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NCT02822599: RiaSTAP

Human Fibrinogen Concentrate in Pediatric Cardiac Surgery

Completed Phase 4 Results posted Last updated 16 September 2021
What this trial tests

Phase 4 trial testing RiaStAP in Hypofibrinogenemia in 30 participants. Completed in 24 December 2020.

Timeline
1 June 2017
Primary endpoint
26 August 2019
24 December 2020

Quick facts

Lead sponsorNicklaus Children's Hospital f/k/a Miami Children's Hospital
PhasePhase 4
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingdouble
Primary purposeprevention
Enrollment30
Start date1 June 2017
Primary completion26 August 2019
Estimated completion24 December 2020
Sites2 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Nicklaus Children's Hospital f/k/a Miami Children's Hospital

Who can join

Adults 1 Day to 1, any sex, with Hypofibrinogenemia or Afibrinogenemia. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Postoperative Blood Loss After Surgery (Estimated Blood Loss (EBL)) Primary · Within 24 hours of surgery

Primary outcome efficacy: Estimated blood loss (EBL); median; A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Thereafter, as per routine care, ROTEM analysis was performed at least every 30 minutes while in the OR, or

GroupValue95% CI
RiaSTAP3521 – 61
Saline3326 – 48
Post-operative 2 hr Hemoglobin (Hg) mg/dL Measure Primary · 2 hour

Post-operative 2 hr hemoglobin (Hg) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Thereafter, as per routine care, ROTEM analysis was performed at least every 30 minutes while

GroupValue95% CI
RiaSTAP13.611.0 – 15.2
Saline12.511.7 – 13.3
Post-operative 24-hr Hemoglobin (Hg) mg/dL Primary · 24 hr

Post-operative 24-hr hemoglobin (Hg) between treatment and placebo. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Thereafter, as per routine care, ROTEM analysis was performed at least every 30 minutes while in the O

GroupValue95% CI
RiaSTAP13.811.7 – 15.8
Saline12.411.0 – 14.7
Post-operative 2 hr Hematocrit (HCT) Measure Primary · 2 hour

Post-operative 2 hr Hematocrit (HCT) between the treatment and placebo group.

GroupValue95% CI
RiaSTAP40.932.7 – 43.5
Saline35.935.4 – 38.8
Post-operative 24 hr Hematocrit (HCT) Measure Primary · 24 hour

Post-operative 24 hr Hematocrit (HCT) between the treatment and placebo group

GroupValue95% CI
RiaSTAP38.934.1 – 45.3
Saline35.432.9 – 42.8
Post-operative 2 hr Platelets Count Test (PLT) 10K/uL Primary · 2 hour

Post-operative 2 hr Platelets Count Test (PLT) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Once the patient left the OR, ROTEM was performed at least every 60 minutes for th

GroupValue95% CI
RiaSTAP282.0234.0 – 309.0
Saline224.0192.0 – 311.0
Post-operative 24 hr Platelets Count Test (PLT) 10K/uL Primary · 24 hour

Post-operative 24 hr Platelets Count Test (PLT) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Once the patient left the OR, ROTEM was performed at least every 60 minutes for t

GroupValue95% CI
RiaSTAP249.0197.0 – 297.0
Saline247.0189.0 – 300.0
Post-operative 2 hr Prothrombin (PT) Seconds Primary · 2 hour

Post-operative 2 hr Prothrombin (PT) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Thereafter, as per routine care, ROTEM analysis was performed at least every 30 minutes whil

GroupValue95% CI
RiaSTAP17.016.7 – 18.5
Saline16.515.8 – 17.2
Post-operative 24 hr Prothrombin (PT) Seconds Primary · 24 hour

Post-operative 24 hr Prothrombin (PT) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Thereafter, as per routine care, ROTEM analysis was performed at least every 30 minutes whi

GroupValue95% CI
RiaSTAP16.015.4 – 18.2
Saline16.114.9 – 17.1
Post-operative 2 hr International Normalize Ratio (INR) Primary · 2 hour

Post-operative 2 hr International Normalize Ratio (INR) between the treatment and placebo group

GroupValue95% CI
RiaSTAP1.41.3 – 1.5
Saline1.41.2 – 1.4
Post-operative 24 hr International Normalize Ratio (INR) Primary · 24 hour

Post-operative 24 hr International Normalize Ratio (INR) between the treatment and placebo group. A transfusion algorithm was developed based on three previous studies, modified for pediatrics. Clinically significant bleeding requiring treatment was defined as a rate \>10 cc kg-1 hr-1 calculated every 15 minutes while in the OR, measured by blood in the suction canister. In cases of continued bleeding following randomization to HFC or placebo, cryoprecipitate was considered for fibrinogen \<200 mg/dL or FIBTEM MCF \<7 mm. Once the patient left the OR, ROTEM was performed at least every 60 minu

GroupValue95% CI
RiaSTAP1.31.2 – 1.5
Saline1.31.2 – 1.4
Post-operative 2 hr Partial Thromboplastin Time (PTT) Seconds Primary · 2 hour

Post-operative 2 hr Partial Thromboplastin Time (PTT) between the treatment and placebo group

GroupValue95% CI
RiaSTAP36.733.7 – 41.1
Saline35.232.1 – 36.6

Adverse events — posted to ClinicalTrials.gov

Time frame: 24 hours after surgery;. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

RiaStap
Serious: 7/15 (47%)
Deaths: 0/15
Placebo
Serious: 5/15 (33%)
Deaths: 0/15

Serious adverse events (2 terms)

ReactionSystemRiaStapPlacebo
ThrombusCardiac disorders
Acute Respiratory FailureRespiratory, thoracic and mediastinal disorders

Most-reported serious reactions: Thrombus, Acute Respiratory Failure.

Data from ClinicalTrials.gov NCT02822599 adverse events section.

Sponsor's own description

The goal of the study is to determine whether the use of Human Fibrinogen Concentrate (RiaSTAP) will decrease blood loss and the need for component blood therapy in neonates and infants undergoing cardiopulmonary bypass.

Publications & conference data

2 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Pro-coagulant haemostatic factors for the prevention and treatment of bleeding in people without haemophilia.
    Fabes J, Brunskill SJ, Curry N, Doree C, et al · · 2018 · cited 11× · PMID 30582172 · DOI 10.1002/14651858.cd010649.pub2
  2. A Randomized Pilot Trial Assessing the Role of Human Fibrinogen Concentrate in Decreasing Cryoprecipitate Use and Blood Loss in Infants Undergoing Cardiopulmonary Bypass.
    Tirotta CF, Lagueruela RG, Gupta A, Salyakina D, et al · · 2022 · cited 9× · PMID 35305111 · DOI 10.1007/s00246-022-02866-4

Verify or expand the search:

Other recruiting trials for Hypofibrinogenemia

Currently open trials in the same condition.

Other Nicklaus Children's Hospital f/k/a Miami Children's Hospital trials

Trials by the same sponsor.

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