Brand B, Gruppo R, Wynn T T, Griskevicius L, Lopez Fernandez M F, Chapman M, Dvorak T, Pavlova B G, Abbuehl B E
Universitaetsspital Zuerich, Zuerich, Switzerland.
Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Haemophilia. 2016 Jul;22(4):e251-8. doi: 10.1111/hae.12963. Epub 2016 Jun 21.
BAX 855 is a pegylated full-length recombinant factor VIII (rFVIII) with an extended half-life, built on a licensed rFVIII (ADVATE(®) ). BAX 855 demonstrated efficacy and safety in prophylaxis and the treatment of bleeding episodes in previously treated patients (PTPs) with severe haemophilia A.
This phase 3 surgery study evaluates the haemostatic efficacy and safety of BAX 855 for perioperative haemostasis in PTPs with severe haemophilia A undergoing surgery.
Elective procedures were prospectively classified as major or minor. The dose and frequency of BAX 855 administered perioperatively were to be guided by each patient's pharmacokinetic profile for major procedures or BAX 855 incremental recovery for minor procedures. Haemostatic efficacy was evaluated using a predefined scale. Blood loss was compared to the expected average and maximum blood loss predicted preoperatively.
A total of 15 male patients (aged 19-52 years) underwent 15 procedures (11 major and four minor). The overall intra- and perioperative haemostatic efficacy of BAX 855 was 'excellent' in all 15 subjects (100%). Postoperatively, evaluated at postoperative Day 1, all treatments were 'excellent' except for one minor (dental) procedure which was rated 'good'. No related adverse events, allergic reactions, thrombotic events, nor signs of immunogenicity in terms of induction of binding antibodies to FVIII, PEG or PEG-VIII, or FVIII inhibitors were observed.
These results demonstrate that BAX 855 is safe and haemostatically effective in patients with severe haemophilia A undergoing surgery.
BAX 855是一种聚乙二醇化的全长重组因子VIII(rFVIII),半衰期延长,基于已获许可的rFVIII(ADVATE®)构建。BAX 855在既往接受治疗的重度甲型血友病患者(PTPs)的预防和出血发作治疗中显示出疗效和安全性。
这项3期手术研究评估BAX 855在接受手术的重度甲型血友病PTPs围手术期止血的止血疗效和安全性。
择期手术前瞻性地分为大手术或小手术。围手术期给予BAX 855的剂量和频率将根据每位患者大手术的药代动力学曲线或小手术的BAX 855增量恢复情况来指导。使用预定义的量表评估止血疗效。将失血量与术前预测的预期平均和最大失血量进行比较。
共有15名男性患者(年龄19 - 52岁)接受了15例手术(11例大手术和4例小手术)。在所有15名受试者(100%)中,BAX 855的总体术中和围手术期止血疗效均为“优秀”。术后,在术后第1天进行评估,除1例小手术(牙科)评为“良好”外,所有治疗均为“优秀”。未观察到相关不良事件、过敏反应、血栓形成事件,也未观察到在诱导针对FVIII、聚乙二醇或聚乙二醇 - VIII的结合抗体或FVIII抑制剂方面的免疫原性迹象。
这些结果表明,BAX 855在接受手术的重度甲型血友病患者中是安全且止血有效的。