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BAY 94-9027,一种聚乙二醇化重组因子 VIII,在严重血友病 A 患者中表现出延长的半衰期和更高的曲线下面积:来自临床研究的综合药代动力学评估。

BAY 94-9027, a PEGylated recombinant factor VIII, exhibits a prolonged half-life and higher area under the curve in patients with severe haemophilia A: Comprehensive pharmacokinetic assessment from clinical studies.

机构信息

Bayer, Whippany, NJ, USA.

TriHealth Cancer Institute, Cincinnati, OH, USA.

出版信息

Haemophilia. 2018 Sep;24(5):733-740. doi: 10.1111/hae.13561. Epub 2018 Jul 2.

Abstract

INTRODUCTION

Recombinant factor VIII (rFVIII) products with extended half-lives, such as BAY 94-9027, can potentially maintain higher FVIII levels for longer periods of time, thus providing improved bleeding protection vs standard-acting FVIII products.

AIM

To characterize the pharmacokinetic (PK) profile of BAY 94-9027 from phase 1, phase 2/3 (PROTECT VIII) and phase 3 (PROTECT VIII Kids) clinical trials in adults, adolescents and children with severe haemophilia A METHODS: Patients with severe haemophilia A (FVIII <1%) with >50 FVIII exposure days (EDs) and no history of inhibitors were included in the phase 1 (18-65 years, ≥150 EDs), PROTECT VIII (12-65 years, ≥150 EDs) and PROTECT VIII Kids (<12 years, >50 EDs) trials. PK parameters were assessed following a 25-IU/kg or 60-IU/kg BAY 94-9027 dose in the phase 1 study after the first and repeated infusion, in PROTECT VIII after the first and repeated 60-IU/kg infusion and in PROTECT VIII Kids after a single 60-IU/kg infusion. The chromogenic assay was used to assess FVIII activity.

RESULTS

Compared with sucrose-formulated rFVIII, BAY 94-9027 had reduced clearance that resulted in a ~1.4-fold increase in half-life and dose-normalized area under the curve (AUC). The BAY 94-9027 PK profile was comparable after single- and repeated-dose administrations. Dose-proportional increases were observed between 25- and 60-IU/kg administrations. BAY 94-9027 PK characteristics were age dependent, consistent with other FVIII products.

CONCLUSIONS

BAY 94-9027 shows an extended half-life and increased AUC vs standard-acting FVIII products. These PK characteristics will result in higher FVIII levels for longer duration.

摘要

简介

具有延长半衰期的重组因子 VIII(rFVIII)产品,如 BAY 94-9027,可以潜在地在更长的时间内维持更高的 FVIII 水平,从而提供优于标准作用因子 VIII 产品的出血保护。

目的

描述在成人、青少年和儿童重度 A 型血友病患者中进行的 BAY 94-9027 的 I 期、II/III 期(PROTECT VIII)和 III 期(PROTECT VIII Kids)临床试验的药代动力学(PK)特征。

方法

纳入在 I 期(18-65 岁,≥150 个 FVIII 暴露日(EDs),无抑制剂史)、PROTECT VIII(12-65 岁,≥150 EDs)和 PROTECT VIII Kids(<12 岁,>50 EDs)试验中具有重度 A 型血友病(FVIII<1%)且>50 EDs 暴露史和无抑制剂史的患者。在 I 期研究中,在首次和重复输注后评估 25-IU/kg 或 60-IU/kg BAY 94-9027 剂量后的 PK 参数,在 PROTECT VIII 中在首次和重复 60-IU/kg 输注后评估,在 PROTECT VIII Kids 中在单次 60-IU/kg 输注后评估。采用显色法评估 FVIII 活性。

结果

与蔗糖配方的 rFVIII 相比,BAY 94-9027 清除率降低,半衰期延长约 1.4 倍,剂量归一化 AUC 增加。单次和重复给药后 BAY 94-9027 的 PK 谱相似。在 25-和 60-IU/kg 给药之间观察到剂量比例增加。BAY 94-9027 的 PK 特征与其他 FVIII 产品一样,随年龄而变化。

结论

BAY 94-9027 与标准作用 FVIII 产品相比,半衰期延长,AUC 增加。这些 PK 特征将导致更长时间内更高的 FVIII 水平。

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