The main aim of this study is to check if there are side effects from BAX 888 and to determine the dose of BAX 888 for treating severe hemophilia A in male adults. Participants will receive one infusion with BAX 888 at the hemophilia treatment center. During the study, participants will visit their study clinic multiple times.
This study consists of 3 cohorts. Participants will be assigned to 1 of 3 dose cohorts with a minimum of 24 hours between dosing of each participant. Initially, 2 participants will be dosed in a cohort, with up to a total of 5 participants if the cohort is expanded based on safety and activity levels data. Dose escalation: After dosing first 2 participants in cohort 1 the decision will be made on the following: If week 4 FVIII activity levels of both participants are less than (\<) 2%, then dose escalation to cohort 2 will be triggered with no further dosing in cohort 1. If FVIII activity levels \>=2% are observed in at least 1 participant among the 2 participants the decision to escalate dose or expand the cohort with dosing of additional participants will be based on all available data through Week 14. Dose expansion: After dose escalation and administration of BAX 888 to the first 2 participants in 3 cohorts: If sustained Week 14 FVIII activity levels are \>=30% are not achieved in both participants (first 2 participants in cohorts 1 and 2) then escalation to immediate next cohort will be triggered after Data Monitoring Committee (DMC) review of all available safety and FVIII activity levels data. For cohort 3 dosing of additional participants will be paused until further review of available data. If sustained Week 14 FVIII levels are \>=30% in at least 1 of the 2 participants (first 2 participant in cohort 1, 2, 3) then expansion of cohorts 1, 2 (with up to 5 participants), 3 (with up to 3 additional participants) will be initiated with dosing or study could be completed with no further dosing. 23 APRIL 2020: Enrollment of new patients into this study has been paused due to the COVID-19 situation. The duration of this pause is dependent on the leveling and control of the COVID-19 pandemic.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
4
Participants will receive a single peripheral IV infusion of BAX 888 in Cohort 1 and 2 Day 0.
Number of Participants With BAX 888-Related Adverse Events (AEs)
An AE is defined as any untoward medical occurrence in a participant administered an investigational product (IP) that does not necessarily have a causal relationship with the treatment. A Serious adverse event (SAE) is an AE resulting in any of the following outcomes: death; life-threatening event; required or prolonged inpatient hospitalization; persistent or significant disability/incapacity; congenital anomaly. AEs include both serious and non-serious adverse events including development of FVIII inhibitory antibodies, clinically significant changes in standard laboratory parameters, physical exam, and vital signs.
Time frame: From first dose up to end of the study (approximately 6 years)
Change From Baseline in Circulating Plasma FVIII Activity Level
Change from baseline in circulating plasma FVIII activity level, based on one-stage clotting assay was assessed.
Time frame: Baseline, up to Month 60
Number of Participants With Clinically Significant Change From Baseline in Circulating Plasma FVIII Antigen Level
Change from baseline in circulating plasma FVIII antigen (protein) levels were to be assessed and number of participants with clinically significant change as determined by the principal investigator (PI) were reported.
Time frame: Baseline, up to Month 60
Annualized Bleed Rate (ABR)
ABR in comparison to before gene transfer will be assessed. A bleed is defined as subjective or objective evidence of bleeding which may or may not require treatment with FVIII. ABR was calculated as (number of bleeding episodes/observed treatment period in days)\*365.25.
Time frame: Up to approximately 6 years 4 months
Percentage of Participants With a Reduction in Consumption of Exogenous FVIII
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Phoenix Childrens Hospital
Phoenix, Arizona, United States
Orthopaedic Hospital DBA Orthopaedic Hemophilia Treatment Center
Los Angeles, California, United States
UC Davis Medical Center
Sacramento, California, United States
University of Colorado Hemophilia & Thrombosis Center
Aurora, Colorado, United States
Mount Sinai Medical Center
New York, New York, United States
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, United States
Medical University of South Carolina (MUSC)
Charleston, South Carolina, United States
Gulf States Hemophilia and Thrombophilia Center
Houston, Texas, United States
AKH - Medizinische Universität Wien
Vienna, Austria
Hôpital de la Timone
Marseille, Bouches-du-Rhône, France
...and 16 more locations
The reduction in consumption of exogenous FVIII was assessed by comparing the amount of exogenous FVIII taken at earliest time point available (prior to BAX 888 infusion) with the amount taken at the last post-infusion timepoint available, during the study. Percentage of participants with reduction in consumption of exogenous FVIII are reported.
Time frame: Up to approximately 6 years 4 months
Number of Participants Who Developed Inhibitory Antibodies to FVIII
Participants were assessed to check if they developed inhibitory antibodies to FVIII.
Time frame: Up to approximately 6 years 4 months
Number of Participants Who Developed Total Binding Antibodies to FVIII
Participants were assessed to check if they developed total binding antibodies to FVIII (Immunoglobulin G \[IgG\], Immunoglobulin M \[IgM\]).
Time frame: Up to approximately 6 years 4 months
Number of Participants With Humoral and Cell-Mediated Immune Response to AAV8 and FVIII Proteins
The humoral (antibody-mediated) and cell-mediated immune response to adeno-associated virus (AAV8) (the vector) and FVIII proteins, was assessed. Humoral Immune Response: It is indicated by presence of specific antibodies. The anti-AAV8 binding antibodies, IgG or IgM were measured by the enzyme-linked immunosorbent assay (ELISA) method. Neutralizing antibodies were measured by a cell-based luminescent assay. Cell-mediated Immune response: The AAV8 and FVIII specific cell mediated immunity was assessed using validated interferon-γ (IFN-γ) enzyme-linked immunosorbent spot (ELISpot) assays. This assay tests the human T-cell recall response to the AAV8 and FVIII proteins. These proteins were called antigens for these tests (AAV8 peptide pools 1, 2, 3 and two pooled test antigens (1 and 2) for FVIII). Number of participants who had humoral and/or cell mediated immune response to AAV8 and FVIII proteins, are reported by humoral and cell mediated immune response categories.
Time frame: Up to approximately 6 years 4 months
Surveillance of AAV8 Genome Shedding
Surveillance of AAV8 genome shedding in blood, saliva, semen, stool and urine until two consecutive negative results were assessed.
Time frame: Blood: Day 1, weekly at Clinic Visits between Weeks 1-15, and at Months 4 and 5; Saliva, Semen, and Stool: Day 1 and Week 1; Urine: Day 1 and Weeks 1,2,3