The purpose of this study is to demonstrate that PEGylated liposomes (PEGLip) can shield FVIII from the immune system and inhibitors, and therefore provide a prophylactic FVIII replacement therapy for patients with inhibitors to FVIII.
This is an open-label multicenter trial for patients with severe haemophilia A with inhibitors to FVIII and without inhibitors as control. The trial consists of 4 periods: Screening, Stage A, Stage B and Safety Follow-up. After signing informed consent, patients are assessed for eligibility during a Screening period lasting up to 21 days. All eligible patients enter Stage A - Regimen estimation. The non-inhibitor patients receive a single IV injection at a dose of 35 IU/kg FVIII reconstituted with Water For Injection. Following a 4-day wash-out period, these patients as well as patients with inhibitors receive a single IV injection of FVIII-PEGLip at a dose of 35 IU/kg FVIII + PEGLip 22 mg/kg to determine the duration of haemostatic cover and therefore required injection frequency to prevent bleeds. Stage B - multiple dosing: all patients receive injections of FVIII-PEGLip for 6 weeks at a frequency determined in Stage A for each individual patient. Safety follow-up: 15 and 30 days after the last injection of FVIII-PEGLip, patients are contacted for any adverse events or bleeding episodes.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
20
Intravenous co-administration of PEGLip with Simoctocog alfa
Kemerovo District Clinical Hospital
Kemerovo, Russia
RECRUITINGKirov Scientific Research Institute of Hematology and Blood Transfusion
Kirov, Russia
RECRUITINGNational Medical Research Centre of Hematology
Moscow, Russia
Clotting activity based on ROTEM [single dose]
Clotting profile of single IV injection of FVIII-PEGLip based on key ROTEM parameters (CT+CFT) determined at 0 hours (pre-injection) and at 20 min, 1, 2, 4, 8, 24, 48, 72, 96, 120, 144 and 168 hours after injection in severe Haemophilia A patients with inhibitors and in patients without inhibitors
Time frame: 7 days
Clotting activity based on FVIII:C concentration [single dose]
Clotting profile of single IV injection of FVIII-PEGLip based on FVIII:C plasma assay measured at 0 hours (pre-injection) and at 20 min, 1, 2, 4, 8, 24, 48, 72, 96, 120, 144 and 168 hours after injection in severe Haemophilia A patients with inhibitors and in patients without inhibitors
Time frame: 7 days
Clotting activity based on ROTEM [multiple dose]
Dynamics of blood clotting activity as quantified by key ROTEM parameters (CT+CFT) measured before and 20 minutes after each injection of FVIII-PEGLip at weeks 2, 4 and 6 of 6-week multiple dosing of FVIII-PEGLip in severe Haemophilia A patients with inhibitors and patients without inhibitors.
Time frame: 6 weeks
Bleed frequency
Frequency of spontaneous bleeding episodes and average length (days) of bleeding-free periods
Time frame: 6 weeks
Area under the concentration-time curve (AUC) of FVIII:C (FVIII-PEGLip) [single dose]
AUC0-∞ of FVIII:C after single IV FVIII-PEGLip injection in severe Haemophilia A patients with inhibitors and in patients without inhibitors
Time frame: 7 days
Area under the concentration-time curve (AUC) of FVIII:C (FVIII-WFI) [single dose]
AUC0-∞ of FVIII:C after single IV FVIII-WFI injection in severe Haemophilia A patients without inhibitors
Time frame: 4 days
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Novosibirsk State Medical University, Novosibirsk City Haematology Center
Novosibirsk, Russia
RECRUITINGSamara State Medical University
Samara, Russia
RECRUITINGMaximum plasma concentration (Cmax) of FVIII:C (FVIII-PEGLip) [single dose]
Cmax of FVIII:C after single IV FVIII-PEGLip injection in severe Haemophilia A patients with inhibitors and in patients without inhibitors
Time frame: 7 days
Maximum plasma concentration (Cmax) of FVIII:C (FVIII-WFI) [single dose]
Cmax of FVIII:C after single IV FVIII-WFI injection in severe Haemophilia A patients without inhibitors
Time frame: 4 days
Time to reaching maximum plasma concentration (Tmax) of FVIII:C (FVIII-PEGLip) [single dose]
Tmax of FVIII:C after single IV FVIII-PEGLip injection in severe Haemophilia A patients with inhibitors and in patients without inhibitors
Time frame: 7 days
Time to reaching maximum plasma concentration (Tmax) of FVIII:C (FVIII-WFI) [single dose]
Tmax of FVIII:C after single IV FVIII-WFI injection in severe Haemophilia A patients with inhibitors and in patients without inhibitors
Time frame: 4 days
Half-life (t1/2) of FVIII:C (FVIII-PEGLip) [single dose]
T1/2 of FVIII:C after single IV FVIII-PEGLip injection in severe Haemophilia A patients with inhibitors and in patients without inhibitors
Time frame: 7 days
Half-life (t1/2) of FVIII:C (FVIII-WFI)
T1/2 of FVIII:C after single IV FVIII-WFI injection in severe Haemophilia A patients without inhibitors
Time frame: 4 days
Inhibitor titres
Individual changes of inhibitor titres from baseline measurement to 168 hours after single IV injection of FVIII-PEGLip and at weeks 2, 4, and 6 of 6-week FVIII-PEGLip multiple dosing period
Time frame: Approximately 12 weeks
Area under the concentration-time curve (AUC) of PEGLip [single dose]
AUC0-∞ of PEGLip determined at 0 hours (pre-injection) and at 20 min, 1, 2, 4, 8, 24, 48, 72, 96, 120, 144 and 168 hours after single IV injection of FVIII-PEGLip
Time frame: 7 days
Maximum plasma concentration (Cmax) of PEGLip [single dose]
Cmax of PEGLip determined at 0 hours (pre-injection) and at 20 min, 1, 2, 4, 8, 24, 48, 72, 96, 120, 144 and 168 hours after single IV injection of FVIII-PEGLip
Time frame: 7 days
Time to reaching maximum plasma concentration (Tmax) of PEGLip [single dose]
Tmax of PEGLip determined at 0 hours (pre-injection) and at 20 min, 1, 2, 4, 8, 24, 48, 72, 96, 120, 144 and 168 hours after single IV injection of FVIII-PEGLip
Time frame: 7 days
Half-life (t1/2) of PEGLip [single dose]
t1/2 of PEGLip determined at 0 hours (pre-injection) and at 20 min, 1, 2, 4, 8, 24, 48, 72, 96, 120, 144 and 168 hours after single IV injection of FVIII-PEGLip
Time frame: 7 days
PEGLip concentration [multiple dose]
PEGLip concentration measured before and 20 minutes after each injection of FVIII-PEGLip at weeks 2, 4 and 6 of 6-week multiple dosing of FVIII-PEGLip
Time frame: 6 weeks