Emicizumab in Hemophilia A: NCT04158648 Clinical Landscape Report 2026
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This Clinical Landscape Report was built with PatSnap Life Sciences MCP workflows. Clinical Trials MCP supplies protocol and result records, Drug & Asset MCP adds asset context, and Company & Deal Intelligence MCP resolves sponsor background. Use the same structured MCP building blocks in your research workflow.
Data snapshot: 16 October 2026. This strategic research report is not medical, regulatory or investment advice. Trial status and dates can change.
Phase 3
Clinical phase
Completed
Recruitment status
not reported
Planned enrollment
2021-10-30
Primary-completion proxy
Executive view
NCT04158648 evaluates Emicizumab in Hemophilia A. The disclosed sponsor is Hoffmann-La Roche, Inc., the design is Interventional, and the geographic footprint is Canada, Netherlands, Belgium, United States, Poland, United Kingdom, South Africa, France, Germany, Spain. The first listed primary endpoint is Model-Based Annualized Bleed Rate for Treated Bleeds, assessed over From the day of first emicizumab dose to at least 52 weeks of emicizumab treatment (median [range, min-max] efficacy period: 55.64 [8.6-89.9] weeks).
The key landscape question is whether this protocol can generate a clinically interpretable signal relative to nearby programs. Phase alone is not a measure of evidence quality. Endpoint relevance, comparator choice, masking, enrollment feasibility, patient selection, country coverage and follow-up must be considered together.
PatSnap MCP Servers make this assessment reproducible by keeping protocol facts, result evidence, asset attributes and sponsor identity in separate structured calls.
How the MCP evidence stack was assembled
Clinical Trials MCP clinical_trial_fetch retrieved the design, outcomes, phase, status, enrollment, sponsor, countries and timing for NCT04158648 and selected peers. clinical_trial_result_fetch supplied detailed result records from the wider Hemophilia A landscape. Drug & Asset MCP drug_fetch was queried for Emicizumab, while Company & Deal Intelligence MCP organization_fetch was queried for Hoffmann-La Roche, Inc..
This separation reduces a common diligence error: treating a registry label, a company description or a result excerpt as if each represented the complete evidence package. Explore the source workflow at the PatSnap MCP marketplace.
Trial landscape table
| Trial | Asset / intervention | Phase / status | Sponsor | Geography | Primary endpoint | Readout proxy |
|---|---|---|---|---|---|---|
| NCT04158648 | Emicizumab | Phase 3 / Completed | Hoffmann-La Roche, Inc. | Canada, Netherlands, Belgium, United States, Poland, United Kingdom, South Africa, France, Germany, Spain | Model-Based Annualized Bleed Rate for Treated Bleeds From the day of first emicizumab dose to at least 52 weeks of emicizu… | 2021-10-30 |
| NCT05441553 | VGB-R04 | Phase 1/2 / Unknown status | Shanghai Vitalgen Biopharma Co., Ltd. | China | Incidence of adverse events Baseline up to Week 52 | 2025-01-01 |
| NCT05421429 | Armocibart | Phase 2 / Completed | Suzhou Alphamab Co., Ltd. | China | Frequency and severity of treatment emergent adverse events(TEAEs) Day 1 up to Day 85 | 2024-01-17 |
| NCT05365217 | Nonacog beta pegol | Phase 3 / Completed | Novo Nordisk A/S | China | Haemostatic Effect of Nonacog Beta Pegol When Used for Treatment of Bleeding Episodes During on Demand and Prophylaxis… From start of treatment (week 0) until end of treatment (up to week 5… | 2024-04-11 |
| NCT05306418 | Denecimig | Phase 3 / Completed | Novo Nordisk A/S | United States, Japan, United Kingdom, Switzerland, Portugal, Spain, Russia, India, Canada, South Korea, Netherlands, China, Taiwan Province, Poland, South Africa, Italy, Israel, Lithuania, Germany | Number of treatment emergent adverse events From treatment initiation to follow up visit (week 0 to week 72) | 2024-11-13 |
The table aligns endpoints, sponsors, phases, geographies and readout proxies. It is descriptive, not a head-to-head efficacy comparison. Differences in population, baseline risk, intervention schedule and follow-up can dominate apparent cross-trial differences.
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Protocol design and endpoint interpretation
NCT04158648 is a Phase 3, completed study with not reported planned participants. Allocation is N/A, masking is None (Open Label), and the intervention model is Single Group Assignment.
The primary endpoint is “Model-Based Annualized Bleed Rate for Treated Bleeds” over “From the day of first emicizumab dose to at least 52 weeks of emicizumab treatment (median [range, min-max] efficacy period: 55.64 [8.6-89.9] weeks).” The retrieved endpoint description is: The number of treated bleeds over the efficacy period was estimated as an annualized bleed rate (ABR) using a negative binomial regression model, which accounts for different follow-up times. A treated bleed was defined as a bleed that was directly followed by a hemophilia medication reported to be a "treatment for bleed". The 72-hour rule was implemented: two bleeds of the same type and at the same anatomical location were counted as one bleed if the second bleed occurred within 72 hours from the last treatment for the first bleed. Bleeds due to surgery/procedure were excluded..
Interpretation should test whether the endpoint captures a clinically meaningful change, whether its time horizon matches the proposed biology, and whether treatment discontinuation or missing data can bias the estimate. The planned enrollment of not reported should be assessed against expected effect size, event frequency, multiplicity, subgroup plans and attrition.
No named control drug was returned in the protocol field set. A placebo comparator can strengthen internal efficacy assessment, while an active comparator may better test clinical differentiation. Single-arm and open-label programs require greater weight on objective outcomes, independent assessment and external benchmarks.
Indexed readouts in the surrounding landscape
0 recent result records were selected as contextual evidence for Hemophilia A. These records do not establish direct evidence for NCT04158648 unless the registration number matches.
Indexed evidence status
No directly comparable result record was retrieved for this disease query. This is a monitoring gap, not evidence of absence.
Result fields should be reconciled with the source record before quantitative comparison. Population definitions, analysis sets, dose cohorts, estimands, confidence intervals, rescue therapy and follow-up can materially change the meaning of a numerical endpoint. Clinical Trials MCP supports repeatable refreshes as result records change.
Asset and sponsor context
Emicizumab is indexed as Bispecific antibody with F10 x factor IXa biology and a global stage of Approved. The asset profile lists Chugai Pharmaceutical Co., Ltd. as an originator or developer.
Hoffmann-La Roche, Inc. is indexed in an unreported country with the website http://roche-nutley.com. Operates as a biotech company that develops pharmaceutical and diagnostic solutions The record lists 91 development-stage drug assets.
For execution diligence, monitor sponsor ownership, collaborator additions, site expansion, protocol amendments and enrollment revisions. A change in ownership or geography can alter operational confidence as well as the commercial meaning of a future readout.
Development white space
- Endpoint white space. Determine whether a more patient-relevant outcome, longer durability window or blinded central assessment would resolve uncertainty left by the current endpoint.
- Population white space. Test biomarker-defined, treatment-line or risk-stratified subgroups where effect size and unmet need could be clearer.
- Comparator white space. Identify whether the study can support differentiation against the current standard of care rather than only activity against baseline or placebo.
- Geographic white space. Assess whether the disclosed footprint supports recruitment, regulatory transferability and commercial generalizability.
- Sequencing white space. Clarify whether Emicizumab is intended for monotherapy, combination, maintenance, rescue or an earlier treatment line.
White space should be framed as an unanswered development question, not merely an unoccupied mechanism label. A credible program closes a measurable clinical uncertainty with a design that can be executed and interpreted.
Strategic implications and next readouts
For sponsors, the endpoint hierarchy, safety window, enrollment pace and protocol amendment history should all support the same target product profile. Advancement criteria should be set before the readout and tied to clinical effect, uncertainty, tolerability and operational feasibility.
For business-development teams, differentiation may come from a sharper population, stronger comparator, more durable benefit, simpler delivery or clearer sequencing role. For investors, the central risk is evidence quality relative to time and capital, not the phase label in isolation.
Track recruitment status, enrollment changes, primary-completion timing, endpoint revisions, new result records, sponsor ownership and collaborator changes. Re-run the PatSnap MCP workflow when a surrogate becomes a clinical outcome, a single-country study expands, the comparator changes or a new result materially shifts the competitive benchmark.
Source trail and bottom line
Anchor trial: NCT04158648
Protocol source: https://clinicaltrials.gov/study/NCT04158648
MCP sources: Clinical Trials MCP (clinical_trial_fetch and clinical_trial_result_fetch); Drug & Asset MCP (drug_fetch); Company & Deal Intelligence MCP (organization_fetch).
Data snapshot: 16 October 2026.
Emicizumab in Hemophilia A is best understood through the interaction of protocol design, surrounding readouts, asset context and sponsor execution. The current record makes Model-Based Annualized Bleed Rate for Treated Bleeds and 2021-10-30 the leading decision points.
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