About this trial
This is a Phase III, multicenter, open-label clinical study designed to evaluate the efficacy, safety, pharmacokinetics, and pharmacodynamics of emicizumab prophylaxis in participants aged 1 month and above, who have been diagnosed with Type 3 von Willebrand disease (VWD). Participants on prior standard of care (SOC) on-demand therapy will be assessed via a randomized comparison (Arm A - emicizumab prophylaxis and Arm B - continuation of SOC on-demand therapy), while participants on prior SOC prophylactic therapy (Arm C - emicizumab prophylaxis) will be assessed via intra-participant analysis with data obtained from the preceding non-interventional study (NIS), WP45335 (NCT06883240).
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Confirmed diagnosis of Type 3 von Willebrand disease (VWD), based on medical records
Preexisting medical record verifying the status of von Willebrand factor (VWF) inhibitor (positive or negative, including titer if available)
Adequate hematologic, hepatic, and renal function
For participants of childbearing potential: agreement to remain abstinent or adhere to the contraception requirements
Disqualifiers
Inherited or acquired bleeding disorder other than Congenital Type 3 VWD
History of gastrointestinal bleeding within 18 months prior to enrollment, or any previous diagnosis of angiodysplasia
History of intracranial hemorrhage
Previous or current treatment for thromboembolic disease or signs of thromboembolic disease
Trial design
Parallel
Treatments tested in this trial
Emicizumab
DrugParticipants will receive emicizumab 3 milligrams per kilogram (mg/kg) subcutaneous (SC) injections every week (QW) for the first 4 weeks as loading doses, followed by maintenance doses of emicizumab 3 mg/kg SC once every 2 weeks (Q2W). During the extension period, participants may remain on maintenance dose of emicizumab 3 mg/kg Q2W, or change their emicizumab maintenance regimen to 1.5 mg/kg once every week (QW) or 6 mg/kg once every 4 weeks (Q4W), if they prefer and if agreed by the investigators.
von Willebrand Factor (VWF) Concentrates
DrugUsed according to local labeling or local treatment guidelines.
Factor VIII (FVIII) Concentrates
DrugUsed according to local labeling or local treatment guidelines.
von Willebrand Factor (VWF) and Factor VIII (FVIII) Concentrates
DrugUsed according to local labeling or local treatment guidelines.
Bypassing Agents
DrugUsed according to local labeling or local treatment guidelines.
Treatment groups
Trial outcomes
Primary outcomes
Annualized Bleed Rate (ABR) for Treated Bleeds in the Randomized Arms
Secondary outcomes
ABR for All Bleeds in the Randomized Arms
ABR for Treated Spontaneous Bleeds in the Randomized Arms
ABR for Treated Joint Bleeds in the Randomized Arms
Intra-Participant Comparison of the ABR for Treated Bleeds with Prophylactic Emicizumab Versus Prophylactic SOC from the Preceeding Non-Interventional Study (NIS) WP45335
Sponsors and contacts
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