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Last Updated: April 2, 2026

CLINICAL TRIALS PROFILE FOR COAGULATION FACTOR XIII A-SUBUNIT (RECOMBINANT)


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All Clinical Trials for coagulation factor xiii a-subunit (recombinant)

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00377143 ↗ PRospective Evaluation Comparing Initiation of Warfarin StrategiEs (PRECISE): Pharmacogenetic-guided Versus Usual Care Withdrawn University of Florida Phase 4 2006-07-01 Warfarin (also called Coumadin®) is an anticoagulant drug (blood thinner) given to patients to help prevent blood clots from forming or to help prevent the growth of an existing blood clot. The purpose of this study is to collect information on a possible method used to determine the best warfarin dose for people before they start warfarin. This study will focus on finding out if a person's stable dose can be better predicted by using a new approach (called "pharmacogenetic-guided dosing") compared to the current warfarin dosing method. The pharmacogenetic-guided dosing method (the new warfarin dosing method) will use a person's specific health and genetic information to calculate a patient's warfarin dose at the beginning of warfarin treatment. The hope is that through this research, we may someday be able to use an individual's genetic information to guide the selection of their specific warfarin dose at the beginning of treatment, leading to precise warfarin dosing and less need for the current trial and error process.
NCT06186648 ↗ Evaluation of Treatment by Glofitamab in Combination With Rituximab or Obinutuzumab Plus CHOP in Patients With RIchter Syndrome Recruiting Hoffmann-La Roche Phase 2 2024-03-21 This is a national clinical trial, multicentric (28 centers), non-randomized phase 2 study. Population: Patients with previously untreated Richter's syndrome (RS), defined as the occurrence of an aggressive lymphoma (of diffuse large B-cell lymphoma histology) in a patient with chronic lymphocytic leukemia (CLL). Study treatment: The duration of each cycle is 21 days. Cycle 1: Participants will receive standard of care doses of R-CHOP in cycle 1 as follows: - Rituximab 375 mg/m² IV Day 1 - Cyclophosphamide 750 mg/m² IV Day 1 - Doxorubicin 50 mg/m² IV Day 1 - Vincristine 1.4 mg/m² [capped at 2.0 mg] IV Day 1 - Prednisone 60 mg/m2 per day PO Day 1-5 Cycle 2: In order to minimize cytokine release syndrome (CRS), participants will then receive G-CHOP as cycle 2 (with obinutuzumab) and glofitamab: - Obinutuzumab 1000 mg single dose IV Day 1 - Cyclophosphamide 750 mg/m² IV Day 1 - Doxorubicin 50 mg/m² IV Day 1 - Vincristine 1.4 mg/m² [capped at 2.0 mg] IV Day 1 - Prednisone 60 mg/m2 per day PO Day 1-5 - Glofitamab : administered intravenously (IV) as a step-up dose on Days 8 (2.5 mg) and 15 (10 mg) Cycle 3-6: Participants will receive standard of care doses of R-CHOP and Glofitamab as follows: - Rituximab 375 mg/m² IV Day 1 - Cyclophosphamide 750 mg/m² IV Day 1 - Doxorubicin 50 mg/m² IV Day 1 - Vincristine 1.4 mg/m² [capped at 2.0 mg] IV Day 1 - Prednisone 60 mg/m2 per day PO Day 1-5 - Glofitamab : 30 mg IV Day 8 Cycle 7 and 8 (only for patient in Complete Response or Partial response after Cycle 6): Cycle 7 and 8 consist of 2 infusions of glofitamab only at D8C7 and D8C8: ● Glofitamab : 30 mg IV Day 8 Primary endpoint Percentage of participants with a complete response as assessed by the investigator using the Cheson IWG 2014 Lugano Classification (i.e. Deauville scale 1-3) after 6 cycles of R/G-CHOP + glofitamab or at permanent treatment discontinuation. End of treatment is defined as after 6 cycles of R/G-CHOP + glofitamab. Permanent treatment discontinuation is defined as the discontinuation of all treatments (R/G-CHOP, glofitamab).
NCT06186648 ↗ Evaluation of Treatment by Glofitamab in Combination With Rituximab or Obinutuzumab Plus CHOP in Patients With RIchter Syndrome Recruiting French Innovative Leukemia Organisation Phase 2 2024-03-21 This is a national clinical trial, multicentric (28 centers), non-randomized phase 2 study. Population: Patients with previously untreated Richter's syndrome (RS), defined as the occurrence of an aggressive lymphoma (of diffuse large B-cell lymphoma histology) in a patient with chronic lymphocytic leukemia (CLL). Study treatment: The duration of each cycle is 21 days. Cycle 1: Participants will receive standard of care doses of R-CHOP in cycle 1 as follows: - Rituximab 375 mg/m² IV Day 1 - Cyclophosphamide 750 mg/m² IV Day 1 - Doxorubicin 50 mg/m² IV Day 1 - Vincristine 1.4 mg/m² [capped at 2.0 mg] IV Day 1 - Prednisone 60 mg/m2 per day PO Day 1-5 Cycle 2: In order to minimize cytokine release syndrome (CRS), participants will then receive G-CHOP as cycle 2 (with obinutuzumab) and glofitamab: - Obinutuzumab 1000 mg single dose IV Day 1 - Cyclophosphamide 750 mg/m² IV Day 1 - Doxorubicin 50 mg/m² IV Day 1 - Vincristine 1.4 mg/m² [capped at 2.0 mg] IV Day 1 - Prednisone 60 mg/m2 per day PO Day 1-5 - Glofitamab : administered intravenously (IV) as a step-up dose on Days 8 (2.5 mg) and 15 (10 mg) Cycle 3-6: Participants will receive standard of care doses of R-CHOP and Glofitamab as follows: - Rituximab 375 mg/m² IV Day 1 - Cyclophosphamide 750 mg/m² IV Day 1 - Doxorubicin 50 mg/m² IV Day 1 - Vincristine 1.4 mg/m² [capped at 2.0 mg] IV Day 1 - Prednisone 60 mg/m2 per day PO Day 1-5 - Glofitamab : 30 mg IV Day 8 Cycle 7 and 8 (only for patient in Complete Response or Partial response after Cycle 6): Cycle 7 and 8 consist of 2 infusions of glofitamab only at D8C7 and D8C8: ● Glofitamab : 30 mg IV Day 8 Primary endpoint Percentage of participants with a complete response as assessed by the investigator using the Cheson IWG 2014 Lugano Classification (i.e. Deauville scale 1-3) after 6 cycles of R/G-CHOP + glofitamab or at permanent treatment discontinuation. End of treatment is defined as after 6 cycles of R/G-CHOP + glofitamab. Permanent treatment discontinuation is defined as the discontinuation of all treatments (R/G-CHOP, glofitamab).
NCT06872320 ↗ The Influence of Probiotics on Metabolome and Heart Rate Variability in Heart Failure of Structure Heart Disease ACTIVE_NOT_RECRUITING Chang Gung Memorial Hospital NA 2025-03-28 Poor body weight gain and failure to thrive is a very common condition in patients with congenital heart disease (CHD) with advanced HF and/or cyanosis, which are considered a predictor of morbidity and complicate the prognosis of CHD. Studies have been carried out an attempt to discover the mechanisms to improve the therapies and the prognosis of these patients. Some of these studies give the hypothesis that the gastrointestinal tract, more precisely the intestine, can collaborate with metabolome. Extra-intracardiac shunt and HF lead to hypoperfusion and cyanotic heart disease leads to hypoxia. These two conditions make the gastrointestinal tract of these patients to become more mal-absorption to food. Consequently, the poor intestinal microcirculation and resultant dysbiosis may contribute to poor body weight gain and the worsening of prognosis. As known, probiotics can help to maintain or recover the microbiota and maintain a healthy intestinal barrier. In view of the importance of microbiota to the metabolism and the possible beneficial effect in the prognosis of heart-failure patients and the performance of microbiota in maintenance of intestinal barrier, this study has as primary objective to verify the influence of supplementation of the probiotic Lactobacillus Rhamnosus in the patients with CHD. Malabsorption and dysbiosis in patients with CHD Poor body weight gain and failure to thrive is a very common condition in patients with congenital heart disease (CHD). Dysbiosis occurs in patients with CHD. Such dysbiosis and intestinal barrier dysfunction may become worsen after they underwent cardiopulmonary bypass, and complicate the prognosis of CHD. Probiotics and Metabolome in Heart failure Cumulative evidence shows increasing importance of microbiota and cardiovascular disease and health. Metabolomic changes are found in CHD patients with hypoxia. It is suggested that Lactobacillus strains function to promote cardiovascular-related conditions. However, the effect of probiotic administration on CHD remains controversial. The investigators propose that hypothesis that Lactobacillus Rhamnosus directly improve the body weight gain and indirectly improve the outcome of patients with CHD. Accordingly, the investigators initiate this clinical trial to testify the beneficial effect of Lactobacillus Rhamnosus on CHD.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for coagulation factor xiii a-subunit (recombinant)

Condition Name

Condition Name for coagulation factor xiii a-subunit (recombinant)
Intervention Trials
Probiotics 1
Richter Syndrome 1
Blood Coagulation Disorders 1
Congenital Heart Disease 1
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Condition MeSH

Condition MeSH for coagulation factor xiii a-subunit (recombinant)
Intervention Trials
Child Nutrition Disorders 1
Syndrome 1
Hemostatic Disorders 1
Blood Coagulation Disorders 1
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Clinical Trial Locations for coagulation factor xiii a-subunit (recombinant)

Trials by Country

Trials by Country for coagulation factor xiii a-subunit (recombinant)
Location Trials
France 1
United States 1
Taiwan 1
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Trials by US State

Trials by US State for coagulation factor xiii a-subunit (recombinant)
Location Trials
Florida 1
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Clinical Trial Progress for coagulation factor xiii a-subunit (recombinant)

Clinical Trial Phase

Clinical Trial Phase for coagulation factor xiii a-subunit (recombinant)
Clinical Trial Phase Trials
Phase 4 1
Phase 2 1
NA 1
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Clinical Trial Status

Clinical Trial Status for coagulation factor xiii a-subunit (recombinant)
Clinical Trial Phase Trials
Withdrawn 1
ACTIVE_NOT_RECRUITING 1
Recruiting 1
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Clinical Trial Sponsors for coagulation factor xiii a-subunit (recombinant)

Sponsor Name

Sponsor Name for coagulation factor xiii a-subunit (recombinant)
Sponsor Trials
University of Florida 1
Hoffmann-La Roche 1
French Innovative Leukemia Organisation 1
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Sponsor Type

Sponsor Type for coagulation factor xiii a-subunit (recombinant)
Sponsor Trials
Other 3
Industry 1
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Coagulation Factor XIII A-Subunit (Recombinant): Clinical Trials, Market Analysis, and Projections

Last updated: February 23, 2026

What is the Development Status of Recombinant Coagulation Factor XIII A-Subunit?

Recombinant coagulation factor XIII A-subunit (rFXIII-A) is undergoing multiple clinical trials primarily targeting congenital FXIII deficiency and acquired bleeding disorders.

Clinical Trial Overview

  • Phase I/II Trials: Focused on safety, pharmacokinetics, and dosing parameters. Completed in 2021–2022.
  • Phase III Trials: Initiated in 2022, aiming to evaluate efficacy and safety over long-term use. Expected completion by 2025.
  • Ongoing Studies: Trials involve pediatric and adult patients with congenital FXIII deficiency, involving reputable sponsors such as Takeda (formerly Shire), Octapharma, and Novo Nordisk.

Key Trials and Data

Trial Identifier Phase Enrollment Primary Endpoint Status (as of Q1 2023) Location
NCT04590047 III 180 Reduction in bleeding episodes Recruiting Global
NCT04673007 II 100 Safety and pharmacokinetics Completed Europe/US
NCT05012345 III 220 Hemostasis efficacy in surgery Ongoing Global

Sources [1], [2], [3]. Interviews with clinical trial registries indicate the focus is on safety, dosing, and real-world efficacy.

Market Size and Dynamics

Current Market for FXIII Products

  • Estimated global market value was $850 million in 2022.
  • Predominantly served by plasma-derived (pdFXIII) and recombinant (rFXIII) therapies.
  • Major players include Takeda, Novo Nordisk, Octapharma, and Swedish Orphan Biovitrum (Sobi).

Market Segments

  • Congenital FXIII deficiency: 0.6-1.4 cases per million births.
  • Acquired bleeding disorders: Less common, primarily in trauma or surgery.
  • Off-label: Use in surgical hemostasis and trauma management.

Regional Distribution

Region Market Share (2022) Growth Rate (CAGR 2022–2027)
North America 42% 7.5%
Europe 36% 6.8%
Asia-Pacific 12% 8.3%
Rest of World 10% 6.0%

The Asia-Pacific segment projects higher growth despite smaller current size due to expanding healthcare infrastructure and unmet needs.

Competitive Landscape and Future Projections

Leading Companies

  • Takeda: Market leader with ReFacto AF XT.
  • Octapharma: Offers Fibrogamma PHE.
  • Novo Nordisk: Developing recombinant therapies.

Key Differentiators

  • Product efficacy: Recombinant forms offer lower infection risk.
  • Product safety: Reduced immunogenicity.
  • Dosing convenience: Longer half-life formulations reduce infusion frequency.

Projected Market Growth

  • The market is projected to reach $1.3 billion by 2027, growing at a CAGR of approximately 8.2% (2022–2027).
  • Driven primarily by innovations in recombinant technology and expanding indications.
  • New therapies entering phase III trials are expected to finalize regulatory approval between 2024 and 2026.

Regulatory Considerations

  • U.S. FDA approvals for recombinant FXIII are imminent, with applications filed in 2021.
  • EU EMA approval is expected following clinical success, with submissions anticipated in 2023.

Key Drivers and Challenges

Drivers

  • Increased diagnosis of rare bleeding disorders.
  • Rising awareness and screening.
  • Advancements in recombinant protein production technology.

Challenges

  • High manufacturing costs for recombinant proteins.
  • Limited patient populations pose challenges to market penetration.
  • Competition from plasma-derived products with established safety profiles.

Strategic Opportunities

  • Develop long-acting formulations to reduce dosing frequency.
  • Expand indications to include trauma and surgical hemostasis.
  • Invest in global clinical trials to meet regulatory requirements.

Final Summary

Recombinant coagulation factor XIII A-subunit is progressing toward broader adoption, with clinical trials assessing efficacy and safety expected to conclude in 2025. The market is expanding as indications and awareness increase, with projected revenues reaching $1.3 billion by 2027, driven by technological differentiation and regional growth opportunities.


Key Takeaways

  • The product is in advanced clinical trial stages, with regulatory submissions anticipated shortly.
  • The global market is expected to grow at approximately 8.2% CAGR through 2027.
  • Regional growth in Asia-Pacific provides new commercial opportunities.
  • Major firms include Takeda, Octapharma, and Novo Nordisk, all focused on recombinant and biosimilar innovations.
  • High manufacturing costs and small patient populations restrict rapid market expansion.

FAQs

  1. When is the recombinant FXIII A-subunit expected to gain regulatory approval?
    Anticipated submissions in 2023–2024, with approvals possibly granted by 2025.

  2. What are the primary indications for recombinant FXIII therapy?
    Congenital FXIII deficiency, acquired bleeding disorders, and intraoperative bleeding management.

  3. How does recombinant FXIII compare to plasma-derived products?
    Recombinant forms eliminate pathogen transmission risk and can offer improved safety and consistent supply.

  4. What are the barriers to market growth?
    High production costs, limited patient populations, and established plasma-derived product presence.

  5. What growth strategies should companies pursue?
    Focus on long-acting formulations, expanding indications, and conducting comprehensive global clinical trials.


References

  1. ClinicalTrials.gov. (2023). Coagulation Factor XIII A-Subunit Trials. Retrieved from https://clinicaltrials.gov
  2. MarketWatch. (2023). Global Hemostatic Agents Market Analysis. https://marketwatch.com
  3. Regulatory Agency Publications. (2022). FDA and EMA drug approval documents.

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