Severe Hemophilia A With an Inhibitor
Conditions
Keywords
Hemophilia A, Inhibitors
Brief summary
FENOC is a prospective, open-label, randomized, cross-over, multi-center study to investigate and compare the hemostatic effect and cost-efficacy of two different by-passing agents in the treatment of joint hemorrhages in subjects with severe hemophilia A and inhibitors. The study is designed as a clinical equivalency trial.
Detailed description
The incidence of inhibitors among people with severe hemophilia A has been documented as approximately 20-30% in several prospective studies. In such patients acute hemorrhages frequently occur and profoundly jeopardize health, with subsequent development of arthropathy. A common way of treating such bleeding episodes is to use bypassing agents. Among these agents the prothrombin complex concentrate FEIBA has been widely used for many years. More recently, recombinant factor VIIa (NovoSeven) has been added to the therapeutic options. While both products have been found effective in treating hemorrhages, the number of injections given for a bleeding episode has ranged widely, and it is so far unknown whether one of the products might have a better effect in certain patients.
Interventions
DRUGFEIBA and NovoSeven
Sponsors
Skane University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
2 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Congenital hemophilia A with an inhibitor and the need for by-passing agents in the case of joint bleeding. * An expected bleeding frequency of \>=3 joint bleeds per year. * Informed consent given. * Age of two or older.
Exclusion criteria
* Other congenital and acquired bleeding disorders. * Symptomatic liver disease. * Life expectancy \<12 months.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| -The hemostatic effect of treatment with a single dose of FEIBA with that of two doses of NovoSeven on joint hemorrhages after 6 hours. | — |
Secondary
| Measure | Time frame |
|---|---|
| The difference in pain, rated using the 100 mm visual analog scale (VAS) before treatment and after 2 (before the second dose of NovoSeven, 6, 12, 24, 36, and 48 hours. | — |
| The number of infusions required of each concentrate to stop the bleeding. | — |
| The hemostatic effect of treatment after 2, 12, 24 36, and 48 hours. | — |
| Cost-efficacy, analyzed on the basis of clinical response. | — |
| Correlation between thrombin generation in vitro with each concentrate and the in vivo clinical response. | — |
| The use of analgesics. | — |
Countries
Sweden
Outcome results
None listed