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非活化凝血因子 IX 在严重或中度血友病 B 患者中的安全性、免疫原性和止血疗效:一项延续研究。

Safety, Immunogenicity, and Hemostatic Efficacy of Nonacog Gamma in Patients With Severe or Moderately Severe Hemophilia B: A Continuation Study.

机构信息

Department of Hemostasis Disorders and Internal Medicine, Institute of Haematology and Transfusion Medicine, Warsaw, Poland.

Institute of Blood Pathology and Transfusion Medicine, Lviv, Ukraine.

出版信息

Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620950836. doi: 10.1177/1076029620950836.

Abstract

This phase 3, prospective, open-label, multicenter, continuation study (NCT01286779) investigated the use of a recombinant factor IX (FIX), nonacog gamma (BAX 326, RIXUBIS) in patients with severe or moderately severe hemophilia B. The study population included 85 patients transitioning from a phase 1/3 pivotal study (NCT01174446), a pediatric study (NCT01488994), and 30 newly recruited patients, naïve to nonacog gamma. Patients received nonacog gamma as prophylaxis treatment (standard, modified or PK-tailored) or on-demand, as determined by the investigator. Treatment was assessed for safety, immunogenicity, hemostatic efficacy and consumption. In this study, after ≥100 exposure days, nonacog gamma resulted in no treatment-related serious adverse events, and no patients developed inhibitory antibodies to FIX. Nonacog gamma was efficacious at controlling bleeding episodes, with an 89.1% overall hemostatic efficacy rating of excellent or good, and 56% of bleeds resolved with one infusion. The annualized bleeding rate was considerably lower during prophylactic treatment (median ABR of 1.3 in 108 patients) than during on-demand treatment (median ABR of 16.5 in 13 patients). These results show that in previously treated patients and nonacog gamma-naïve patients, long-term use of nonacog gamma had acceptable safety and tolerability, and was efficacious as a prophylactic treatment for the management of bleeding episodes.NCT01286779, EudraCT: 2010-022726-33.

摘要

这项 3 期、前瞻性、开放标签、多中心、延续研究(NCT01286779)调查了重组凝血因子 IX(FIX)、非活化凝血因子 IX(FIX)(BAX 326,RIXUBIS)在重度或中度重度乙型血友病患者中的应用。研究人群包括 85 名从 1 期/3 期关键研究(NCT01174446)、儿科研究(NCT01488994)和 30 名新招募的、对非活化凝血因子 IX 无经验的患者中过渡而来的患者。根据研究者的决定,患者接受非活化凝血因子 IX 作为预防治疗(标准、改良或 PK 定制)或按需治疗。治疗安全性、免疫原性、止血疗效和消耗情况进行了评估。在这项研究中,≥100 个暴露日后,非活化凝血因子 IX 没有导致与治疗相关的严重不良事件,也没有患者产生针对 FIX 的抑制性抗体。非活化凝血因子 IX 能有效控制出血发作,总体止血疗效评分为优秀或良好的比例为 89.1%,56%的出血发作通过一次输注得到解决。在预防治疗期间(108 名患者的年出血率中位数 ABR 为 1.3),年出血率明显低于按需治疗期间(13 名患者的 ABR 中位数为 16.5)。这些结果表明,在先前接受治疗的患者和非活化凝血因子 IX 无经验的患者中,长期使用非活化凝血因子 IX 具有可接受的安全性和耐受性,并且作为预防治疗管理出血发作是有效的。NCT01286779,EudraCT:2010-022726-33。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ef2/7469725/47f4b38733cb/10.1177_1076029620950836-fig1.jpg

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