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长达 5 年的重组凝血因子 IX Fc 融合蛋白治疗乙型血友病患者的长期安全性和持续疗效:B-YOND 扩展研究结果。

Long-term safety and sustained efficacy for up to 5 years of treatment with recombinant factor IX Fc fusion protein in subjects with haemophilia B: Results from the B-YOND extension study.

机构信息

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.

出版信息

Haemophilia. 2020 Nov;26(6):e262-e271. doi: 10.1111/hae.14036. Epub 2020 Jun 4.

Abstract

INTRODUCTION

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.

AIM

To report long-term rFIXFc safety and efficacy in subjects with haemophilia B.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

摘要

简介

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。

目的

报告乙型血友病患者接受 rFIXFc 长期治疗的安全性和疗效。

方法

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。

结果

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。

结论

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。

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