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Study to Investigate Efficacy, Safety and Pharmacokinetics of BT595 in Subjects With PID

An Open-label, Prospective, Multicenter Study Investigating Clinical Efficacy, Safety, and Pharmacokinetic Properties of the Human Normal Immunoglobulin for Intravenous Administration BT595 as Replacement Therapy in Patients With Primary Immunodeficiency Disease (PID)

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02810444
Enrollment
81
Registered
2016-06-23
Start date
2016-10-04
Completion date
2020-04-01
Last updated
2023-07-20

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Primary Immunodeficiency Disease

Brief summary

This Phase III clinical study is to test efficacy, safety and pharmacokinetics of BT595 in treating patients with Primary Immunodeficiency (PID)

Interventions

BIOLOGICALIgG Next Generation (BT595)

Sponsors

Syneos Health
CollaboratorOTHER
Biotest
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
2 Years to 75 Years
Healthy volunteers
No

Inclusion criteria

Criteria for inclusion: 1. Written informed consent/assent obtained from subjects/subjects' parent(s) or legally acceptable representative indicating that they understood the purpose of, and procedures required for the study and are willing to participate in it. 2. Male or female, aged 2 through 75 years, inclusive. 3. Diagnosis of PID with impaired antibody production, ie: \- Diagnosis of common variable immunodeficiency (CVID) as defined by the European Society for Immunodeficiencies (ESID)/Pan American Group for Immunodeficiency (PAGID) diagnostic criteria. Or \- X-linked agammaglobulinaemia (XLA) as defined by ESID/PAGID diagnostic criteria. 4. Established replacement therapy with any immunoglobulin for intravenous administration (IVIg) reference preparation during the previous 6 months, including documentation of IgG trough levels. 5. Established replacement therapy with a single IVIg reference preparation for ≥3 months prior to treatment start with BT595 at a 3 week (Q3W) or 4 week (Q4W) schedule with a constant IVIg dose that did not change by ±20% of the mean dose, regular dosage intervals, and at least 1 IgG trough level of ≥5 g/L during the previous 3 months. Criteria for exclusion: 1. Pregnancy or unreliable contraceptive measures or lactation period (females only). 2. Known intolerance to immunoglobulins or comparable substances (eg, vaccination reaction). 3. Known intolerance to proteins of human origin or known allergic reactions to components of the study product. 4. Participation in another clinical study within 30 days before entering the study or during the study and/or previous participation in this study. 5. Employee or direct relative of an employee of the contract research organization, the study site, or Biotest. 6. Acquired medical conditions known to cause secondary immune deficiency, such as chronic lymphatic leukemia, lymphoma, multiple myeloma, as well as protein losing enteropathies and hypoalbuminemia. 7. Other medical condition, laboratory finding, or physical examination finding that precludes participation. 8. Recent febrile illness that precludes or delays participation. 9. Active infection and receiving antibiotic therapy for the treatment of this infection at the time of screening. Note: if the subject was deemed to be a screen failure due to a nonserious active infection requiring antibiotic therapy, the subject may have been rescreened after the initial screening. 10. Therapy with systemic steroids or other immunosuppressant drugs at the time of enrollment (current daily use of corticosteroids, ie, \>10 mg prednisone equivalent/day for \>30 days. Intermittent corticosteroid use during the study was allowable, if medically necessary). 11. History of thrombotic events (including myocardial infarction, cerebral vascular accident \[including stroke\], pulmonary embolism, and deep vein thrombosis) within the 6 months before treatment start with BT595 or the presence of significant risk factors for thrombotic events. 12. Therapy with live-attenuated virus vaccines within 3 months before start of the study. 13. Selective, absolute immunoglobulin A (IgA) deficiency or known antibodies to IgA. 14. Positive diagnosis of hepatitis B or hepatitis C. 15. Positive human immunodeficiency virus (HIV) test. 16. History of drug or alcohol abuse within the 12 months before treatment start with BT595. 17. Inability or lacking motivation to participate in the study.

Design outcomes

Primary

MeasureTime frameDescription
Rate of Acute Serious Bacterial Infectionsapprox. 12 month treatment periodThe primary efficacy endpoint was the rate of acute serious bacterial infections, ie, the mean number of acute serious bacterial infections \[SBIs as defined by EMA and FDA\] per subject-year.

Secondary

MeasureTime frameDescription
IgG Trough Levels (Total IgG) Before Each Infusionapprox. 12 month treatment periodTotal IgG levels \[g/L\] before each infusion, mean (SD)
Rate of Any Infectionsapprox. 12 month treatment periodThe annual rate of infections was calculated as the number of all infections (serious plus nonserious) per subject-year
Rate of Nonserious Infectionsapprox. 12 month treatment periodThe annual rate of nonserious infections was calculated as the number of nonserious infections per subject-year
Time to Resolution of Infectionsapprox. 12 month treatment periodTime to resolution of infections (days) was calculated as infection stop date - infection start date +1.
Antibiotic Treatment Informationapprox. 12 month treatment periodMedian (min-max) number of days on antibiotics treatment per subject
Rate of Time Lost From School/Work Due to Infectionsapprox. 12 month treatment periodAnnual rates of the number of days subjects are not able to attend school/work due to infections and their treatment will be calculated per subject-year.
Hospitalization / Hospitalization Due to Infectionapprox. 12 month treatment periodAnnual rates of the number of days of hospitalization (any hospitalization/ hospitalization due to infection) will be calculated per subject-year.
Fever Episodesapprox. 12 month treatment periodThe number of days with episodes of fever will be calculated as the number of fever episodes per subject-year. Fever is defined as a body temperature ≥38°C (≥100.4°F).

Countries

Germany, Hungary, Russia, Spain, United States

Participant flow

Participants by arm

ArmCount
BT595
Subjects received BT595 (100 mg/mL human normal immunoglobulin) at doses between 0.2 and 0.8 g per kg body weight (bw) (2 to 8 mL/kg bw), either at a Q3W or Q4W schedule. The initial doses and dosage interval had to be consistent with the subject's prestudy IVIg treatment.
67
Total67

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyAdverse Event3
Overall StudyScreen Failures14
Overall StudyWithdrawal by Subject4

Baseline characteristics

CharacteristicBT595
Age, Categorical
<=18 years
18 Participants
Age, Categorical
>=65 years
5 Participants
Age, Categorical
Between 18 and 65 years
44 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
Race (NIH/OMB)
Asian
1 Participants
Race (NIH/OMB)
Black or African American
0 Participants
Race (NIH/OMB)
More than one race
0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
White
66 Participants
Region of Enrollment
Germany
4 Participants
Region of Enrollment
Hungary
28 Participants
Region of Enrollment
Russia
11 Participants
Region of Enrollment
Spain
3 Participants
Region of Enrollment
United States
21 Participants
Sex: Female, Male
Female
30 Participants
Sex: Female, Male
Male
37 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
0 / 67
other
Total, other adverse events
63 / 67
serious
Total, serious adverse events
9 / 67

Outcome results

Primary

Rate of Acute Serious Bacterial Infections

The primary efficacy endpoint was the rate of acute serious bacterial infections, ie, the mean number of acute serious bacterial infections \[SBIs as defined by EMA and FDA\] per subject-year.

Time frame: approx. 12 month treatment period

Population: The primary analysis intended to demonstrate that the SBI rate (upper limit of the 1-sided 99% CI) was \<1.0 per subject-year in the overall FAS

ArmMeasureValue (NUMBER)
BT595Rate of Acute Serious Bacterial Infections0.015 SBI rate per subject-year
Secondary

Antibiotic Treatment Information

Median (min-max) number of days on antibiotics treatment per subject

Time frame: approx. 12 month treatment period

Population: Full analysis set

ArmMeasureValue (MEDIAN)
BT595Antibiotic Treatment Information6.0 days
Secondary

Fever Episodes

The number of days with episodes of fever will be calculated as the number of fever episodes per subject-year. Fever is defined as a body temperature ≥38°C (≥100.4°F).

Time frame: approx. 12 month treatment period

Population: Full analysis set

ArmMeasureValue (NUMBER)
BT595Fever Episodes1.69 days per subject-year
Secondary

Hospitalization / Hospitalization Due to Infection

Annual rates of the number of days of hospitalization (any hospitalization/ hospitalization due to infection) will be calculated per subject-year.

Time frame: approx. 12 month treatment period

Population: Full analysis set

ArmMeasureGroupValue (NUMBER)
BT595Hospitalization / Hospitalization Due to InfectionAny Hospitalization0.70 days per subject-year
BT595Hospitalization / Hospitalization Due to InfectionHospitalization due to Infection0.36 days per subject-year
Secondary

IgG Trough Levels (Total IgG) Before Each Infusion

Total IgG levels \[g/L\] before each infusion, mean (SD)

Time frame: approx. 12 month treatment period

Population: Full analysis set

ArmMeasureGroupValue (MEAN)Dispersion
BT595IgG Trough Levels (Total IgG) Before Each InfusionScreening, Q4W8.467 g/LStandard Deviation 3.4562
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 7 (Week 18), Q3W10.032 g/LStandard Deviation 2.2755
BT595IgG Trough Levels (Total IgG) Before Each InfusionBaseline, Q4W7.824 g/LStandard Deviation 2.7705
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 1 (Week 0), Q4W7.824 g/LStandard Deviation 2.7705
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 2 (Week 4), Q4W8.278 g/LStandard Deviation 2.5919
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 3 (Week 8), Q4W8.246 g/LStandard Deviation 2.397
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 4 (Week 12), Q4W8.410 g/LStandard Deviation 2.2998
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 5 (Week 16), Q4W8.634 g/LStandard Deviation 3.4997
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 6 (Week 20), Q4W8.203 g/LStandard Deviation 2.2912
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 7 (Week 24), Q4W8.298 g/LStandard Deviation 2.3822
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 8 (Week 28), Q4W8.308 g/LStandard Deviation 2.1087
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 9 (Week 32), Q4W8.410 g/LStandard Deviation 2.2353
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 10 (Week 36), Q4W8.264 g/LStandard Deviation 2.2994
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 11 (Week 40), Q4W8.181 g/LStandard Deviation 2.1706
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 12 (Week 44), Q4W8.336 g/LStandard Deviation 2.0893
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 13 (Week 48), Q4W8.479 g/LStandard Deviation 2.3571
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 14 (Week 52), Q4W8.437 g/LStandard Deviation 2.1703
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 15 (extra dose administered), Q4W8.950 g/LStandard Deviation 0.6608
BT595IgG Trough Levels (Total IgG) Before Each InfusionFollow-up, Q4W8.461 g/LStandard Deviation 2.2248
BT595IgG Trough Levels (Total IgG) Before Each InfusionScreening, Q3W10.238 g/LStandard Deviation 2.47
BT595IgG Trough Levels (Total IgG) Before Each InfusionBaseline, Q3W10.064 g/LStandard Deviation 2.6829
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 1 (Week 0), Q3W10.261 g/LStandard Deviation 2.7216
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 2 (Week 3), Q3W10.422 g/LStandard Deviation 2.9521
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 3 (Week 6), Q3W10.509 g/LStandard Deviation 2.9857
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 4 (Week 9), Q3W10.050 g/LStandard Deviation 3.0155
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 5 (Week 12), Q3W10.267 g/LStandard Deviation 3.2398
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 6 (Week 15), Q3W10.026 g/LStandard Deviation 3.2135
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 8 (Week 21), Q3W10.268 g/LStandard Deviation 2.7719
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 9 (Week 24), Q3W9.889 g/LStandard Deviation 2.1752
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 10 (Week 27), Q3W10.343 g/LStandard Deviation 2.2324
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 11 (Week 30), Q3W10.188 g/LStandard Deviation 2.6981
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 12 (Week 33), Q3W10.427 g/LStandard Deviation 2.732
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 13 (Week 36), Q3W10.087 g/LStandard Deviation 2.6267
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 14 (Week 39), Q3W10.245 g/LStandard Deviation 2.4434
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 15 (Week 42), Q3W10.539 g/LStandard Deviation 2.249
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 16 (Week 45), Q3W10.045 g/LStandard Deviation 2.7147
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 17 (Week 48), Q3W9.877 g/LStandard Deviation 2.019
BT595IgG Trough Levels (Total IgG) Before Each InfusionInfusion 18 (Week 51), Q3W10.412 g/LStandard Deviation 2.4921
BT595IgG Trough Levels (Total IgG) Before Each InfusionFollow-up, Q3W10.415 g/LStandard Deviation 2.6176
Secondary

Rate of Any Infections

The annual rate of infections was calculated as the number of all infections (serious plus nonserious) per subject-year

Time frame: approx. 12 month treatment period

Population: Full analysis set

ArmMeasureValue (NUMBER)
BT595Rate of Any Infections2.80 infections per subject-year
Secondary

Rate of Nonserious Infections

The annual rate of nonserious infections was calculated as the number of nonserious infections per subject-year

Time frame: approx. 12 month treatment period

Population: Full analysis set

ArmMeasureValue (NUMBER)
BT595Rate of Nonserious Infections2.74 infections per subject-year
Secondary

Rate of Time Lost From School/Work Due to Infections

Annual rates of the number of days subjects are not able to attend school/work due to infections and their treatment will be calculated per subject-year.

Time frame: approx. 12 month treatment period

Population: Full analysis set

ArmMeasureValue (NUMBER)
BT595Rate of Time Lost From School/Work Due to Infections4.32 days per subject-year
Secondary

Time to Resolution of Infections

Time to resolution of infections (days) was calculated as infection stop date - infection start date +1.

Time frame: approx. 12 month treatment period

Population: Full analysis set

ArmMeasureValue (MEDIAN)
BT595Time to Resolution of Infections7.0 days

Source: ClinicalTrials.gov · Data processed: Feb 11, 2026