Choraria Nirmalkumar, Rangarajan Savita, John M Joseph, Apte Shashikant, Gupta Pritam, Pai Seema, Chand Rohit, Parvatini Shyam, Ramakanth G S H, Rupon Jeremy, Chhabra Amit, Muley Hitesh Bhaskarrao, Simoneau Damien
Nirmal Hospital Pvt. Ltd, Surat, Gujarat India.
K.J. Somaiya Hospital & Research Center, Mumbai, India.
Indian J Hematol Blood Transfus. 2023 Oct;39(4):630-634. doi: 10.1007/s12288-022-01588-0. Epub 2022 Nov 27.
Hemophilia B is an X-linked congenital bleeding disorder caused by a deficiency of coagulation factor IX (FIX) clotting activity. This study evaluated safety and efficacy of nonacog alfa, a recombinant human blood coagulation FIX replacement product, in males aged 12-65 years with hemophilia B (FIX activity ≤ 2%) with or without inhibitors in India.
In this multicenter, open-label, post-approval phase 4 study, participants were treated for up to 8 weeks, with up to a 4-week screening period and a subsequent post-treatment 28-day safety observation period. Intravenous nonacog alfa 40 IU/kg (range 13-78 IU/kg) was administered at intervals of 3-4 days, in accordance with the approved local product document.
A total of 25 participants were enrolled and completed the study. No participants developed FIX inhibitors during the study, experienced treatment-related adverse events (AEs) or serious AEs, or developed a thrombotic event and/or hypersensitivity reaction. No participants experienced bleeding events requiring on-demand treatment with nonacog alfa. Seventeen bleeding episodes (16 spontaneous and 1 traumatic) were reported in 10 participants; all occurred post treatment, with the exception of a minor gum-bleeding event, and were managed without treatment. The mean (SD) annualized total factor consumption (TFC) per patient was 224,582 (75,527) IU; the mean (SD) annualized TFC by weight per patient was 3639 (573) IU/kg.
Nonacog alfa was safe and effective for the prevention of hemorrhagic episodes in Indian males with congenital, severe hemophilia B. No participants developed FIX inhibitors, and no new safety signals were reported.
乙型血友病是一种X连锁先天性出血性疾病,由凝血因子IX(FIX)凝血活性缺乏引起。本研究评估了重组人凝血FIX替代产品非阿可法在印度12至65岁患有或不患有抑制剂的乙型血友病(FIX活性≤2%)男性中的安全性和有效性。
在这项多中心、开放标签、批准后4期研究中,参与者接受了长达8周的治疗,包括长达4周的筛查期和随后28天的治疗后安全观察期。根据批准的当地产品文件,每3 - 4天静脉注射一次非阿可法40 IU/kg(范围为13 - 78 IU/kg)。
共有25名参与者入组并完成了研究。在研究期间,没有参与者产生FIX抑制剂,没有经历与治疗相关的不良事件(AE)或严重AE,也没有发生血栓形成事件和/或过敏反应。没有参与者经历需要使用非阿可法进行按需治疗的出血事件。10名参与者报告了17次出血发作(16次自发性出血和1次创伤性出血);除了一次轻微牙龈出血事件外,所有出血事件均发生在治疗后,且无需治疗即可处理。每位患者的平均(标准差)年化总因子消耗量(TFC)为224,582(75,527)IU;每位患者按体重计算的平均(标准差)年化TFC为3639(573)IU/kg。
非阿可法对于预防印度先天性重度乙型血友病男性的出血发作是安全有效的。没有参与者产生FIX抑制剂,也没有报告新的安全信号。