Efficacy, safety and pharmacokinetics of a new 10% normal human immunoglobulin for intravenous infusion, BT595, in children and adults with primary immunodeficiency disease

BT595, a 10% Human Normal Immunoglobulin, for Replacement Therapy of Primary Immunodeficiency Disease: Results of a Subcohort Analysis in Children

PURPOSE

To assess the efficacy, pharmacokinetics, and safety of a new, highly purified 10% IVIg (BT595, Yimmugo^®) administered in children with PID.

METHODS

This was an open-label, prospective, uncontrolled, multicenter Phase III pivotal trial. Among the 67 subjects in the trial were 18 pediatric patients aged 2 to 17 years with diagnosis of PID included in this analysis. They received doses between 0.2 and 0.8 g/kg body weight for approximately 12 months at intervals of either 3 or 4 weeks. Dosage and dosing interval were based on each patient's pre-trial infusion schedule. The rates of acute serious bacterial infections (SBI), secondary efficacy, safety, and pharmacokinetic outcomes were evaluated.

RESULTS

No SBI occurred in the pediatric population. Two hundred sixty infusions were administered to the 18 pediatric patients. The mean (SD) IgG trough level was 8.55 (1.67) g/L at baseline and 8.84 (2.17) g/L at the follow-up visit after the last BT595 infusion. At the single infusions respectively, the average mean IgG trough levels ranged between 8.52 and 10.58 g/L. More than 85% of all infusions administered were not associated with any infusional AE (start during or within 72 h post-infusion). None of the severe or serious AEs were related to the investigational medicinal product (IMP). No premedication was used. Thirteen children reached a maximum infusion rate between > 2.0 and 8 mL/kg/h; no AE with an onset during the infusion occurred at these infusion rates.

CONCLUSION

BT595 is effective, convenient, well tolerated, and safe for the treatment of children with PID.

TRIAL REGISTRATION

EudraCT: 2015-003652-52; NCT02810444, registered June 23, 2016.

Efficacy and safety of BT595 (10% human intravenous immunoglobulin) in adult patients with chronic immune thrombocytopenia

PURPOSE

This trial investigated the efficacy and safety of the new 10% human intravenous immunoglobulin (IVIg) BT595 (Yimmugo®).

METHODS

Adult patients with chronic immune thrombocytopenia (ITP) received a total dose of 2 g/kg body weight (bw) IVIg either over 2 or 5 days.

RESULTS

Response as defined by the European Medicines Agency (EMA) was achieved in 18 of 34 patients (52.9%) in the full analysis set (FAS), with a complete response in 11 patients (32.4%). The median time to response was 1.0 days (range 1-4); the median duration was 28.0 days. In a subgroup with a baseline platelet count <20*10⁹ /L evaluated according to FDA criteria, a platelet response ≥50*10⁹ /L was achieved in 18 of 19 patients at day 8. No fatal case occured. One serious treatment-emergent adverse event (TEAE) (anaemia, not related) was reported (2.9%). The most frequent infusional adverse drug reaction (ADR) was headache, which was reported for 14.7% of all patients. All other infusional ADRs (pyrexia, [intravascular] haemolysis, skin reaction, tinnitus, and Coombs test positive) occurred in only one patient (2.9%). Premedication was administered only once. The 5-day schedule showed less side effects with similar efficacy.

CONCLUSION

The benefit-risk profile of BT595 is favourable.

TRIAL REGISTRATION NUMBER

Eudra CT Number 2015-003653-17, ClinicalTrials.gov NCT02859909.