Department of Pediatrics, Hematology and Oncology, Warsaw Medical University, Warszawa, Poland.
Thromb Res. 2011 Mar;127(3):247-53. doi: 10.1016/j.thromres.2010.11.030. Epub 2011 Jan 8.
The new-generation coagulation factor VIII (FVIII)/von Willebrand factor (VWF) concentrate, Wilate(®), is effective in the therapy of von Willebrand disease for which it was originally developed. The ratio of haemostatic components (FVIII to VWF) of this high-purity plasma-derived concentrate is 1:1, with VWF naturally stabilising FVIII. Bleeding episode control in patients with haemophilia A (HA) is generally managed by replacement therapy with recombinant or plasma-derived FVIII. When complexed with VWF as in the physiological situation, the product may also show a lower incidence of inhibitor development in patients with HA. The clinical efficacy, safety and tolerability of Wilate(®) were therefore evaluated in 81 previously treated individual patients with severe HA. Data from 5 good clinical practice (GCP) prospective clinical studies were pooled and assessed with regards to the prevention and treatment of bleeding and during surgical procedures. Haemostatic efficacy was excellent or good in 96.7% of 1495 rated treatments of bleeding episodes. The average dose per treatment was approximately 30 IU FVIII/kg. In surgical settings, the global haemostatic efficacy of Wilate(®) was generally rated excellent or good for use during and after operations with a mean total dose of FVIII of 848.6 IU/kg±578.5 IU/kg administered peri-operatively. Overall, tolerability of Wilate(®) was rated very good or good by patients and physicians. Rarely occurring adverse events were mild in intensity and no anti-FVIII inhibitors were detected. Wilate(®) also displayed a good viral safety profile with no seroconversions occurring in response to treatment. These data show that Wilate(®) is an efficacious treatment option in the management of patients with severe HA.
新一代凝血因子 VIII(FVIII)/血管性血友病因子(VWF)浓缩物 Wilate(®)最初是为治疗血管性血友病而开发的,在该疾病的治疗中具有疗效。这种高纯度血浆衍生浓缩物的止血成分(FVIII 与 VWF)比例为 1:1,VWF 可自然稳定 FVIII。一般通过用重组或血浆衍生的 FVIII 进行替代疗法来控制血友病 A(HA)患者的出血事件。当与 VWF 复合时,如在生理情况下,该产品也可能降低 HA 患者产生抑制剂的发生率。因此,对 81 例先前接受治疗的重度 HA 患者进行了 Wilate(®)的临床疗效、安全性和耐受性评估。来自 5 项良好临床实践(GCP)前瞻性临床研究的数据进行了汇总,并评估了预防和治疗出血以及手术过程中的疗效。在 1495 次出血事件的治疗中,有 96.7%被评为止血效果极好或良好。每次治疗的平均剂量约为 30 IU FVIII/kg。在手术环境中,Wilate(®)的总体止血效果在手术期间和手术后通常被评为极好或良好,平均总剂量为 848.6 IU/kg±578.5 IU/kg 的 FVIII 在围手术期给予。总体而言,患者和医生对 Wilate(®)的耐受性评价均为非常好或好。不良反应罕见,强度为轻度,未检测到抗 FVIII 抑制剂。Wilate(®)还具有良好的病毒安全性,治疗后未发生血清转化。这些数据表明,Wilate(®)是治疗重度 HA 患者的有效治疗选择。