The purpose of this research study is to see how well an experimental freeze dried plasma product, known as FDP, works to reverse the anticoagulation effects of a prescription medication called warfarin sodium (warfarin) compared to a licensed and routinely used plasma product known as fresh frozen plasma (FFP). The study hypothesis is that FDP is not inferior to FFP when used for this purpose. Enrolled subjects are required to undergo a minimum of 4 plasmapheresis procedures, generating approximately 2,400 mL. Half will be used as FFP and half will be manufactured into FDP. Each subject will receive a total of 6 autologous units (approximately 1,620 mL) of plasma product over the course of 2 infusion visits (approximately 810 mL per infusion visit) with a 14 day washout period between infusions. Warfarin will be administered to each subject prior to each infusion visit. Subjects will be randomized to a treatment arm at their first warfarin administration visit leading up to the first infusion. This establishes the sequence of the plasma products to be infused across the 2 infusion visits. Those randomized to receive 3 units of FDP (approximately 810 mL) at the first infusion visit will receive the equivalent dose of FFP at their second infusion visit and vice versa for those randomized to receive 3 units of FFP at the first infusion visit. FDP and FFP will be infused intravenously.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Autologous units of fresh frozen plasma collected from the subject by plasmapheresis
Autologous units of freeze dried plasma manufactured from plasma collected from the subject by plasmapheresis
Hoxworth Blood Center
Cincinnati, Ohio, United States
Relative change in International Normalized Ratio (INR)
Relative change in INR between pre-infusion baseline and the lowest INR recovery value measured within 6 hours post infusion using equivalent 3-unit doses of FDP compared to FFP
Time frame: pre-infusion baseline, 6 hours post infusion
Occurrence of treatment emergent adverse events (TEAE)
Conclusions about safety will be based on the occurrence of TEAEs
Time frame: Start of first plasma infusion through 14 day follow up visit post second plasma infusion
Changes in INR
changes between pre-infusion baseline and 6 hours post-infusion after infusion with FDP compared to FFP
Time frame: pre-infusion baseline, 6 hours post infusion
Changes in aPTT
changes between pre-infusion baseline and 6 hours post-infusion after infusion with FDP compared to FFP
Time frame: pre-infusion baseline, 6 hours post infusion
Changes in Factor II (FII)
changes between pre-infusion baseline and 6 hours post-infusion after infusion with FDP compared to FFP
Time frame: pre-infusion baseline, 6 hours post infusion
Changes in Factor VII (FVII)
changes between pre-infusion baseline and 6 hours post-infusion after infusion with FDP compared to FFP
Time frame: pre-infusion baseline, 6 hours post infusion
Changes in Factor IX (FIX)
changes between pre-infusion baseline and 6 hours post-infusion after infusion with FDP compared to FFP
Time frame: pre-infusion baseline, 6 hours post infusion
Changes in Factor X (FX)
changes between pre-infusion baseline and 6 hours post-infusion after infusion with FDP compared to FFP
Time frame: pre-infusion baseline, 6 hours post infusion
Changes in protein C
changes between pre-infusion baseline and 6 hours post-infusion after infusion with FDP compared to FFP
Time frame: pre-infusion baseline, 6 hours post infusion
Changes in protein S
changes between pre-infusion baseline and 6 hours post-infusion after infusion with FDP compared to FFP
Time frame: pre-infusion baseline, 6 hours post infusion
Factor VII (FVII) kinetics area under the curve (AUC)
the AUC for FVII between pre-infusion baseline and 6 hours post infusion with equivalent 3 -unit doses (approximately 810 mL) of FDP vs FFP.
Time frame: pre-infusion baseline, 6 hours post infusion
Factor VII (FVII) kinetics maximum concentration (Cmax)
the Cmax for FVII between pre-infusion baseline and 6 hours post infusion with equivalent 3 -unit doses (approximately 810 mL) of FDP vs FFP.
Time frame: pre-infusion baseline, 6 hours post infusion
Factor VII (FVII) kinetics half-life (t1/2)
the t1/2 for FVII between pre-infusion baseline and 24 hours post infusion with equivalent 3 unit doses (approximately 810 mL) of FDP vs FFP
Time frame: pre-infusion baseline, 24 hours post infusion
Thrombin generation assay (TGA)
Report and describe thrombin generation assay (TGA) results after infusion with FDP compared to FFP including lag time, peak amount, and ETP
Time frame: 1 hour post infusion
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