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对六例甲型血友病患者临床研究中的无血浆和无白蛋白重组因子VIII(rAHF-PFM)的安全性和有效性进行综合分析。

Integrated analysis of safety and efficacy of a plasma- and albumin-free recombinant factor VIII (rAHF-PFM) from six clinical studies in patients with hemophilia A.

作者信息

Shapiro Amy, Gruppo Ralph, Pabinger Ingrid, Collins Peter W, Hay Charles R M, Schroth Phillip, Casey Kathleen, Patrone Lisa, Ehrlich Hartmut, Ewenstein Bruce M

机构信息

Indiana Hemophilia and Thrombosis Center, 8402 Harcourt Rd, Suite 420, Indianapolis, IN 46260, USA.

出版信息

Expert Opin Biol Ther. 2009 Mar;9(3):273-83. doi: 10.1517/14712590902729392.

Abstract

BACKGROUND

Hemophilia A is an X-linked bleeding disorder that results from insufficient levels of factor VIII (FVIII) coagulant activity.

OBJECTIVE

To evaluate the efficacy and safety of ADVATE rAHF-PFM (Baxter Healthcare Corporation), a recombinant FVIII concentrate manufactured without human or bovine blood-derived additives, and to assess the effect of compliance with prophylactic use in preventing bleeding episodes (BEs).

METHODS

Clinical data were integrated from six prospective studies. Two hundred thirty-four hemophilia A subjects (FVIII levels < or = 2%) (median age 14.7 (range: 0.02 - 72.7) years) were included.

RESULTS

BEs were managed with one or two infusions and nearly all (1953/1956) responded to treatment. Compliance with a prophylactic treatment regimen significantly reduced the incidence of BEs (p = 0.0061) and prevented non-traumatic joint BEs (median annualized BE rate was 0). One previously treated subject developed an inhibitor; no other safety concerns were observed.

CONCLUSIONS

These results reinforce the efficacy and safety of rAHF-PFM and suggest that compliance is an essential contributor to the effectiveness of prophylaxis in the treatment of hemophilia A.

摘要

背景

甲型血友病是一种X连锁出血性疾病,由凝血因子VIII(FVIII)凝血活性水平不足所致。

目的

评估ADVATE rAHF-PFM(百特医疗保健公司)的疗效和安全性,这是一种不含人源或牛源血液衍生添加剂生产的重组FVIII浓缩物,并评估预防性使用的依从性对预防出血事件(BEs)的效果。

方法

整合了六项前瞻性研究的临床数据。纳入了234例甲型血友病患者(FVIII水平≤2%)(中位年龄14.7岁(范围:0.02 - 72.7岁))。

结果

通过一至两次输注处理出血事件,几乎所有患者(1953/1956)对治疗有反应。预防性治疗方案的依从性显著降低了出血事件的发生率(p = 0.0061),并预防了非创伤性关节出血事件(年化出血率中位数为0)。一名既往接受过治疗的患者产生了抑制剂;未观察到其他安全问题。

结论

这些结果强化了重组人凝血因子VIII预防和治疗的有效性和安全性,并表明依从性是甲型血友病预防性治疗有效性的重要因素。

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