ClinicalTrials.gg
RecruitingNCT07094087Updated Oct 15, 2026

Efficacy and Safety of 4F-PCC (4-Factor Prothrombin Complex Concentrate) in Adult Patients Undergoing Complex Cardiovascular Surgery With Cardiopulmonary Bypass (CPB)

A Phase 3 interventional study of BE1116 and FFP in Complex Cardiovascular Surgery With Cardiopulmonary Bypass, sponsored by CSL Behring. Recruiting at 24 sites in 4 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-10-15.

Sponsored by CSL Behring (part of CSL Limited) · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Started Sep 2025; still recruiting 1 year 1 month later.
Updated Oct 15, 2026Site recruiting status changedGo to Updates ↓
Phase
Phase 3
Study type
Interventional
Enrollment
200
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This is a phase 3, multicenter, randomized, open-label, parallel-group, controlled study to assess the efficacy and safety of BE1116 compared with fresh frozen plasma (FFP) in adult participants undergoing complex cardiovascular surgery with CPB. The primary purpose of the study is to compare the efficacy of BE1116 and FFP in correcting coagulation factor deficiencies in bleeding participants undergoing complex cardiovascular surgery with CPB.

02

Conditions studied

  • Complex Cardiovascular Surgery With Cardiopulmonary Bypass

Keywords

  • Cardiopulmonary bypass
  • Coagulopathic Bleeding
  • Coagulation factor deficiency
  • Prothrombin complex concentrates
  • Fresh frozen plasma
03

In context

Lead sponsor

CSL Behring is the lead sponsor of 145 studies on the registry; 17 are open to participants now.

Of its 24 completed or terminated interventional studies of FDA-regulated products, 17 (71%) have results posted.

First submitted after CSL Behring became part of CSL Limited.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

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.

Inclusion criteria

  • Adult greater than or equal to (≥) 18 years and has provided written .
  • Undergoing elective complex cardiovascular surgery requiring CPB, including procedures of the thoracic aorta (with or without additional cardiac interventions), aortic valve replacement + coronary artery bypass graft (CABG), complex valve surgeries, mitral valve repair + CABG, and mitral valve replacement + CABG and reoperative CABG. Reoperative procedures are permitted. Excluded surgeries are as follows: heart transplantation, insertion or removal of ventricular assist devices (except for intra-aortic balloon pumps), and acute repair of thoracoabdominal aneurysms.
  • Coagulation factor replacement (ie, 4F-PCC or FFP) is ordered in the operating room for the management of bleeding, in accordance with accepted clinical standards. The following criteria must be met:
  • ≥ 1.6 (point-of-care INR testing by Hemochron ≥ 5 to 10 minutes after protamine infusion for heparin reversal). If a participant needs a second dose of protamine, a new INR measurement should be performed to confirm eligibility.
  • Significant microvascular hemorrhage (ie, not due to surgical complications), as defined by a BSS score of ≥ 2.

Exclusion criteria

Exclusion Criteria:

  • Administration of any systemic hemostatic therapy, such as cryoprecipitate, , FFP, PCC (eg, 4-factor / 3-factor PCC [4F-PCC / 3F-PCC]), Factor VIII (FVIII) inhibitor bypassing activity (FEIBA), recombinant activated Factor VIIa (rFVIIa), or other coagulation factor products, in the 24 hours before study surgery, except when FFP is added to the CPB circuit.
Terms in these criteria, in plain language(3)

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.

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.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
200 participants (estimated)

Study arms

  • Experimental
    BE1116

    Biological: BE1116

  • Active comparator
    Fresh frozen plasma

    Biological: FFP

Interventions

  • BiologicalBE1116

    A single dose of BE1116 will be administered by intravenous (IV) infusion intraoperatively.

    Also known as: 4F-PCC

  • BiologicalFFP

    A single dose of FFP will be administered as investigational product (IP) by IV infusion intraoperatively.

06

What researchers measure

Primary outcomes

  1. Number of Participants With and Without a Successful Correction of Coagulation Factor Deficiency

    Successful correction ("yes" vs "no") of coagulation factor deficiency as measured by an international normalized ratio (INR) of less than or equal to (≤) 1.4 at 30 minutes after the end of IP infusion.

    Time frame: At Day 1 after IP infusion (30 minutes after the end of infusion)

Secondary outcomes

  1. Number of Participants With Effective or Not Effective Hemostatic Response from 30 Minutes to 24 Hours After the End of IP Infusion

    The hemostatic response will be recorded as either effective or not effective. 'Effective' is defined as no hemostatic intervention was required, whereas 'non effective' is defined as a hemostatic intervention was required in the period from 30 minutes to 24 hours after the end of IP infusion. Hemostatic intervention includes surgical re-intervention for bleeding and / or the administration of any systemic hemostatic agents.

    Time frame: Up to 24 hours after the end of IP infusion

  2. Number of Participants With and Without Successful Correction of Coagulation Factor Deficiency

    Successful correction ("Yes or No") of coagulation factor deficiency measured by a rotational thromboelastometry (ROTEM) extrinsically activated thromboelastometric test (EXTEM) clotting time (CT) ≤ 80 seconds or thromboelastography (TEG) reaction time ≤ 8 minutes. ROTEM and TEG are viscoelastic coagulation tests that quantify the process of clot formation and degradation.

    Time frame: At Day 1 after IP infusion (30 minutes after the end of infusion)

  3. Change in INR from Baseline

    Time frame: From baseline (before IP infusion), to 30 minutes, 6 hours, 24 hours, and 48 hours after the end IP infusion

  4. Number of Participants With Effective and Not Effective Hemostatic Response From the Start of IP Infusion to 24 Hours After the Start of IP Infusion

    The hemostatic response will be recorded as either effective or not effective. 'Effective' is defined as no hemostatic intervention was required, whereas 'non effective' is defined as a hemostatic intervention was required in the period from the start of IP infusion to 24 hours after the start of IP infusion. Hemostatic intervention includes surgical re-intervention for bleeding and / or the administration of any systemic hemostatic agents.

    Time frame: Up to 24 hours after the start of IP infusion

  5. Change in Z-Scores for ROTEM EXTEM CT and TEG Reaction Time

    Measurements on either ROTEM EXTEM CT or TEG reaction time will be collected. To combine these measurements, z-scores will be calculated for each method of measurement. The z-score standardizes each measurement by subtracting the mean and dividing by the standard deviation of the respective method.

    Time frame: From baseline (before IP infusion) to 30 minutes and 24 hours after the end IP infusion

  6. Change in Bleeding Severity Scale (BSS) Score From Baseline

    The BSS is a validated intraoperative scale used in clinical studies of hemostatic agents as a measure of bleeding severity. Bleeding is scored on a scale from 0 (no bleeding) to 4 (unidentified or inaccessible spurting or gush). A lower score indicates a better outcome.

    Time frame: From baseline (before IP infusion) to 30 minutes after end of IP infusion

  7. Number of Participants in Each Universal Definition for Perioperative Bleeding (UDPB) Class

    Bleeding is assessed based on 9 events occurring during surgery or within the first postoperative day. These 9 events will be used to determine UDPB class ranging from Class 0 to 5 as follows: Class 0 (insignificant), Class 1 (mild), Class 2 (moderate), Class 3 (severe), and Class 4 (massive).

    Time frame: During surgery (Day 1) and on the first postoperative day (Day 2)

  8. Total Number of Units of Allogeneic Blood Products (ABPs) Administered

    The ABPs include whole blood, cryoprecipitate, platelets, red blood cells (RBCs), and FFP (except the dose administered as IP). For the purposes of this study, a dose of fibrinogen concentrate will be counted as an ABP, because it is administered in lieu of cryoprecipitate.

    Time frame: From the start of IP infusion and up to 24 hours and 5 days after surgery

  9. Number of Units of Individual ABPs Administered

    The ABPs include whole blood, cryoprecipitate, platelets, RBCs, and FFP (except the dose administered as IP). For the purposes of this study, a dose of fibrinogen concentrate will be counted as an ABP, because it is administered in lieu of cryoprecipitate.

    Time frame: Up to 24 hours after the start of IP infusion

  10. Volume of Chest Tube Output

    Time frame: Up to 24 hours after the end of surgery

  11. Number of Participants Requiring Reoperation for Bleeding and for Other Reasons

    Time frame: Up to 30 days after surgery

  12. Duration of Mechanical Ventilation

    The duration of mechanical ventilation is defined as the number of days on mechanical ventilation after the study surgery. If there are multiple incidences of mechanical ventilation, the duration will be the sum of the number of days for all incidences.

    Time frame: Up to 30 days after surgery

  13. Duration of Primary Intensive Care Unit (ICU) Stay

    The duration of primary ICU stay is defined as the number of days in the ICU after the study surgery.

    Time frame: Up to 30 days after surgery

  14. Duration of Primary Hospital Stay

    The duration of primary hospital stay is defined as the duration in calendar days from the date of IP administration to the date of primary hospital discharge, or death in the hospital, or end of study (EOS) visit, whichever occurs first.

    Time frame: Up to 30 days after surgery

  15. Number of Deaths

    Time frame: Up to Day 1 during the primary hospital stay, and within 28 days following IP infusion

  16. Number of Participants With Treatment-Emergent Adverse Events (TEAEs), Serious TEAEs, and Adverse Events of Special Interest (AESIs)

    Time frame: Up to 30 days after IP infusion

  17. Change in Plasma Concentrations of Coagulation Factor II (FII), Factor VII (FVII), Factor IX (FIX), and Factor X (FX), and Proteins C and S From Baseline

    Time frame: From baseline to 30 minutes after the end of IP infusion

  18. Plasma Concentrations of Coagulation FII, FVII, FIX, and FX and Proteins C and S

    Time frame: Up to 48 hours after the end of IP infusion

07

Study locations

15 of 24 sites recruiting
08

References and documents

Individual participant data

Plan to share: Yes — CSL will consider on a case-by-case basis requests to share Individual Patient Data (IPD) with external bona-fide, qualified scientific and medical researchers. For information on the process and requirements for submitting a voluntary data sharing request for IPD, please contact CSL at clinicaltrials@cslbehring.com.

Supporting information: Study protocol, Statistical analysis plan

Time frame: Requests for IPD will generally be considered once review by major regulatory authorities (ie FDA, EMA) is complete and the primary publication is available.

Access criteria: Proposed research should seek to answer a previously unanswered important medical or scientific question. Applicable country specific privacy and other laws and regulations will be considered and may prevent sharing of IPD. If the request is approved and the researcher has executed an appropriate data sharing agreement, IPD that has been appropriately anonymized will be available.

No publications or documents are linked to this record.

09

Updates

1 registry update since Sep 25, 2026
Sites
4 sites changed recruiting status (4 now recruiting)
Show 4 sites
  • University of Chicago Medicine · Chicago, United StatesNot yet recruiting→Recruiting
  • University of Virginia Health System · Charlottesville, United StatesNot yet recruiting→Recruiting
  • University of Toronto - St. Michael's Hospital (SMH) - Keenan Research Centre for Biomedical Science · Toronto, CanadaNot yet recruiting→Recruiting
  • National Cerebral and Cardiovascular Center · Suita, JapanNot yet recruiting→Recruiting
Oct 15, 2026
Show all 1 update
  1. Oct 15, 2026
    4 sites changed recruiting status (4 now recruiting)
    Show 4 sites
    • University of Chicago Medicine · Chicago, United StatesNot yet recruiting→Recruiting
    • University of Virginia Health System · Charlottesville, United StatesNot yet recruiting→Recruiting
    • University of Toronto - St. Michael's Hospital (SMH) - Keenan Research Centre for Biomedical Science · Toronto, CanadaNot yet recruiting→Recruiting
    • National Cerebral and Cardiovascular Center · Suita, JapanNot yet recruiting→Recruiting
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07094087
Lead sponsor
CSL Behring
Responsible party
Sponsor
First posted
Jul 30, 2025
Start date
Sep 15, 2025
Primary completion
Apr 6, 2027 (estimated)
Completion
May 5, 2027 (estimated)
Last update
Oct 15, 2026

Study contacts

Trial Registration Coordinator
Contact
clinicaltrials@cslbehring.com
+1 610-878-4697
Study Director
study director · CSL Behring

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Four-factor Prothrombin Complex Concentrate

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