Recombinant factor VIII for the prevention of bleeding in women/girls with haemophilia A undergoing major surgery
Female patients with mild to moderate haemophilia A will often need FVIII concentrates to provide haemostatic cover during major surgery. This prospective, open-label, non-controlled, single-arm, multinational, multicentre study aims to evaluate the overall perioperative haemostatic efficacy of Nuwiq in women/girls over 12 with haemophilia A undergoing major surgery requiring FVIII treatment
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
28
Nuwiq is a purified B-domain-deleted FVIII glycoprotein synthesised by a genetically engineered human embryonic kidney cell line (HEK 293F).
UT Health San Antonio
San Antonio, Texas, United States
RECRUITINGHelsinki University Hospital,Coagulation Disorder Unit
Helsinki, Finland
Overall haemostatic efficacy
Overall haemostatic efficacy of treatment measured as binary "success" or "failure". The overall perioperative haemostatic efficacy of Nuwiq will be adjudicated by an Independent Data Monitoring Committee (IDMC) and determined using a composite assessment algorithm that considers the surgeon's assessment of intraoperative haemostatic efficacy and the investigator's assessment of postoperative haemostatic efficacy to classify the overall haemostatic efficacy as success or failure.
Time frame: During surgery and until completion of wound healing (e.g. removal of sutures, cessation of drainage, etc.) as defined by the investigator, during the study duration of 30 ± 3 days after the day of surgical procedure
Intraoperative haemostatic efficacy
Assessment of intraoperative haemostatic efficacy of Nuwiq using a 4-point ordinal scale: Excellent: Intraoperative blood loss was lower than or equal to the average expected blood loss for the type of procedure performed in a patient with normal haemostasis and of the same sex, age, and stature Good: Intraoperative blood loss was higher than the average expected blood loss but lower or equal to the maximal expected blood loss for the type of procedure in a patient with normal haemostasis. Moderate: Intraoperative blood loss was higher than the maximum expected blood loss for the type of procedure performed in a patient with normal haemostasis, but haemostasis was controlled. None: Haemostasis was uncontrolled, necessitating a change in the clotting factor replacement regimen.
Time frame: During surgery: From first skin incision to last suture
Postoperative haemostatic efficacy
Assessment of postoperative haemostatic efficacy of Nuwiq using a 4-point ordinal scale: Excellent: No postoperative bleeding or oozing that was not due to complications of surgery. All postoperative bleeding (due to complications of surgery) was controlled with Nuwiq as anticipated for the type of procedure. Good: No postoperative bleeding or oozing that was not due to complications of surgery. Control of postoperative bleeding due to complications of surgery required increased dosing with Nuwiq or additional injections not originally anticipated for the type of procedure. Moderate: Some postoperative bleeding and oozing that was not due to complications of surgery. Control of postoperative bleeding required increased dosing with Nuwiq or additional injections not originally anticipated for the type of procedure. None: Extensive uncontrolled postoperative bleeding and oozing.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Avenue de la République
Chambray-lès-Tours, France
RECRUITINGCHU de Nantes Hôtel-Dieu
Nantes, France
RECRUITINGChu de Strasbourg
Stasbourg, France
NOT_YET_RECRUITINGUniversitätsklinikum Bonn,Institut für Experimentelle Haematologie und Transfusionsmedizin
Bonn, Germany
RECRUITINGGerinnungszentrum Rhein-Ruhr
Duisburg, Germany
RECRUITINGUniversitätsklinikum Hamburg Eppendorf,II. Medizinische Klinik und Poliklinik
Hamburg, Germany
RECRUITINGAziendo Ospedaliera "Puglieze Ciaccio"
Catanzaro, Italy
RECRUITINGPoliclinico "P. Giaconne"
Palermo, Italy
RECRUITING...and 6 more locations
Time frame: During surgery and until completion of wound healing (e.g. removal of sutures, cessation of drainage, etc.) as defined by the investigator, during the study duration of 30 ± 3 days after the day of surgical procedure
Allogenic blood products
Use of allogeneic blood products (red blood cells, platelets, and other blood products)
Time frame: During surgery and until completion of wound healing (e.g. removal of sutures, cessation of drainage, etc.) as defined by the investigator, during the study duration of 30 ± 3 days after the day of surgical procedure
FVIII plasma levels
Perioperative plasma levels
Time frame: ≤30 minutes before and 15-30 minutes after Nuwiq injection
Perioperative haemostatic efficacy per WFH criteria
Assessed using 4-point scale recommended by WFH: Excellent: Intra- and post-operative blood loss similar to non-haemophilic patient. No extra doses of FVIII/bypassing agents needed Good: Intra- and/or post-operative blood loss slightly increased over expectation for non-haemophilic patient, but judged to be clinically insignificant. No extra doses of FVIII/bypassing agents needed Fair: Intra- and/or post-operative blood loss increased over expectation for the non-haemophilic patient, and additional treatment needed. Extra dose of FVIII/bypassing agents needed, or increased blood component of anticipated transfusion requirement Poor: Significant intra- and/or post-operative blood loss substantially increased over expectation for non-haemophilic patient, requires intervention not explained by medical issue other than haemophilia. Unexpected hypotension, unexpected transfer to ICU due to bleeding, substantially increased blood component of the anticipated transfusion requirement
Time frame: ≤30 minutes before and 15-30 minutes after Nuwiq injection
Adverse events
Incidence of adverse events recorded during the full study period
Time frame: From start of first Nuwiq injection to 30 ±3 days following the surgical procedure
Thrombotic events
Incidence of thrombotic events during the study
Time frame: From start of first Nuwiq injection to 30 ±3 days following the surgical procedure
FVIII inhibitor formation
Incidence of FVIII inhibitor formation
Time frame: From start of first Nuwiq injection to 30 ±3 days following the surgical procedure