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Congenital Bleeding DisorderPhase 2explorer™4NCT03196284

A Trial Evaluating the Efficacy and Safety of Prophylactic Administration of Concizumab in Haemophilia A and B Patients With Inhibitors

A Phase 2 study testing Concizumab and Eptacog alfa in people with Congenital Bleeding Disorder and Haemophilia A With Inhibitors, run by Novo Nordisk A/S at 22 sites in 14 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 trial is conducted in Africa, Asia, Europe and North America. The aim of the trial is to assess the efficacy of concizumab administered s.c. (subcutaneously, under the skin) once daily in preventing bleeding episodes in haemophilia A and B patients with inhibitors. Read more about this study

Who is it for?
Ages 18 years and older, men only
What is being tested?
Concizumab and Eptacog alfa
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
26 participants
Where
22 sitesin 14 countries
Study dates
10 Aug 2017to 31 Jan 2020
Phase
Phase 2
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
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Inclusion Criteria: - 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 the suitability for the trial - Male haemophilia A or B patients with inhibitors aged 18 years or older at the time of signing informed consent - Patients currently in need of treatment with bypassing agents Exclusion Criteria: - Known or suspected hypersensitivity to trial product(s) or related products - Known inherited or acquired bleeding disorder other than haemophilia - Ongoing or planned immune tolerance induction therapy or prophylaxis with FVIII or FIX

Trial locations and contacts

22 sites in 14 countries.

22 sites in 14 countries

United States3 sites
  • Novo Nordisk Investigational Site

    Indianapolis, Indiana, 46260

  • Novo Nordisk Investigational Site

    Iowa City, Iowa, 52242

  • Novo Nordisk Investigational Site

    Los Angeles, California, 90027

Other trials in United States

Japan3 sites
  • Novo Nordisk Investigational Site

    Aichi, 466-8560

  • Novo Nordisk Investigational Site

    Nara, 634-8522

  • Novo Nordisk Investigational Site

    Tokyo, 167-0035

Other trials in Japan

Italy2 sites
  • Novo Nordisk Investigational Site

    Florence, 50134

  • Novo Nordisk Investigational Site

    Milan, 20124

Other trials in Italy

Malaysia2 sites
  • Novo Nordisk Investigational Site

    Georgetown, Penang, 10450

  • Novo Nordisk Investigational Site

    Kota Kinabalu, 88586

Other trials in Malaysia

Spain2 sites
  • Novo Nordisk Investigational Site

    Madrid, 28046

  • Novo Nordisk Investigational Site

    Seville, 41013

Other trials in Spain

United Kingdom2 sites
  • Novo Nordisk Investigational Site

    London, SE1 7EH

  • Novo Nordisk Investigational Site

    Sheffield, S10 2JF

Other trials in United Kingdom

Austria1 site
  • Novo Nordisk Investigational Site

    Vienna, 1090

Other trials in Austria

Canada1 site
  • Novo Nordisk Investigational Site

    Toronto, Ontario, M5B 1X1

Other trials in Canada

Croatia1 site
  • Novo Nordisk Investigational Site

    Zagreb, 10 000

Other trials in Croatia

Denmark1 site
  • Novo Nordisk Investigational Site

    Århus N, 8200

Other trials in Denmark

Greece1 site
  • Novo Nordisk Investigational Site

    Athens, GR-11527

Other trials in Greece

Israel1 site
  • Novo Nordisk Investigational Site

    Tel Litwinsky, 52621

Other trials in Israel

Sweden1 site
  • Novo Nordisk Investigational Site

    Solna, 171 64

Other trials in Sweden

Ukraine1 site
  • Novo Nordisk Investigational Site

    Lviv, 79044

Other trials in Ukraine

About this study

Official title: A Multi-Centre, Randomised, Open-Label, Controlled Trial Evaluating the Efficacy and Safety of Prophylactic Administration of Concizumab in Haemophilia A and B Patients With Inhibitors

This trial is conducted in Africa, Asia, Europe and North America. The aim of the trial is to assess the efficacy of concizumab administered s.c. (subcutaneously, under the skin) once daily in preventing bleeding episodes in haemophilia A and B patients with inhibitors.

Being tested
Concizumab, Eptacog alfa

What participants receive

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

  • ConcizumabDrug

    A loading dose of 0.5 mg/kg will be given as the first dose, followed by 0.15 mg/kg (with potential stepwise dose escalation to 0.25 mg/kg) administered daily s.c. (subcutaneously, under the skin). Treatment duration is 24 weeks in the main trial, and up to 52 weeks in the extension phase

  • Eptacog alfaDrug

    A single dose of 90 μg/kg eptacog alfa one week after dosing with concizumab. On-demand treatment during bleeding episodes in both treatment arms

Study groups in NCT03196284
Study groupRoleWhat they receive
ConcizumabExperimentalConcizumab administered in both the main phase and extension phase, with eptacog alfa administered on-demand during bleeding episodes
Receives: Drug: Concizumab; Drug: Eptacog alfa
Eptacog alfa and concizumabActive comparatorEptacog alfa administered on-demand during bleeding episodes as the only intervention during the main phase. Concizumab given in the extension phase
Receives: Drug: Concizumab; Drug: Eptacog alfa

What is being measured

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

  1. The Number of Bleeding Episodes

    The number of bleeding episodes that were treated during at least 24 weeks from treatment onset (week 0) are presented.

    Measured: During at least 24 weeks from treatment onset (week 0)

Secondary outcomes (30)
  1. The Number of Bleeding Episodes

    The number of bleeding episodes that were treated during at least 76 weeks from treatment onset (week 0) are presented. This outcome measure is applicable for only 'Concizumab' treatment arm.

    Measured: During at least 76 weeks from treatment onset (week 0)

  2. The Number of Spontaneous Bleeding Episodes

    Bleeds that were not linked to a specific, known action or event are called spontaneous bleeding episodes. The number of spontaneous bleeding episodes that were treated during at least 24 weeks from treatment onset (week 0) are presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: During at least 24 weeks from treatment onset (week 0)

  3. The Number of Spontaneous Bleeding Episodes

    Bleeds that were not linked to a specific, known action or event are called spontaneous bleeding episodes. The number of spontaneous bleeding episodes that were treated during at least 76 weeks from treatment onset (week 0) are presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: During at least 76 weeks from treatment onset (week 0)

  4. Number of Treatment-emergent Adverse Events (TEAEs) During at Least 24 Weeks From Treatment Onset

    An adverse event (AE) was any untoward medical occurrence in a participant administered a medicinal product, and which does not necessarily had a causal relationship with this treatment. A TEAE was defined as an event that had onset from the first exposure to treatment until the last visit in the trial. Number of TEAEs that occurred during at least 24 weeks from treatment onset (week 0) are presented. The data is presented per the dose level which the participants have reached at the time of event.

    Measured: During at least 24 weeks from treatment onset (week 0)

  5. Number of Treatment-emergent Adverse Events (TEAEs) During at Least 76 Weeks From Treatment Onset

    An adverse event (AE) was any untoward medical occurrence in a participant administered a medicinal product, and which does not necessarily had a causal relationship with this treatment. A TEAE was defined as an event that had onset from the first exposure to treatment until the last visit in the trial. Number of TEAEs that occurred during at least 76 weeks from treatment onset (week 0) are presented. The data is presented per the dose level which the participants have reached at the time of event.

    Measured: During at least 76 weeks from treatment onset (week 0)

  6. Number of Treatment-emergent Adverse Events (TEAEs) Within 24 Hours After Eptacog Alfa Administration

    An adverse event (AE) was any untoward medical occurrence in a participant administered a medicinal product, and which does not necessarily had a causal relationship with this treatment. A TEAE was defined as an event that had onset from the first exposure to treatment until the last visit in the trial. Number of TEAEs that occurred within 24 hours after eptacog alfa administration are presented. This outcome measure is applicable only for 'Eptacog alfa' treatment arm.

    Measured: Within 24 hours after eptacog alfa administration

  7. Occurrence of Anti-concizumab Antibodies During at Least 24 Weeks From Treatment Onset

    Occurrence of anti-concizumab antibodies during at least 24 weeks from treatment onset (week 0) is presented. This outcome measure is applicable for only 'Concizumab' treatment arm.

    Measured: During at least 24 weeks from treatment onset (week 0)

  8. Occurrence of Anti-concizumab Antibodies During at Least 76 Weeks From Treatment Onset

    Occurrence of anti-concizumab antibodies during at least 76 weeks from treatment onset (week 0) is presented. This outcome measure is applicable for only 'Concizumab' treatment arm.

    Measured: During at least 76 weeks from treatment onset (week 0)

  9. Change in Fibrinogen

    Change in fibrinogen during at least 24 weeks from treatment onset (week 0) is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: During at least 24 weeks from treatment onset (week 0)

  10. Change in Fibrinogen

    Change in fibrinogen during at least 76 weeks from treatment onset (week 0) is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: During at least 76 weeks from treatment onset (week 0)

  11. Change in D-dimer

    Change in D-dimer during at least 24 weeks from treatment onset (week 0) is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: During at least 24 weeks from treatment onset (week 0)

  12. Change in D-dimer

    Change in D-dimer during at least 76 weeks from treatment onset (week 0) is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: During at least 76 weeks from treatment onset (week 0)

  13. Change in Prothrombin Fragment 1 + 2 (F1 + 2)

    Change in F1 + 2 during at least 24 weeks from treatment onset (week 0) is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: During at least 24 weeks from treatment onset (week 0)

  14. Change in Prothrombin Fragment 1 + 2 (F1 + 2)

    Change in F1 + 2 during at least 76 weeks from treatment onset (week 0) is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: During at least 76 weeks from treatment onset (week 0)

  15. Change in Prothrombin Time (PT)

    Change in PT during at least 24 weeks from treatment onset (week 0) is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: During at least 24 weeks from treatment onset (week 0)

  16. Change in Prothrombin Time (PT)

    Change in PT during at least 76 weeks from treatment onset (week 0) is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: During at least 76 weeks from treatment onset (week 0)

  17. Change in Activated Partial Thromboplastin Time (APTT)

    Change in APTT during at least 24 weeks from treatment onset (week 0) is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: During at least 24 weeks from treatment onset (week 0)

  18. Change in Activated Partial Thromboplastin Time (APTT)

    Change in APTT during at least 76 weeks from treatment onset (week 0) is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: During at least 76 weeks from treatment onset (week 0)

  19. Change in Anti-thrombin (AT)

    Change in AT during at least 24 weeks from treatment onset (week 0) is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: During at least 24 weeks from treatment onset (week 0)

  20. Change in Anti-thrombin (AT)

    Change in AT after at least 76 weeks from treatment onset (week 0) is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: After at least 76 weeks from treatment onset (week 0)

  21. Concentration of Concizumab

    Concentration of concizumab prior to the last dose administration at 24 weeks is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: Prior to the last dose administration at 24 weeks

  22. Concentration of Concizumab

    Concentration of concizumab prior to the last dose administration after atleast 76 weeks is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: Prior to the last dose administration after atleast 76 weeks

  23. Free Tissue Factor Pathway Inhibitor (TFPI) Concentration Value

    Free TFPI (TFPI not bound to concizumab) concentration value prior to the last dose administration at 24 weeks is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: Prior to the last dose administration at 24 weeks

  24. Free Tissue Factor Pathway Inhibitor (TFPI) Concentration Value

    Free TFPI concentration value prior to the last dose administration after atleast 76 weeks is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: Prior to the last dose administration after atleast 76 weeks

  25. Peak Thrombin Generation

    Peak thrombin generation is the maximal concentration of thrombin formed at a given point in time. Peak thrombin generation prior to the last dose administration at 24 weeks is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: Prior to the last dose administration at 24 weeks

  26. Peak Thrombin Generation

    Peak thrombin generation is the maximal concentration of thrombin formed at a given point in time. Peak thrombin generation prior to the last dose administration after atleast 76 weeks is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: Prior to the last dose administration after atleast 76 weeks

  27. Endogenous Thrombin Potential

    Endogenous thrombin potential prior to the last dose administration at 24 weeks is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: Prior to the last dose administration at 24 weeks

  28. Endogenous Thrombin Potential

    Endogenous thrombin potential prior to the last dose administration after at least 76 weeks is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: Prior to the last dose administration after atleast 76 weeks

  29. Thrombin Generation Velocity Index

    Thrombin generation velocity index prior to the last dose administration at 24 weeks is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: Prior to the last dose administration at 24 weeks

  30. Thrombin Generation Velocity Index

    Thrombin generation velocity index prior to the last dose administration after at least 76 weeks is presented. The data is presented per the last dose level which the participants have reached at the time of assessment.

    Measured: Prior to the last dose administration after atleast 76 weeks

Timeline

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

  1. First posted22 Jun 2017
  2. Study start10 Aug 2017
  3. Primary completion19 Sep 2018
  4. Study completion31 Jan 2020

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
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
26 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03196284
Sponsor's protocol ID
NN7415-4310
Other IDs
U1111-1179-2925, 2016-000510-30, JapicCTI-173681, 2016
Acronym
explorer™4
Status last verified
Sep 2021
First submitted
20 Jun 2017
Last updated
22 Oct 2021
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: According to disclosure commitment on novonordisk-trials.com

Publications

  • Shapiro AD, Angchaisuksiri P, Astermark J, Benson G, Castaman G, Eichler H, Jimenez-Yuste V, Kavakli K, Matsushita T, Poulsen LH, Wheeler AP, Young G, Zupancic-Salek S, Oldenburg J, Chowdary P. Long-term efficacy and safety of subcutaneous concizumab prophylaxis in hemophilia A and hemophilia A/B with inhibitors. Blood Adv. 2022 Jun 14;6(11):3422-3432. doi: 10.1182/bloodadvances.2021006403.

    PubMed 35290453
  • Shapiro AD, Angchaisuksiri P, Astermark J, Benson G, Castaman G, Chowdary P, Eichler H, Jimenez-Yuste V, Kavakli K, Matsushita T, Poulsen LH, Wheeler AP, Young G, Zupancic-Salek S, Oldenburg J. Subcutaneous concizumab prophylaxis in hemophilia A and hemophilia A/B with inhibitors: phase 2 trial results. Blood. 2019 Nov 28;134(22):1973-1982. doi: 10.1182/blood.2019001542.

    PubMed 31444162

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Concizumab and Eptacog alfa in people with Congenital Bleeding Disorder and Haemophilia A With Inhibitors, run by Novo Nordisk A/S at 22 sites in 14 countries.

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

Who may be eligible to take part?

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 22 Oct 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 22 sites in United States, Japan, Italy, Malaysia, Spain and 9 more countries. 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 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.

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 22 Oct 2021). 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?

The Number of Bleeding Episodes (time frame: During at least 24 weeks from treatment onset (week 0)). 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 NCT03196284, 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 22 Oct 2021.

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explorer™4 Clinical Trial NCT03196284 | AzTrials