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在中国既往接受过治疗的重度甲型血友病患者中,重组人凝血因子Ⅷ(Turoctocog Alfa)预防和治疗出血发作的安全性和有效性:来自Guardian 7试验的结果

Safety and Efficacy of Turoctocog Alfa in the Prevention and Treatment of Bleeding Episodes in Previously Treated Patients from China with Severe Hemophilia A: Results from the Guardian 7 Trial.

作者信息

Wu Runhui, Sun Jing, Xu Weiqun, Hu Qun, Li Wenqian, Xiao Jianwen, Yang Feng'e, Zeng Xiaojing, Zeng Yun, Zhou Jianfeng, Matytsina Irina, Zhang Sali, Pluta Michael, Yang Renchi

机构信息

Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Children's Health Center, Beijing, People's Republic of China.

Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China.

出版信息

Ther Clin Risk Manag. 2020 Jun 23;16:567-578. doi: 10.2147/TCRM.S243146. eCollection 2020.

Abstract

PURPOSE

Hemophilia care in China is characterized by widespread use of on-demand regimens and low-dose prophylaxis. With a limited number of approved recombinant factor VIII (FVIII) products, the incidence of arthropathy and disability in hemophilia patients remains high in China. The purpose of this trial was to evaluate the safety and efficacy of turoctocog alfa for prophylaxis and treatment of bleeding episodes in patients from China with severe hemophilia A across all age groups.

PATIENTS AND METHODS

In this Phase 3, open-label trial, previously treated males of all ages with severe hemophilia A from China received turoctocog alfa for prophylaxis or on-demand treatment of bleeds. The primary endpoint was hemostatic effect for the treatment of bleeds during the main phase of the trial. Secondary endpoints included annualized bleeding rate during prophylaxis and the frequency of FVIII inhibitor development.

RESULTS

Overall, 42 pediatric patients (age <12 years) and 26 adolescent/adult patients (≥12 years) were dosed with turoctocog alfa; 51 patients initiated treatment with prophylaxis, while 17 patients initiated on-demand treatment. During the main phase of the trial (6 months), hemostatic success was 95.1%. During the full trial (up to 24 months), hemostatic success was 95.4%; the overall median ABR was 1.18 bleeds/patient/year for prophylaxis patients; and 25 (51.0%) of 49 patients with target joints at baseline had all target joints resolved. No FVIII inhibitors (≥0.6 BU) were reported.

CONCLUSION

Turoctocog alfa was safe and effective for prophylaxis and treatment of bleeding episodes and for surgery in patients from China with severe hemophilia A across all ages.

摘要

目的

中国的血友病治疗以广泛使用按需治疗方案和低剂量预防治疗为特点。由于获批的重组凝血因子VIII(FVIII)产品数量有限,中国血友病患者的关节病和残疾发生率仍然很高。本试验的目的是评估聚乙二醇化重组人凝血因子VIII预防和治疗中国各年龄段重度A型血友病患者出血事件的安全性和有效性。

患者与方法

在这项3期开放标签试验中,来自中国的所有年龄的曾接受过治疗的重度A型血友病男性患者接受聚乙二醇化重组人凝血因子VIII进行出血的预防或按需治疗。主要终点是试验主要阶段出血治疗的止血效果。次要终点包括预防期间的年化出血率和FVIII抑制剂产生的频率。

结果

总体而言,42名儿科患者(年龄<12岁)和26名青少年/成人患者(≥12岁)接受了聚乙二醇化重组人凝血因子VIII治疗;51名患者开始预防治疗,17名患者开始按需治疗。在试验的主要阶段(6个月),止血成功率为95.1%。在整个试验期间(长达24个月),止血成功率为95.4%;预防治疗患者的总体中位年化出血率为1.18次出血/患者/年;基线时49名有关节目标的患者中有25名(51.0%)所有关节目标均得到解决。未报告FVIII抑制剂(≥0.6 BU)。

结论

聚乙二醇化重组人凝血因子VIII对于中国各年龄段重度A型血友病患者预防和治疗出血事件以及手术是安全有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5969/7320881/712e15f3185a/TCRM-16-567-g0001.jpg

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