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Fibrin Sealant, Vapor Heated, Solvent/Detergent-treated with/mL thrombin and synthetic aprotinin

Phase 3

Deep Partial or Full Thickness Wounds | Monoclonal antibody | Dermatology |Baxter International Inc.|Last Updated: Apr 20, 2017

Target and mechanism

ModalityMonoclonal antibody

Also known as Fibrin Sealant

Success Probability

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Market & Valuation

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Trial Design

RandomizedACTIVE_CONTROLLED
Total Trials1
Total Enrollment150

FDA Designations

No designations recorded

Clinical trial landscape

Fibrin Sealant, Vapor Heated, Solvent/Detergent-treated with/mL thrombin and synthetic aprotinin · 5 trials · 6 indications

Phase 3 3Phase 2 2
NCT00892957FS VH S/D 500 S-apr in Vascular SurgeryHemostasis in Participants Receiving Peripheral Vascular Expanded Polytetrafluoroethylene (ePTFE) Graft Prostheses
COMPLETED176 Analytics
NCT00157131Safety and Efficacy Study of FS 4 IU VH S/D (Fibrin Sealant With 4IU/mL Thrombin, Vapor Heated, Solvent/Detergent Treated) to Adhere Split Thickness Skin Grafts and Improve Wound Healing in Burn PatientsDeep Partial or Full Thickness Wounds
COMPLETED150 Analytics
NCT00161915Efficacy and Safety of Endoscopic Injection of Fibrin Sealant Versus Endoscopic Ligature for Bleeding Esophageal VaricesEsophageal and/or Gastric Varices
COMPLETED- Analytics
PHASE3COMPLETED
FS VH S/D 500 S-apr in Vascular Surgery
Hemostasis in Participants Receiving Peripheral Vascular Expanded Polytetrafluoroethylene (ePTFE) Graft ProsthesesUnlock trial analytics
PHASE3COMPLETED
Safety and Efficacy Study of FS 4 IU VH S/D (Fibrin Sealant With 4IU/mL Thrombin, Vapor Heated, Solvent/Detergent Treated) to Adhere Split Thickness Skin Grafts and Improve Wound Healing in Burn Patients
Deep Partial or Full Thickness WoundsUnlock trial analytics
PHASE3COMPLETED
Efficacy and Safety of Endoscopic Injection of Fibrin Sealant Versus Endoscopic Ligature for Bleeding Esophageal Varices
Esophageal and/or Gastric VaricesUnlock trial analytics

Study Endpoints

Primary Endpoints

Percentage of Participants Who Achieved Hemostasis at 4 Minutes Post Treatment Application.
4 minutes post start of treatment application

Hemostasis at the study suture line must be maintained until closure of the surgical wound.

Hemostasis at 4 Minutes After Treatment Application at the Suture Line by Bleeding Severity - Moderate Bleeding
4 minutes post start of treatment application

Investigators were shown videos of bleeding severities to standardize assessments. Moderate bleeding defined as: * Either \>25% of the suture line bleeds, or * ≥5 suture line bleedings were present, if counting of suture line bleedings was possible, or * 1 pulsatile suture line bleeding was present.

Hemostasis at 4 Minutes After Treatment Application at the Suture Line by Bleeding Severity - Severe Bleeding
4 minutes post start of treatment application

Investigators were shown videos of bleeding severities to standardize assessments. Severe bleeding defined as: * Either \>50% of the suture line bleeds, or * ≥10 suture line bleedings were present, if counting of suture line bleedings was possible, or * \>1 pulsatile suture line bleeding was present, or * ≥1 spurting suture line bleeding was present.

Complete wound closure by Day 28 after treatment with either FS 4IU VH S/D or staples as determined by a blinded independent review of the Day 28 photographs
28 days after treatment
Adverse experiences (AEs) deemed possibly or probably related to treatment with FS 4IU VH S/D
12 months after treatment
Visual Comparison of Ecchymosis at Postoperative Day 3
Through Postoperative Day 3

Comparison between the FS VH S/D 4 treated side of the face and the side treated using standard of care (SoC) assessed by 5 separate blinded reviewers using standard digital photographs.

Incidence of Adverse Events (AEs) Related to Study Product (FS VH S/D 4) Throughout the Study Period
Through Postoperative Day 14 (± 1)
Incidence of Cerebrospinal Fluid (CSF) Leakage Observed After Surgery
33 +/- 3 days after surgery

Study-relevant CSF leakage is defined as one or more of following: 1. Discrete subcutaneous or subgaleal CSF collection (pseudomeningocele) in surgical area confirmed by positive test for β2-transferrin, or by computed tomography (CT) or magnetic resonance imaging (MRI) 2. Epidural CSF collection in surgical area depicted by CT or MRI 3. Leakage of CSF through surgical wound observed during physical examination, confirmed by a positive test for β2-transferrin 4. Progressive pneumatocephalus (air in subarachnoidal space) depicted by repeat CT in absence of CSF drainage.

Number of Participants With Cerebrospinal Fluid (CSF) Leakage Observed After Surgery
33 +/- 3 days after surgery

Study-relevant CSF leakage is defined as one or more of following: 1. Discrete subcutaneous or subgaleal CSF collection (pseudomeningocele) in surgical area confirmed by positive test for β2-transferrin, or by computed tomography (CT) or magnetic resonance imaging (MRI) 2. Epidural CSF collection in surgical area depicted by CT or MRI 3. Leakage of CSF through surgical wound observed during physical examination, confirmed by a positive test for β2-transferrin 4. Progressive pneumatocephalus (air in subarachnoidal space) depicted by repeat CT in absence of CSF drainage.

Secondary Endpoints

Percentage of Participants Who Achieved Hemostasis at 6 Minutes Post Treatment Application
6 minutes post start of treatment application
Percentage of Participants Who Achieved Hemostasis at 10 Minutes Post Treatment Application
10 minutes post start of treatment application
Percentage of Participants With Intraoperative Rebleeding After Hemostasis at Study Suture Line
Intraoperative day 0
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Study Design & Arms

AllocationRANDOMIZED
MaskingSINGLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
FS VH S/D 500 s-aprEXPERIMENTALFS VH S/D 500 s-apr will be applied to the study suture line.
Manual compression with surgical gauze padsACTIVE_COMPARATORDry gauze pads will be positioned to cover the complete study suture line.
FS 4IU VH S/DEXPERIMENTALFS 4IU VH S/D was administered intraoperatively to the wound bed by spray application using the TISSOMAT and Spray Set. Only the DUPLOJECTvii system and Spray Set (connection tube with sterile filter and spray head) device was used for simultaneous spray application of the study product. A thin layer of FS 4IU VH S/D was applied to the wound bed using a "painting motion" from side to side to achieve coverage. The recommended dosing volume was 2.0 to 4.0 mL/100 cm2. One 2-mL pack (4 mL total volume) of FS 4IU VH S/D applied using the TISSOMAT and Spray Set was sufficient to coat a wound bed of 100-200 cm2.
StaplesACTIVE_COMPARATORStaples are the current standard of care in burn surgery and are well accepted as the control in this type of study.
1EXPERIMENTALOne side of the face is treated with FS VH S/D 4; the other side of the face is treated using standard of care.
Standard of Care (Control group)ACTIVE_COMPARATORThe treatment of the control group consisted of Standard of Care (SoC) which was defined as the closure of a dura defect by suturing in a patch of autologous fascia, pericranium or suturable collagen based dura substitute.

Interventions

NameTypeDescription
Fibrin Sealant, Vapor Heated, Solvent/Detergent-treated with 500 IU/ml thrombin and synthetic aprotinin (FS VH S/D 500 s-apr)BIOLOGICALThe actual dose of FS VH S/D 500 s-apr will depend on the length of the suture line and the intensity of bleeding (but shall not exceed 4 mL FS VH S/D 500 s-apr).
Surgical gauze padsOTHERManual compression with surgical gauze pads
Fibrin Sealant, ARTISS 4IU/ml VH SDBIOLOGICALFS 4IU VH S/D, a two-component fibrin sealant with 4 IU/mL human thrombin, vapor heated, solvent detergent treated, provided in a frozen, ready-to-use formulation. Administration by a topical spray application using the TISSOMAT device and Spray Set.
StaplesOTHERAdministration by mechanical/multiple point fixation.
Fibrin SealantDRUG -
Fibrin Sealant with 4 IU/ml Thrombin, Vapor-Heated, Solvent Detergent Treated Containing Synthetic Aprotinin (FS VH S/D 4)BIOLOGICALEach subject received fibrin sealant with 4 IU/mL thrombin, vapor heated, solvent detergent treated containing synthetic aprotinin (FS VH S/D 4 ) to one side of the face. The dosing volume to be applied is 0.02 mL/cm2 to 0.04 mL/cm2. The study product will be applied to the subcutaneous plane in both the neck and the face area. The product will be applied using the spray device provided by the sponsor. (The other side of the face will be treated using standard of care.)
Standard of carePROCEDUREStandard care: defined as the closure of a dura defect by suturing in a patch of autologous fascia, pericranium or suturable collagen-based dura substitute.
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Eligibility Criteria

Age RangeN/A to 65 Years
SexALL
Healthy VolunteersNo
Study Sites22

Inclusion Criteria: Preoperative inclusion criteria: * Subjects undergoing vascular surgery (ie, conduit placement with an ePTFE graft), including arterio-arterial bypasses, including: * axillo-femoral * axillo-bifemoral * aorto-bifemoral * ilio-femoral * femoro-femoral * ilio-poplite...

Countries:United StatesGermanyCanada
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Frequently asked questions about Fibrin Sealant, Vapor Heated, Solvent/Detergent-treated with/mL thrombin and synthetic aprotinin

What is Fibrin Sealant, Vapor Heated, Solvent/Detergent-treated with 500 IU/mL thrombin and synthetic aprotinin?

It is a fibrin sealant product developed by Baxter International Inc. (ticker: BAX) for use in surgical and wound settings. It is a two-component biologic that combines a fibrinogen-containing sealant protein with thrombin and synthetic aprotinin to form a clot at the application site. It is investigational and in Phase 3 development.

What is Fibrin Sealant, Vapor Heated, Solvent/Detergent-treated with 500 IU/mL thrombin and synthetic aprotinin used for?

It is being studied for hemostasis in participants receiving peripheral vascular expanded polytetrafluoroethylene (ePTFE) graft prostheses, as well as for deep partial or full thickness wounds, esophageal and/or gastric varices, facial rhytidectomy (face-lift), and pathological processes in the posterior fossa. These are the indications under clinical investigation.

Who makes Fibrin Sealant, Vapor Heated, Solvent/Detergent-treated with 500 IU/mL thrombin and synthetic aprotinin?

Baxter International Inc., which trades under the ticker BAX, is the developer of this fibrin sealant. Baxter is the company responsible for its clinical development across the studied surgical and wound indications.

What phase is Fibrin Sealant, Vapor Heated, Solvent/Detergent-treated with 500 IU/mL thrombin and synthetic aprotinin in?

The program is in Phase 3 development. It is investigational and has not been approved by the FDA. The clinical program includes one completed Phase 3 trial and additional completed Phase 2 trials across several indications.

What clinical trials is Fibrin Sealant, Vapor Heated, Solvent/Detergent-treated with 500 IU/mL thrombin and synthetic aprotinin in?

Completed trials include NCT00892957, a Phase 3 study of FS VH S/D 500 S-apr in vascular surgery with 176 participants; NCT00708071, a Phase 2 face-lift study with 45 participants; NCT00681824, a Phase 2 dura suture sealing study with 95 participants; and NCT00161915, a Phase 3 study in bleeding esophageal varices.

Is Fibrin Sealant, Vapor Heated, Solvent/Detergent-treated with 500 IU/mL thrombin and synthetic aprotinin the same as ARTISS?

Yes, ARTISS is an alternative name for this product. Other names used include FS VH S/D 500 s-apr, Fibrin Sealant with 4 IU/mL Thrombin, Vapor-Heated, Solvent Detergent Treated Containing Synthetic Aprotinin (FS VH S/D 4), and Fibrin Sealant, ARTISS 4IU/mL VH SD.