A Phase 3 interventional study of BT524 and FFP/Cryo in Bleeding Disorder and Hypofibrinogenemia; Acquired, sponsored by Biotest. Completed at 19 sites in 7 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-06-13.
Sponsored by Biotest (part of Grifols) · Phase 3, Interventional, and Treatment
The main purpose of this study was to demonstrate the efficacy and safety of intraoperative use of fibrinogen concentrate BT524, as a complementary therapy for the management of uncontrolled severe hemorrhage in acquired hypofibrinogenemia. This non-inferiority study focused on the primary objective of demonstrating that BT524 is non-inferior that means not worse than the comparator fresh frozen plasma/cryoprecipitate in reducing intraoperative blood loss when administered intravenously in subjects with acquired hypofibrinogenemia undergoing elective major spinal or abdominal surgery.
Fibrinogen is the first coagulation factor to become critically reduced during intraoperative bleeding. Therefore, rapid supplementation of fibrinogen to restore physiological plasma levels is an important component in achieving and maintaining hemostasis in bleeding patients. In this study, subjects with major blood loss during elective spinal surgery or abdominal surgery were randomized to receive either intravenous transfusion of the fibrinogen concentrate BT524, or fibrinogen-containing fresh frozen plasma/cryoprecipitate as first hemostatic intervention to rapidly replenish fibrinogen and control bleeding.
361 studies on the registry are indexed under Hemostatic Disorders; 65 are open to participants now.
This study's enrollment of 222 is above the median of 60 across 171 interventional studies indexed under Hemostatic Disorders.
Browse Hemostatic Disorders studies →Biotest is the lead sponsor of 14 studies on the registry; 1 is open to participants now.
First submitted before Biotest became part of Grifols.
Counted across the registry records on this site, refreshed daily.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
At screening:
Intra-operative:
5.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.
Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.
Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.
An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.
A drug or device being studied in a clinical trial.
It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Clinically significant
Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Contraception
Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.
Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Hypersensitivity
An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Investigational drug or device
A drug or device being studied in a clinical trial.
It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Investigational Human Fibrinogen Concentrate
Biological: BT524
Standard of Care
Biological: FFP/Cryo
BT524 was administered intravenously at a patient specific dosage depending on the type of surgery, the extent of bleeding and the subject's clinical condition.
Also known as: Human Fibrinogen concentrate
Drug page: Human plasma
FFP/Cryo was administered intravenously; dosage according to local standards. FFP, 15 mL per kg body weight (BW); Cryoprecipitate, fixed dose of 10 units.
Also known as: Fresh Frozen Plasma, Cryoprecipitate
Intra-operative Blood Loss
Intra-operative blood loss as measured by amount of blood from blood suction unit and amount of blood from surgical cloths and compresses.
Time frame: From decision to treat the subject with IMP until end of surgery, an average of 5 hours
Proportion (%) of Subjects With Successful Correction of Fibrinogen Level (FIBTEM A10) 15 Minutes After Start of First IMP Administration
Successful correction of the fibrinogen level is defined as restoring fibrinogen FIBTEM A10 baseline (prior surgery) levels measured by ROTEM (thromboelastometry) 15 minutes after start of first IMP administration
Time frame: Prior first dose, 15 minutes after start of first IMP administration
Time to First Successful Correction of Fibrinogen Level
Correction of the fibrinogen level, measured via thromboelastometry (ROTEM/FIBTEM A10), within 15 minutes after IMP start, between 15 and 90 minutes after IMP start, after 90 minutes after IMP start, or unsuccessful correction. The 4 categories were compared between the two treatment arms using a Chi-square test.
Time frame: prior 1st dose, pre-dose, 15 minutes and 90 minutes after start of first IMP administration, end of surgery
Transfusion Requirements: Cell Salvage
Total amount of transfusion products (allogeneic blood products) or autologous blood transfusion infused after start of first IMP administration until end of surgery. The end of surgery is defined as time of last suture.
Time frame: After start of first IMP administration until end of surgery, an average of 5 hours
Transfusion Requirements: Allogeneic Platelets
Total amount of transfusion products (allogeneic blood products) or autologous blood transfusion infused after start of first IMP administration until end of surgery. The end of surgery is defined as time of last suture.
Time frame: After start of first IMP administration until end of surgery, an average of 5 hours
Transfusion Requirements: Allogeneic Red Blood Cells
Total amount of transfusion products (allogeneic blood products) or autologous blood transfusion infused after start of first IMP administration until end of surgery. The end of surgery is defined as time of last suture.
Time frame: After start of first IMP administration until end of surgery, an average of 5 hours
Transfusion Requirements: Fresh Frozen Plasma
Total amount of transfusion products (allogeneic blood products) or autologous blood transfusion infused after start of first IMP administration until end of surgery. The end of surgery is defined as time of last suture.
Time frame: After start of first IMP administration until end of surgery, an average of 5 hours
Transfusion Requirements, Cryoprecipitate
Total amount of transfusion products (allogeneic blood products) or autologous blood transfusion infused after start of first IMP administration until end of surgery. The end of surgery is defined as time of last suture.
Time frame: After start of first IMP administration until end of surgery, an average of 5 hours
Amount of Red Blood Cells (RBCs)
Amount (volume) of RBCs (allogenic and autologous RBCs) infused after start of first IMP administration until end of surgery. The end of surgery is defined as time of last suture.
Time frame: After start of first IMP administration until end of surgery, an average of 5 hours
Post-operative Blood Loss
Post-operative drainage volume in the first 24 hours after end of surgery
Time frame: From end of surgery (time of last suture) up to 24 hours after the end of surgery
Subjects With Rebleeds
Proportion (%) of subjects with rebleeds after the end of surgery until day 8
Time frame: End of surgery up to 8 days after surgery
Hospital Length of Stay After Surgery
Length of stay after surgery (days) = 'date of hospital discharge' minus 'date of surgery'. Where date of discharge is the date of discharge following the IMP treated surgery.
Time frame: From day of surgery until day of hospital discharge, an average of 16 days (up to 56 days)
In-hospital Mortality
Number and percentages of subjects who died during hospital stay
Time frame: From day of surgery until day of hospital discharge, an average of 16 days (up to 56 days)
Number of Subjects With Thrombosis or Thromboembolic Events (TEEs)
Total number of subjects with thrombosis or TEEs documented as treatment-emergent adverse events of special interest
Time frame: From day of surgery until closing visit (up to 181 days)
Change in Viral Status
Number of subjects with change in status of viral infections
Time frame: Screening visit (up to 42 days prior to surgery) and closing visit (up to 181 days after surgery)
339 subjects were screened, of these 222 subjects were eligible for the study and randomized. Baseline characteristics are available for the 222 randomized subjects.
| Milestone | BT524 | FFP/Cryo |
|---|---|---|
| Started | 110 | 112 |
| Completed | 105 | 106 |
| Not completed | 5 | 6 |
| Withdrew: Withdrawal by subject | 0 | 1 |
| Withdrew: Lost to follow-up | 4 | 2 |
| Withdrew: Protocol violation | 0 | 1 |
| Withdrew: Lack of trial compliance | 1 | 1 |
| Withdrew: Physical disability to come to the site for the closing visit | 0 | 1 |
Intra-operative blood loss as measured by amount of blood from blood suction unit and amount of blood from surgical cloths and compresses.
| mL | BT524 | Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo) |
|---|---|---|
| Intra-operative Blood Loss | 1380.7 (1187.09 to 1574.31) | 1660.13 (1460.65 to 1859.61) |
Successful correction of the fibrinogen level is defined as restoring fibrinogen FIBTEM A10 baseline (prior surgery) levels measured by ROTEM (thromboelastometry) 15 minutes after start of first IMP administration
| Participants | BT524 | Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo) |
|---|---|---|
| Proportion (%) of Subjects With Successful Correction of Fibrinogen Level (FIBTEM A10) 15 Minutes After Start of First IMP Administration | 59 | 19 |
Correction of the fibrinogen level, measured via thromboelastometry (ROTEM/FIBTEM A10), within 15 minutes after IMP start, between 15 and 90 minutes after IMP start, after 90 minutes after IMP start, or unsuccessful correction. The 4 categories were compared between the two treatment arms using a Chi-square test.
| Participants | BT524 | Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo) |
|---|---|---|
| <=15 minutes after IMP start | 59 | 19 |
| >15 and <= 90 minutes after IMP start | 17 | 11 |
| >90 minutes after IMP start | 11 | 16 |
| Unsuccessful correction | 20 | 58 |
Total amount of transfusion products (allogeneic blood products) or autologous blood transfusion infused after start of first IMP administration until end of surgery. The end of surgery is defined as time of last suture.
| mL | BT524 | Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo) |
|---|---|---|
| Transfusion Requirements: Cell Salvage | 95.6 ± 244.57 | 78.0 ± 234.77 |
Total amount of transfusion products (allogeneic blood products) or autologous blood transfusion infused after start of first IMP administration until end of surgery. The end of surgery is defined as time of last suture.
| mL | BT524 | Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo) |
|---|---|---|
| Transfusion Requirements: Allogeneic Platelets | 3.0 ± 30.94 | 3.6 ± 36.38 |
Total amount of transfusion products (allogeneic blood products) or autologous blood transfusion infused after start of first IMP administration until end of surgery. The end of surgery is defined as time of last suture.
| mL | BT524 | Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo) |
|---|---|---|
| Transfusion Requirements: Allogeneic Red Blood Cells | 455.5 ± 492.19 | 488.4 ± 547.72 |
Total amount of transfusion products (allogeneic blood products) or autologous blood transfusion infused after start of first IMP administration until end of surgery. The end of surgery is defined as time of last suture.
| mL | BT524 | Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo) |
|---|---|---|
| Transfusion Requirements: Fresh Frozen Plasma | 60.5 ± 217.68 | 14.8 ± 110.94 |
Total amount of transfusion products (allogeneic blood products) or autologous blood transfusion infused after start of first IMP administration until end of surgery. The end of surgery is defined as time of last suture.
| mL | BT524 | Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo) |
|---|---|---|
| Transfusion Requirements, Cryoprecipitate | 0 ± 0 | 0 ± 0 |
Amount (volume) of RBCs (allogenic and autologous RBCs) infused after start of first IMP administration until end of surgery. The end of surgery is defined as time of last suture.
| mL | BT524 | Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo) |
|---|---|---|
| Amount of Red Blood Cells (RBCs) | 543.4 (441.99 to 644.77) | 558.9 (456.08 to 661.62) |
Post-operative drainage volume in the first 24 hours after end of surgery
| mL | BT524 | Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo) |
|---|---|---|
| Post-operative Blood Loss | 306.3 (234.15 to 378.38) | 293.9 (220.76 to 366.95) |
Proportion (%) of subjects with rebleeds after the end of surgery until day 8
| Participants | BT524 | Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo) |
|---|---|---|
| Subjects With Rebleeds | 0 | 5 |
Length of stay after surgery (days) = 'date of hospital discharge' minus 'date of surgery'. Where date of discharge is the date of discharge following the IMP treated surgery.
| Participants | BT524 | Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo) |
|---|---|---|
| >36 days | 7 | 4 |
| 29-36 days | 4 | 10 |
| 22-28 days | 13 | 12 |
| 15-21 days | 34 | 17 |
| 8-14 days | 39 | 49 |
| 1-7 days | 10 | 12 |
Number and percentages of subjects who died during hospital stay
| Participants | BT524 | Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo) |
|---|---|---|
| In-hospital Mortality | 0 | 0 |
Total number of subjects with thrombosis or TEEs documented as treatment-emergent adverse events of special interest
| Participants | BT524 | Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo) |
|---|---|---|
| Number of Subjects With Thrombosis or Thromboembolic Events (TEEs) | 8 | 13 |
Number of subjects with change in status of viral infections
| Participants | BT524 | Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo) |
|---|---|---|
| Change in Viral Status | 0 | 0 |
Collected over From day of surgery to closing visit (up to 181 days). Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| BT524 | 0/110 (0%) | 28/110 (25.5%) | 92/110 (83.6%) |
| Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo) | 1/112 (0.9%) | 41/112 (36.6%) | 93/112 (83%) |
| Event | BT524 | Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo) |
|---|---|---|
| Pulmonary embolismRespiratory, thoracic and mediastinal disorders | 3/110 | 7/112 |
| Dural tearInjury, poisoning and procedural complications | 3/110 | 0/112 |
| Deep vein thrombosisVascular disorders | 1/110 | 3/112 |
| SeromaInjury, poisoning and procedural complications | 1/110 | 3/112 |
| Anaemia postoperativeInjury, poisoning and procedural complications | 0/110 | 3/112 |
| Postoperative wound infectionInfections and infestations | 1/110 | 3/112 |
| Impaired healingGeneral disorders | 2/110 | 1/112 |
| Wound dehiscenceInjury, poisoning and procedural complications | 2/110 | 1/112 |
| Cerebrospinal fluid leakageNervous system disorders | 2/110 | 0/112 |
| ParaparesisNervous system disorders | 2/110 | 0/112 |
| Event | BT524 | Fresh Frozen Plasma (FFP)/Cryoprecipitate (Cryo) |
|---|---|---|
| HallucinationPsychiatric disorders | 29/110 | 26/112 |
| HypotensionVascular disorders | 23/110 | 10/112 |
| TachycardiaCardiac disorders | 19/110 | 14/112 |
| Anaemia postoperativeInjury, poisoning and procedural complications | 15/110 | 6/112 |
| HypertransaminasaemiaHepatobiliary disorders | 13/110 | 11/112 |
| NauseaGastrointestinal disorders | 10/110 | 4/112 |
| PneumoniaInfections and infestations | 10/110 | 10/112 |
| Urinary tract infectionInfections and infestations | 10/110 | 10/112 |
| Gamma-glutamyltransferase increasedInvestigations | 5/110 | 8/112 |
| Oxygen saturation decreasedInvestigations | 2/110 | 7/112 |
| Age, Categorical(Participants) | BT524 | FFP/Cryo | Total |
|---|---|---|---|
| <=18 years | 0 | 0 | 0 |
| Between 18 and 65 years | 62 | 58 | 120 |
| >=65 years | 48 | 54 | 102 |
| Age, Continuous(years) | BT524 | FFP/Cryo | Total |
|---|---|---|---|
| Mean | 61.2 ± 12.52 | 60.8 ± 14.07 | 61.0 ± 13.29 |
| Sex: Female, Male(Participants) | BT524 | FFP/Cryo | Total |
|---|---|---|---|
| Female | 67 | 64 | 131 |
| Male | 43 | 48 | 91 |
| Ethnicity (NIH/OMB)(Participants) | BT524 | FFP/Cryo | Total |
|---|---|---|---|
| Hispanic or Latino | 6 | 6 | 12 |
| Not Hispanic or Latino | 103 | 106 | 209 |
| Unknown or Not Reported | 1 | 0 | 1 |
| Race (NIH/OMB)(Participants) | BT524 | FFP/Cryo | Total |
|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 |
| Asian | 1 | 2 | 3 |
| Native Hawaiian or Other Pacific Islander | 0 | 1 | 1 |
| Black or African American | 0 | 1 | 1 |
| White | 109 | 107 | 216 |
| More than one race | 0 | 0 | 0 |
| Unknown or Not Reported | 0 | 1 | 1 |
| Region of Enrollment(participants) | BT524 | FFP/Cryo | Total |
|---|---|---|---|
| Czechia | 28 | 30 | 58 |
| Poland | 0 | 1 | 1 |
| United Kingdom | 48 | 50 | 98 |
| Switzerland | 9 | 9 | 18 |
| Germany | 14 | 9 | 23 |
| Spain | 11 | 13 | 24 |
| Expected Blood Loss(participants) | BT524 | FFP/Cryo | Total |
|---|---|---|---|
| >1000 mL to <=2000 mL | 44 | 48 | 92 |
| >2000 mL | 66 | 64 | 130 |
PDFs hosted by the registry, ClinicalTrials.gov.
Plan to share: No
Ran from Apr 2018 to primary completion in Sep 2023, 65 months.
Results were first posted in Jun 2025, 1 year 8 months after primary completion.
Of 19 phase 3 interventional studies under Hemostatic Disorders, half reached primary completion within 33 months of starting (the median), counting those still running; a quarter within 21 and three quarters within 46. This study's 65 months is above that.
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