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溶剂/去污处理并经过朊病毒安全保障的输血血浆在健康志愿者中进行的随机、交叉临床试验中的恢复、安全性和耐受性。

Recovery, safety, and tolerability of a solvent/detergent-treated and prion-safeguarded transfusion plasma in a randomized, crossover, clinical trial in healthy volunteers.

机构信息

Department of Blood Group Serology and Transfusion Medicine, Laboratory Medicine, Medical University of Vienna, Vienna, Austria; Department of Emergency Medicine, and Clinical Pharmacology, Medical University of Vienna, Vienna, Austria; Clinical Research and Development Department, Octapharma Pharmazeutika Produktionsges.m.b.H, Vienna, Austria.

出版信息

Transfusion. 2013 Sep;53(9):1906-17. doi: 10.1111/trf.12075. Epub 2013 Jan 16.

Abstract

BACKGROUND

Octaplas LG is a prion-depleted version of a previous generation product called Octaplas S/D. We compared the recovery, safety, and tolerability of these two pharmaceutical-grade plasmas.

STUDY DESIGN AND METHODS

In this comparative, block-randomized, open-label, active-controlled, crossover Phase I trial, 60 healthy adult volunteers received single transfusions of 1200 mL of parent product (in Period 1) and of the LG plasma product (in Period 2) or vice versa. In both periods, plasmapheresis (600 mL) preceded the transfusion. Blood samples were drawn before and after apheresis and 15 minutes, 2 hours, 24 hours, and 7 days after end of plasma transfusion, to assess recovery, safety, and tolerability. The primary efficacy endpoints were the changes in coagulation factors and hemostatic variables compared to baseline; their relative recovery was computed in the per-protocol analysis (n = 43). Safety and tolerability were assessed (n = 60).

RESULTS

Variations in coagulation factors and hemostatic variables over time were similar between the two treatments and within normal range; 90% confidence intervals for the derived recovery data were within predefined limits of equivalence. Both products were well tolerated. The advanced manufacturing process also significantly increased plasmin inhibitor concentrations after transfusion in vivo.

CONCLUSION

The LG plasma product was bioequivalent to its predecessor with respect to recovery of clotting factors and demonstrated comparable safety and tolerability in healthy volunteers. Both products compensated well for the loss of clotting factors after apheresis (NCT01063595).

摘要

背景

Octaplas LG 是前一代产品 Octaplas S/D 的朊病毒 depleted 版本。我们比较了这两种医药级血浆的恢复情况、安全性和耐受性。

研究设计与方法

在这项比较性、随机分组、开放性、活性对照、交叉的 I 期试验中,60 名健康成年志愿者接受了单次输注 1200 毫升的母体产品(在第 1 期)和 LG 血浆产品(在第 2 期),或者反之。在两个时期,都进行了血浆置换(600 毫升)。在血浆输注结束前、后以及 15 分钟、2 小时、24 小时和 7 天,抽取血液样本,以评估恢复情况、安全性和耐受性。主要疗效终点是与基线相比凝血因子和止血变量的变化;在方案分析中(n = 43)计算了它们的相对恢复。评估了安全性和耐受性(n = 60)。

结果

两种处理方法和正常范围内的时间变化中凝血因子和止血变量的变化相似;从恢复数据推导得出的 90%置信区间在预先设定的等效性范围内。两种产品均耐受良好。先进的制造工艺还显著增加了体内输血后纤溶抑制剂的浓度。

结论

LG 血浆产品在凝血因子的恢复方面与其前体产品具有生物等效性,并且在健康志愿者中表现出类似的安全性和耐受性。两种产品都很好地补偿了血浆置换后的凝血因子损失(NCT01063595)。

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