A Phase 3 interventional study of FACTOR X in Factor X Deficiency, sponsored by Bio Products Laboratory. Terminated at 7 sites in 4 countries. Open to participants aged 12 Years and older. Per ClinicalTrials.gov, last updated 2019-02-05.
Sponsored by Bio Products Laboratory · Phase 3, Interventional, and Treatment
To primary efficacy variable is to assess the presence or absence of excessive blood loss during and after surgery.
The secondary efficacy endpoints are as follows:
To investigate the safety and efficacy of FACTOR X administered by bolus infusion to prevent bleeding and achieve haemostasis in factor X deficient subjects undergoing surgery.
Exclusion Criteria:
Human Coagulation Factor X
Biological: FACTOR X
Presurgery loading dose- The FX level of 70%-90% should be achieved.This will be calculated based on the patients weight on day of surgery and the required rise. Initial dose should not exceed 60IU/kg. Post surgery- FX trough levels of 50% should be achieved. Intravenous infusion of factor X is given at a suggested rate of 10mL/min but not exceeding more than 20mL/min.
Clinical Estimation of Volume of Blood Loss During Surgery
As soon as possible after wound closure, the investigator estimated the volume of blood loss during surgery and made a clinical assessment against the volume of blood loss typically expected in a normal patient (i.e. one without a bleeding disorder and undergoing the same surgical procedure). The assessment may have been supported by a swab and pad count. The clinical assessment was rated as follows: * Blood loss less than expected * Blood loss as expected * Blood loss more than expected * Blood loss excessive (defined as more than twice the pre defined amount that would be expected in a normal patient for this type of surgery)
Time frame: Blood loss is measured during and after surgery, the overall assessment is made after the last dose of FACTOR X.
Clinical Assessment of Blood Loss During Surgery Against the Volume of Blood Loss Expected in Patients Without a Bleeding Disorder.
The investigator's estimation of the volume of blood loss during surgery compared to the volume of blood loss expected in patients without a bleeding disorder undergoing the same surgical procedure and reported as greater than, equal to or less than.
Time frame: After wound closure
Requirement for Blood Transfusion
Number of blood transfusions required (units of packed red blood cells or units of whole blood) or infusion of autologous red cells during and after surgery
Time frame: during and after surgery
Number of Post Operative Bleeding Episodes (See Table Below)
Bleeding was assessed at least once each day by the investigator, more frequently if indicated by the severity of the operation or the subject's response. This included all bleeding episodes from the end of the surgical procedure until the subject was no longer at risk of bleeding due to surgery
Time frame: End of surgery till end of study
Change of Haemoglobin From Pre-surgery Till End of Treatment
The subject's haemoglobin was measured pre operatively, within 2 hours post operatively and at the End of Treatment Assessment. Changes in the subject's haemoglobin from pre to post operatively and from post operatively to the End of Treatment Assessment were assessed, taking into account the volume of fluid infused into the subject during the intervening periods, any blood transfusions in the intervening periods, the subject's haematocrit at the same time points and the subject's pre dose serum ferritin
Time frame: 2 hrs pre-operatively till end of treatment
Number of Participants With Degree of Bleeding Control Rated as Excellent.
Investigators made an overall assessment of FACTOR X in controlling bleeding at the End of Treatment Assessment. The degree of bleeding control was rated as excellent, good, poor or unassessable, in accordance with the following criteria listed below: * Excellent -Parameters were similar to those in subjects without a bleeding disorder. * Good -Parameters were inferior to those in subjects without a bleeding disorder, but no other factor X containing agents were required to restore haemostasis. * Poor - Blood loss was excessive (defined as more than twice the pre defined amount that would be expected in a subject without a bleeding disorder for this type of surgery) and/or Haemostasis was not achieved and/or Additional factor X containing agents were required to restore haemostasis. * Unassessable -Efficacy was not possible to assess, or Additional factor X containing agents (excluding blood transfusions) were required before efficacy of FACTOR X could be assessed.
Time frame: During and till end of treatment
Incremental Recovery After Bolus Dose of FACTOR X
Incremental Recovery of FX:C after the Pre surgery Bolus Infusion The factor X increment is calculated by subtracting the pre-infusion factor X level from the post-dose value. Incremental recovery is calculated by FX increment (IU/dL)/ FX dose (IU/kg)
Time frame: incremental recovery was assessed at approximately 30 minutes after the pre surgery bolus
Dose Per Infusion (IU/kg)
weight adjusted dose per infusion until a subject was no longer at risk of bleeding due to surgery
Time frame: before surgery, during the post operative period
| Milestone | Active Treatment With FACTOR X |
|---|---|
| Started | 4 |
| Completed | 4 |
| Not completed | 0 |
As soon as possible after wound closure, the investigator estimated the volume of blood loss during surgery and made a clinical assessment against the volume of blood loss typically expected in a normal patient (i.e. one without a bleeding disorder and undergoing the same surgical procedure). The assessment may have been supported by a swab and pad count. The clinical assessment was rated as follows: * Blood loss less than expected * Blood loss as expected * Blood loss more than expected * Blood loss excessive (defined as more than twice the pre defined amount that would be expected in a normal patient for this type of surgery)
| ml | FACTOR X |
|---|---|
| Clinical Estimation of Volume of Blood Loss During Surgery | 160.5 ± 168.49 |
Incremental Recovery of FX:C after the Pre surgery Bolus Infusion The factor X increment is calculated by subtracting the pre-infusion factor X level from the post-dose value. Incremental recovery is calculated by FX increment (IU/dL)/ FX dose (IU/kg)
| IU/dL per IU/kg | FACTOR X |
|---|---|
| Incremental Recovery After Bolus Dose of FACTOR X | 2.14 ± 0.224 |
The investigator's estimation of the volume of blood loss during surgery compared to the volume of blood loss expected in patients without a bleeding disorder undergoing the same surgical procedure and reported as greater than, equal to or less than.
| participants | Active Treatment With FACTOR X |
|---|---|
| Less Than | 1 |
| More Than | 0 |
| Equal to | 3 |
Number of blood transfusions required (units of packed red blood cells or units of whole blood) or infusion of autologous red cells during and after surgery
| number of transfusions | Active Treatment With FACTOR X |
|---|---|
| Requirement for Blood Transfusion | 0 |
Bleeding was assessed at least once each day by the investigator, more frequently if indicated by the severity of the operation or the subject's response. This included all bleeding episodes from the end of the surgical procedure until the subject was no longer at risk of bleeding due to surgery
| number of bleeds | Active Treatment With FACTOR X |
|---|---|
| Number of Post Operative Bleeding Episodes (See Table Below) | 0 |
The subject's haemoglobin was measured pre operatively, within 2 hours post operatively and at the End of Treatment Assessment. Changes in the subject's haemoglobin from pre to post operatively and from post operatively to the End of Treatment Assessment were assessed, taking into account the volume of fluid infused into the subject during the intervening periods, any blood transfusions in the intervening periods, the subject's haematocrit at the same time points and the subject's pre dose serum ferritin
| g/L | Active Treatment With FACTOR X |
|---|---|
| Change of Haemoglobin From Pre-surgery Till End of Treatment | -36.0 ± 26.17 |
weight adjusted dose per infusion until a subject was no longer at risk of bleeding due to surgery
| IU/kg | Active Treatment With FACTOR X |
|---|---|
| Dose Per Infusion (IU/kg) | 16.14 (10.13 to 22.30) |
Investigators made an overall assessment of FACTOR X in controlling bleeding at the End of Treatment Assessment. The degree of bleeding control was rated as excellent, good, poor or unassessable, in accordance with the following criteria listed below: * Excellent -Parameters were similar to those in subjects without a bleeding disorder. * Good -Parameters were inferior to those in subjects without a bleeding disorder, but no other factor X containing agents were required to restore haemostasis. * Poor - Blood loss was excessive (defined as more than twice the pre defined amount that would be expected in a subject without a bleeding disorder for this type of surgery) and/or Haemostasis was not achieved and/or Additional factor X containing agents were required to restore haemostasis. * Unassessable -Efficacy was not possible to assess, or Additional factor X containing agents (excluding blood transfusions) were required before efficacy of FACTOR X could be assessed.
| Participants | Active Treatment With FACTOR X |
|---|---|
| Number of Participants With Degree of Bleeding Control Rated as Excellent. | 4 |
Collected over Adverse events were documented from the date the Informed Consent Form was signed until the end of the subject's participation in the study. Non-serious events are listed at a 1% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| FACTOR X | — | 0/4 (0%) | 4/4 (100%) |
| Event | FACTOR X |
|---|---|
| ConstipationGastrointestinal disorders | 3/4 |
| DyspepsiaGastrointestinal disorders | 3/4 |
| Procedural painGeneral disorders | 2/4 |
| Oedema peripheralGeneral disorders | 2/4 |
| HaematomaVascular disorders | 1/4 |
| Post procedural discomfortInjury, poisoning and procedural complications | 1/4 |
| ContusionInjury, poisoning and procedural complications | 1/4 |
| Incision site complicationInjury, poisoning and procedural complications | 1/4 |
| Haemoglobin decreasedInvestigations | 1/4 |
| Oropharyngeal painRespiratory, thoracic and mediastinal disorders | 1/4 |
| Age, Categorical(Participants) | Active Treatment With FACTOR X |
|---|---|
| <=18 years | 0 |
| Between 18 and 65 years | 4 |
| >=65 years | 0 |
| Age, Continuous(years) | Active Treatment With FACTOR X |
|---|---|
| Median | 57 (55 to 59) |
| Sex: Female, Male(Participants) | Active Treatment With FACTOR X |
|---|---|
| Female | 0 |
| Male | 4 |
| Ethnicity (NIH/OMB)(Participants) | Active Treatment With FACTOR X |
|---|---|
| Hispanic or Latino | 0 |
| Not Hispanic or Latino | 4 |
| Unknown or Not Reported | 0 |
| Race (NIH/OMB)(Participants) | Active Treatment With FACTOR X |
|---|---|
| American Indian or Alaska Native | 0 |
| Asian | 2 |
| Native Hawaiian or Other Pacific Islander | 0 |
| Black or African American | 0 |
| White | 2 |
| More than one race | 0 |
| Unknown or Not Reported | 0 |
| Region of Enrollment(participants) | Active Treatment With FACTOR X |
|---|---|
| United States | 2 |
| United Kingdom | 2 |
| FX:C at diagnosis (IU/dL)(IU/dL) | Active Treatment With FACTOR X |
|---|---|
| Median | 7.5 (7 to 8) |
This study is terminated, as verified in Jan 2019. You cannot join it, but the record below documents what was studied.
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Factor X Deficiency
Bio Products Laboratory