; 6. CNS-related adverse events including, but not limited to, any learning and behavioral deficits; 7. Renal adverse events including new onset of renal disorder or renal impairment or acute and chronic renal failure.
Measured: When minimum 20 PUPs have reached at least 50 ED (up to 156 weeks); when minimum 40 PUPs have reached at least 100 ED (up to 208 weeks); at end of trial (up to 434 weeks)
Number of Breakthrough Bleeding Episodes During Prophylaxis (Annualised Bleeding Rate)
Number of breakthrough bleeding episodes during prophylaxis (annualised bleeding rate) after 50 ED, after 100 ED, and at end of trial is presented. Annualised bleeding rate is the number of bleeding episodes per year.
Measured: When minimum 20 PUPs have reached at least 50 ED (up to 156 weeks); when minimum 40 PUPs have reached at least 100 ED (up to 208 weeks); at end of trial (up to 434 weeks)
Haemostatic Effect of Nonacog Beta Pegol in Treatment of Bleeding Episodes by 4-point Haemostatic Response Scale ("Excellent", "Good", "Moderate" and "Poor")
Haemostatic effect of nonacog beta pegol in treatment of bleeding episodes by 4-point haemostatic response scale after 50 ED, after 100 ED, and at end of trial is presented. The haemostatic response after treatment of a bleed with nonacog beta pegol was evaluated on a 4-point scale as excellent, good, moderate or poor. Excellent: abrupt pain relief and/or clear improvement in objective signs of bleeding; Good: noticeable pain relief and/or improvement in signs of bleeding; Moderate: probable or slight beneficial effect after the first injection; Poor: no improvement or worsening of symptoms. If the haemostatic response was rated as excellent or good, the treatment of the bleed was considered a success. If the haemostatic response was rated as moderate or poor, the treatment was considered a failure.
Measured: When minimum 20 PUPs have reached at least 50 ED (up to 156 weeks); when minimum 40 PUPs have reached at least 100 ED (up to 208 weeks); at end of trial (up to 434 weeks)
Incremental Recovery at 30 Minutes (IR30min)
Incremental recovery 30 minutes post dosing (IR30min) after 50 ED, after 100 ED is presented. IR30min was defined as the rise in FIX activity per international units per kilogram (IU/kg) administered and was recorded 30 minutes after the end of nonacog beta pegol injection. It was calculated as the baseline adjusted FIX activity recorded 30 minutes after ended nonacog beta pegol injection divided by the administered dose (IU/kg body weight). It was recorded as international units per milliliter (IU/mL)/international units per kilogram (IU/kg).
Measured: When minimum 20 PUPs have reached at least 50 ED (up to 156 weeks); when minimum 40 PUPs have reached at least 100 ED (up to 208 weeks)
FIX Activity at 30 Minutes (C30min)
FIX Activity 30 minutes post dosing (C30min) after 50 ED, after 100 ED is presented. The FIX activity was measured by one-stage clotting assay - a modified activated partial thromboplastin time (aPTT) assay.
Measured: When minimum 20 PUPs have reached at least 50 ED (up to 156 weeks); when minimum 40 PUPs have reached at least 100 ED (up to 208 weeks)
FIX Trough Levels
FIX trough levels after 50 ED, after 100 ED, and at end of trial is presented. FIX trough level was defined as the activity recorded immediately before nonacog beta pegol injection was given and was measured by one-stage clotting assay - a modified activated partial thromboplastin time (aPTT) assay. The analysis is based on a mixed model on the log-transformed plasma concentrations with participant as a random effect. The mean trough level is presented back-transformed to the natural scale.
Measured: When minimum 20 PUPs have reached at least 50 ED (up to 156 weeks); when minimum 40 PUPs have reached at least 100 ED (up to 208 weeks); at end of trial (up to 434 weeks)
Amount of Drug Administered to Treat a Bleeding Episode
Amount of nonacog beta pegol administered (average dose of nonacog beta pegol) to treat a bleeding episode after 50 ED, after 100 ED, and at end of trial is presented as international units per kilogram per bleed (IU/kg/bleed).
Measured: When minimum 20 PUPs have reached at least 50 ED (up to 156 weeks); when minimum 40 PUPs have reached at least 100 ED (up to 208 weeks); at end of trial (up to 434 weeks)
Number of Injections Needed to Treat a Bleeding Episode
The mean number of injections needed to treat a bleeding episode is presented.
Measured: When minimum 20 PUPs have reached at least 50 ED (up to 156 weeks); when minimum 40 PUPs have reached at least 100 ED (up to 208 weeks); at end of trial (up to 434 weeks)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 May 2014 (estimated)
- Study start2 Jul 2014
- Primary completion27 Oct 2022
- Study completion27 Oct 2022
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Congenital Bleeding DisorderStudies of the same condition, open and under way.
- More trials run by Novo Nordisk A/SThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 3
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 54 participants (actual)
Sponsor and investigators
- Lead sponsor
- Novo Nordisk A/S
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Global Clinical Registry (GCR, 1452), Study director, Novo Nordisk A/S
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02141074
- Sponsor's protocol ID
- NN7999-3895
- Other IDs
- 2012-004867-38, U1111-1135-9557, JapicCTI-142611, NL53683.091.15
- Acronym
- paradigm™6
- Status last verified
- Dec 2025
- First submitted
- 28 Mar 2014
- Last updated
- 23 Dec 2025
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Publications
Chan AK, Alamelu J, Barnes C, Chuansumrit A, Garly ML, Meldgaard RM, Young G. Nonacog beta pegol (N9-GP) in hemophilia B: First report on safety and efficacy in previously untreated and minimally treated patients. Res Pract Thromb Haemost. 2020 Jul 29;4(7):1101-1113. doi: 10.1002/rth2.12412. eCollection 2020 Oct.
PubMed 33134776