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欧洲中度或重度血友病 A 儿童使用 Kovaltry(81-8973)的真实世界证据:嵌套队列分析。

Real-world evidence on Kovaltry (81-8973) in children with moderate or severe hemophilia A in Europe: a nested cohort analysis.

机构信息

Department of Health and Social Care, University of Chester, Chester, UK.

HCD Economics, Daresbury, UK.

出版信息

Orphanet J Rare Dis. 2021 Jan 15;16(1):33. doi: 10.1186/s13023-021-01676-w.

Abstract

BACKGROUND

Untreated hemophilia A patients may experience recurrent bleeding events leading to debilitating joint damages. While RCT and pharmacokinetic data support the value of Kovaltry [an unmodified full-length recombinant factor VIII (FVIII) product], real world evidence in children is lacking. This report describes a descriptive and multivariate analysis of the effectiveness of Kovaltry in children with hemophilia A in the real-world setting, using data from medical chart abstraction and cross-sectional surveys of physicians, patients, and caregivers.

RESULTS

Male patients aged < 18 years with moderate or severe hemophilia A, residing in five European countries and treated with FVIII were studied. The co-primary endpoints were the annualized bleeding rate (ABR) and the annual FVIII utilization rate. Twenty nine patients treated with Kovaltry were included, of whom 93% had severe disease and 75% were on continuous prophylactic treatment. The mean ABR was 2.66 ± 2.06, with rates decreasing with age. The children received on average 2.45 infusions per week, consistent across age groups (median 3; range 1-3). There were no reports of inhibitor development or adverse events in the study (AEs), and all patients were satisfied or very satisfied with the treatment. An exploratory multivariate analysis suggests no significant difference in ABR or units utilized between Kovaltry and some extended half life products in children with severe hemophilia A, though characteristics of these patient cohorts were markedly different.

CONCLUSION

This analysis demonstrates the effectiveness and safety of Kovaltry in a pan-European pediatric population with severe hemophilia A.

摘要

背景

未经治疗的血友病 A 患者可能会经历反复出血事件,导致关节受损。虽然 RCT 和药代动力学数据支持 Kovaltry(一种未经修饰的全长重组凝血因子 VIII [FVIII] 产品)的价值,但缺乏儿童的真实世界证据。本报告描述了使用来自病历摘录和医生、患者和护理人员的横断面调查数据,在真实世界环境中评估 Kovaltry 在血友病 A 儿童中的有效性的描述性和多变量分析。

结果

研究纳入了居住在五个欧洲国家且接受 FVIII 治疗的年龄<18 岁的男性中度或重度血友病 A 患者。主要共同终点是年化出血率(ABR)和年化 FVIII 使用率。共纳入 29 名接受 Kovaltry 治疗的患者,其中 93%患有重度疾病,75%接受持续预防性治疗。平均 ABR 为 2.66±2.06,随着年龄的增长而降低。儿童平均每周接受 2.45 次输注,各年龄组的中位数均为 3(范围 1-3)。研究中未报告抑制剂的发展或不良事件(AE),所有患者对治疗均满意或非常满意。一项探索性多变量分析表明,在重度血友病 A 儿童中,Kovaltry 与某些延长半衰期产品的 ABR 或使用单位之间没有显著差异,尽管这些患者队列的特征明显不同。

结论

这项分析表明 Kovaltry 在欧洲范围内患有严重血友病 A 的儿科人群中的有效性和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dba3/7809751/20acbc04ca7a/13023_2021_1676_Fig1_HTML.jpg

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