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Nonacog alfa

Phase 4

Hemophilia B | Monoclonal antibody | Hematology |Pfizer, Inc.|Trials Updated: Jul 25, 2016

Nonacog alfa development status

Highest phase Phase 4 (NCT04286412)
Phase scored for PFEPhase 3
Registered trials 10 across 5 sponsors since May 2002

Nonacog alfa target and mechanism

Molecular targetF9
Target classExogenous Protein
ModalityMonoclonal antibody

Also known as BeneFIX

Success Probability

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Market & Valuation

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Trial Design

UNCONTROLLEDDMC
Total Trials4
Total Enrollment92

FDA Designations

No designations recorded

Nonacog alfa clinical trials

Nonacog alfa · 4 trials · 1 indication

Phase 3 3Phase 1 1
NCT01335061Study To Compare On-Demand Treatment To A Prophylaxis Regimen Of BeneFIX In Subjects With Moderately Severe to Severe Hemophilia BHemophilia B
COMPLETED25 Analytics
NCT00866606Study Evaluating On-Demand Treatment With BeneFIX In Chinese SubjectsHemophilia B
COMPLETED35 Analytics
NCT00037557Study Evaluating rFIX; BeneFIX in Severe Hemophilia BHemophilia B
COMPLETED20 Analytics
PHASE3COMPLETED
Study To Compare On-Demand Treatment To A Prophylaxis Regimen Of BeneFIX In Subjects With Moderately Severe to Severe Hemophilia B
Hemophilia BUnlock trial analytics
PHASE3COMPLETED
Study Evaluating On-Demand Treatment With BeneFIX In Chinese Subjects
Hemophilia BUnlock trial analytics
PHASE3COMPLETED
Study Evaluating rFIX; BeneFIX in Severe Hemophilia B
Hemophilia BUnlock trial analytics

Study Endpoints

Primary Endpoints

Annualized Number of Bleeding Episodes.
2 years

The annualized bleed rate (ABR) or the annualized number of bleeding episodes per year, will be derived for each participant for each treatment period by using the following formula: ABR = number of bleeds / (Days on treatment period / 365.25) The number of bleeds for the ABR calculation includes all bleeds requiring treatment with factor IX product during the time on treatment.

Investigator Hemostatic Efficacy Assessment of Participants After 8 Hours Post Infusion
8 hours post infusion

Investigator Hemostatic Efficacy Assessment was based on response of bleeding episodes to BeneFIX treatment on 4-point rating scale: Excellent(1): definite pain relief or improvement in signs of bleeding starting within 8 hrs after infusion, with no additional infusion; Good(2): definite pain relief or improvement in signs of bleeding starting within 8 hrs or following infusion; Moderate(3): probable or slight improvement starting after 8 hours following infusion; No Response(4): no improvement at all between infusions or during 24 hour interval following an infusion, or condition worsens.

Investigator Hemostatic Efficacy Assessment of Participants After 24 Hours Post Infusion
24 hours post infusion

Investigator Hemostatic Efficacy Assessment was based on response of bleeding episodes to BeneFIX treatment on 4-point rating scale: Excellent(1): definite pain relief or improvement in signs of bleeding starting within 8 hrs after infusion, with no additional infusion; Good(2): definite pain relief or improvement in signs of bleeding starting within 8 hrs or following infusion; Moderate(3): probable or slight improvement starting after 8 hours following infusion; No Response(4): no improvement at all between infusions or during 24 hour interval following an infusion, or condition worsens.

Percentage of Participants With FIX Inhibitor Development
Baseline up to 6 months

Incidence of FIX inhibitor was defined as any result determined as positive at local laboratory, and confirmed at central laboratory with Nijmegen assay result \>=0.6 Bethesda Unit (BU). Incidence was stratified by participant exposure history - Minimally Treated Patients (MTPs): those who had received at least one prior FIX infusion, and \<= 100 documented Exposure Days (EDs); while Previously Treated Patients (PTPs): those who had received \>100 documented prior EDs. When number of prior EDs for an individual was not known to be at least 100, participants were included in the MTP population.

To characterize the safety and efficacy of rFIX in children less than 6 years of age with severe hemophilia B in the setting of acute bleeding episodes, prophylaxis, and/or surgery.
Maximum Observed Plasma Concentration (Cmax)
Pre-dose, 0.25, 0.5, 1, 3, 6, 9, 24, 50, 72 and 96 hours post-dose
Area Under the Concentration Time Curve From Time 0 to the Time of the Last Quantifiable Concentration (AUClast)
Pre-dose, 0.25, 0.5, 1, 3, 6, 9, 24, 50, 72 and 96 hours post-dose
Area Under the Concentration Time Curve From Time 0 to Infinity (AUCinf)
Pre-dose, 0.25, 0.5, 1, 3, 6, 9, 24, 50, 72 and 96 hours post-dose
Time to Reach Cmax (Tmax)
Pre-dose, 0.25, 0.5, 1, 3, 6, 9, 24, 50, 72 and 96 hours post-dose
Volume of Distribution at Steady State (Vss)
Pre-dose, 0.25, 0.5, 1, 3, 6, 9, 24, 50, 72 and 96 hours post-dose

Volume of distribution is defined as the theoretical volume in which the total amount of drug would need to be uniformly distributed to produce the desired blood concentration of a drug. Vss is the apparent volume of distribution at steady-state.

Terminal Phase Rate Constant (Kel)
Pre-dose, 0.25, 0.5, 1, 3, 6, 9, 24, 50, 72 and 96 hours post-dose

Linear regression of the log linear concentration time curve. Only those data points judged to describe the terminal log linear decline were used in the regression.

Mean Residence Time (MRT)
Pre-dose, 0.25, 0.5, 1, 3, 6, 9, 24, 50, 72 and 96 hours post-dose

AUMCinf/AUCinf, where AUMCinf is the area under the first moment curve from time 0 extrapolated to infinite time, calculated using the linear/log trapezoidal method.

Plasma Decay Half-Life (t½)
Pre-dose, 0.25, 0.5, 1, 3, 6, 9, 24, 50, 72 and 96 hours post-dose

Plasma decay half-life is the time measured for the plasma concentration to decrease by one half.

Systemic Clearance (CL)
Pre-dose, 0.25, 0.5, 1, 3, 6, 9, 24, 50, 72 and 96 hours post-dose

CL is a quantitative measure of the rate at which a drug substance is removed from the body.

Incremental Recovery
Pre-dose, 0.25, 0.5 and 1 hour post-dose

Incremental recovery: Increase in circulating increase in FIX activity for every IU of BeneFIX administered per kg of body weight.

Secondary Endpoints

Response to On-Demand Treatment for All Bleeding Episodes.
2 years
Number of Nonacog Alfa, Recombinant Factor IX (BeneFIX) Infusions Used to Treat Each Bleeding Episode.
2 years
Number of Breakthrough (Spontaneous/Non-Traumatic) Bleeds Within 48 Hours of a Prophylaxis Dose of BeneFIX.
2 years
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Study Design & Arms

AllocationNON_RANDOMIZED
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
BeneFIXOTHER -

Interventions

NameTypeDescription
Nonacog alfaBIOLOGICALPeriod 1: During on-demand period, dosing at the discretion of investigator.
BenefixBIOLOGICALBeneFIX for on-demand treatment of bleeding episodes were according to investigator prescription. FIX recovery was assessed by determining the FIX activity (FIX:C) levels in individual subjects. BeneFIX dosage for recovery assessments: single 75 IU/kg (±5 IU/kg) IV bolus infusion.
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Eligibility Criteria

Age Range12 Years to 65 Years
SexMALE
Healthy VolunteersNo
Study Sites17

Inclusion Criteria: * Documented history of moderately-severe to severe hemophilia B (FIX activity \</=2%). * Male subjects, aged 12 years to 65 years. * Subjects with at least 100 exposure days (EDs) to factor IX products. * Subjects with a minimum of 12 bleeding episodes, 6 of which must be joint...

Countries:BulgariaCanadaCroatiaMalaysiaMexicoPolandSingaporeSouth KoreaTurkey (Türkiye)ChinaUnited States
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Frequently asked questions about Nonacog alfa

What is nonacog alfa used for?

Nonacog alfa is used to treat hemophilia B, a bleeding disorder caused by deficient or defective coagulation factor IX. It is studied in patients with moderately severe to severe hemophilia B, including on-demand treatment of bleeding episodes and prophylaxis regimens. The clinical program enrolled males aged 12 years and older.

What does nonacog alfa target?

Nonacog alfa targets coagulation factor IX, encoded by the F9 gene. It is an exogenous protein that supplies functional factor IX to replace the missing or defective protein in hemophilia B, supporting the coagulation cascade and clot formation. Its target class is an exogenous protein rather than a small molecule or antibody.

Who makes nonacog alfa?

Nonacog alfa is developed by Pfizer, Inc., which trades under the ticker PFE. Pfizer is the sponsor responsible for the clinical development program in hemophilia B, including the Phase 3 study comparing on-demand treatment with a prophylaxis regimen.

What phase is nonacog alfa in?

Nonacog alfa is in Phase 3 clinical development for hemophilia B. The program includes one completed Phase 3 trial with 25 enrolled participants. It is an investigational product in this development stage and is not described as approved.

What clinical trials is nonacog alfa in?

Nonacog alfa has been studied in the Phase 3 trial NCT01335061, titled Study To Compare On-Demand Treatment To A Prophylaxis Regimen Of BeneFIX In Subjects With Moderately Severe to Severe Hemophilia B. The trial is completed, enrolled 25 participants, and was conducted in Bulgaria, Canada, Croatia, Malaysia, Mexico, Poland, Singapore, South Korea, and Turkey.