The purpose of this study is to evaluate the efficacy and safety of DX-88 (ecallantide) versus placebo in the treatment of moderate to severe acute attacks of hereditary angioedema.
This is a randomized placebo-controlled trial. The study is designed to assess the efficacy and safety of 30 mg subcutaneous ecallantide versus placebo in the treatment of moderate to severe acute attacks of hereditary angioedema. This study is conducted under Special Protocol Assessment with the FDA and is designed to provide pivotal efficacy data on ecallantide. These data are intended to support the marketing authorization of ecallantide in the treatment of acute attacks of hereditary angioedema. Efficacy and safety of ecallantide will be evaluated in this study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
96
dose of 30 mg (10 mg/ml) given as 3 subcutaneous injections.
given as three 1mL subcutaneous injections.
Change From Baseline in Mean Symptom Complex Severity (MSCS) Score at 4 Hours Post-dose
The Mean Symptom Complex Severity (MSCS) score is a validated, comprehensive point-in-time measure of symptom severity. At baseline and 4 hours, patients rated the severity on a categorical scale (0 = normal, 1 = mild, 2 = moderate, 3 = severe) for symptoms at each affected anatomical location. Ratings were averaged to obtain the MSCS score. A decrease in MSCS score reflected an improvement in symptoms; clinically meaningful improvement was indicated by a reduction in the score of 0.30 or more.
Time frame: baseline, 4 hours post-dose
Treatment Outcome Score at 4 Hours Post-Dose
Treatment Outcome Score (TOS) is a validated, comprehensive measure of symptom response to treatment. At 4 hours , patient assessment of response characterized by their change from baseline in symptom severity and collected by anatomic site of attack involvement, was recorded on a categorical scale (significant improvement \[100; best value\]to significant worsening \[-100; worst value\]). Clinically meaningful improvement was indicated by a TOS of 30 or higher.
Time frame: 4 hours post-dose
Patients With Significant Improvement in Overall Response
Patients were to be asked to perform an overall response assessment at intervals during the first 4 hours post-dose. Assessments were to be made relative to baseline (ie, immediately before initial dosing) using a 5-category scale. Categories were: significant improvement = "a lot better or resolved"; improvement = "a little better"; same = response unchanged; worsening = "a little worse"; significant worsening = "a lot worse". Significant improvement is the first time that a patient responded to the overall response assessment as "a lot better or resolved."
Time frame: 4 hours post-dose
Patients With a Successful Response at 4 Hours Post-dosing, Based on the Change From Baseline in the MSCS Score
A successful response was defined as improvement in existing laryngeal symptom complex,stabilization of an existing peripheral symptom complex, or a change from baseline in the MSCS score at 4 hours of at least -1.0.
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Aaron J. Davis
Scottsdale, Arizona, United States
Arkansas Children's Hospital
Little Rock, Arkansas, United States
Little Rock Allergy & Asthma Clinic
Little Rock, Arkansas, United States
Alta Bates Comprehensive Cancer Center
Berkeley, California, United States
Pacific Coast Allergy
Crescent City, California, United States
Jacob Offenberger
Granada Hills, California, United States
UCLA David Geffen School of Medicine, Department of Medicine
Los Angeles, California, United States
Asthma and Allergy Associates, P.C.
Colorado Springs, Colorado, United States
Christiana Hospital
Newark, Delaware, United States
Georgetown University Hospital
Washington D.C., District of Columbia, United States
...and 35 more locations
Time frame: baseline, 4 hours post-dosing
Proportion of Patients Maintaining a Significant Improvement in Overall Response Through 24 Hours
Maintenance of significant improvement was defined as achieving and maintaining a significant improvement in overall response through 24 hours after dosing. Patient response categories were: significant improvement = "a lot better or resolved"; improvement = "a little better"; same = response unchanged; worsening = "a little worse"; significant worsening = "a lot worse".
Time frame: 24 hours post-dosing