Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
Also known as BAX326, RIXUBIS, Coagulation Factor IX [Recombinant]
Recombinant factor IX · 4 trials · 1 indication
Assessment by the operating surgeon on a 4 point ordinal scale (according to the definitions provided below): - Excellent: Intraoperative blood loss was less than or equal to that expected for the type of procedure performed in a hemostatically normal participant (≤ 100% ) - Good: Intraoperative blood loss was up to 50% more than expected for the type of procedure performed in a hemostatically normal participant (101 - 150%) - Fair: Intraoperative blood loss was more than 50% of that expected for the type of procedure performed in a hemostatically normal participant (\> 150%) - None: Uncontrolled hemorrhage that was the result of inadequate therapeutic response despite proper dosing, necessitating a change of Factor IX concentrate
Actual intraoperative blood loss was determined by the drainage volume, if a drain was placed, and the estimated blood loss into swabs and towels during the procedure.
Predicted average/maximum blood loss minus actual blood loss. Prior to the surgery, the surgeon predicted the estimated volume (mL) of the expected average and maximum blood loss for the planned surgical intervention in a hemostatically normal individual of the same sex, age, and stature as the study participant for the intraoperative period.
The postoperative hemostatic efficacy was to be assessed by the operating surgeon according to the following criteria (4-point ordinal scale): - Excellent: Volume in drain was less than or equal than that expected for the type of procedure performed in a hemostatically normal participant (≤ 100% ) - Good: Volume in drain was up to 50% more than expected for the type of procedure performed in a hemostatically normal participant (101% - 150%) - Fair: Volume in drain was more than 50% of that expected for the type of procedure performed in a hemostatically normal participant (\> 150%) - None: Uncontrolled bleeding that was the result of inadequate therapeutic response despite proper dosing, necessitating a change of Factor IX concentrate
Assessment by the operating surgeon on a 4 point ordinal scale: - Excellent: Postoperative hemostasis achieved with BAX326 was as good or better than that expected for the type of surgical procedure performed in a hemostatically normal participant - Good: Postoperative hemostasis achieved with BAX326 was probably as good as that expected for the type of surgical procedure performed in a hemostatically normal participant - Fair: Postoperative hemostasis with BAX326 was clearly less than optimal for the type of procedure performed but was maintained without the need to change the Factor IX concentrate - None: Participant experienced uncontrolled bleeding that was the result of inadequate therapeutic response despite proper dosing, necessitating a change of Factor IX concentrate
Assessment by the operating surgeon on a 4 point ordinal scale: - Excellent: Postoperative hemostasis achieved with BAX326 was as good or better than that expected for the type of surgical procedure performed in a hemostatically normal participant - Good: Postoperative hemostasis achieved with BAX326 was probably as good as that expected for the type of surgical procedure performed in a hemostatically normal participant - Fair: Postoperative hemostasis with BAX326 was clearly less than optimal for the type of procedure performed but was maintained without the need to change the Factor IX concentrate - None: Participant experienced uncontrolled bleeding that was the result of inadequate therapeutic response despite proper dosing, necessitating a change of Factor IX concentrate
Postoperative blood loss was based on the drainage fluid and was only assessed for participants who had a drain placed during surgery.
Predicted average/maximum blood loss minus actual blood loss for participants who had a drain placed during surgery. Prior to the surgery, the surgeon will predict the estimated volume (mL) of the expected average and maximum blood loss for the planned surgical intervention in a hemostatically normal individual of the same sex, age, and stature as the study subject for the postoperative period until drain removal.
Daily weight-adjusted doses of BAX326 per participant were recorded from the day of surgery until postoperative Days 11+. Each category in outcome measure includes number of all, major and minor surgeries, respectively, if different from the totals.
Assessed for the intra- and postoperative periods.
Blood product transfusions consisted of packed red blood cells (PRBC) or fresh frozen plasma (FFP) or both.
Blood product transfusions consisted of packed red blood cells (PRBC) or fresh frozen plasma (FFP) or both.
If there was more than 2-dilution increase as compared to pre-study level at screening.
AUC0-72h (area under the plasma concentration/time curve from time 0 to 72 hours) was computed using the linear trapezoidal method. The concentration at 72 hours was interpolated from the two nearest sampling time points or extrapolated using the last quantifiable concentration and the terminal rate constant λz. λz was estimated from the slope of natural log-linear fitting to latter quantifiable concentrations, with largest adjusted R2.
Total AUC/Dose is also AUC0-inf (area under the plasma concentration/time curve from time 0 to infinity) and was defined as AUC0-t + Ct / λz, where t is the time of last quantifiable concentration, Ct is the last quantifiable concentration and λz is the terminal rate constant.
The MRT is the average time that the study product stays in the body (or plasma) and is calculated as: AUMC 0-inf / AUC 0-inf, where AUMC 0-inf was determined in a similar manner as AUC 0-inf.
CL is the volume of plasma which is completely cleared of study product per unit time and is calculated as the dose divided by the total area under the curve from 0 to infinity (AUC0-inf).
IR was defined as (C post-infusion - C pre-infusion) / Dose, where C post-infusion is the measured concentration achieved at 30±5 minutes for pre-surgical PK.
T1/2 was determined as ln2 / λz.
Vss was computed as CL·MRT.
IR was defined as (C post-infusion - C pre-infusion) / Dose, where C post-infusion is the measured concentration achieved at 15±5 minutes for the loading dose.
Possibly or probably related adverse events that occurred during or after first BAX326 infusion.
Computed using the linear trapezoidal method. The concentration at 72 hours was interpolated from the two nearest sampling time points or extrapolated using the last quantifiable concentration and the terminal rate constant λz. λz was estimated from the slope of natural log-linear fitting to latter quantifiable concentrations, with largest adjusted R\^2.
| Arm | Type | Description |
|---|---|---|
| BAX326 in Surgery | EXPERIMENTAL | BAX 326 (recombinant factor IX) in Surgery |
| BAX 326 | EXPERIMENTAL | - |
| BeneFIX | ACTIVE_COMPARATOR | Recombinant Factor IX (rFIX) |
| BAX326 < 6 years of age | EXPERIMENTAL | - |
| BAX326 6 to <12 years of age | EXPERIMENTAL | - |
| Name | Type | Description |
|---|---|---|
| Recombinant factor IX | BIOLOGICAL | Following a loading dose with BAX326, participants will receive BAX326 as a bolus infusion. The treatment regimen will be determined by the intensity and duration of the hemostatic challenge and the institution´s standard of care. The dose will be tailored to raise FIX concentration to at least 80%-100% of normal for major surgeries and to at least 30%-60% of normal for minor surgeries. |
| BAX 326 (Recombinant factor IX) | BIOLOGICAL | The treatment with BAX 326 will be at the discretion of the investigator and will consist of either twice weekly prophylactic treatment with 50 IU/kg, modified prophylaxis, or on-demand treatment. |
| BAX 326 | BIOLOGICAL | * Study Part 1: Pharmacokinetic (PK) Crossover with BAX326 and BeneFIX * Study Part 2: Open-label evaluation of prophylaxis and on-demand BAX326 only * Study Part 3: Open-label repeat of PK evaluation (repeat Study Part 1) with BAX326 only and same study participants as Study Part 1 |
| BeneFIX | BIOLOGICAL | * Study Part 1: Pharmacokinetic (PK) Crossover with BAX326 and BeneFIX. * BeneFIX only used in Part 1 of this study. * Study Part 2 and 3 only utilized BAX326 |
| BAX326 | BIOLOGICAL | All participants underwent a pharmacokinetic evaluation with BAX326 (recombinant Factor IX) followed by twice weekly prophylactic treatment for 6 months or for at least 50 exposure days, whichever occurred last. |
Main Inclusion Criteria: * Participant and/or legal representative has/have voluntarily provided signed informed consent. * Participant has severe (FIX level \< 1%) or moderately severe (FIX level 1-2%) hemophilia B (based on the one stage activated partial thromboplastin time (aPTT) assay), as tes...
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Recombinant factor IX is used to treat hemophilia B, a bleeding disorder caused by deficient or defective clotting factor IX. It is being developed as a replacement therapy for patients with this condition, including use in surgical settings. Takeda Pharmaceutical Company Limited is developing it under the designation BAX 326.
Recombinant factor IX targets factor IX, also known as F9, the coagulation protein that is missing or defective in hemophilia B. It is an exogenous protein designed to supply functional factor IX to support blood clotting. By providing this protein, it aims to restore the clotting activity that patients with hemophilia B lack.
Recombinant factor IX is developed by Takeda Pharmaceutical Company Limited, which trades under the ticker TAK. Takeda is the sponsor of the clinical program studying this agent in hemophilia B, including the completed Phase 3 surgery study BAX 326.
Recombinant factor IX is in Phase 3 development. It is an investigational agent and is not described as approved. The clinical program includes one completed Phase 3 trial, and no active trials are currently listed for this asset.
Recombinant factor IX has been studied in the Phase 3 BAX 326 Surgery Study in Hemophilia B Patients, registered as NCT01507896. That trial is completed and enrolled 30 participants aged 12 years and older across Argentina, Bulgaria, Chile, Colombia, Czechia, Poland, Romania, Russia, Ukraine, and the United Kingdom.
The BAX 326 surgery study, NCT01507896, was an uncontrolled Phase 3 trial of recombinant factor IX in hemophilia B patients undergoing surgery. It enrolled 30 participants of any sex, aged 12 years and older, and did not use randomization or double blinding. The study is completed.