Institute of Experimental Haematology and Transfusion Medicine, University Clinic Bonn, Bonn, Germany.
CSL Behring, King of Prussia, PA, USA.
Curr Med Res Opin. 2020 Jan;36(1):9-15. doi: 10.1080/03007995.2019.1662675. Epub 2019 Sep 13.
An extended half-life factor IX (FIX) fusion protein linking recombinant FIX with recombinant human albumin (rIX-FP), indicated for the treatment of hemophilia B, was approved by the European Medicines Agency in May 2016. We aimed to compare clinical outcomes and drug utilization in patients who switched from prior FIX therapies to rIX-FP. Anonymized patient chart data were collected from German institutions treating patients with hemophilia B. Patients were included if they had been treated with rIX-FP for ≥8 weeks at the time of data collection. Bleeding rates and FIX consumption were compared between rIX-FP and patients' prior FIX products. Data were obtained for 81 male patients treated with rIX-FP, including 59 who received prophylaxis with both their prior drug and rIX-FP (prophylaxis-to-prophylaxis group). Mean factor consumption in this group was 44.2 IU/kg/wk for rIX-FP compared with 82.3 IU/kg/wk for all prior FIX products. In addition, intra-patient analysis of factor consumption showed lower consumption of rIX-FP compared with prior FIX in 56 of 59 patients. Among the patients for whom bleed data were available ( = 42), annualized bleeding rate decreased from a mean (standard deviation) of 2.6 ± 2.9 on prior product to 0.3 ± 0.6 on rIX-FP. The proportion of patients with zero bleeds increased from 24% with prior therapy to 81% with rIX-FP. rIX-FP was associated with substantial reductions in bleeding rates and consumption of FIX compared with standard half-life products that require more frequent administration.
一种延长半衰期的因子 IX(FIX)融合蛋白,将重组 FIX 与重组人白蛋白(rIX-FP)连接在一起,用于治疗乙型血友病,已于 2016 年 5 月获得欧洲药品管理局批准。我们旨在比较从先前的 FIX 治疗转为 rIX-FP 治疗的患者的临床结果和药物利用情况。从治疗乙型血友病患者的德国机构收集了匿名患者图表数据。如果患者在数据收集时接受 rIX-FP 治疗≥8 周,则将其纳入研究。比较了 rIX-FP 与患者先前的 FIX 产品的出血率和 FIX 消耗情况。共纳入 81 名接受 rIX-FP 治疗的男性患者,其中 59 名患者同时接受先前药物和 rIX-FP 的预防治疗(预防治疗组)。该组 rIX-FP 的平均因子消耗为 44.2IU/kg/周,而所有先前的 FIX 产品为 82.3IU/kg/周。此外,59 名患者中有 56 名患者的个体内因子消耗分析显示,rIX-FP 的消耗低于先前的 FIX。在有出血数据的患者中(n=42),年出血率从先前产品的平均(标准差)2.6±2.9 降至 rIX-FP 的 0.3±0.6。有零出血的患者比例从先前治疗的 24%增加到 rIX-FP 的 81%。与需要更频繁给药的标准半衰期产品相比,rIX-FP 可显著降低出血率和 FIX 消耗。