Ascending Doses of Autologous FDP vs FFP

United States Army Medical Research and Development Command (USAMRDC)

Status and phase: Completed; Phase 1

Conditions: Freeze Dried Plasma in Healthy Volunteers

Treatments: Biological: Fresh Frozen Plasma (FFP); Biological: Autologous Freeze Dried Plasma (FDP)

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT02930226

IND 17154 (Other Identifier)

S-14-12

Details and patient eligibility

About

Assess the safety of single infusions with RePlas FDP product at increasing fixed doses

Full description

This is a single-site, partial double-blind study in healthy volunteers designed to assess the safety of infusing ascending doses of reconstituted autologous freeze dried plasma (FDP) in 3 fixed-dose cohorts. Beginning with Cohort 1, subjects will receive a single infusion of 1 unit (approximately 270 mL) of either FDP manufactured from fresh frozen plasma (FFP) derived from autologous whole blood (WB) collection(s) that use citrate phosphate dextrose (CPD) as the anticoagulant (FDP-CPD) or FDP manufactured from FFP units from autologous plasmapheresis where acid citrate dextrose (ACD) is used as the anticoagulant (FDP-ACD). Recruitment of subjects for Cohort 2 follows the completion of infusions in Cohort 1. Subjects in Cohort 2 will receive a single infusion of 2 units (approximately 540 mL) of either FDP-CPD or FDP-ACD before recruitment for Cohort 3 is initiated. Subjects enrolled in Cohort 3 will receive the highest study dose, a plasma infusion dose of 3 units (approximately 810 mL) of FDP-ACD at one infusion visit and the same dose of autologous FFP at another infusion visit. Cohort 3 subjects will only be infused with FDP and FFP products sourced from autologous plasmapheresis. Randomization of Cohort 3 subjects to a treatment sequence determines whether they will be infused with 3 units of FDP or 3 units of FFP at their first infusion visit followed by infusion with the alternate product at the second infusion visit. A 2-week interval will be maintained between infusion visits in Cohort 3. Crossover of FDP and FFP enables comparison of infusion safety and select coagulation factor recoveries within the same subjects between FDP and FFP at this higher dose.

Enrollment: 30 patients

Sex: All

Ages: 18 to 55 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Males and non-pregnant/non-breastfeeding females;
• Minimum weight is 140 pounds, maximum weight is 220 pounds;
• Ages 18-55 years;
• Self-reports that he or she feels well and healthy;
• Scores ≥ 35 on the Duke Activity Status Index;
• Able to donate 1 unit of WB based on the AABB donor history questionnaire with modifications indicated. Subjects with history of travel which puts them at risk for Creutzfeldt-Jakob Disease (CJD) or malaria will be eligible to participate;
• Has read the educational materials on donating blood and has had his or her questions answered;
• Able and willing to provide written informed consent;
• Available for the duration of the trial, which is approximately 12 weeks for subjects in Cohort 1 and Cohort 2, Arm 4; approximately 16 weeks for Cohort 2, Arm 3 and Cohort 3 (includes time for collections, product manufacture, and infusions), and able to come to the treatment clinic for scheduled study visits;
• Females of childbearing potential should either be surgically sterile (hysterectomy or tubal ligation), or should use a highly effective, medically accepted contraceptive regimen. Highly effective methods of birth control are defined as those which result in a lower failure rate (i.e., less than 1% per year) when used consistently and correctly such as implants, injectables, combined oral contraceptives, some intrauterine devices, sexual abstinence, or vasectomized partner;
• All females must have a negative urine pregnancy test prior to enrollment; and
• Understands the English language.

Exclusion criteria

• Known liver, kidney, cardiovascular, neurologic, gastrointestinal, blood, endocrine/metabolic, autoimmune or pulmonary disease, or treated or untreated hypertension;
• Cancer of any kind, under treatment or resolved;
• Known or past coagulopathy conditions;
• Any conditions, medications, etc. on the AABB medical deferral list;
• Past history of asthma (defined as use of a prescribed daily asthma controller medication or required asthma medication in the past 2 weeks);
• Past diagnosis of stroke, deep vein thrombosis, or transient ischemic attack
• Family history of venous or arterial thrombosis before the age of 50 in first-degree relatives (i.e., biological parents, full siblings, or children);
• History of abnormal electrocardiogram (EKG);
• Current smoker (defined as having smoked within the last 6 months);
• Known Human Immunodeficiency Virus (HIV) or Acquired Immunodeficiency Syndrome (AIDS)-related illness or received a positive test result for HIV infection;
• Positive test for Hepatitis B Virus (HBV) or Hepatitis C Virus (HCV) or Human T-cell Lymphotropic Virus (HTLV);
• History or significant treated or untreated mental health issues;
• Female subject who is pregnant, lactating, or with a positive pregnancy test;
• Currently taking an antibiotic or another medication for an infection;
• Treatment or use of aspirin (or other platelet inhibiting agents) within 14 days of study donation and infusion visits;
• Currently using any medications for anticoagulant therapy;
• Previous use of clotting factor concentrate(s);
• Receipt of blood or blood products within the past 12 months;
• In the past week, has had a headache and fever at the same time;
• Known intolerance to any excipients (citrate) in the study drug formulation;
• Systolic blood pressure greater than 140 mmHg;
• Diastolic blood pressure greater than 90 mmHg;
• Temperature greater than 100°F;
• Known hematocrit less than 38% for both male and female donors;
• Positive direct antiglobulin test (DAT);
• Treatment with any investigational agent within 1 month before treatment infusion for this trial;
• Participation in any phase of any other investigational trials while participating in this trial;
• Unwilling or unable to comply with the requirements of this protocol, including the presence of any condition (physical, mental, or social) that is likely to affect the subject's return for follow-up visits on schedule;
• Other unspecified reasons that, in the opinion of the PI, make the subject unsuitable for enrollment; or
• Institutionalized because of legal or regulatory order.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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30 participants in 6 patient groups

1 unit FDP-CPD

Experimental group

Description:

Subjects are to have sufficient plasma withdrawn during a single WB collection visit to allow re-infusion with 1 unit of autologous FDP-CPD

Treatment:

Biological: Autologous Freeze Dried Plasma (FDP)

Reinfusion 1 unit FDP-ACD

Experimental group

Description:

Subjects are to have sufficient plasma withdrawn during 1 plasmapheresis collection visit to allow re-infusion with 1 unit of autologous FDP-ACD

Treatment:

Biological: Autologous Freeze Dried Plasma (FDP)

Reinfusion 2 units FDP-CPD

Experimental group

Description:

Subjects are to have sufficient plasma withdrawn during 2 separate WB collection visits to allow re-infusion with 2 units of autologous FDP-CPD

Treatment:

Biological: Autologous Freeze Dried Plasma (FDP)

Reinfusion 2 units FDP-ACD

Experimental group

Description:

Subjects are to have sufficient plasma withdrawn during 1 plasmapheresis collection to allow re-infusion with 2 units of autologous FDP-ACD

Treatment:

Biological: Autologous Freeze Dried Plasma (FDP)

Reinfusion 3 units FDP, 3 units FFP (1st)

Active Comparator group

Description:

Subjects plasma withdrawn during 2 or 3 plasmapheresis collections to allow re-infusion with 3 units of autologous FDP-ACD and 3 units of autologous control FFP. Subjects will receive in total 6 units over the course of 2 infusion visits. Subjects are to be randomized to treatment schedule arms that dictate the sequence for infusing FDP-ACD and FFP across the 2 infusion visits

Treatment:

Biological: Autologous Freeze Dried Plasma (FDP)

Biological: Fresh Frozen Plasma (FFP)

Reinfusion 3 units FDP, 3 units FFP (2nd)

Active Comparator group

Description:

Subjects plasma withdrawn during 2 or 3 plasmapheresis collections to allow re-infusion with 3 units of autologous FDP-ACD and 3 units of autologous control FFP. Subjects will receive in total 6 units over the course of 2 infusion visits. Subjects are to be randomized to treatment schedule arms that dictate the sequence for infusing FDP-ACD and FFP across the 2 infusion visits

Treatment:

Biological: Autologous Freeze Dried Plasma (FDP)

Biological: Fresh Frozen Plasma (FFP)