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Safety and Tolerability of Higher Infusion Parameters of IgPro20 (Hizentra) in Subjects With Primary Immunodeficiency (PID)

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ClinicalTrials.gov Identifier: NCT03033745
Recruitment Status : Completed
First Posted : January 27, 2017
Results First Posted : January 13, 2020
Last Update Posted : March 25, 2020
Sponsor:
Information provided by (Responsible Party):
CSL Behring

Brief Summary:
This multicenter, open-label, parallel-arm, non-randomized study is designed to evaluate safety and tolerability of higher infusion parameters of IgPro20 in subjects with primary immunodeficiency (PID). A total of 45 subjects (including at least 14 [30%] pediatric subjects ≤ 17 years of age and at least 9 [20%] obese subjects with body mass index [BMI] of ≥30 kg/m2) with confirmed PID will be evaluated in the study. The study will include three cohorts of 15 subjects each as follows: i) Pump-Assisted Volume Cohort (weekly infusions), volume per injection site of 25 mL up to 50 mL, ii) Pump Assisted Flow Rate Cohort (weekly infusions), flow rate per injection site of 25 mL/hour up to 100 mL/hour, iii) Manual Push Flow Rate Cohort (2 to 7 infusions per week), flow rate per injection site of 25 to 30 mL/hour up to 120 mL/hour (equivalent of approximately 0.5 mL/minute up to 2 mL/minute). Each cohort will test 3 infusion parameter levels (4 for the pump-assisted flow rate cohort), repeated at least 4 times over a duration of 12 weeks (16 weeks for the flow rate cohort). After 4 infusion weeks at each level, qualifying subjects (responders) will switch to the next infusion parameter level (eg, from 25 to 50 mL/h). During the study, the weekly dose will remain unchanged (as prescribed by treating physician, usually within 100-200 mg/kg per week range); only the respective infusion parameter under evaluation will change.

Condition or disease Intervention/treatment Phase
Primary Immunodeficiency Drug: IgPro20 Phase 4

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 49 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: An Open-label Multicenter Study to Evaluate the Safety and Tolerability of Higher Infusion Parameters of Immune Globulin Subcutaneous (Human), 20% Liquid (Hizentra®) in Subjects With Primary Immunodeficiency
Actual Study Start Date : February 1, 2017
Actual Primary Completion Date : December 14, 2018
Actual Study Completion Date : December 14, 2018


Arm Intervention/treatment
Experimental: IgPro20 (Pump-Assisted Volume Cohort)
Weekly volumes per injection site of 25 mL up to 50 mL administered subcutaneously.
Drug: IgPro20
A liquid formulation of normal human IgG at a concentration of 20% administered as a subcutaneous infusion at a dose prescribed by subject's physician prior to study entry.
Other Name: Hizentra

Experimental: IgPro20 (Pump Assisted Flow Rate Cohort)
Weekly flow rates per injection site of 25 mL/hour up to 100 mL/hour administered subcutaneously.
Drug: IgPro20
A liquid formulation of normal human IgG at a concentration of 20% administered as a subcutaneous infusion at a dose prescribed by subject's physician prior to study entry.
Other Name: Hizentra

Experimental: IgPro20 (Manual Push Flow Rate Cohort)
Frequent (ie, 2 to 7 times per week) flow rates per injection site of 25 to 30 mL/hour up to 120 mL/hour (equivalent of approximately 0.5 mL/minute up to 2 mL/minute) administered subcutaneously.
Drug: IgPro20
A liquid formulation of normal human IgG at a concentration of 20% administered as a subcutaneous infusion at a dose prescribed by subject's physician prior to study entry.
Other Name: Hizentra




Primary Outcome Measures :
  1. Percentage of Responders [ Time Frame: At the end of 4 weeks for each planned infusion parameter ]
    A responder is a subject within the Pump-Assisted Cohorts that performs at least 3 out of 4 valid infusions at a certain infusion parameter level (weekly volumes per injection site of 25-50 mL; weekly flow rates per injection site of 25-100 mL/hour). Determination of a responder in the Manual Push Cohort is more complex due to the expected variable frequency of infusions per week (ie, 5-17) for different subjects. A responder within the Manual Push Cohort is a subject that performs a minimum number of valid infusions during 4 weeks corresponding to a certain flow rate level ([ie, 2-7 times per week], flow rates per injection site of 30-120 mL/hour). Valid infusions do not need to be consecutive, but each subject needs to adhere to the same schedule (number of infusions per week) throughout the study. An infusion parameter will be considered successful if at least one third (≥ 33%) of the subjects in the corresponding cohort are responders at that infusion parameter level.


Secondary Outcome Measures :
  1. Rate of Treatment-emergent Adverse Events (TEAEs) Per Infusion [ Time Frame: At the end of 4 weeks for each planned infusion parameter ]
    Adverse event rate per infusion = number of adverse events/total number of infusions prior to subject's start date of non-response. Only events are included which start prior to subject's start date of non-response.

  2. Rate of Local TEAEs Per Infusion [ Time Frame: At the end of 4 weeks for each planned infusion parameter ]
    Local adverse event rate per infusion = number of local adverse events/total number of infusions prior to subject's start date of non-response. Local Adverse Events: comprises all events reported within the MedDRA high level terms "administration site reactions NEC (Not Elsewhere Classified)", "infusion site reactions", and "injection site reactions". Only events are included which start prior to subject's start date of non-response.

  3. Time to Onset of Local TEAEs [ Time Frame: At the end of 4 weeks for each planned infusion parameter ]
    Local Adverse Events: comprises all events reported within the MedDRA high level terms "administration site reactions NEC", "infusion site reactions", and "injection site reactions". Only events are included which start prior to subject's start date of non-response.

  4. Intensity of Local TEAEs [ Time Frame: At the end of 4 weeks for each planned infusion parameter ]
    Mild = A type of AE that is usually transient and may require only minimal treatment or therapeutic intervention. The event does not generally interfere with usual activities of daily living. Moderate = A type of AE that is usually alleviated with additional specific therapeutic intervention. The event interferes with usual activities of daily living, causing discomfort but poses no significant or permanent risk of harm to the subject. Severe = A type of AE that interrupts usual activities of daily living, or significantly affects clinical status, or may require intensive therapeutic intervention. Only events are included which start prior to subject's start date of non-response.

  5. Duration of Local TEAEs [ Time Frame: At the end of 4 weeks for each planned infusion parameter ]
    Local Adverse Events: comprises all events reported within the MedDRA high level terms "administration site reactions NEC", "infusion site reactions", and "injection site reactions".

  6. Tolerability of Infusions [ Time Frame: At the end of 4 weeks for each planned infusion parameter ]
    Tolerability = number of infusions without severe local adverse events / total number of infusions. Severe = A type of AE that interrupts usual activities of daily living, or significantly affects clinical status, or may require intensive therapeutic intervention. Only events are included which start prior to subject's start date of non-response.



Information from the National Library of Medicine

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Ages Eligible for Study:   2 Years and older   (Child, Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Male or female on stable dose of IgPro20 (Hizentra) therapy.
  • Women of childbearing potential must be using and agree to continue using medically approved contraception (which must be discussed with the study doctor) and must have a negative pregnancy test at screening.
  • Subjects with PID, eg, with a diagnosis of common variable immunodeficiency or X-linked agammaglobulinemia, as defined by the Pan American Group for Immune Deficiency and the European Society of Immune Deficiencies.
  • With infusion parameters as specified below:

Pump-Assisted Flow Rate Cohort subjects only

  • Experience with pump-assisted infusions of IgPro20 at the tolerated flow rate of 25 mL/h per injection site for at least 1 month prior to Day 1.

Pump-Assisted Volume Cohort subjects only

  • Total weekly IgPro20 dose of ≥ 50 mL (≥ 10 g).
  • Experience with pump-assisted infusions of IgPro20 at tolerated volumes of 25 mL/injection site for at least 1 month prior to Day 1.

Manual Push Flow Rate Cohort subjects only

  • Experience with frequent (2-7 times per week) infusions of IgPro20 at the tolerated flow rate of approximately 0.5 mL/min (equivalent of 25-30 mL/h) per injection site for at least 1 month prior to Day 1. The dose (volume) per injection site should not exceed 25 mL.

Exclusion Criteria:

  • Ongoing serious bacterial infections at the time of screening.
  • Other significant medical conditions that could increase the risk to the subject.
  • Females who are pregnant, breast feeding, or planning a pregnancy during the course study.
  • Participation in a study with an Investigational Medicinal Product (IMP) other than IgPro20 within three months prior to enrollment.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03033745


Locations
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United States, Alabama
Clinical Research Center of Alabama
Birmingham, Alabama, United States, 35209
United States, Arizona
Research Solutions of Arizona
Litchfield Park, Arizona, United States, 85340
United States, Florida
University of Southern Florida
Saint Petersburg, Florida, United States, 33701
United States, Georgia
Georgia Pollens Clinical Research Centers
Albany, Georgia, United States, 31707
United States, New York
Long Island Jewish Medical Center
Great Neck, New York, United States, 11021
Icahn Medical Institute
New York, New York, United States, 10029
Center for Clinical Research Rochester General Hospital
Rochester, New York, United States, 14607
United States, North Carolina
Levine Children's Hospital
Charlotte, North Carolina, United States, 28203
Duke University School of Medicine
Durham, North Carolina, United States, 27705
United States, Wisconsin
Medical College of Wisconsin
Milwaukee, Wisconsin, United States, 53226
Canada, Ontario
The Ottawa Hospital
Ottawa, Ontario, Canada, K1H 8L6
Canada, Quebec
McGill University
Montréal, Quebec, Canada, H4A3J1
Sponsors and Collaborators
CSL Behring
Investigators
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Study Director: Study Physician CSL Behring
  Study Documents (Full-Text)

Documents provided by CSL Behring:
Study Protocol  [PDF] December 2, 2017
Statistical Analysis Plan  [PDF] July 26, 2018

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Responsible Party: CSL Behring
ClinicalTrials.gov Identifier: NCT03033745    
Other Study ID Numbers: IgPro20_4004
2016-003799-33 ( EudraCT Number )
First Posted: January 27, 2017    Key Record Dates
Results First Posted: January 13, 2020
Last Update Posted: March 25, 2020
Last Verified: March 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Immunologic Deficiency Syndromes
Immune System Diseases