This is a randomized, prospective, multicenter study to examine whether or not the current recommended factor dosing strategy - i.e., dosing by actual body weight - in overweight and obese patients with Hemophilia A may deliver excessive clotting factor to achieve the desired result of bleeding prevention and cessation. This study also examines ways to prevent delivering excessive factor by using a patient's ideal body weight as a new dosing strategy compared to the current dosing strategy. The hypothesis being tested is that factor dosing based on ideal body weight will result in protective factor levels.
This is a randomized, prospective, multicenter, open-label, crossover study to examine whether or not the current recommended factor dosing strategy, i.e., dosing by actual body weight in overweight and obese patients, may deliver more clotting factor than necessary to cause bleeding to stop in participants with Hemophilia A who use Factor VIII (FVIII). This study also examines ways to prevent delivering too much factor by using a participant's ideal body weight as a new dosing strategy compared to the current dosing strategy. The hypothesis being tested is that factor dosing based on ideal body weight will result in hemostatic factor levels. The study will be conducted at the Washington Center for Bleeding Disorders (WCBD) at Bloodworks Northwest, Oregon Health \& Science University (OHSU), Seattle Children's Hospital (SCH), and Providence Sacred Heart Children's Hospital (SH). Cumulatively across the four sites, up to 20 participants will be enrolled. Randomization will be performed centrally at WCBD. Participants will provide their own factor. Prior to the first study-related dose, participants will stop taking any FVIII products for either 48 hours if currently using a short-acting FVIII product or 72 hours for a long acting FVIII product. Factor levels will be measured immediately before and at multiple points after two different factor doses. Subjects will be randomized to start their dosage based either on actual body weight or ideal body weight first and then crossover to receive dosage based on the other category.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
20
Randomized to receive 50 U/kg (+/- 20%) of the factor product participants routinely use based on ideal body weight. For participants age 12-19, ideal weight is calculated using the McLaren method. For participants age 20 and over, ideal weight is calculated using the following equation: \[50kg + (2.3kg\*every inch over 5 feet)\].
Randomized to receive 50 U/kg (+/- 20%) of the factor product participants routinely use based on actual body weight.
Oregon Health & Science University
Portland, Oregon, United States
RECRUITINGWashington Center for Bleeding Disorders at Bloodworks Northwest
Seattle, Washington, United States
RECRUITINGSeattle Children's Hospital
Seattle, Washington, United States
Recovery
Compare the recovery with FVIII between doses calculated on actual body weight versus ideal body weight in subjects with Hemophilia A
Time frame: Change from baseline at up to two months
Underdosing
Determine the likelihood of underdosing when using ideal body weight
Time frame: Change from baseline at up to two months
Overdosing
Determine the likelihood of overdosing when using actual body weight
Time frame: Change from baseline at up to two months
Effect of half-life
Determine the effect on half-life of these dosing strategies
Time frame: Change from baseline at up to two months
Effect on hemophilia severity
Determine the effect of pharmacokinetic differences on hemophilia severity
Time frame: Change from baseline at 20-40 minutes, 5-7 hours, 20-26 hours, and 44-50 hours for both half-life and extended half-life and also at 69-75 hours, and 93-99 hours for extended half-life
Regular half-life vs. extended half-life Regular half-life vs. extended half-life
Determine differences in participants receiving regular half-life versus extended half-life products
Time frame: Change from baseline at up to two months
Overweight vs. obese
Determine the differences, if any, between overweight and obese participants
Time frame: Change from baseline at up to two months
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Providence Sacred Heart Children's Hospital
Spokane, Washington, United States
RECRUITING