Trial Outcomes & Findings for Efficacy and Safety Study of Augmentation Therapy With ARALAST Fraction IV-1 (Human Alpha 1 - Proteinase Inhibitor) (NCT NCT00396006)

NCT ID: NCT00396006

Last Updated: 2021-05-13

Results Overview

Median change BAL ELF antigenic α1-PI level the from baseline to post-treatment

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

21 participants

Primary outcome timeframe

BAL procedures were performed at baseline and after 8 consecutive weeks of treatment (minimum of 12 weeks)

Results posted on

2021-05-13

Participant Flow

Participants were recruited at 5 hospital sites in New Zealand and Australia. The period studied was 1 year and 2 months.

21 participants enrolled: 4 were screen failures (i.e., did not meet inclusion/exclusion criteria), 3 were discontinued due to unevaluable baseline bronchoalveolar lavage (BAL) samples, and 1 subject withdrew consent prior to receiving investigational product.

Participant milestones

Participant milestones
Measure
Participants Treated With ARALAST Fraction IV-1 (Fr. IV-1)
Weekly infusions of ARALAST Fr. IV-1 were administered to participants at a dosage of 60 mg/kg
Overall Study
STARTED
13
Overall Study
COMPLETED
13
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Efficacy and Safety Study of Augmentation Therapy With ARALAST Fraction IV-1 (Human Alpha 1 - Proteinase Inhibitor)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Participants Treated With ARALAST Fr. IV-1
n=13 Participants
Age, Categorical
<=18 years
0 Participants
n=99 Participants
Age, Categorical
Between 18 and 65 years
10 Participants
n=99 Participants
Age, Categorical
>=65 years
3 Participants
n=99 Participants
Age, Continuous
59.6 years
n=99 Participants
Sex: Female, Male
Female
6 Participants
n=99 Participants
Sex: Female, Male
Male
7 Participants
n=99 Participants
Region of Enrollment
Australia
8 Participants
n=99 Participants
Region of Enrollment
New Zealand
5 Participants
n=99 Participants

PRIMARY outcome

Timeframe: BAL procedures were performed at baseline and after 8 consecutive weeks of treatment (minimum of 12 weeks)

Population: Per protocol

Median change BAL ELF antigenic α1-PI level the from baseline to post-treatment

Outcome measures

Outcome measures
Measure
Per Protocol
n=10 Participants
Treated participants with no major protocol violations, evaluable pre- and post-treatment BAL procedures, and 8 consecutive weekly treatments.
Change in Bronchoalveolar Lavage (BAL) Epithelial Lining Fluid (ELF) Alpha1-Proteinase Inhibitor (α1-PI) Level
0.28 μM
Interval -0.24 to 4.9

PRIMARY outcome

Timeframe: During 8 consecutive weeks of treatment

Population: Intent to treat

Outcome measures

Outcome measures
Measure
Per Protocol
n=13 Participants
Treated participants with no major protocol violations, evaluable pre- and post-treatment BAL procedures, and 8 consecutive weekly treatments.
The Number of Adverse Events (AEs) Related to the Infusion of ARALAST Fr. IV 1 Administered at a Rate of 0.2 mL/kg/Min
0 adverse events

PRIMARY outcome

Timeframe: During 8 consecutive weeks of treatment

Number of decreases in the rate or discontinuations of infusion at 0.2 mL/kg/min

Outcome measures

Outcome measures
Measure
Per Protocol
n=13 Participants
Treated participants with no major protocol violations, evaluable pre- and post-treatment BAL procedures, and 8 consecutive weekly treatments.
Number of Changes in the Rate of Infusion
0 infusions

SECONDARY outcome

Timeframe: BAL procedures were performed at baseline and after 8 consecutive weeks of treatment (minimum of 12 weeks)

Population: Per protocol

Median ratio of post- to pre-treatment BAL ELF ANEC levels

Outcome measures

Outcome measures
Measure
Per Protocol
n=2 Participants
Treated participants with no major protocol violations, evaluable pre- and post-treatment BAL procedures, and 8 consecutive weekly treatments.
Ratio of Post- to Pre-treatment BAL ELF Antineutrophil Elastase Capacity (ANEC) Levels
1.22 μM
Interval 0.63 to 1.81

SECONDARY outcome

Timeframe: BAL procedures were performed at baseline and after 8 consecutive weeks of treatment (minimum of 12 weeks)

Population: No per protocol subject had both pre- and post-treatment analytes available, therefore no analysis could be performed on this outcome measure

Median change in the ratio of BAL ELF α1-PI to HNE complex concentration from baseline to post-treatment

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Blood samples were collected at baseline and after 8 consecutive weeks of treatment

Population: Per protocol

Mean change in the plasma level of α1-PI from baseline to post-treatment

Outcome measures

Outcome measures
Measure
Per Protocol
n=12 Participants
Treated participants with no major protocol violations, evaluable pre- and post-treatment BAL procedures, and 8 consecutive weekly treatments.
Change in the α1-PI Plasma Level
10.34 μM
Standard Deviation 2.50

SECONDARY outcome

Timeframe: Blood samples were collected at baseline and after 8 consecutive weeks of treatment

Population: Per protocol

Mean change in the plasma ANEC level from baseline to post-treatment

Outcome measures

Outcome measures
Measure
Per Protocol
n=12 Participants
Treated participants with no major protocol violations, evaluable pre- and post-treatment BAL procedures, and 8 consecutive weekly treatments.
Change in the Plasma Antineutrophil Elastase Capacity (ANEC) Level
9.46 μM
Standard Deviation 2.31

SECONDARY outcome

Timeframe: During 8 consecutive weeks of infusion

Population: Intention to treat

Clinically significant changes in vital signs from pre- to post-infusion are: • Heart rate: 25% increase above pre-infusion value • Blood pressure: ≥ 30 mm Hg change from pre-infusion blood pressure (systolic or diastolic) • Temperature: an increase in body temperature to \>38°C (\>100.4°F). If the pre-infusion body temperature was already \>38°C (\>100.4°F), then any further increase in body temperature by 1.1°C (1.98°F) or more was considered clinically significant. • Respiratory rate: 25% increase above pre-infusion value

Outcome measures

Outcome measures
Measure
Per Protocol
n=13 Participants
Treated participants with no major protocol violations, evaluable pre- and post-treatment BAL procedures, and 8 consecutive weekly treatments.
Clinically Significant Changes in Vital Signs From Pre- to Post-Infusion
2 # Clinically significant events

OTHER_PRE_SPECIFIED outcome

Timeframe: BAL procedures were performed at baseline and after 8 consecutive weeks of treatment (minimum of 12 weeks)

Population: Per protocol population with both pre- and post-treatment analytes available from BAL procedures

Median change in the BAL ELF Free Neutrophil Elastase Level from baseline to post-treatment

Outcome measures

Outcome measures
Measure
Per Protocol
n=3 Participants
Treated participants with no major protocol violations, evaluable pre- and post-treatment BAL procedures, and 8 consecutive weekly treatments.
Change in the BAL ELF Free Neutrophil Elastase Level
41.17 nM
Interval 3.91 to 41.61

OTHER_PRE_SPECIFIED outcome

Timeframe: BAL procedures were performed at baseline and after 8 consecutive weeks of treatment (minimum of 12 weeks)

Population: Per protocol

Median ratio of post- to pre-treatment BAL ELF Total Neutrophil Elastase Level

Outcome measures

Outcome measures
Measure
Per Protocol
n=5 Participants
Treated participants with no major protocol violations, evaluable pre- and post-treatment BAL procedures, and 8 consecutive weekly treatments.
Ratio of Post- to Pre-treatment BAL ELF Total Neutrophil Elastase Level
1.24 nM
Interval 0.47 to 30.97

OTHER_PRE_SPECIFIED outcome

Timeframe: BAL procedures were performed at baseline and after 8 consecutive weeks of treatment (minimum of 12 weeks)

Population: Per protocol

Median ratio of post- to pre-treatment BAL ELF IL-8 Level

Outcome measures

Outcome measures
Measure
Per Protocol
n=6 Participants
Treated participants with no major protocol violations, evaluable pre- and post-treatment BAL procedures, and 8 consecutive weekly treatments.
Ratio of Post- to Pre-treatment BAL ELF Interleukin 8 (IL-8) Level
1.46 pg/mL
Interval 0.48 to 10.38

OTHER_PRE_SPECIFIED outcome

Timeframe: BAL procedures were performed at baseline and after 8 consecutive weeks of treatment (minimum of 12 weeks)

Population: Per protocol population with both pre- and post-treatment analytes available from BAL procedures

Median change in the BAL ELF TNF-α from baseline to post-treatment

Outcome measures

Outcome data not reported

Adverse Events

Intent to Treat

Serious events: 1 serious events
Other events: 7 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Intent to Treat
n=13 participants at risk
Treated participants with relevant assessments, e.g. if pre- and post-treatment BAL procedures were required to assess the parameter, then the participant had both evaluable BAL procedures.
Investigations
Hepatitis A antibody positive
7.7%
1/13 • Number of events 1 • 1 year, 2 months

Other adverse events

Other adverse events
Measure
Intent to Treat
n=13 participants at risk
Treated participants with relevant assessments, e.g. if pre- and post-treatment BAL procedures were required to assess the parameter, then the participant had both evaluable BAL procedures.
General disorders
Inflammation
7.7%
1/13 • Number of events 1 • 1 year, 2 months
General disorders
Sluggishness
15.4%
2/13 • Number of events 2 • 1 year, 2 months
General disorders
Vessel puncture site haematoma
7.7%
1/13 • Number of events 1 • 1 year, 2 months
Infections and infestations
Bronchitis
7.7%
1/13 • Number of events 1 • 1 year, 2 months
Infections and infestations
Sinusitis
7.7%
1/13 • Number of events 1 • 1 year, 2 months
Injury, poisoning and procedural complications
Contusion
7.7%
1/13 • Number of events 1 • 1 year, 2 months
Injury, poisoning and procedural complications
Post procedural complication
15.4%
2/13 • Number of events 3 • 1 year, 2 months
Investigations
Blood pressure systolic abnormal
7.7%
1/13 • Number of events 1 • 1 year, 2 months
Investigations
Respiratory rate increased
7.7%
1/13 • Number of events 1 • 1 year, 2 months
Musculoskeletal and connective tissue disorders
Back pain
7.7%
1/13 • Number of events 1 • 1 year, 2 months
Nervous system disorders
Migrane
7.7%
1/13 • Number of events 1 • 1 year, 2 months
Respiratory, thoracic and mediastinal disorders
Chest discomfort
7.7%
1/13 • Number of events 1 • 1 year, 2 months
Respiratory, thoracic and mediastinal disorders
Rhinorrhoea
7.7%
1/13 • Number of events 6 • 1 year, 2 months

Additional Information

Study Director

Shire

Phone: +1 866 842 5335

Results disclosure agreements

  • Principal investigator is a sponsor employee The data from the study shall be published (if applicable) by the sponsor. The investigators and the steering committee may be involved if agreed to by the sponsor. Neither the investigator nor any other person within his/her institution has the right to publish separately or individually without permission by the sponsor.
  • Publication restrictions are in place

Restriction type: OTHER