Summary

for people ages up to 13 years (full criteria)
at San Francisco, California and other locations
study started
estimated completion
Tiffany Lin, MD

Description

Summary

This is a multi-center cohort study of approximately 250 previously untreated patients (PUPs) with congenital moderate to severe hemophilia A or B in a network of up to 50 US Hemophilia Treatment Centers (HTCs). Participants will be followed as they receive their first 50 exposure days (ED) to clotting factor replacement product, both prospectively and retrospectively. The data collected on evolving treatment practices will define the incidence and risk factors for inhibitor development during the high risk period of first 50 ED and improve the outcomes of this vulnerable population.

Official Title

US Cohort Study of Previously Untreated Patients (PUPs) With Congenital Hemophilia

Details

This multi-center, longitudinal, observational, prospective and retrospective study of previously untreated patients (PUPs) with moderate to severe hemophilia A or B during the initial 50 exposure days (ED) to clotting factor replacement product or until the development of a confirmed inhibitor. The Primary Investigators have designed the study to utilize the American Thrombosis and Hemostasis Network (ATHN) electronic infrastructure to leverage existing data and enable the collection of more in-depth clinical and laboratory data on PUPs. The study aligns with the National Hemophilia Foundation Medical and Scientific Advisory Council (MASAC) recently issued Recommendation #243 which includes: "Regardless of which option is chosen, all PUPs should be enrolled in the ATHN data collection system or a clinical trial to assess outcomes." Co-enrollment in the ATHNdataset by participants is required. The total study duration is planned for 6 years.

The primary objective is to determine the percentage of patients with confirmed inhibitors within the first 50 ED. Confirmed inhibitors are defined as two consecutive positive inhibitor titers (per CDC laboratory criteria; >0.5 Nijmegen Bethesda Units for hemophilia A and >0.3 Nijmegen Bethesda Units for hemophilia B) on different blood samples which result in change in treatment recommendations.

Please note - the treatment regimen will be at the discretion of the participants' hemophilia caregivers. No treatment products are being provided by the study nor will the participants be paid. However, inhibitor titer testing will be provided at no cost to participants by the Centers for Disease Control and Prevention (CDC).

All study procedures and follow-up will be timed to coincide with scheduled hemophilia care whenever possible. Ad hoc, quarterly follow-up, annual and final visits are for participants who have not met study endpoints (50 ED or inhibitor development) prior to enrollment.

Data collected will include eligibility, demographics, medical history (co-morbidities, surgery/procedures, immunizations and allergies), hemophilia history (severity, genotype and family history), birth history, inhibitor testing results, detailed treatment product(s) usage, bleeding events, bleeding disorder related medical visits during the study, and EUHASS adverse events.

Sub-studies

A number of sub-studies are planned with pharmaceutical sponsors to collect information from patients about their specific product use. Participation in these product specific sub-studies is optional and sub-study visits will be planned to coincide with HTC visits. The sub-study will collect information from patients about their perception and use of treatment products, physical activity levels and other general health questions. This data will be collected via questionnaire.

Data Collection System

All data collected will be entered into electronic case report forms (eCRFs) within the secure ATHN System by HTC site personnel. All participating study sites will have in place a current, executed Data Use and Business Associate Agreement (DUBAA) with ATHN.

Keywords

Hemophilia Hemophilia A Hemophilia B Hemophilia A With Inhibitor Hemophilia B With Inhibitor Haemophilia B Without Inhibitor Haemophilia A Without Inhibitor Haemophilia Previously Untreated Patients (PUPs) Clotting Factor Replacement Products

Eligibility

You can join if…

Open to people ages up to 13 years

  • Congenital hemophilia A; FVIII </=5% or congenital hemophilia B; FIX </=5%;
  • Birth date on or after January 1, 2010;
  • Care established at one of the participating HTCs;
  • Co-enrollment in the ATHNdataset; and
  • Parent or authorized guardian can provide informed consent

You CAN'T join if...

  • Patients who are referred to the HTC with no record of bleed and factor utilization data

Locations

  • UCSF Pediatric Hemophilia Treatment Center at Mission Bay not yet accepting patients
    San Francisco California 94158 United States
  • Valley Children's Hospital not yet accepting patients
    Madera California 93636 United States

Lead Scientist

  • Tiffany Lin, MD
    As a faculty member at UCSF Pediatric Hematology/Oncology, I see patients with pediatric hematologic and oncologic disorders although the majority of my time is spent in hematologic diseases such as patients with bleeding disorders, thromboses, immune cytopenias or aplastic anemia, bone marrow failure syndromes, and more.

Details

Status
accepting new patients
Start Date
Completion Date
(estimated)
Sponsor
American Thrombosis and Hemostasis Network
ID
NCT03818529
Study Type
Observational
Last Updated