Bevacizumab injections to prevent repeat joint bleeds in Hemophilia A with chronic synovitis
Efficacy of Intra-Articular Bevacizumab in Preventing Recurrent Hemarthrosis in Hemophilia Patients With Chronic Synovitis: A Pre- and Post-Design Study
This trial will try injecting bevacizumab into affected joints to see if it reduces repeat joint bleeds in people with Hemophilia A and chronic synovitis.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 25 (estimated) |
| Sex | All |
| Sponsor | Khyber Medical University Peshawar Academic / other |
| Drugs / interventions | Bevacizumab |
| Locations | 2 sites (Peshawar, KPK and 1 other locations) |
| Trial ID | NCT07187661 on ClinicalTrials.gov |
What this trial studies
Recurrent joint bleeding in hemophilia is driven in part by VEGF-mediated abnormal blood vessel growth in chronically inflamed synovium. This open-label, single-arm trial will give intra-articular bevacizumab injections to 25 participants with Hemophilia A and chronic synovitis in target knee, elbow, or ankle joints and follow them for two years. The intervention targets local VEGF to reduce synovial angiogenesis, bleeding frequency, and progression of hemophilic arthropathy while minimizing systemic exposure. Clinical bleeding rates, joint scores, imaging, and safety labs will be monitored according to the protocol.
Who should consider this trial
Good fit: Adults with confirmed Hemophilia A who have chronic synovitis in one or more target joints (knee, elbow, or ankle) and a history of more than two hemarthroses in the past six months with WFH joint scores of 2–3 are ideal candidates.
Not a fit: Patients with severely damaged or anatomically unsuitable joints, uncontrolled hypertension, active major comorbidities, HIV positivity, or contraindications to MRI are unlikely to benefit or may be excluded for safety reasons.
Why it matters
Potential benefit: If successful, this approach could lower the number of repeat joint bleeds, slow joint damage, and improve mobility and quality of life with limited systemic side effects.
How similar studies have performed: This local intra-articular anti-VEGF approach is relatively novel for hemophilic synovitis with limited prior clinical data, although anti-VEGF therapies have been used in other diseases and anatomical sites.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Confirmed diagnosis of Hemophilia A. * Presence of one or more target joints (knee, elbow, ankle) with chronic synovitis and a history of \>2 hemarthrosis episodes in the past 6 months. * Target joint World Federation of Hemophilia (WFH) joint score of 2-3. * Adequate hematological, renal, and liver function (as specified by protocol lab values). * Ability and willingness to provide informed consent and comply with the study protocol. Exclusion Criteria: * HIV positive diagnosis. * Severely damaged joints or anatomical limitations preventing safe injection. * Contraindications to MRI. * Uncontrolled hypertension. * Recent major surgery/trauma (\<28 days). * Serious non-healing wound, active cardiovascular disease, or other significant comorbidities that could increase risk or interfere with the study.
Where this trial is running
Peshawar, KPK and 1 other locations
- Hayatabad Medical Complex — Peshawar, Kpk, Pakistan (Recruiting)
- Institute of Pathology and Diagnostic Medicine (IPDM) — Peshawar, Kpk, Pakistan (Recruiting)
Study contacts
- Principal investigator: Dr Kinza Ayaz, MBBS — Khyber Medical University Peshawar
- Study coordinator: Dr Kinza Ayaz, MBBS
- Email: drkinzaayaz@gmail.com
- Phone: +92 320 9124645
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.