Phase 3
N=23
rVWF IN PROPHYLAXIS
Von Willebrand Disease
Bottom Line
View on ClinicalTrials.gov: NCT02973087 ↗Enrolled (actual)
23
Serious AEs
13.0%
Results posted
Aug 2021
Primary outcome: Primary: Ratio of Annualized Bleeding Rate (ABR) for Spontaneous Bleeding Episodes (BEs) (On-study ABR / Historical ABR) Assessed by Investigator During Prophylactic Treatment With rVWF Through Month 12 — 0.085; 0.550 ratio
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- von Willebrand factor (Recombinant) (Biological); Antihemophilic Factor (Recombinant) (Biological)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Takeda
- Primary completion
- Jul 2020
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Ratio of Annualized Bleeding Rate (ABR) for Spontaneous Bleeding Episodes (BEs) (On-study ABR / Historical ABR) Assessed by Investigator During Prophylactic Treatment With rVWF Through Month 12 |
0.085; 0.550 | — |
| SECONDARY Percentage of Prior On-demand Participants Achieved Spontaneous ABR Percent Reduction Success Through Month 12 |
92.3 | — |
| SECONDARY Percentage of Switch Participants With Spontaneous ABR Preservation Success Through Month 12 |
90.0 | — |
| SECONDARY Number of Participants Based on Categorized Spontaneous ABR (sABR) Through Month 12 |
0; 6; 0; 3; 10; 0 | — |
| SECONDARY Total Number of Infusions Administered Per Participant During Prophylactic Treatment With rVWF Through Month 12 |
65.1; 87.8 | — |
| SECONDARY Average Number of Infusions Per Week Per Participant During Prophylactic Treatment With rVWF Through Month 12 |
1.88; 1.85 | — |
| SECONDARY Total Weight Adjusted Consumption of rVWF Per Participant During Prophylactic Treatment Through Month 12 |
3431.584; 4433.752 | — |
| SECONDARY Number of Treated Spontaneous BEs by Location of Bleeding While on Prophylactic Treatment With rVWF Through Month 12 |
5; 14; 3; 0; 0; 1 | — |
| SECONDARY Number of Participants Reporting One or More Treatment-emergent Adverse Events (TEAEs) and Serious TEAEs |
10; 7; 1; 2 | — |
| SECONDARY Number of Participants Based on Severity of TEAEs |
7; 4; 1; 2; 2; 1 | — |
| SECONDARY Number of Participants With TEAEs Based Causality |
1; 0 | — |
| SECONDARY Number of Participants With Thromboembolic Events |
1; 0 | — |
| SECONDARY Number of Participants With Hypersensitivity Reactions |
0; 1 | — |
| SECONDARY Number of Participants Who Developed Neutralizing Antibodies to Von Willebrand Factor (rVWF) and Factor VIII (FVIII) |
0; 0 | — |
| SECONDARY Number of Participants Who Developed of Total Binding Antibodies to Von Willebrand Factor (rVWF) and Factor VIII (FVIII) |
0; 0 | — |
| SECONDARY Number of Participants Who Developed Binding Antibodies to Chinese Hamster Ovary (CHO) Proteins, Mouse Immunoglobulin G (IgG) and/or rFurin |
0; 0 | — |
| SECONDARY Number of Participants With Clinically Significant Change From Baseline in Vital Signs |
0; 0 | — |
| SECONDARY Number of Participants With Clinically Significant Change From Baseline in Clinical Laboratory Parameters |
0; 0 | — |
| SECONDARY Pharmacokinetic (PK) Assessment: Incremental Recovery (IR) Based on Von Willebrand Factor: Ristocetin Cofactor (VWF:Rco) Activity |
1.463 | — |
| SECONDARY Pharmacokinetic Assessment: Incremental Recovery (IR) Based on Von Willebrand Factor Antigen (VWF:Ag) Activity |
1.699 | — |
| SECONDARY Pharmacokinetic Assessment: Incremental Recovery (IR) Based on Von Willebrand Factor Collagen Binding (VWF:CB) Activity |
2.405 | — |
| SECONDARY Pharmacokinetic Assessment: Terminal Half-life (T1/2) Based on Von Willebrand Factor: Ristocetin Cofactor (VWF:Rco) Activity |
15.98 | — |
| SECONDARY Pharmacokinetic Assessment: Terminal Half-life (T1/2) Based on Von Willebrand Factor Antigen (VWF:Ag) Activity |
21.81 | — |
| SECONDARY Pharmacokinetic Assessment: Terminal Half-life (T1/2) Based on Von Willebrand Factor Collagen Binding (VWF:CB) Activity |
18.64 | — |
| SECONDARY Pharmacokinetic Assessment: Mean Residence Time (MRT) Based on Von Willebrand Factor: Ristocetin Cofactor (VWF:Rco) Activity |
23.27 | — |
| SECONDARY Pharmacokinetic Assessment: Mean Residence Time (MRT) Based on Von Willebrand Factor Antigen (VWF:Ag) Activity |
33.55 | — |
| SECONDARY Pharmacokinetic Assessment: Mean Residence Time (MRT) Based on Von Willebrand Factor Collagen Binding (VWF:CB) Activity |
27.39 | — |
| SECONDARY Pharmacokinetic Assessment: Area Under the Plasma Concentration Versus Time Curve From Time 0 Extrapolated to Infinity (AUC0-∞) Based on Von Willebrand Factor: Ristocetin Cofactor (VWF:Rco) Activity |
1199 | — |
| SECONDARY Pharmacokinetic Assessment: Area Under the Plasma Concentration Versus Time Curve From Time 0 Extrapolated to Infinity (AUC0-∞) Based on Von Willebrand Factor Antigen (VWF:Ag) Activity |
2578 | — |
| SECONDARY Pharmacokinetic Assessment: Area Under the Plasma Concentration Versus Time Curve From Time 0 Extrapolated to Infinity (AUC0-∞) Based on Von Willebrand Factor Collagen Binding (VWF:CB) Activity |
3010 | — |
| SECONDARY Pharmacokinetic Assessment: Area Under the Plasma Concentration Versus Time Curve From Time 0 to the Last Measurable Concentration (AUC0-tlast) Based on Von Willebrand Factor: Ristocetin Cofactor (VWF:Rco) Activity |
919.8 | — |
| SECONDARY Pharmacokinetic Assessment: Area Under the Plasma Concentration Versus Time Curve From Time 0 to the Last Measurable Concentration (AUC0-tlast) Based on Von Willebrand Factor Antigen (VWF:Ag) Activity |
2357 | — |
| SECONDARY Pharmacokinetic Assessment: Area Under the Plasma Concentration Versus Time Curve From Time 0 to the Last Measurable Concentration (AUC0-tlast) Based on Von Willebrand Factor Collagen Binding (VWF:CB) Activity |
2824 | — |
| SECONDARY Pharmacokinetic Assessment: Maximum Plasma Concentration (Cmax) Based on Von Willebrand Factor: Ristocetin Cofactor (VWF:Rco) Activity |
74.62 | — |
| SECONDARY Pharmacokinetic Assessment: Maximum Plasma Concentration (Cmax) Based on Von Willebrand Factor Antigen (VWF:Ag) Activity |
85.1 | — |
| SECONDARY Pharmacokinetic Assessment: Maximum Plasma Concentration (Cmax) Based on Von Willebrand Factor Collagen Binding (VWF:CB) Activity |
120.74 | — |
| SECONDARY Pharmacokinetic Assessment: Minimum Time to Reach the Maximum Plasma Concentration (Tmax) Based on Von Willebrand Factor: Ristocetin Cofactor (VWF:Rco) Activity |
0.540 | — |
| SECONDARY Pharmacokinetic Assessment: Minimum Time to Reach the Maximum Plasma Concentration (Tmax) Based on Von Willebrand Factor Antigen (VWF:Ag) Activity |
1 | — |
| SECONDARY Pharmacokinetic Assessment: Minimum Time to Reach the Maximum Plasma Concentration (Tmax) Based on Von Willebrand Factor Collagen Binding (VWF:CB) Activity |
0.500 | — |
| SECONDARY Pharmacokinetic Assessment: Volume of Distribution at Steady State (Vss) Based on Von Willebrand Factor: Ristocetin Cofactor (VWF:Rco) Activity |
1.052 | — |
| SECONDARY Pharmacokinetic Assessment: Volume of Distribution at Steady State (Vss) Based on Von Willebrand Factor Antigen (VWF:Ag) Activity |
0.6860 | — |
| SECONDARY Pharmacokinetic Assessment: Volume of Distribution at Steady State (Vss) Based on Von Willebrand Factor Collagen Binding (VWF:CB) Activity |
0.4889 | — |
| SECONDARY Pharmacokinetic Assessment: Clearance (CL) Based on Von Willebrand Factor: Ristocetin Cofactor (VWF:Rco) Activity |
0.04765 | — |
| SECONDARY Pharmacokinetic Assessment: Clearance (CL) Based on Von Willebrand Factor Antigen (VWF:Ag) Activity |
0.02185 | — |
| SECONDARY Pharmacokinetic Assessment: Clearance (CL) Based on Von Willebrand Factor Collagen Binding (VWF:CB) Activity |
0.01872 | — |
| SECONDARY Pharmacodynamic (PD) Assessment: Maximum Plasma Concentration (Cmax) Based on Factor VIII Clotting (FVIII:C) Activity |
90.8 | — |
| SECONDARY Pharmacodynamic Assessment: Minimum Time to Reach the Maximum Plasma Concentration (Tmax) Based on Factor VIII Clotting (FVIII:C) Activity |
24.055 | — |
| SECONDARY Pharmacodynamic Assessment: Area Under the Plasma Concentration Versus Time Curve From Time 0 to the Last Measurable Concentration (AUC0-tlast) Based on Factor VIII Clotting (FVIII:C) Activity |
4949 | — |
| SECONDARY Pharmacokinetic Assessment at Steady State: Area Under the Plasma Concentration Versus Time Curve From Time 0 to End of the Partial Dosing Interval (AUC0- Tau;ss) Based on Von Willebrand Factor: Ristocetin Cofactor (VWF:Rco) Activity |
1561; 1662 | — |
| SECONDARY Pharmacokinetic Assessment at Steady State: Area Under the Plasma Concentration Versus Time Curve From Time 0 to End of the Partial Dosing Interval (AUC0- Tau;ss) Based on Von Willebrand Factor Antigen (VWF:Ag) Activity |
2908; 3196 | — |
| SECONDARY Pharmacokinetic Assessment at Steady State: Area Under the Plasma Concentration Versus Time Curve From Time 0 to End of the Partial Dosing Interval (AUC0- Tau;ss) Based on Von Willebrand Factor Collagen Binding (VWF:CB) Activity |
3445; 4276 | — |
| SECONDARY Pharmacokinetics Assessment at Steady State: Maximum Plasma Concentration During the Partial Dosing Interval at Steady State (Cmax;ss) Based on Von Willebrand Factor: Ristocetin Cofactor (VWF:Rco) Activity |
92.63; 102.89 | — |
| SECONDARY Pharmacokinetics Assessment at Steady State: Maximum Plasma Concentration During the Partial Dosing Interval at Steady State (Cmax;ss) Based on Von Willebrand Factor Antigen (VWF:Ag) Activity |
108.1; 107.1 | — |
| SECONDARY Pharmacokinetics Assessment at Steady State: Maximum Plasma Concentration During the Partial Dosing Interval at Steady State (Cmax;ss) Based on Von Willebrand Factor Collagen Binding (VWF:CB) Activity |
137.48; 162.19 | — |
| SECONDARY Pharmacokinetics Assessment at Steady State: Minimum Time to Reach the Maximum Plasma Concentration at Steady State (Tmax;ss) Based on Von Willebrand Factor: Ristocetin Cofactor (VWF:Rco) Activity |
0.330; 0.400 | — |
| SECONDARY Pharmacokinetics Assessment at Steady State: Minimum Time to Reach the Maximum Plasma Concentration at Steady State (Tmax;ss) Based on Von Willebrand Factor Antigen (VWF:Ag) Activity |
0.580; 0.330 | — |
| SECONDARY Pharmacokinetics Assessment at Steady State: Minimum Time to Reach the Maximum Plasma Concentration at Steady State (Tmax;ss) Based on Von Willebrand Factor Collagen Binding (VWF:CB) Activity |
0.420; 0.670 | — |
| SECONDARY Pharmacokinetics Assessment at Steady State: Minimum Plasma Concentration During the Partial Dosing Interval at Steady State (Cmin;ss) Based on Von Willebrand Factor: Ristocetin Cofactor (VWF:Rco) Activity |
NA; NA | — |
| SECONDARY Pharmacokinetics Assessment at Steady State: Minimum Plasma Concentration During the Partial Dosing Interval at Steady State (Cmin;ss) Based on Von Willebrand Factor Antigen (VWF:Ag) Activity |
6.3; 11.7 | — |
| SECONDARY Pharmacokinetics Assessment at Steady State: Minimum Plasma Concentration During the Partial Dosing Interval at Steady State (Cmin;ss) Based on Von Willebrand Factor Collagen Binding (VWF:CB) Activity |
3.82; 9.94 | — |
| SECONDARY Pharmacodynamic Assessment at Steady State: Area Under the Plasma Concentration Versus Time Curve From Time 0 to End of the Partial Dosing Interval (AUC0- Tau;ss) Based on Factor VIII Clotting (FVIII:C) Activity |
5984; 5836 | — |
| SECONDARY Pharmacodynamic Assessment at Steady State: Maximum Plasma Concentration During the Partial Dosing Interval at Steady State (Cmax;ss) Based on Factor VIII Clotting (FVIII:C) Activity |
104.1; 75.7 | — |
| SECONDARY Pharmacodynamic Assessment at Steady State: Minimum Time to Reach the Maximum Plasma Concentration at Steady State (Tmax;ss) Based on Factor VIII Clotting (FVIII:C) Activity |
24.500; 24.070 | — |
| SECONDARY Pharmacodynamic Assessment at Steady State: Minimum Plasma Concentration During the Partial Dosing Interval at Steady State (Cmin;ss) Based on Factor VIII Clotting (FVIII:C) Activity |
15.8; 22.9 | — |
| SECONDARY Factor VIII (FVIII) Clotting Activity |
22.1; 28.0; 28.7; 30.9; 32.1; 33.4 | — |
Summary
The purpose of this phase 3 study is to investigate the efficacy and safety, including immunogenicity, thrombogenicity and hypersensitivity reactions, as well as pharmacokinetics (PK), health related quality of life (HRQoL) and pharmacoeconomics of prophylactic treatment with recombinant von Willebrand factor (rVWF) (vonicog alfa) in adult participants with severe von Willebrand disease (VWD).
Eligibility Criteria
Inclusion Criteria
- Participant has a documented diagnosis of severe von Willebrand disease (VWD) (baseline Von Willebrand factor: Ristocetin cofactor activity (VWF:RCo) less than ( or=) 3 documented spontaneous bleeds (not including menorrhagia) requiring von Willebrand factor (VWF) treatment during the past 12 months.
- Availability of records to reliably evaluate type, frequency and treatment of bleeding episodes during at least 12 months preceding enrollment. Up to 24 months retrospective data should be collected if available. Availability of dosing and factor consumption during 12 months (up to 24 months) of treatment prior to enrollment is required for pdVWF switch participants and is desired (but not a requirement) for on-demand participants.
- Participant is > or = 18 years old at the time of screening and has a body mass index > or = 15 but ]1.4).
- The participant is currently receiving prophylactic treatment with more than 5 infusions per week.
- The participant is currently receiving prophylactic treatment with a weekly dose exceeding 240 IU/kg.
- The participant has a history or presence of a VWF inhibitor at screening.
- The participant has a history or presence of a Factor VIII (FVIII) inhibitor with a titer ≥0.4 Bethesda units (BU) (by Nijmegen modified Bethesda assay) or > or = 0.6 Bethesda Unit (BU) (by Bethesda assay).
- The participant has a known hypersensitivity to any of the components of the study drugs, such as to mouse or hamster proteins.
- The participant has a medical history of immunological disorders, excluding seasonal allergic rhinitis/conjunctivitis, mild asthma, food allergies or animal allergies.
- The participant has a medical history of a thromboembolic event.
- The participant is human immunodeficiency virus (HIV) positive with an absolute Helper T cell (CD4) count or = 2.5 milligram per deciliter (mg/dL).
- The participant has a platelet count <100,000/ milliliter (mL) at screening.
- The participant has been treated with an immunomodulatory drug, excluding topical treatment (e.g., ointments, nasal sprays), within 30 days prior to signing the informed consent.
- The participant is pregnant or lactating at the time of enrollment.
- Patient has cervical or uterine conditions causing menorrhagia or metrorrhagia (including infection, dysplasia).
- The participant has participated in another clinical study involving another Investigational product (IP) or investigational device within 30 days prior to enrollment or is scheduled to participate in another clinical study involving an IP or investigational device during the course of this study.
- The participant has a progressive fatal disease and/or life expectancy of less than 15 months.
- The participant is scheduled for a surgical intervention.
- The participant is identified by the investigator as being unable or unwilling to cooperate with study procedures.
- The participant has a mental condition rendering him/her unable to understand the nature, scope and possible consequences of the study and/or evidence of an uncooperative attitude.
- The participant is in prison or compulsory detention by regulatory and/or juridical order.
- The participant is member of the study team or in a dependent relationship with one of the study team members which includes close relatives (i.e., children, partner/spouse, siblings and parents) as well as employees.
Data sourced from ClinicalTrials.gov (NCT02973087). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.