Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy.
Faculty of Health Sciences, University of the Witwatersrand and NHLS, Johannesburg, South Africa.
Haemophilia. 2020 Nov;26(6):1009-1018. doi: 10.1111/hae.14183. Epub 2020 Oct 21.
Persons with haemophilia A (PwHA) with factor (F)VIII inhibitors, including children, have impaired health-related quality of life (HRQoL). The HAVEN 2 study (NCT027955767) of paediatric PwHA with FVIII inhibitors demonstrated that subcutaneous emicizumab prophylaxis resulted in low annualizedbleed rates.
We assessed the impact of emicizumab prophylaxis on the HRQoL of children and their caregivers participating in HAVEN 2.
Children aged 8-11 years self-reported HRQoL using the Haemophilia-Specific Quality of Life Assessment Instrument for Children and Adolescents Short Form (Haemo-QoL SF II). Caregivers of children aged 0-11 years completed the Adapted Inhibitor-Specific Quality of Life Assessment with Aspects of Caregiver Burden. All scores were transformed to a 0-100 scale, where lower scores reflect a better HRQoL. The number of missed days from school/day care and hospitalizations was also recorded.
In HAVEN 2 (n = 88), the median age was 6.5 years (range: 1-15 years); 85 participants were aged < 12 years and included in this analysis, and 34 participants were aged 8-11 years, thereby eligible to complete the Haemo-QoL SF II questionnaire. The mean (standard deviation, n) baseline Haemo-QoL SF II 'Total' score was 30.2 (14.9, 30), indicating moderate impairment; with emicizumab, mean score decreased by -9.62 (7.73, 17) points to 23.0 (13.93, 20) by Week 49. The most improved domains were 'Sports & School' and 'Physical Health'. Caregivers reported similar improvements.
Prophylactic emicizumab is accompanied by substantial and sustained improvements in HRQoL of paediatric PwHA with FVIII inhibitors and their caregivers.
患有因子(F)VIII 抑制剂的甲型血友病(HA)患者(包括儿童)的健康相关生活质量(HRQoL)受损。HAVEN 2 研究(NCT027955767)显示,皮下注射依库珠单抗预防治疗可降低年化出血率。
我们评估了依库珠单抗预防治疗对 HAVEN 2 中接受治疗的儿童和其照顾者 HRQoL 的影响。
8-11 岁的儿童使用儿童青少年血友病特异性生活质量评估量表(Haemo-QoL SF II)短表自我报告 HRQoL。0-11 岁儿童的照顾者完成了经照顾者负担方面修正的抑制剂特异性生活质量评估。所有评分均转换为 0-100 分制,得分越低表明 HRQoL 越好。同时还记录了缺课/缺勤天数和住院天数。
在 HAVEN 2 中(n=88),中位年龄为 6.5 岁(范围:1-15 岁);85 名参与者年龄<12 岁,包含在本分析中,其中 34 名年龄为 8-11 岁,有资格完成 Haemo-QoL SF II 问卷。Haemo-QoL SF II“总体”评分的基线平均(标准偏差,n)为 30.2(14.9,30),表明中度受损;使用依库珠单抗后,到第 49 周时平均评分降低了-9.62(7.73,17)分,降至 23.0(13.93,20)。改善最明显的领域是“运动和学校”和“身体健康”。照顾者报告了类似的改善。
预防性依库珠单抗可显著和持续改善患有 FVIII 抑制剂的儿童血友病患者及其照顾者的 HRQoL。