A Study to Evaluate the Pharmacokinetics, Safety, and Tolerability of Immune Globulin (Human) 10% (Gamunex-C) PEG Process (IVIG-PEG) Compared to Gamunex-C in Participants With Primary Humoral Immunodeficiency

NCT04561115 | Completed Phase 3 Results DMC FDA Drug

• 1 other identifier: GC1902
• Study Type: interventional
• Target: 33
• Locations: 1 country
• Sites: 10

Brief Summary

The purpose of this study is to demonstrate bioequivalence of IVIG-PEG with Gamunex-C (IVIG-C) at steady-state as determined by comparing total Immunoglobulin G (IgG) area under the concentration-time curve during the defined dosing interval (\[AUC0-τ\] either every 3 weeks \[AUC0-21 days\] or every 4 weeks \[AUC0-28 days\]) and maximum concentration in a dosing interval (Cmax) in participants diagnosed with primary humoral immunodeficiency (PI) currently receiving chronic IVIG replacement treatment.

Conditions

Primary Immunodeficiency

Outcome Measures

Primary Outcomes (2)

• AUC (0-7): Area Under the Concentration Time Curve Over a Dosing Interval of Either Every 3 Weeks [AUC0-21 Days] or Every 4 Weeks [AUC0-28 Days] for Total Immunoglobulin G (IgG)

  AUC (0-7 days) is calculated as AUC (0-21 days)/3 for subjects with a dosing frequency of every 3 weeks and as AUC(0-28 days)/4 for subjects with a dosing frequency of every 4 weeks.

  Pre-dose, within 10 minutes of last infusion completion, at 1, 3, 6, 24, 48 hours and 4, 7, 14 and 21 days (up to 3 weeks), and 28 days (up to 4 weeks - only for subjects on a 4-week dosing schedule) post-infusion

• Cmax: Maximum Concentration in a Dosing Interval for Total IgG

  Pre-dose, within 10 minutes of last infusion completion, at 1, 3, 6, 24, 48 hours, and 4, 7, 14, 21 and 28 days post-infusion (up to 4 weeks)

Secondary Outcomes (5)

• Rate of Serious Bacterial Infections (SBIs)

  Baseline up to 6 months for each period, i.e., overall GC treatment phase and overall IVIG-PEG treatment phase with an aggregate duration of up to 12 months

• Rate of Events Per Participant Per Year in Participants With Any Kind of Infection

  Baseline up to 6 months for each period, i.e., overall GC treatment phase and overall IVIG-PEG treatment phase with an aggregate duration of up to 12 months

• Rate of Days Per Person Per Year That Participants Were on Antibiotics

  Baseline up to 6 months for each period, i.e., overall GC treatment phase and overall IVIG-PEG treatment phase with an aggregate duration of up to 12 months

• Number of Participants Hospitalized Due to Infection

  Baseline up to 6 months for each period, i.e., overall GC treatment phase and overall IVIG-PEG treatment phase with an aggregate duration of up to 12 months

• Rate of Days of Work/School/Daily Activities Missed Per Participant Due to Infections and Their Treatment

  Baseline up to 6 months for each period, i.e., overall GC treatment phase and overall IVIG-PEG treatment phase with an aggregate duration of up to 12 months

Study Arms (2)

Gamunex-C

ACTIVE COMPARATOR

Participants received Gamunex-C by means of an infusion pump at a dose of 200 to 800 mg/kg per infusion at an infusion rate of 1 mg/kg/min or up to 8 mg/kg/min depending on participant tolerance. The participant's usual mg/kg dose (given on either a 3 or 4 week repeating schedule) was the same mg/kg dose and schedule that the participant was receiving prior to entering screening. This mg/kg dose and schedule were used throughout the study duration. Gamunex-C was administered every 3 weeks (±4 days) or 4 weeks (±4 days), depending on the participant's prior IVIG dosing schedule. The duration of Gamunex-C treatment included the Gamunex-C PK Phase (up to 4 weeks) plus the additional Gamunex-C Run-in Phase (up to 4.5 months) for participants not receiving Gamunex-C or not on a stable dose of Gamunex-C upon entering the trial. The approximate maximum duration was up to 6 months.

Biological: Gamunex-C

IVIG-PEG

EXPERIMENTAL

Participants received IVIG-PEG by means of an infusion pump at a dose of 200 to 800 mg/kg per infusion at an infusion rate of 1 mg/kg/min or up to 8 mg/kg/min depending on participant tolerance. IVIG-PEG was administered every 3 weeks (±4 days) or 4 weeks (±4 days), depending on the participant's prior IVIG dosing schedule. The duration of IVIG-PEG treatment included the IVIG-PEG Treatment Phase (up to 4.5 months) and the IVIG-PEG PK Phase (up to 4 weeks), for an approximate maximum of up to 6 months.

Biological: IVIG-PEG

Interventions

Gamunex-C BIOLOGICAL

Intravenous infusion.

Also known as: IVIG-C

Gamunex-C

IVIG-PEG BIOLOGICAL

Intravenous infusion.

IVIG-PEG

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Male or female between 18 and 75 years of age (inclusive) at Screening
• Documented and confirmed pre-existing diagnosis of PI with features of hypogammaglobulinemia requiring IV IgG replacement therapy including but not limited to the following humoral-based immunodeficiency syndromes (example, X-linked agammaglobulinemia, common variable immunodeficiency), and combined immunodeficiency syndromes without lymphocytopenia (example, hyper immunoglobulin M \[IgM\] immunodeficiency syndrome).
• IgG trough level ≥500 milligrams per deciliter (mg/dL) at screening visit. Note: Patients entering Group 1 must additionally have trough levels ≥500 mg/dL documented within the previous year. For patients entering Group 2, if Screening trough levels are not ≥500 mg/dL, the subject will be a Screen Failure, but may be rescreened following dose adjustment of their original IV IgG replacement therapy regimen and recording an IgG trough level ≥500 mg/dL
• Has not had an SBI within the last 6 months prior to screening or during the screening.
• Medical records are available to document diagnosis, previous infections, and treatment.
• Willing to comply with all aspects of the study protocol, including blood sampling, for the duration of the study.
• Signed and dated a written informed consent form (ICF) confirming his or her willingness to participate in study GC1902.

You may not qualify if:

• Has an acquired medical condition that is known to cause secondary immune deficiency such as chronic lymphocytic leukemia, lymphoma, multiple myeloma, chronic or recurrent neutropenia (absolute neutrophil count less than 1000per microliters (1000/μL) \[1.0 x 10\^9/L\]), or human immunodeficiency virus (HIV) infection/acquired immune deficiency syndrome (AIDS).
• Has isolated IgG subclass deficiency or an isolated specific antibody deficiency disorder, or transient hypogammaglobulinemia of infancy
• The subject has had a known serious adverse reaction to immunoglobulin or any severe anaphylactic reaction to blood or any blood-derived product.
• Has a history of thrombotic complications following IVIG therapy.
• Has a history of or current diagnosis of deep venous thrombosis (DVT) or thromboembolism (e.g., myocardial infarction, cerebrovascular accident or transient ischemic attack); history refers to an incident in the year prior to the Screening Visit or 2 episodes over lifetime or has thrombosis risk factors (e.g., prolonged immobilization, use of estrogens, indwelling central vascular catheters).
• Has a known hyperviscosity syndrome or hypercoagulable states.
• Has liver enzyme levels (alanine aminotransferase \[ALT\], aspartate aminotransferase \[AST\], gammaglutamyl transferase \[GGT\], or lactate dehydrogenase \[LDH\]) greater than 2.5 times the upper limit of normal (ULN) at the screening visit as defined by the testing laboratory.
• Has pre-existing renal impairment (defined by serum creatinine greater than 1.5 times the ULN or blood urea nitrogen \[BUN\] greater than 2.5 times the ULN, or any subject who is on dialysis) at the screening visit or any history of acute renal injury.
• Has clinically significant history of drug or alcohol abuse or dependence in the opinion of the Investigator (must be within the past 12 months and noted in the subject's medical records or documented at screening).
• Clinical evidence of any significant acute or chronic medical condition (e.g., renal disease or predisposing conditions for renal disease, coronary artery disease, or protein losing state) that, in the opinion of the Investigator, may interfere with the conduct of the study or may place the subject at undue medical risk.
• Females of childbearing potential who are pregnant, have a positive pregnancy test at Screening (human chorionic gonadotropin \[HCG\]-based assay), are breastfeeding, or unwilling to practice a highly effective method of contraception (eg, oral, injectable or implanted hormonal methods of contraception, placement of an intrauterine device \[IUD\] or intrauterine system \[IUS\], condom or occlusive cap with spermicidal foam/gel/film/cream/suppository, male sterilization, or true abstinence) throughout the study. Note: True abstinence: When this is in line with the preferred and usual lifestyle of the subject. (Periodic abstinence \[e.g., calendar, ovulation, symptothermal, postovulation methods\], declaration of abstinence for the duration of a trial, and withdrawal are not acceptable methods of contraception).
• Receiving any of the following medications: (a) immunosuppressants including chemotherapeutic agents, (b) immunomodulators, (c) long-term systemic corticosteroids defined as daily dose \>1 mg of prednisone equivalent/kg/day for \>30 days. Note: Intermittent courses not exceeding \>1mg of prednisone equivalent/kg/day for \>30 days would not exclude the subject. Inhaled or topical corticosteroids are allowed.
• Has uncontrolled arterial hypertension (systolic blood pressure \[SBP\] \>160 mm Hg and/or diastolic blood pressure \[DBP\] \>100 mm Hg)
• Has hemoglobin \<11 g/dL at the Screening Visit
• Unable or unwilling to provide a storage serum sample at the Screening Visit. Note: A pre-treatment serum sample to be stored at -94°F (-70ºC) for possible future testing is required.

Sponsors & Collaborators

• Grifols Therapeutics LLC: lead

Study Sites (10)

Alabama Allergy & Asthma Center

Birmingham, Alabama, 35209, United States

Location

Allergy Associates of the Palm Beaches PA

North Palm Beach, Florida, 33408, United States

Location

The South Bend Clinic Center for Research

South Bend, Indiana, 56617, United States

Location

Institute for Asthma and Allergy

Chevy Chase, Maryland, 20815, United States

Location

Washington University

St Louis, Missouri, 63141, United States

Location

Optimed Research, LLC

Columbus, Ohio, 43235, United States

Location

Allergy, Asthma and Immunology Center, P.C.

Tulsa, Oklahoma, 74136, United States

Location

Allergy Partners of North Texas Research

Dallas, Texas, 75230, United States

Location

AARA Research Center

Dallas, Texas, 75231, United States

Location

Allergy, Asthma & Immunology Clinic, P.A.

Irving, Texas, 75063, United States

Location

MeSH Terms

Conditions

Primary Immunodeficiency Diseases

Interventions

Hizentra

Condition Hierarchy (Ancestors)

Genetic Diseases, Inborn; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Immunologic Deficiency Syndromes; Immune System Diseases

Results Point of Contact

• Title: Rhonda Griffin
• Organization: Grifols Therapeutics LLC

rhonda.griffin@grifols.com

+1 919 757 1744

Publication Agreements

• PI is Sponsor Employee: No
• Restriction Type: OTHER
• Restrictive Agreement: Yes

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SEQUENTIAL
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Model Details: The study model for this is Single-Sequence crossover.

Study Record Dates

• First Submitted: September 10, 2020
• First Posted: September 23, 2020
• Study Start: September 2, 2020
• Primary Completion: March 28, 2022
• Study Completion: March 28, 2022
• Last Updated: June 5, 2023
• Results First Posted: June 5, 2023

Record last verified: 2023-06

Data Sharing

• IPD Sharing: Will not share

Locations

US (10)