Royal London Haemophilia Centre, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Van Creveldkliniek, University Medical Center, Utrecht, Netherlands.
Haemophilia. 2020 Nov;26(6):e262-e271. doi: 10.1111/hae.14036. Epub 2020 Jun 4.
Recombinant factor IX Fc fusion protein (rFIXFc) has demonstrated efficacy for treatment of haemophilia B in the Phase 3 B-LONG and Kids B-LONG studies. However, long-term rFIXFc safety and efficacy data have not yet been reported.
To report long-term rFIXFc safety and efficacy in subjects with haemophilia B.
B-YOND (NCT01425723) was an open-label extension for eligibl previously treated subjects who completed B-LONG or Kids B-LONG. Subjects received ≥1 treatment regimen: weekly prophylaxis (WP), individualized interval prophylaxis (IP), modified prophylaxis or episodic treatment. Subjects could switch regimens at any time. The primary endpoint was inhibitor development.
Ninety-three subjects from B-LONG and 27 from Kids B-LONG (aged 3-63 years) were enrolled. Most subjects received WP (B-LONG: n = 51; Kids B-LONG: n = 23). For subjects from B-LONG, median (range) treatment duration was 4.0 (0.3-5.4) years and median (range) number of exposure days (EDs) was 146 (8-462) EDs. Corresponding values for paediatric subjects were 2.6 (0.2-3.9) years and 132 (50-256) EDs. No inhibitors were observed (0 per 1000 subject-years; 95% confidence interval, 0-8.9) and the overall rFIXFc safety profile was consistent with prior studies. Annualized bleed rates remained low and extended-dosing intervals were maintained for most subjects. Median dosing interval for the IP group was approximately 14 days for adults and adolescents (n = 31) and 10 days for paediatric subjects (n = 5).
B-YOND results confirm the long-term (up to 5 years, with cumulative duration up to 6.5 years) well-characterized safety and efficacy of rFIXFc treatment for haemophilia B.
重组凝血因子 IX Fc 融合蛋白(rFIXFc)在 3 期 B-LONG 和 Kids B-LONG 研究中已被证明对乙型血友病的治疗有效。然而,尚未报告 rFIXFc 的长期安全性和疗效数据。
报告乙型血友病患者接受 rFIXFc 长期治疗的安全性和疗效。
B-YOND(NCT01425723)是一项开放标签扩展研究,纳入了完成 B-LONG 或 Kids B-LONG 研究的先前接受过治疗的合格受试者。受试者接受了至少 1 种治疗方案:每周预防治疗(WP)、个体化间隔预防治疗(IP)、改良预防治疗或按需治疗。受试者可以随时切换治疗方案。主要终点是抑制剂的发生情况。
93 名来自 B-LONG 研究和 27 名来自 Kids B-LONG 研究(年龄 3-63 岁)的受试者被纳入。大多数受试者接受 WP(B-LONG:n=51;Kids B-LONG:n=23)。对于来自 B-LONG 研究的受试者,中位(范围)治疗持续时间为 4.0(0.3-5.4)年,中位(范围)暴露天数(EDs)为 146(8-462)EDs。儿科受试者的相应值分别为 2.6(0.2-3.9)年和 132(50-256)EDs。未观察到抑制剂(每 1000 个受试者年 0 例;95%置信区间,0-8.9),rFIXFc 的总体安全性特征与之前的研究一致。年出血率仍然较低,大多数受试者维持了延长的给药间隔。成人和青少年(n=31)的 IP 组的中位给药间隔约为 14 天,儿科受试者(n=5)的中位给药间隔约为 10 天。
B-YOND 的研究结果证实了 rFIXFc 治疗乙型血友病的长期(长达 5 年,累积时间长达 6.5 年)安全性和有效性,特征明确。