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Trial to Evaluate the Effect of Secondary Prophylaxis With rFVIII Therapy in Severe Hemophilia A Adult Subjects Compared to That of Episodic Treatment. (SPINART)
This study is currently recruiting participants.
Verified by Bayer, January 2009
Sponsored by: Bayer
Information provided by: Bayer
ClinicalTrials.gov Identifier: NCT00623480
  Purpose

To evaluate the effect of secondary prophylaxis on bleeding frequency (number of bleeds per year) and on joint damage compared to episodic treatment.


Condition Intervention Phase
Hemophilia A
Drug: Recombinant Anti-hemophilic Factor VIII (Kogenate®FS)
Phase III

Genetics Home Reference related topics: hemophilia
MedlinePlus related topics: Hemophilia
Drug Information available for: Factor VIII Octocog alfa
U.S. FDA Resources
Study Type: Interventional
Study Design: Prevention, Randomized, Open Label, Active Control, Parallel Assignment, Safety/Efficacy Study
Official Title: Randomized, Controlled, Parallel, Prospective Trial to Evaluate the Effect of Secondary Prophylaxis With rFVIII Therapy in Severe Hemophilia A Adult Subjects Compared to That of Episodic Treatment. (SPINART)

Further study details as provided by Bayer:

Primary Outcome Measures:
  • Bleeding frequency. [ Time Frame: Annualized number of bleeds will be analyzed after all subjects have completed one year. ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Anatomical Joint damage by MRI (in the 6 index joints). [ Time Frame: Change from baseline in anatomical joint damage by MRI will be anlyzed at 3 years ] [ Designated as safety issue: No ]

Estimated Enrollment: 80
Study Start Date: March 2008
Estimated Study Completion Date: January 2012
Estimated Primary Completion Date: November 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Arm 2: Experimental Drug: Recombinant Anti-hemophilic Factor VIII (Kogenate®FS)
Treated according to the Kogenate®FS package insert indications and study physician recommendations.
Arm 1: Experimental Drug: Recombinant Anti-hemophilic Factor VIII (Kogenate®FS)
Three times per week administration of 25 IU/kg of Kogenate®FS. Dose escalation steps by 5 IU/kg (to 30 IU/kg or 35 IU/kg maximum) exhibiting a bleeding frequency of 12 bleeding episodes per year or greater

  Eligibility

Ages Eligible for Study:   18 Years to 50 Years
Genders Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Males aged 18 to 50 years
  • Subjects with severe hemophilia A (<1% FVIII:C) as confirmed by the central lab from a sample obtained at least 96 hours after FVIII administration wash-out. Allow for the inclusion of a maximum of 10% (n=8) of patients with 1-2% FVIII:C baseline levels as long as they exhibit clinical severity and comply with all other inclusion criteria.
  • Subjects with at least 150 prior exposure days with any FVIII
  • Subjects who have been on episodic treatment and no known regular prophylaxis treatment for more than 12 consecutive months in the previous 5 years
  • Subjects with at least 6 bleeding events and/or treatments in the previous 6 months prior to study entry which are documented and available in the subjects medical records, and a maximum of 12.
  • Subjects with no measurable inhibitor activity by Nijmegen-modified Bethesda assay (>0.6BU is considered positive) in two consecutive samples and absence of clinical signs or symptoms of decreased response to rFVIII administration. (First negative sample can be historical if obtained within 3 months prior to screening. Second sample confirmatory must in all cases be performed by the study reference lab using the Nijmegen test. If a first recent sample is not available, then 2 negative samples by the study reference lab at least 1 week apart should be obtained). Prior to collecting samples for inhibitors the subject must not have received FVIII for a minimum of 96 hours or 4 days. For Nijmegen negative (but measurable) values between ≥ 0.3 and < 0.6BU, a FVIII recovery determination over 2% /IU/kg infused will be required.
  • Subjects with no history of FVIII inhibitor antibody formation ≥0.6BU by Nijmegen- modified Bethesda assay but with a maximum historical titer of 1.0BU on no more than one occasion with the Classical Bethesda assay but at least three successive negative [<0.6BU]determinations thereafter are also eligible.
  • Subjects who complete an EPD device training and demonstrate the ability to correctly use it.
  • Documented, signed, dated informed consent obtained prior to any study specific procedures being performed.

Exclusion Criteria:

  • Subjects with any other bleeding disease besides hemophilia A (i.e. von Willebrand disease)
  • Subjects with thrombocytopenia (platelets < 100,000/mm3)
  • Subjects with abnormal renal function (Cockcroft-Gault Creatinine Clearance value of 60 mL/min or lower)
  • Subjects with active hepatic disease (AST or ALT > 5xULN)
  • Subjects on treatment with immunomodulatory agents within the last 3 months prior to study entry or during the study (the following drugs are however allowed: interferon-a; treatment for HCV, HAART therapy for HIV and /or a total of two courses of pulse treatment with steroids for a maximum of 7 days at 1mg/kg or less)
  • Subjects with an absolute CD4 lymphocyte cell count < 200 cells/mm3 (due to HIV, HCV or another suspected medical condition)
  • Subjects with known hypersensitivity to rFVIII, mouse or hamster proteins
  • Subjects who are receiving or had received other experimental drugs within 1 month prior to study entry
  • Subjects who require any pre-medication to tolerate FVIII injections (e.g. anti-histamines)
  • Subjects who are unwilling to comply with study visits or either of the possible treatment regimens
  • Subjects who have a planned orthopedic intervention to be performed during the study that may substantially affect bleeding (e.g. surgical or chemical or radiological synovectomy)
  • Subjects who are not suitable for participation in this study for any reason, according to the Investigator
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00623480

Contacts
Contact: Bayer Clinical Trials Contact clinical-trials-contact@bayerhealthcare.com
Contact: For trial location information (Phone Menu Options '3' or '4') (+)1-888-84 22937

  Show 27 Study Locations
Sponsors and Collaborators
Bayer
Investigators
Study Director: Bayer Study Director Bayer
  More Information

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Responsible Party: Bayer HealthCare Pharmaceuticals Inc. ( Therapeutic Area Head )
Study ID Numbers: 12800, EudraCT: 2008-000985-21, SPINART
Study First Received: February 4, 2008
Last Updated: January 12, 2009
ClinicalTrials.gov Identifier: NCT00623480  
Health Authority: United States: Food and Drug Administration

Keywords provided by Bayer:
Hemophilia A
Prophylaxis
Secondary prophylaxis

Study placed in the following topic categories:
Hemorrhagic Disorders
Genetic Diseases, Inborn
Hematologic Diseases
Blood Coagulation Disorders
Hemophilia A
Neoplasm Metastasis
Hemostatic Disorders
Factor VIII

Additional relevant MeSH terms:
Blood Coagulation Disorders, Inherited
Coagulants
Coagulation Protein Disorders
Therapeutic Uses
Hematologic Agents
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009