Indiana Hemophilia & Thrombosis Center, Inc., Indianapolis, IN, USA.
Center for Inherited Blood Disorders, Orange, CA, USA.
Haemophilia. 2020 Nov;26(6):975-983. doi: 10.1111/hae.14152. Epub 2020 Oct 4.
In clinical trials, recombinant factor IX fusion protein (rFIXFc) has demonstrated safety, efficacy and prolonged activity with extended dosing intervals for treatment of haemophilia B.
To assess the real-world clinical utility of rFIXFc in a variable patient population and routine clinical practice.
A multicentre, retrospective chart review was conducted of patients with haemophilia B who had received rFIXFc prophylaxis or on-demand treatment for ≥6 months across six sites in the United States.
Sixty-four eligible patients were identified who had a median (range) duration on rFIXFc of 2.7 (0.5-5.0) years. Of 32 patients on rFIXFc prophylaxis who switched from prophylaxis with another factor treatment (ie pre-rFIXFc) and had a known pre-rFIXFc dosing interval, the initial dosing interval was lengthened for 26 (81%) patients and maintained for the remaining 6 (19%) patients. Most (n = 48 [91%]) patients who received rFIXFc prophylaxis from the beginning to the end of the chart review period (n = 53) maintained or lengthened the dosing interval from first through last dose of rFIXFc. For patients receiving rFIXFc prophylaxis, there was an approximate 50% reduction in weekly factor consumption compared with pre-rFIXFc prophylaxis. Overall annualized bleed rates, annualized spontaneous bleed rates and annualized joint bleed rates decreased after switching to rFIXFc prophylaxis (n = 24 with bleed data). Compliance to recommended treatment improved or remained stable in most patients with available data (30/31).
Recombinant factor IX fusion protein prophylaxis improved bleed control, reduced overall consumption, reduced frequency of infusion and improved compliance for patients with haemophilia B in a real-world setting.
在临床试验中,重组凝血因子 IX 融合蛋白(rFIXFc)已被证明在延长给药间隔的情况下用于治疗乙型血友病是安全、有效且具有延长活性的。
评估 rFIXFc 在多变的患者人群和常规临床实践中的实际临床应用。
对美国六个地点接受 rFIXFc 预防治疗或按需治疗≥6 个月的乙型血友病患者进行了一项多中心、回顾性图表审查。
确定了 64 名符合条件的患者,他们使用 rFIXFc 的中位(范围)时间为 2.7(0.5-5.0)年。在 32 名从另一种因子治疗(即 pre-rFIXFc)的预防治疗转为 rFIXFc 预防治疗且具有已知 pre-rFIXFc 给药间隔的患者中,26 名(81%)患者的初始给药间隔延长,其余 6 名(19%)患者维持不变。大多数(n=48[91%])在图表审查期间从开始到结束一直接受 rFIXFc 预防治疗的患者(n=53)保持或延长了从第一剂到最后一剂 rFIXFc 的给药间隔。对于接受 rFIXFc 预防治疗的患者,与 pre-rFIXFc 预防治疗相比,每周因子消耗减少了约 50%。在转向 rFIXFc 预防治疗后,总体年化出血率、年化自发性出血率和年化关节出血率均降低(n=24 名有出血数据的患者)。大多数有可用数据的患者(30/31)的治疗依从性得到改善或保持稳定。
在真实环境中,重组凝血因子 IX 融合蛋白预防治疗改善了乙型血友病患者的出血控制,降低了总体消耗,减少了输注频率,并提高了治疗的依从性。