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重组凝血因子IX预防治疗对重度或中度重度B型血友病患者健康相关生活质量的改善:BAX326关键研究结果

Improvement in health-related quality of life with recombinant factor IX prophylaxis in severe or moderately severe haemophilia B patients: results from the BAX326 Pivotal Study.

作者信息

Windyga J, Lin V W, Epstein J D, Ito D, Xiong Y, Abbuehl B E, Ramirez J H

机构信息

Institute of Hematology and Transfusion Medicine, Warsaw, Poland.

出版信息

Haemophilia. 2014 May;20(3):362-8. doi: 10.1111/hae.12315. Epub 2013 Nov 20.

DOI:10.1111/hae.12315
PMID:24251442
Abstract

Little is known about the health-related quality of life (HRQoL) burden of haemophilia B. The aim of this study was to assess HRQoL burden of haemophilia B, the benefit of recombinant factor IX (rFIX) prophylaxis and the HRQoL benefit of achieving a zero annual bleed rate. Subjects receiving rFIX (BAX326) prophylaxis or on-demand completed the SF-36 survey. Baseline SF-36 scores were compared to the general US population scores to understand the HRQoL burden. Changes in SF-36 scores between baseline and follow-up were tested using t-tests. Subgroup analysis was conducted to examine SF-36 change among subjects who switched to BAX326 prophylaxis. SF-36 scores were also compared between those with zero bleeds and those who bled during the study. Compared to the US norms, subjects reported lower average scores in all physical and several mental HRQoL domains. At follow-up, prophylaxis subjects reported statistically significant and clinically meaningful improvements in overall physical HRQoL, as measured by the Physical Component Score (PCS) (mean change 2.60, P = 0.019), Bodily Pain (BP) (3.45, P = 0.015) and Role Physical (RP) domains (3.47, P = 0.016). Subjects who switched to prophylaxis from intermittent prophylaxis or on-demand experienced more pronounced improvements not only in the PCS (3.21, P = 0.014), BP (3.71, P = 0.026), RP (4.43, P = 0.008) but also in Vitality (3.71, P = 0.04), Social Functioning (5.06, P = 0.002) and General Health domains (3.40, P = 0.009). Subjects achieving zero bleeds reported lower BP (P = 0.038). Prophylaxis with BAX326 significantly improved HRQoL in patients with moderately severe or severe haemophilia B by reducing bleeds.

摘要

关于B型血友病与健康相关的生活质量(HRQoL)负担,人们了解甚少。本研究的目的是评估B型血友病的HRQoL负担、重组凝血因子IX(rFIX)预防治疗的益处以及实现年度出血率为零对HRQoL的益处。接受rFIX(BAX326)预防治疗或按需治疗的受试者完成了SF - 36调查问卷。将基线SF - 36评分与美国普通人群评分进行比较,以了解HRQoL负担。使用t检验对基线和随访之间SF - 36评分的变化进行检验。进行亚组分析以检查转为BAX326预防治疗的受试者的SF - 36变化情况。还比较了在研究期间出血为零的受试者和有出血的受试者之间的SF - 36评分。与美国标准相比,受试者在所有身体和几个心理HRQoL领域的平均得分较低。在随访时,通过身体成分评分(PCS)(平均变化2.60,P = 0.019)、身体疼痛(BP)(3.45,P = 0.015)和身体功能(RP)领域(3.47,P = 0.016)衡量,接受预防治疗的受试者在总体身体HRQoL方面报告了具有统计学意义和临床意义的改善。从间歇性预防治疗或按需治疗转为预防治疗的受试者不仅在PCS(3.21,P = 0.014)、BP(3.71,P = 0.026)、RP(4.43,P = 0.008)方面有更明显的改善,而且在活力(Vitality)(3.71,P = 0.04)、社会功能(Social Functioning)(5.06,P = 0.002)和总体健康(General Health)领域(3.40,P = 0.0上,出血为零的受试者报告的BP较低(P = 0.038)。通过减少出血,使用BAX326进行预防治疗显著改善了中度至重度B型血友病患者的HRQoL。

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