Bleeding and Clotting Disorders Institute, Peoria, Illinois, USA.
Indiana Hemophilia and Thrombosis Center, Indianapolis, Indiana, USA.
Haemophilia. 2023 Sep;29(5):1259-1268. doi: 10.1111/hae.14832. Epub 2023 Aug 16.
Recombinant porcine factor VIII (rpFVIII, susoctocog alfa) is indicated for the treatment of bleeding episodes in adults with acquired haemophilia A (AHA).
To provide long-term real-world safety and effectiveness data for rpFVIII in the management of AHA bleeding episodes.
US PASS (NCT02610127) was a multicentre, uncontrolled, open-label, post-marketing safety surveillance study conducted in adults with AHA. Data were collected retrospectively or prospectively for 180 days after rpFVIII treatment. The primary outcome was the incidence of treatment-related serious adverse events (SAEs). Secondary outcomes included haemostatic effectiveness of rpFVIII and rpFVIII utilization.
Fifty-three patients were enrolled from December 2015 to June 2019 (prospective, n = 30; retrospective, n = 23). Six patients experienced seven treatment-related SAEs (incidence 12.0%). The most common treatment-related SAE was FVIII inhibition (inhibiting antibodies to rpFVIII; incidence 8.0%, 95% CI: 2.2-19.2). Five patients reported seven thromboembolic events; one was an SAE and possibly related to rpFVIII. Of bleeding events treated with rpFVIII, 80.3% (57/71) of bleeds resolved with rpFVIII. The median (range) dose of rpFVIII per infusion was 50 (10-300) units/kg, with a median (range) of 6.0 (1-140) infusions and a median (range) time from bleed onset to bleed resolution of 14.0 (2.0-132.7) days.
In this real-world study of rpFVIII for AHA, no new safety signals were identified compared with previous clinical trial findings. Eighty percent of bleeds resolved with rpFVIII treatment.
重组猪因子 VIII(rpFVIII,苏可托戈阿尔法)用于治疗成人获得性血友病 A(AHA)的出血发作。
提供 rpFVIII 治疗 AHA 出血发作的长期真实世界安全性和有效性数据。
美国 PASS 研究(NCT02610127)是一项多中心、非对照、开放性、上市后安全性监测研究,纳入了 AHA 成人患者。在 rpFVIII 治疗后 180 天内,数据以回顾性或前瞻性方式收集。主要结局是治疗相关严重不良事件(SAE)的发生率。次要结局包括 rpFVIII 的止血效果和 rpFVIII 的利用情况。
2015 年 12 月至 2019 年 6 月期间,共纳入 53 例患者(前瞻性 n=30,回顾性 n=23)。6 例患者发生 7 例治疗相关 SAE(发生率 12.0%)。最常见的治疗相关 SAE 是 FVIII 抑制(对 rpFVIII 的抑制性抗体;发生率 8.0%,95%CI:2.2-19.2)。5 例患者报告了 7 例血栓栓塞事件,其中 1 例为 SAE,可能与 rpFVIII 相关。在接受 rpFVIII 治疗的出血事件中,80.3%(57/71)的出血得到缓解。每剂输注 rpFVIII 的中位数(范围)剂量为 50(10-300)单位/kg,中位数(范围)输注次数为 6.0(1-140)次,从出血发作到出血缓解的中位数(范围)时间为 14.0(2.0-132.7)天。
与之前的临床试验结果相比,在这项关于 rpFVIII 治疗 AHA 的真实世界研究中,未发现新的安全性信号。80%的出血在 rpFVIII 治疗后得到缓解。