The purpose of the study is to learn about safety, how the body processes marstacimab and how it works in patients with severe hemophilia A without inhibitors. Hemophilia A is rare bleeding disorder where the blood doesn't clot normally. This causes a person to bleed a lot, even from a small cut. These patients who are on emicizumab medicine for routine prophylaxis for at least 6 months, and desire to switch to marstacimab medicine. Inhibitors are antibodies that the immune system develops because it sees the infused clotting factor as a foreign substance that needs to be destroyed. Antibodies are proteins that eat up the activated factor before it has time to stop the bleeding. Prophylaxis are preventive medicines. This study is seeking for participants: * with severe Hemophilia A withouth inhibitors who are on emicizumab treatment for at least 6 months. * must be 12 to less than 75 years old * must have a body weight of at least 35 kilograms. The results from this study will serve as a guide to doctors and their hemophilia A patients who will change their medicines in the real-world clinical setting. Patients who can take part in the study will receive marstacimab medicine as weekly injections under the skin of 150 milligrams for 4 months. Study treatment with marstacimab will be initiated no earlier than 14 days after last dose of emicizumab. The study can last up to 6 months. The sponsor will provide marstacimab. Patients will continue their usual treatment with the infused clotting factor for their bleeds when taking part in the study. Roll-over into an optional study treatment extension period will be available to participants who wish to continue prophylaxis with marstacimab in countries where it is not commercially available.
This is a non-randomized open-label study in approximately 10-15 adolescent and adult participants between ages 12 to \<75 years with severe hemophilia A (defined as FVIII activity \<1%) without inhibitors who are currently on treatment with emicizumab for ≥6 months. The study is designed to assess the safety and PK/PD during a 4-month treatment period with marstacimab 150 mg SC QW after a minimum 14-day wash-out period following discontinuation of emicizumab. Assessment of safety will be conducted by summarizing AEs and SAEs reported during the study, from the time each participant provides informed consent through and including a minimum of 28 calendar days after last dose of study intervention. Participants will continue to use their standard of care factor replacement for breakthrough bleeds during the course of the study. PK, PD, and ADA measurements will support the clinical safety data. The anticipated study duration for an individual participant is approximately 6 months. After completion of marstacimab treatment period participants will resume their standard of care prophylactic treatment after a 14-day wash-out period following the last dose of marstacimab. Roll-over into an optional study treatment extension period will be available to participants who wish to continue prophylaxis with marstacimab in countries where it is not commercially available.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
15
Marstacimab 150 mg administered subcutaneous (SC) once weekly (QW)
Orthopaedic Institute for Children
Los Angeles, California, United States
RECRUITINGIncidence of marstacimab-related adverse events (AEs)
Time frame: Approximately 178 days: from the time the participant provides informed consent, through and including a minimum of 28 calendar days after last dose of study treatment
Incidence of marstacimab-related serious AEs (SAEs)
Time frame: Approximately 178 days: from the time the participant provides informed consent, through and including a minimum of 28 calendar days after last dose of study treatment
Plasma Concentration Versus Time of Marstacimab (Listings)
Time frame: Day 1 up to day 135
Maximum Observed Plasma Concentration (Cmax) of Marstacimab
Time frame: Day 1 up to day 135
Average Plasma Concentration (Cavg) of Marstacimab
Time frame: Day 1 up to day 135
Minimum Observed Plasma Concentration (Cmin)
Time frame: Day 1 up to day 135
Change from baseline in tissue factor pathway inhibitor (TFPI).
Time frame: Baseline, Day 1 up to day 135
Change from baseline in prothrombin fragment 1+2 (PF 1+2)
Time frame: Baseline, Day 1 up to day 135
Change from baseline in D-dimer
Time frame: Baseline, Day 1 up to day 135
Change from baseline in TGA (thrombin generation assay).
Time frame: Baseline, Day 1 up to day 135
Incidence of Anti-Drug Antibody (ADA)
Time frame: Day 1 up to day 135
Incidence of clinically significant persistent neutralizing antibodies (NAb)
Time frame: Day 1 up to day 135
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