Martinowitz U, Lissitchkov T, Lubetsky A, Jotov G, Barazani-Brutman T, Voigt C, Jacobs I, Wuerfel T, Santagostino E
The Israeli National Hemophilia Center, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Department of Coagulation Disorders and Anemia, SHAT Joan Pavel, Sofia, Bulgaria.
Haemophilia. 2015 Nov;21(6):784-90. doi: 10.1111/hae.12721. Epub 2015 May 20.
rIX-FP is a coagulation factor IX (recombinant), albumin fusion protein with more than fivefold half-life prolongation over other standard factor IX (FIX) products available on the market.
This prospective phase II, open-label study evaluated the safety and efficacy of rIX-FP for the prevention of bleeding episodes during weekly prophylaxis and assessed the haemostatic efficacy for on-demand treatment of bleeding episodes in previously treated patients with haemophilia B.
The study consisted of a 10-14 day evaluation of rIX-FP pharmacokinetics (PK), and an 11 month safety and efficacy evaluation period with subjects receiving weekly prophylaxis treatment. Safety was evaluated by the occurrence of related adverse events, and immunogenic events, including development of inhibitors. Efficacy was evaluated by annualized spontaneous bleeding rate (AsBR), and the number of injections to achieve haemostasis.
Seventeen subjects participated in the study, 13 received weekly prophylaxis and 4 received episodic treatment only. No inhibitors were detected in any subject. The mean and median AsBR were 1.25, and 1.13 respectively in the weekly prophylaxis arm. All bleeding episodes were treated with 1 or 2 injections of rIX-FP. Three prophylaxis subjects who were treated on demand prior to study entry had >85% reduction in AsBR compared to the bleeding rate prior to study entry.
This study demonstrated the efficacy for weekly routine prophylaxis of rIX-FP to prevent spontaneous bleeding episodes and for the treatment of bleeding episodes. In addition no safety issues were detected during the study and an improved PK profile was demonstrated.
重组人凝血因子IX-白蛋白融合蛋白(rIX-FP)是一种凝血因子IX(重组)白蛋白融合蛋白,其半衰期比市面上其他标准凝血因子IX(FIX)产品延长了五倍多。
这项前瞻性II期开放标签研究评估了rIX-FP在每周预防期间预防出血发作的安全性和有效性,并评估了其对既往接受治疗的B型血友病患者按需治疗出血发作的止血效果。
该研究包括对rIX-FP药代动力学(PK)进行10-14天的评估,以及对接受每周预防治疗的受试者进行11个月的安全性和有效性评估期。通过相关不良事件的发生情况以及免疫原性事件(包括抑制剂的产生)来评估安全性。通过年化自发出血率(AsBR)以及实现止血所需的注射次数来评估有效性。
17名受试者参与了该研究,13名接受每周预防治疗,4名仅接受按需治疗。所有受试者均未检测到抑制剂。在每周预防组中,AsBR的平均值和中位数分别为1.25和1.13。所有出血发作均通过注射1或2次rIX-FP进行治疗。三名在研究入组前按需治疗的预防组受试者,其AsBR较研究入组前的出血率降低了85%以上。
本研究证明了rIX-FP每周常规预防预防自发出血发作以及治疗出血发作的有效性。此外,研究期间未发现安全问题,并证明了其改善的药代动力学特征。