NIHR Academic Clinic Fellow in Haematology, Haematology Department, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Oxford Biomedical Research Centre, Oxford Haemophilia and Thrombosis Centre, Oxford, UK.
Haemophilia. 2020 Mar;26(2):278-281. doi: 10.1111/hae.13936. Epub 2020 Feb 21.
Extended half-life factor IX concentrates (EHL-FIX) can be administered weekly to prevent bleeding for persons with severe haemophilia B. We report the experience of a large UK haemophilia comprehensive care centre using low dose EHL-FIX for persons with severe haemophilia B.
The low doses used in real world are approximately half of the doses used in clinical trials. We aim to assess the efficacy and safety of low dose EHL-FIX.
Data from a cohort of 13 patients who were switched from standard half-life factor IX (SHL-FIX) to Alprolix (mean dose 31.5 IU/kg) and seven patients who switched from standard half-life factor IX to Idelvion (mean dose 20.2 IU/kg) were included.
The median annualized bleeding rate was similar for SHL-FIX (median 3, interquartile range [IQR] 1-5) and EHL-FIX (median 3, IQR 1-5.25). Quality of life scores, measured using the European Quality of Life 5 Dimensions assessment were similar for SHL-FIX (median 0.76, IQR: 0.63-0.84) and EHL-FIX (median 0.79, IQR: 0.58-0.88).
This study shows that EHL-FIX given at low doses can be effective for prevention of bleeding for persons with severe haemophilia B.
延长半衰期因子 IX 浓缩物(EHL-FIX)可每周给药一次,以预防严重乙型血友病患者出血。我们报告了一个英国大型血友病综合护理中心使用低剂量 EHL-FIX 治疗严重乙型血友病患者的经验。
在真实世界中使用的低剂量约为临床试验中使用剂量的一半。我们旨在评估低剂量 EHL-FIX 的疗效和安全性。
纳入了从标准半衰期因子 IX(SHL-FIX)转为 Alprolix(平均剂量 31.5 IU/kg)的 13 名患者和从标准半衰期因子 IX 转为 Idelvion(平均剂量 20.2 IU/kg)的 7 名患者的数据。
SHL-FIX(中位数 3,四分位距 [IQR] 1-5)和 EHL-FIX(中位数 3,IQR 1-5.25)的年化出血率中位数相似。使用欧洲生活质量 5 维度评估量表测量的生活质量评分在 SHL-FIX(中位数 0.76,IQR:0.63-0.84)和 EHL-FIX(中位数 0.79,IQR:0.58-0.88)之间相似。
本研究表明,低剂量 EHL-FIX 可有效预防严重乙型血友病患者出血。