1
|
Meijon-Ortigueira MDM, Alvarez-Roman MT, De La Corte H, Butta N, Jimenez-Yuste V. Predicting joint involvement through tailored prophylaxis in severe haemophilia A, is it possible? Haemophilia 2024; 30:678-684. [PMID: 38575526 DOI: 10.1111/hae.15014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/12/2024] [Accepted: 03/26/2024] [Indexed: 04/06/2024]
Abstract
INTRODUCTION Tailored prophylaxis is the current treatment regimen for patients with severe haemophilia A. Recently, published guidelines describe two possible approaches, based on clinical characteristics or estimation of pharmacokinetic parameters. However, both have strengths and weaknesses, and their characteristics need to be integrated to optimize treatment appropriately. In this paper, we present a model that considers together the characteristics of prophylaxis and the relevance of each. METHODS The age at initiation of prophylaxis, number of bleeding events, treatment regimen, therapeutic adherence, FVIII trough levels, and joint status were analyzed in 59 patients followed at La Paz University Hospital between January 2000 and December 2019. RESULTS The mean duration of primary prophylaxis of 113.37 ± 57.79 months. Eighty-three percent (n = 49) had no joint status involvement at the end of follow-up (HJHS and HEAD-US = 0). The median ABR was 0.7 (IQR 0.2 -1.0) and 54.2% presented trough levels of FVIII during follow-up >1 IU/dL. 72,9% engaged in some type of physical activity and overall adherence was over 85% in all patients evaluated. The regression analysis performed, considering all these factors, showed that the initiation of prophylaxis before 21 months of age was the most relevant protective factor against the appearance of joint involvement (OR 88.33 p.031 CI 95% 1.49-5224.40) CONCLUSION: Early initiation of prophylaxis was the most relevant factor in the protection of joint status. More comprehensive analysis models adapted to the characteristics of each population, are needed to adequately individualize treatment.
Collapse
Affiliation(s)
| | | | - Hortensia De La Corte
- Department of Physical Medicine and Rehabilitation, La Paz University Hospital-IdiPAZ, Madrid, Spain
| | - Nora Butta
- Department of Hematology, La Paz University Hospital-IdiPAZ, Madrid, Spain
| | - Victor Jimenez-Yuste
- Department of Hematology, La Paz University Hospital-IdiPAZ, Autonomous University of Madrid, Madrid, Spain
| |
Collapse
|
2
|
Escobar MA, Kavakli K. Plasma-derived human factor X concentrate for the treatment of patients with hereditary factor X deficiency. Haemophilia 2024; 30:59-67. [PMID: 37902395 DOI: 10.1111/hae.14894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/18/2023] [Accepted: 10/07/2023] [Indexed: 10/31/2023]
Abstract
INTRODUCTION Hereditary factor X (FX) deficiency (HFXD) is an autosomal recessive rare bleeding disorder that leads to defects in the FX protein. Depending on the degree of deficiency, patients may be at risk of life-threatening bleeding episodes. Historical treatments for FX deficiency include prothrombin complex concentrates, which can increase the risk of thrombosis, and fresh frozen plasma, which can cause volume overload and transfusion reactions. Plasma-derived FX (pdFX), a single-factor, high-purity, high-potency human FX treatment, was approved in 2015 in the United States and in 2016 in Europe for on-demand treatment and prophylaxis of bleeding episodes and perioperative management of patients with HFXD. METHODS Five studies that examined the use of pdFX in patients with mild (plasma FX activity [FX:C] ≥5 IU/dL), moderate (FX:C ≥1 and <5 IU/dL), or severe (FX:C < 1 IU/dL) HFXD were reviewed: TEN01, TEN02 and TEN03 were prospective, open-label, multicentre, nonrandomised studies, and TEN05 and TEN06 were multicentre retrospective studies. RESULTS When used as an on-demand treatment, pdFX was judged by investigators to be successful in treating 41/42 (97.6%), 2/3 (66.6%) and 79/79 (100%) bleeds in TEN01, TEN02 and TEN05, respectively. When used prophylactically, pdFX was judged 'excellent' for the prevention of bleeds in nine (100%) and eight (100%) patients in TEN02 and TEN05, respectively. Perioperative treatment and pharmacokinetics were also assessed. pdFX was safe and well tolerated. CONCLUSIONS Together, these studies support the use of pdFX for on-demand treatment of bleeding, routine prophylaxis, and perioperative management of bleeding in patients with HFXD.
Collapse
Affiliation(s)
- Miguel A Escobar
- University of Texas Health Science Center at Houston-McGovern Medical School and the Gulf States Hemophilia and Thrombophilia Center, Houston, Texas, USA
| | - Kaan Kavakli
- Department of Pediatrics, Division of Hemato-Oncology, Ege University Faculty of Medicine, İzmir, Turkey
| |
Collapse
|
3
|
Meijón Ortigueira MDM, Álvarez-Román MT, De La Corte Rodríguez H, Butta Coll N, Jiménez-Yuste V. Long-term impact of primary prophylaxis on joint status in patients with severe hemophilia A. Res Pract Thromb Haemost 2023; 7:100005. [PMID: 36891521 PMCID: PMC9986103 DOI: 10.1016/j.rpth.2022.100005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 10/14/2022] [Accepted: 10/23/2022] [Indexed: 01/13/2023] Open
Abstract
Background Primary prophylaxis with factor VIII concentrates is the therapeutic gold standard for severe hemophilia A. Although this approach will change substantially with the use of nonsubstitutive therapies, the long-term effects of primary prophylaxis remain unclear. We present information on joint health with tailored primary prophylaxis in a consecutive series at a single center. Methods We retrospectively analyzed 60 patients who did not develop early inhibitors. The annual bleeding rate and annual joint bleeding rate, prophylaxis characteristics, physical activity, adherence, and development of inhibitors were compared between those with and without joint involvement at the end of follow-up. Joint involvement was defined as a Hemophilia Joint Health Score or Hemophilia Early Arthropathy Detection with an ultrasound score ≥1. Results Among 60 patients with median follow-up of 113 ± 6 months after starting prophylaxis, 76.7% had no joint involvement at the end of the follow-up. Those without joint involvement started prophylaxis at a younger median age (1 [IQR 1-1] year vs 3 [IQR 2-4.3] years). They also had lower annual joint bleeding rate (0.0 [IQR 0-0.2] vs 0.2 [IQR 0.1-0.5]), were more often physically active (70% vs 50%), and had lower trough factor VIII levels. Adherence to treatment was not significantly different between groups. Conclusion Initiation of primary prophylaxis at a younger age was the main factor associated with long-term preservation of joint status in patients with severe hemophilia A.
Collapse
Affiliation(s)
| | | | | | - Nora Butta Coll
- Department of Hematology, La Paz University Hospital-IdiPAZ, Madrid, Spain
| | - Víctor Jiménez-Yuste
- Department of Hematology, La Paz University Hospital-IdiPAZ, Autonoma University, Madrid, Spain
| |
Collapse
|
4
|
Payne J, Batsuli G, Leavitt AD, Mathias M, McGuinn CE. A review of the pharmacokinetics, efficacy and safety of high‐purity factor X for the prophylactic treatment of hereditary factor X deficiency. Haemophilia 2022; 28:523-531. [PMID: 35499465 PMCID: PMC9541946 DOI: 10.1111/hae.14570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/07/2022] [Accepted: 04/02/2022] [Indexed: 11/29/2022]
Abstract
Introduction Hereditary factor X (FX) deficiency (FXD) is a rare autosomal recessive bleeding disorder. Plasma‐derived FX (pdFX) is a high‐purity FX concentrate approved in the United States and Europe for the treatment and prophylaxis of bleeding episodes and for peri‐operative management in patients with hereditary FXD (HFXD). Aim To review pharmacokinetic dosing, efficacy, and safety data for pdFX as routine prophylaxis for HFXD. Methods Summary of the published pharmacokinetic and safety data from TEN01, TEN02, TEN05, and real‐world publications of pdFX for prophylaxis. Results Pharmacokinetic modelling data from the phase 3 TEN01 study supported administration of pdFX 25 IU/kg twice weekly for routine prophylaxis in adolescents/adults (aged ≥12 years). Results from nine paediatric patients in the phase 3 TEN02 study and eight adolescents/adults (aged ≥12 years) in the retrospective data‐collection TEN05 study, along with real‐world evidence, showed that routine prophylaxis with pdFX ≈40 IU/kg twice weekly in patients aged <12 years and pdFX ≈25 IU/kg twice weekly in patients aged ≥12 years was effective in bleeding prevention. Conclusions pdFX was well tolerated in clinical studies, with no new safety signals identified during routine prophylactic use. Based on current evidence, it is recommended that routine prophylaxis with pdFX be initiated at 25 IU/kg twice weekly in adults/adolescents ≥12 years of age, and at a dosage of 40 IU/kg twice weekly in children <12 years of age. Thereafter, FX levels should be closely monitored, and dosages should be adjusted according to clinical response and to maintain trough levels ≥5 IU/dl.
Collapse
Affiliation(s)
- Jeanette Payne
- Department of Paediatric Haematology Sheffield Children's NHS Foundation Trust Sheffield UK
| | - Glaivy Batsuli
- Department of Pediatrics Division of Pediatric Hematology and Oncology Emory University Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta Atlanta Georgia USA
| | - Andrew D. Leavitt
- Departments of Laboratory Medicine & Medicine (Hematology) University of California San Francisco San Francisco California USA
| | - Mary Mathias
- Great Ormond Street Hospital for Children NHS Foundation Trust Haemophilia Comprehensive Care Centre London UK
| | - Catherine E. McGuinn
- Department of Pediatrics Division of Pediatric Hematology Oncology Weill Cornell Medicine New York New York USA
| |
Collapse
|
5
|
Morgan G, Brighton S, Laffan M, Goudemand J, Franks B, Finnegan A. The Cost of Von Willebrand Disease in Europe: The CVESS Study. Clin Appl Thromb Hemost 2022; 28:10760296221120583. [PMID: 35979588 PMCID: PMC9393670 DOI: 10.1177/10760296221120583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Von Willebrand disease (VWD) is one of the most common inherited bleeding
disorders, imposing a substantial health impact and financial burden. The
Cost of von Willebrand disease in
Europe: A Socioeconomic Study
(CVESS) characterises the socio-economic cost of VWD across Germany, Spain,
Italy, France, and the UK. Methods A retrospective, cross-sectional design captured 12 months of patient disease
management, collected from August-December 2018, for 974 patients. This
enabled estimation of direct medical, direct non-medical and indirect costs,
utilising prevalence estimates to extrapolate to population level. Results Total annual direct medical cost (including/excluding von Willebrand factor
[VWF]) across all countries was the highest cost
(€2 845 510 345/€444 446 023), followed by indirect costs (€367 330 271) and
direct non-medical costs (€60 223 234). Differences were seen between
countries: the UK had the highest direct medical costs excluding VWF
(€159 791 064), Italy the highest direct-non medical (€26 564 496), and
Germany the highest indirect cost burden (€197 036 052). Total direct
medical costs per adult patient increased across VWD types with Type 1
having the lowest cost (€23 287) and Type 3 having the highest cost
(€133 518). Conclusion A substantial financial burden arises from the prevalence of VWD for the
European healthcare systems considered.
Collapse
Affiliation(s)
| | | | - Mike Laffan
- Centre for Haematology, Department of Immunology and Inflammation, 216773Imperial College London, London, UK
| | - Jenny Goudemand
- Department of Hemostasis and Transfusion, 26902Lille University Hospital, Lille, France
| | | | - Alan Finnegan
- 41953Faculty of Health and Social Care, University of Chester, Chester, UK
| |
Collapse
|
6
|
[Congenital factor X deficiency: a retrospective analysis of 11 cases]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2022; 43:26-30. [PMID: 35231989 PMCID: PMC8980670 DOI: 10.3760/cma.j.issn.0253-2727.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: To analyze the clinical characteristics, laboratory examination, diagnosis, treatment, and outcome of hereditary factor Ⅹ (FⅩ) deficiency. Methods: Clinical data of 11 patients with congenital FⅩ deficiency were retrospectively analyzed from July 2009 to February 2021. Results: There were 3 males and 8 females. Median age was 39 (5-55) years. The media duration of follow-up was 81.67 (1.87-142.73) months. Of the 11 patients, 10 had bleeding symptoms, 7 had ecchymosis or hemorrhage after skin bump, 7 had nosebleed, 6 had gingival hemorrhage, and 1 had muscle hematoma. Among the female patients, 6 had menorrhagia and 1 experienced bleeding after vaginal delivery. Family history of FⅩ deficiency was found in one case. Eight patients had a history of surgery, and four had postoperative bleeding. Laboratory findings were characterized by significantly prolonged activated partial thromboplastin time, prothrombin time, and decreased FⅩ activity (FⅩ∶C) . Four cases underwent gene mutation analysis and five new mutations were found. Four cases were treated with prothrombin complex concentrates (PCC) and seven cases with fresh frozen plasma (FFP) . One female patient had significantly reduced menstrual volume after PCC prophylactic therapy. One patient received FFP for prophylactic infusion with no bleeding during and after the operation. Conclusion: Most patients with congenital FⅩ deficiency had bleeding symptoms and there was no significant correlation between severity of bleeding symptoms and FⅩ∶C. Prophylaxis should be applied in patients with severe bleeding tendencies. Gene mutation test is significant for screening, diagnosis, and prognosis prediction of congenital FX deficiency.
Collapse
|
7
|
Huang JN, Liesner R, Austin SK, Kavakli K, Akanezi C. Plasma-derived factor X concentrate compassionate use for hereditary factor X deficiency: Long-term safety and efficacy in a retrospective data-collection study. Res Pract Thromb Haemost 2021; 5:e12550. [PMID: 34263102 PMCID: PMC8268662 DOI: 10.1002/rth2.12550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 04/02/2021] [Accepted: 04/07/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Coagadex is a high-purity plasma-derived factor X concentrate (pdFX) developed to treat hereditary factor X deficiency (FXD). OBJECTIVE Evaluate the efficacy and safety of pdFX administered to patients with hereditary FXD. METHODS This was an open-label, multicenter, retrospective analysis of patients receiving pdFX for compassionate use. Efficacy end points included treatments administered, the number and treatment of bleeds, and investigator assessments. Adverse drug reactions (ADRs) were monitored. RESULTS Fifteen patients were included: seven received routine prophylaxis, seven received on-demand treatment, and one alternated. Most were aged ≥12 years (n = 13) and had severe hereditary FXD (n = 12). The median follow-up time was 19.2 months (range, 3.5-48.8). The number of infusions per patient per month was higher for the routine prophylaxis group (median [range], 5.4 [1.4-10.1]) than for the on-demand group (0.8 [0.1-2.3]), as was the dose per infusion (27.9 [21.9-53.6] IU/kg vs 20.0 [13.6-27.7] IU/kg). Patients experienced 88 bleeds (34 minor, 7 major, 47 unclassified). The monthly bleed rate per patient was 0.04 in the routine prophylaxis group (based on 17 bleeds in four patients) and 0.8 in the on-demand group (based on 71 bleeds in eight patients). pdFX was used to treat 79 bleeds and was rated effective in all instances. In an overall assessment, investigators rated pdFX as excellent for 14 patients (93.3%) and good for 1 patient (6.3%). No ADRs or safety concerns were reported. CONCLUSIONS This analysis supports the use of pdFX as a safe, effective treatment for hereditary FXD. Routine prophylaxis with pdFX may reduce bleed frequency.
Collapse
Affiliation(s)
- James N. Huang
- UCSF Benioff Children's Hospital and University of California San FranciscoSan FranciscoCAUSA
| | - Ri Liesner
- Haemophilia Comprehensive Care CentreGreat Ormond Street Hospital NHS Foundation TrustLondonUK
| | - Steven K. Austin
- St George's Haemophilia CentreSt George's University Hospitals NHS Foundation TrustLondonUK
| | - Kaan Kavakli
- Department of Pediatric HematologyEge University Children's HospitalIzmirTurkey
| | | |
Collapse
|
8
|
Stonebraker JS, O'Mahony B, Noone D, Iorio A. Converting factor and nonfactor usage into a single metric to facilitate benchmarking the resources consumed for haemophilia care across jurisdictions and over time. Haemophilia 2021; 27:e596-e608. [PMID: 34145693 DOI: 10.1111/hae.14364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/07/2021] [Indexed: 01/19/2023]
Abstract
INTRODUCTION The World Federation of Hemophilia started measuring factor utilization at the country level as IU/capita (International Units of factor concentrates used per country population) in 2001 for its Annual Global Survey. IU/capita have been used to benchmark a country's usage over time and for advocacy. The introduction of a common metric usage spanning across standard half-life (SHL), and extended half-life (EHL) clotting factor concentrates (CFCs) and emicizumab would be a valuable simplification for national healthcare policymaking and industrial production planning. AIM Develop and examine a method of converting IU of SHL or EHL, and milligrams of emicizumab into a single metric. METHODS We developed conversion factors from manufacturer's recommended dose for prophylaxis with SHL, EHL, and emicizumab as reported on the licensing information for the United States and Europe. We validate the accuracy of these conversion factors against real-world usage data. RESULTS The prescribing information in the United States and Europe is marginally different. The SHL/EHL conversion factors are higher when calculated based on the prescribing information than on real-world studies, which are considered more representative of clinical practice. The best estimate of the SHL/EHL conversion factors for FVIII and FIX were 1.04 and 1.87. The conversion factor for emicizumab to SHL is 70 IU/mg. CONCLUSION We have generated robust estimates of conversion factors for currently used treatment options for prophylaxis in haemophilia. Usage of a single, harmonized metric will facilitate benchmarking across different countries or longitudinally irrespective of the case-mix of treatment options.
Collapse
Affiliation(s)
- Jeffrey S Stonebraker
- Department of Business Management, Poole College of Management, North Carolina State University, Raleigh, North Carolina, USA
| | - Brian O'Mahony
- Irish Haemophilia Society, Dublin, Trinity College, Dublin, Ireland
| | - Declan Noone
- European Haemophilia Consortium, Brussels, Belgium
| | - Alfonso Iorio
- Department of Health Research Methods, Evidence, and Impact, Mike Gent Chair in HealthCare Research, McMaster University, Hamilton, Ontario, Canada.,Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
9
|
Discussing investigational AAV gene therapy with hemophilia patients: A guide. Blood Rev 2021; 47:100759. [DOI: 10.1016/j.blre.2020.100759] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/28/2020] [Accepted: 09/02/2020] [Indexed: 01/19/2023]
|
10
|
Peyvandi F, Auerswald G, Austin SK, Liesner R, Kavakli K, Álvarez Román MT, Millar CM. Diagnosis, therapeutic advances, and key recommendations for the management of factor X deficiency. Blood Rev 2021; 50:100833. [PMID: 34024682 DOI: 10.1016/j.blre.2021.100833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 12/20/2022]
Abstract
Factor X deficiency is a rare coagulation disorder that can be hereditary or acquired. The typology and severity of the associated bleeding symptoms are highly heterogeneous, adding to the difficulties of diagnosis and management. Evidence-based guidelines and reviews on factor X deficiency are generally limited to publications covering a range of rare bleeding disorders. Here we provide a comprehensive review of the literature on factor X deficiency, focusing on the hereditary form, and discuss the evolution in disease management and the evidence associated with available treatment options. Current recommendations advise clinicians to use single-factor replacement therapy for hereditary disease rather than multifactor therapies such as fresh frozen plasma, cryoprecipitate, and prothrombin complex concentrates. Consensus in treatment guidelines is still urgently needed to ensure optimal management of patients with factor X deficiency across the spectrum of disease severity.
Collapse
Affiliation(s)
- Flora Peyvandi
- IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy; Università degli Studi di Milano, Department of Pathophysiology and Transplantation, Milan, Italy.
| | - Guenter Auerswald
- Klinikum Bremen-Mitte, Professor Hess Children's Hospital, Bremen, Germany.
| | - Steven K Austin
- St George's University Hospitals NHS Foundation Trust, London, UK.
| | - Ri Liesner
- Haemophilia Comprehensive Care Centre/NIHR GOSH BRC, Great Ormond Street Hospital for Children NHS Trust, London, UK.
| | - Kaan Kavakli
- Ege University Faculty of Medicine, Department of Pediatrics, Division of Hematology, Izmir, Turkey.
| | | | - Carolyn M Millar
- Imperial College London, London, UK; Imperial College Healthcare NHS Trust, London, UK.
| |
Collapse
|
11
|
O'Mahony B. Haemophilia care in Europe: Past progress and future promise. Haemophilia 2020; 26:752-758. [DOI: 10.1111/hae.14097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Brian O'Mahony
- Irish Haemophilia Society Ltd. and Trinity College Dublin Ireland
| |
Collapse
|
12
|
Peyvandi F, Berger K, Seitz R, Hilger A, Hecquet ML, Wierer M, Buchheit KH, O'Mahony B, Bok A, Makris M, Mansmann U, Schramm W, Mannucci PM. Kreuth V initiative: European consensus proposals for treatment of hemophilia using standard products, extended half-life coagulation factor concentrates and non-replacement therapies. Haematologica 2020; 105:2038-2043. [PMID: 32467138 PMCID: PMC7395279 DOI: 10.3324/haematol.2019.242735] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 05/20/2020] [Indexed: 12/30/2022] Open
Abstract
This report contains the updated consensus recommendations for optimal hemophilia care produced in 2019 by three Working Groups (WG) on behalf of the European Directorate for Quality of Medicines and Healthcare in the frame of the Kreuth V Initiative. WG1 recommended access to prophylaxis for all patients, the achievement of plasma factor trough levels of at least 3-5% when extended half-life factor VIII (FVIII) and FIX products are used, a personalized treatment regimen, and a choice of chromogenic assays for treatment monitoring. It was also emphasized that innovative therapies should be supervised by hemophilia comprehensive care centers. WG2 recommended mandatory collection of postmarketing data to assure the long-term safety and efficacy of new hemophilia therapies, the establishment of national patient registries including the core data recommended by the European Medicines Agency and the International Society on Thrombosis and Haemostasis, with adequate support under public control, and greater collaboration to facilitate a comprehensive data evaluation throughout Europe. WG3 discussed methodological aspects of hemophilia care in the context of access decisions, particularly for innovative therapies, and recommended that clinical studies should be designed to provide the quality of evidence needed by regulatory authorities, HTA bodies and healthcare providers. The dialogue between all stakeholders in hemophilia care and patient organizations should be fostered to implement these recommendations.
Collapse
Affiliation(s)
- Flora Peyvandi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Fondazione Luigi Villa, Milan, Italy .,Università degli Studi di Milano, Department of Pathophysiology and Transplantation, Milan, Italy
| | - Karin Berger
- University Hospital, Ludwig-Maximilian University, Department of Medicine III, Munich, Germany.,Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilian-University, Munich, Germany
| | | | | | - Marie-Laure Hecquet
- European Directorate for the Quality of Medicines and Healthcare, Strasbourg, France
| | - Michael Wierer
- European Directorate for the Quality of Medicines and Healthcare, Strasbourg, France
| | - Karl-Heinz Buchheit
- European Directorate for the Quality of Medicines and Healthcare, Strasbourg, France
| | - Brian O'Mahony
- Trinity College, Dublin, Ireland.,European Haemophilia Consortium, Brussels, Belgium
| | - Amanda Bok
- European Haemophilia Consortium, Brussels, Belgium
| | - Mike Makris
- Sheffield Haemophilia and Thrombosis Centre, Sheffield, UK
| | - Ulrich Mansmann
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilian-University, Munich, Germany
| | - Wolfgang Schramm
- Department of Transfusion Medicine and Haemostasis, Ludwig-Maximilians-University, Munich, Germany
| | - Pier Mannuccio Mannucci
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Fondazione Luigi Villa, Milan, Italy
| |
Collapse
|
13
|
De la Corte-Rodriguez H, Rodriguez-Merchan EC, Alvarez-Roman MT, Martin-Salces M, Jimenez-Yuste V. 'Do not Do' Recommendations in Hemophilia. Cardiovasc Hematol Disord Drug Targets 2020; 20:168-174. [PMID: 32133968 DOI: 10.2174/1871529x20666200305111323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 01/20/2020] [Accepted: 02/17/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND It is important to discard those practices that do not add value. As a result, several initiatives have emerged. All of them try to improve patient safety and the use of health resources. PURPOSE To present a compendium of "do not do recommendations" in the context of hemophilia. METHODS A review of the literature and current clinical guidelines has been made, based on the best evidence available to date. RESULTS The following 13 recommendations stand out: 1) Do not delay the administration of factor after trauma; 2) do not use fresh frozen plasma or cryoprecipitate; 3) do not use desmopressin in case of hematuria; 4) do not change the product in the first 50 prophylaxis exposures; 5) do not interrupt immunotolerance; 6) do not administer aspirin or NSAIDs; 7) do not administer intramuscular injections; 8) do not do routine radiographs of the joint in case of acute hemarthrosis; 9) Do not apply closed casts for fractures; 10) do not discourage the performance of physical activities; 11) do not deny surgery to a patient with an inhibitor; 12) do not perform instrumental deliveries in fetuses with hemophilia; 13) do not use factor IX (FIX) in patients with hemophilia B with inhibitor and a history of anaphylaxis after administration of FIX. CONCLUSION The information mentioned previously can be useful in the management of hemophilia, from different levels of care. As far as we know, this is the first initiative of this type regarding hemophilia.
Collapse
|
14
|
Grottke O, Moser O, Farrag A, Elbracht M, Orlikowsky T, Trepels-Kottek S. Plasma-derived Factor X therapy for treatment of intracranial bleeding in a patient with Factor X deficiency: a case report. Transfusion 2019; 59:2228-2233. [PMID: 30964547 DOI: 10.1111/trf.15308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 03/11/2019] [Accepted: 03/23/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Factor X (FX) deficiency (FXD) is an extremely rare autosomal recessive hereditary hematologic disorder, affecting approximately one in 1,000,000 of the general population. CASE REPORT This case report describes an infant with hereditary severe FXD who presented with a spontaneous, life-threatening intracranial hemorrhage and was treated with the first licensed plasma-derived FX (pdFX) concentrate. On admission, laboratory assays showed severe coagulopathy of unknown cause; the patient was empirically treated using a multimodal hemostatic approach with prothrombin complex concentrate, fresh-frozen plasma, and tranexamic acid. Subsequent single-factor coagulation and genetic analyses confirmed the hereditary FXD diagnosis, and the therapeutic regimen was changed to a targeted regimen of 250 IU pdFX daily. Based on careful monitoring of the coagulation profile, pdFX administration frequency was increased to twice daily, followed by a reduction to once every 18 hours. The patient was discharged after 7 weeks of hospitalization in good clinical condition and now receives prophylactic pdFX three times weekly.
Collapse
Affiliation(s)
- Oliver Grottke
- Department of Anaesthesiology, RWTH Aachen University Hospital, Aachen, Germany
| | - Olga Moser
- Section of Pediatric Hematology and Oncology, Department of Pediatrics, RWTH Aachen University Hospital, Aachen, Germany
| | - Ahmed Farrag
- Section of Pediatric Hematology and Oncology, Department of Pediatrics, RWTH Aachen University Hospital, Aachen, Germany.,Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Miriam Elbracht
- Institute of Human Genetics, RWTH Aachen University Hospital, Aachen, Germany
| | - Thorsten Orlikowsky
- Section of Neonatology and Pediatric Intensive Care, Department of Pediatrics, RWTH Aachen University Hospital, Aachen, Germany
| | - Sonja Trepels-Kottek
- Section of Neonatology and Pediatric Intensive Care, Department of Pediatrics, RWTH Aachen University Hospital, Aachen, Germany
| |
Collapse
|
15
|
Djambas Khayat C, El Khorassani M, Lambert T, Gay V, Barthez-Toullec M, Lamazure J, Bellon A, Henriet C, Bridey F, Négrier C. Clinical pharmacology, efficacy and safety study of a triple-secured fibrinogen concentrate in adults and adolescent patients with congenital fibrinogen deficiency. J Thromb Haemost 2019; 17:635-644. [PMID: 30661302 DOI: 10.1111/jth.14392] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Indexed: 11/29/2022]
Abstract
Essentials A novel fibrinogen concentrate was evaluated in patients with congenital fibrinogen deficiency. An open-label, phase 2-3 trial studied pharmacology, efficacy, and safety in patients >6 years. The product offers safe and effective therapy in the treatment and prophylaxis of bleeding. Data in recovery show the need of adjusted treatment and further investigation in children. SUMMARY: Background Single-factor replacement therapy is considered the most suitable treatment option for hereditary fibrinogen deficiency. A triple-secured plasma-derived human fibrinogen product was developed to increase the safety of the former fibrinogen concentrate. Objectives This non-randomized, open-label, prospective study investigated pharmacokinetics, efficacy, and safety of a novel fibrinogen concentrate (FibCLOT® /CLOTTAFACT® LFB, France) in inherited deficiency. Patients/Methods Fourteen patients ≥40 kg received fibrinogen concentrate for pharmacology and 16 ≥ 23 kg received treatment for bleeding or surgery. Each treatment was followed by a 3-week safety observation period. Key outcomes included number of infusions, dose, bleeding control, daily assessment, hemoglobin, blood loss, transfusions, and physicians' global assessment of response. Results Incremental recovery was 2.35 mg mL-1 per mg kg-1 and maximal concentration 1.41 g L-1 (geometric mean) after 0.060 g kg-1 infusion in 14 afibrinogenemic patients. Terminal half-life was 69.3 h (non-compartmental analysis). The maximum clot firmness was increased by a mean of 10.3 mm from baseline to maximal effect. Sixteen patients participated to the efficacy phase: 32 bleeding episodes were treated in 9 patients, and 15 patients underwent 38 surgical/invasive procedures. All patients achieved appropriate hemostasis: response to treatment was successful in all bleeds (95% CI, 0.89-1.00) and procedures (95% CI, 0.91-1.00). Most (94%) bleeds were controlled with a single infusion (median 0.050 g kg-1 ). Two patients experienced asymptomatic distal venous thromboses identified by systematic ultrasound. Conclusion FibCLOT® /CLOTTAFACT® showed a pharmacokinetic profile comparable to that of other fibrinogen concentrates and provides safe and clinically effective substitution therapy for fibrinogen-deficient patients.
Collapse
Affiliation(s)
| | | | | | | | - Malika Barthez-Toullec
- Clinical Development, Laboratoire français du Fractionnement et des Biotechnologies (LFB), Les Ulis, France
| | - Jennifer Lamazure
- Clinical Development, Laboratoire français du Fractionnement et des Biotechnologies (LFB), Les Ulis, France
| | - Anne Bellon
- Clinical Development, Laboratoire français du Fractionnement et des Biotechnologies (LFB), Les Ulis, France
| | - Céline Henriet
- Clinical Development, Laboratoire français du Fractionnement et des Biotechnologies (LFB), Les Ulis, France
| | - Françoise Bridey
- Clinical Development, Laboratoire français du Fractionnement et des Biotechnologies (LFB), Les Ulis, France
| | - Claude Négrier
- Hematology Division, Hemophilia Comprehensive Care Center, Louis Pradel Hospital, University Lyon1, Bron, France
| |
Collapse
|
16
|
Genotype analysis and identification of novel mutations in a multicentre cohort of patients with hereditary factor X deficiency. Blood Coagul Fibrinolysis 2019; 30:34-41. [DOI: 10.1097/mbc.0000000000000787] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
17
|
Liesner R, Akanezi C, Norton M, Payne J. Prophylactic treatment of bleeding episodes in children <12 years with moderate to severe hereditary factor X deficiency (FXD): Efficacy and safety of a high-purity plasma-derived factor X (pdFX) concentrate. Haemophilia 2018; 24:941-949. [DOI: 10.1111/hae.13500] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2018] [Indexed: 12/26/2022]
Affiliation(s)
- R. Liesner
- Haemophilia Comprehensive Care Centre; Great Ormond Street Hospital; London UK
| | | | - M. Norton
- Bio Products Laboratory Ltd; Elstree UK
| | - J. Payne
- Department of Paediatric Haematology; Sheffield Children's NHS Foundation Trust; Sheffield UK
| |
Collapse
|
18
|
O'Mahony B, Dolan G, Nugent D, Goodman C. Patient-centred value framework for haemophilia. Haemophilia 2018; 24:873-879. [PMID: 29626368 DOI: 10.1111/hae.13456] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2018] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Growing budgetary demands have led to increased scrutiny of healthcare spending for rare diseases, leading to a unified goal within the haemophilia community to define objectively patient-centred value in haemophilia care. AIM To develop a patient-centred outcomes framework with global applicability for assessing value in haemophilia healthcare. METHODS An international, multidisciplinary panel of experts convened to identify the range of patient impacts of haemophilia health care and organize these into a three-tiered, patient-centred outcomes framework based on Porter's model for assessing value. RESULTS In addition to measures common to other chronic diseases (eg survival and quality of life), Tier 1, health status achieved or retained, includes haemophilia-specific outcomes of bleeding frequency, musculoskeletal complications and life-threatening bleeds, as well as measures of function or activity. Tier 2, process of recovery, includes such outcomes as time to initial treatment, time to recovery and time missed at education/work; also included are disutility of care, measured by inhibitor development, pathogen transmission/infections, orthopaedic intervention and difficult venous access. Tier 3, sustainability of health, is measured by bleed avoidance, maintenance of productive lives and good health over time; potential long-term negative consequences include insufficient or inappropriate therapy and age-related complications. The applicability of the outcomes framework for different types of haemophilia healthcare interventions is described. CONCLUSION Haemophilia health care can affect multiple patient-centred outcomes across diverse patient types and healthcare systems. This framework organizes those outcomes for informing value-based decision making by multiple stakeholders and provides the basis for further refinement and development of a standardized outcomes set.
Collapse
Affiliation(s)
- B O'Mahony
- Irish Haemophilia Society, Trinity College, Dublin, Ireland
| | - G Dolan
- Guy's and St Thomas' NHS Trust, London, UK
| | - D Nugent
- Children's Hospital of Orange County, University of California at Irvine, Irvine, CA, USA
| | - C Goodman
- The Lewin Group, Falls Church, VA, USA
| |
Collapse
|
19
|
Öner AF, Celkan T, Timur Ç, Norton M, Kavaklı K. Use of a High-Purity Factor X Concentrate in Turkish Subjects with Hereditary Factor X Deficiency: Post Hoc Cohort Subanalysis of a Phase 3 Study. Turk J Haematol 2018; 35:129-133. [PMID: 29545231 PMCID: PMC5972335 DOI: 10.4274/tjh.2017.0446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Hereditary factor X (FX) deficiency is a rare bleeding disorder more prevalent in countries with high rates of consanguineous marriage. In a prospective, open-label, multicenter phase 3 study, 25 IU/kg plasma-derived factor X (pdFX) was administered as on-demand treatment or short-term prophylaxis for 6 months to 2 years. In Turkish subjects (n=6), 60.7% of bleeds were minor. A mean of 1.03 infusions were used to treat each bleed, and mean total dose per bleed was 25.38 IU/kg. Turkish subjects rated pdFX efficacy as excellent or good for all 84 assessable bleeds; investigators judged overall pdFX efficacy to be excellent or good for all subjects. Turkish subjects had 51 adverse events; 96% with known severity were mild/moderate, and 1 (infusion-site pain) was possibly pdFX-related. These results demonstrate that 25 IU/kg pdFX is safe and effective in this Turkish cohort (ClinicalTrials.gov identifier: NCT00930176).
Collapse
Affiliation(s)
- Ahmet F Öner
- Yüzüncü Yıl University Faculty of Medicine, Department of Pediatric Hematology, Van, Turkey
| | - Tiraje Celkan
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Hematology and Oncology, İstanbul, Turkey
| | - Çetin Timur
- İstanbul Medeniyet University, Göztepe Training and Research Hospital, Clinic of Pediatric Hematology, İstanbul, Turkey
| | - Miranda Norton
- Bio Products Laboratory Ltd., Elstree, Hertfordshire, United Kingdom
| | - Kaan Kavaklı
- Ege University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| |
Collapse
|
20
|
Şalcıoğlu Z, Bayram C, Şen H, Ersoy G, Aydoğan G, Akçay A, Tuğcu D, Akıcı F, Gökçe M, Demirkaya M, Ayçiçek A, Başlar Z. Congenital Factor Deficiencies in Children: A Report of a Single-Center Experience. Clin Appl Thromb Hemost 2017; 24:901-907. [PMID: 29050499 PMCID: PMC6714728 DOI: 10.1177/1076029617731596] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Congenital factor deficiencies (CFDs) refer to inherited deficiency of coagulation factors in the blood. A total of 481 patients with CFDs, who were diagnosed and followed at our Pediatric Hematology and Oncology Clinic between 1990 and 2015, were retrospectively evaluated. Of the 481 cases, 134 (27.8%) were hemophilia A, 38 (7.9%) were hemophilia B, 57 (11.8%) were von Willebrand disease (vWD), and 252 (52.3%) were rare bleeding disorders (RBDs). The median age of the patients at the time of diagnosis and at the time of the study was 4.1 years (range: 2 months to 20.4 years) and 13.4 years (range: 7 months to 31.3 years), respectively. The median duration of the follow-up time was 6.8 years (range: 2.5 months to 24.8 years). One hundred nineteen (47.2%) of 252 patients with RBDs were asymptomatic, 49 (41.1%) of whom diagnosed by family histories, 65 (54.6%) through preoperative laboratory studies, and 5 (4.2%) after prolonged bleeding during surgeries. Consanguinity rate for the RBDs was 47.2%. Prophylactic treatment was initiated in 80 patients, 58 of whom were hemophilia A, 7 were hemophilia B, 13 were RBDs, and 2 were vWD. Significant advances have been achieved during the past 2 decades in the treatment of patients with CFDs, particularly in patients with hemophilias. The rarity and clinical heterogeneity of RBDs lead to significant diagnostic challenges and improper management. In this regard, multinational collaborative efforts are needed with the hope that can improve the management of patients with RBDs.
Collapse
Affiliation(s)
- Zafer Şalcıoğlu
- 1 Department of Pediatric Hematology and Oncology, İstanbul Kanuni Sultan Süleyman Education and Research Hospital, İstanbul, Turkey
| | - Cengiz Bayram
- 1 Department of Pediatric Hematology and Oncology, İstanbul Kanuni Sultan Süleyman Education and Research Hospital, İstanbul, Turkey
| | - Hülya Şen
- 1 Department of Pediatric Hematology and Oncology, İstanbul Kanuni Sultan Süleyman Education and Research Hospital, İstanbul, Turkey
| | - Gizem Ersoy
- 1 Department of Pediatric Hematology and Oncology, İstanbul Kanuni Sultan Süleyman Education and Research Hospital, İstanbul, Turkey
| | - Gönül Aydoğan
- 1 Department of Pediatric Hematology and Oncology, İstanbul Kanuni Sultan Süleyman Education and Research Hospital, İstanbul, Turkey
| | - Arzu Akçay
- 1 Department of Pediatric Hematology and Oncology, İstanbul Kanuni Sultan Süleyman Education and Research Hospital, İstanbul, Turkey
| | - Deniz Tuğcu
- 1 Department of Pediatric Hematology and Oncology, İstanbul Kanuni Sultan Süleyman Education and Research Hospital, İstanbul, Turkey
| | - Ferhan Akıcı
- 1 Department of Pediatric Hematology and Oncology, İstanbul Kanuni Sultan Süleyman Education and Research Hospital, İstanbul, Turkey
| | - Müge Gökçe
- 1 Department of Pediatric Hematology and Oncology, İstanbul Kanuni Sultan Süleyman Education and Research Hospital, İstanbul, Turkey
| | - Metin Demirkaya
- 1 Department of Pediatric Hematology and Oncology, İstanbul Kanuni Sultan Süleyman Education and Research Hospital, İstanbul, Turkey
| | - Ali Ayçiçek
- 1 Department of Pediatric Hematology and Oncology, İstanbul Kanuni Sultan Süleyman Education and Research Hospital, İstanbul, Turkey
| | - Zafer Başlar
- 2 Department of Hematology-Internal Medicine, Cerrahpaşa Medical School, İstanbul University, İstanbul, Turkey
| |
Collapse
|
21
|
Giangrande PLF, Peyvandi F, O'Mahony B, Behr-Gross ME, Hilger A, Schramm W, Mannucci PM. Kreuth IV: European consensus proposals for treatment of haemophilia with coagulation factor concentrates. Haemophilia 2017; 23:370-375. [PMID: 28401658 DOI: 10.1111/hae.13211] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2017] [Indexed: 01/06/2023]
Abstract
INTRODUCTION This report summarizes recommendations relating to haemophilia therapy arising from discussions among experts from 36 European countries during the 'Kreuth IV' meeting in May 2016. AIM The objective of the meeting was for experts in the field of haemophilia from across Europe to draft resolutions regarding current issues relating to the treatment of haemophilia. RESULTS Hospitals providing clinical care for people with haemophilia and related disorders are strongly recommended to seek formal designation as either European Haemophilia Treatment Centres (EHTC) or European Haemophilia Comprehensive Care Centres (EHCCC). There should be agreed national protocols or guidelines on management of the ageing patient with haemophilia. The minimum consumption of factor VIII and IX concentrate in any country should be 4 IU and 0.5 IU per capita of general population respectively. Treatment for hepatitis C with direct-acting antiviral agents should be provided to all people with haemophilia on a priority basis. Genotype analysis should be offered to all patients with severe haemophilia. Genetic counselling, when given, should encompass the recommendation that genetic relatives of the affected person be advised to seek genetic counselling. People with inhibitors should have access to bypassing agents, immune tolerance and elective surgery. National or regional tenders for factor concentrates are encouraged. Outcome data including health related quality of life should be collected. Treatment with extended half-life factors should be individualized and protection against bleeding should be improved by increasing trough levels. Steps should be taken to understand and minimize the risk of inhibitor development. CONCLUSION It is hoped that these recommendations will help to foster equity of haemophilia care throughout Europe.
Collapse
Affiliation(s)
- P L F Giangrande
- European Haemophilia Consortium, Brussels, Belgium.,University of Oxford, Oxford, UK
| | - F Peyvandi
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - B O'Mahony
- European Haemophilia Consortium, Brussels, Belgium.,Trinity College, Dublin, Ireland
| | - M-E Behr-Gross
- European Directorate for the Quality of Medicines and HealthCare (EDQM), Council of Europe, Strasbourg, France
| | - A Hilger
- Paul-Ehrlich-Institut, Langen, Germany
| | - W Schramm
- Rudolf-Marx-Foundation, University of Munich, Munich, Germany
| | - P M Mannucci
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
22
|
Shapiro A. Plasma-derived human factor X concentrate for on-demand and perioperative treatment in factor X-deficient patients: pharmacology, pharmacokinetics, efficacy, and safety. Expert Opin Drug Metab Toxicol 2016; 13:97-104. [DOI: 10.1080/17425255.2016.1237504] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
23
|
Abstract
Retrospective and prospective studies unambiguously show that prophylactic treatment of severe hemophilia A or B should be started as primary prophylaxis at 1–2 years’ of age and ideally before the first joint bleed. The dose and dose frequency should be individually tailored depending on the goal of treatment, venous access and the bleeding phenotype. The circumstances during the first exposures of factor VIII concentrates in hemophilia A may have an impact on the risk of developing inhibitors. Enhanced half-life products, in particular in hemophilia B, will facilitate treatment in patients with difficult venous access but also in achieving a higher trough level. Evidence accumulate that prophylactic treatment is beneficial also in adults and in patients with inhibitors.
Collapse
Affiliation(s)
- Rolf Ljung
- Department of Clinical Sciences Lund-Paediatrics, Lund University, Lund, Sweden ; Department of Paediatrics and Malmö Centre for Thrombosis and Haemostasis, Skåne University Hospital, Malmö, Sweden
| |
Collapse
|
24
|
Berntorp E, Hart D, Mancuso ME, d'Oiron R, Perry D, O'Mahony B, Kaczmarek R, Crato M, Pasi J, Miners A, Carlsson KS, Kitchen S, Boehlen F, Giangrande P, Cebura E, Uitslager N, Osooli M, Janeckova D, Haldon R, Rivolta GF. The first Team Haemophilia Education meeting, 2015, Amsterdam, The Netherlands. Eur J Haematol 2016; 97 Suppl 83:3-18. [DOI: 10.1111/ejh.12760] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2016] [Indexed: 01/12/2023]
Affiliation(s)
- Erik Berntorp
- Skåne University Hospital; Lund University; Malmö Sweden
| | - Daniel Hart
- Barts and the London School of Medicine and Dentistry; Queen Mary University of London; London UK
| | - Maria Elisa Mancuso
- Angelo Bianchi Bonomi Haemophilia and Thrombosis Centre; Fondazione IRCCS Ca’ Granda; Ospedale Maggiore Policlinico; Milan Italy
| | - Roseline d'Oiron
- Centre for Haemophilia and Rare Congenital Bleeding Disorders; University Hospitals Paris-Sud, AP-HP Bicêtre Hospital; Le Kremlin-Bicêtre France
| | - David Perry
- Addenbrooke's Hospital; University of Cambridge; Cambridge UK
| | | | | | | | - John Pasi
- Barts and the London School of Medicine and Dentistry; Queen Mary University of London; London UK
| | - Alec Miners
- London School of Hygiene and Tropical Medicine; London UK
| | | | - Steve Kitchen
- Department of Coagulation; Royal Hallamshire Hospital; Sheffield UK
| | - Françoise Boehlen
- Haemostasis Unit; University Hospitals of Geneva; Geneva Switzerland
| | - Paul Giangrande
- Oxford Haemophilia & Thrombosis Centre; Oxford University Hospitals; Oxford UK
| | - Elizabete Cebura
- Haemophilia Treatment Centre; University Children's Hospital; Riga Latvia
| | - Nanda Uitslager
- Van Creveldkliniek; University Medical Centre; Utrecht The Netherlands
| | - Mehdi Osooli
- Skåne University Hospital; Lund University; Malmö Sweden
| | - Daniela Janeckova
- Haemophilia Treatment Centre; University Hospital Motol; Prague Czech Republic
| | - Rosie Haldon
- Katharine Dormandy Haemophilia Centre and Thrombosis Unit; Royal Free Hospital; London UK
| | - Gianna Franca Rivolta
- Regional Reference Centre for Inherited Bleeding Disorders; University Hospital of Parma; Parma Italy
| |
Collapse
|
25
|
Escobar MA, Auerswald G, Austin S, Huang JN, Norton M, Millar CM. Experience of a new high-purity factor X concentrate in subjects with hereditary factor X deficiency undergoing surgery. Haemophilia 2016; 22:713-20. [DOI: 10.1111/hae.12954] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2016] [Indexed: 11/30/2022]
Affiliation(s)
- M. A. Escobar
- University of Texas Health Science Center and Gulf States Hemophilia and Thrombophilia Center; Houston TX USA
| | - G. Auerswald
- Klinikum Bremen-Mitte; Prof-Hess-Kinderklinik; Bremen Germany
| | - S. Austin
- St. George's Hospital University NHS Foundation Trust; London UK
| | - J. N. Huang
- University of California San Francisco Benioff Children's Hospital; San Francisco CA USA
| | | | - C. M. Millar
- Centre for Haematology; Hammersmith Campus; Imperial College Academic Health Sciences Centre; Imperial College; London UK
| |
Collapse
|
26
|
O'Mahony B, Skinner MW, Noone D, Page D, O'Hara J. Assessments of outcome in haemophilia – a patient perspective. Haemophilia 2016; 22:e208-9. [DOI: 10.1111/hae.12922] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2016] [Indexed: 01/31/2023]
Affiliation(s)
- B. O'Mahony
- Irish Haemophilia Society Ltd. Dublin 8Ireland
- European Haemophilia Consortium Trinity College Dublin Dublin 8 Ireland
| | - M. W. Skinner
- Institute for Policy Advancement Ltd. Washington DC USA
| | - D. Noone
- Irish Haemophilia Society Ltd. Dublin 8Ireland
| | - D. Page
- Canadian Hemophilia Society Montreal QC Canada
| | - J. O'Hara
- The Innovation Centre HCD Economics Ltd. Cheshire UK
| |
Collapse
|
27
|
Austin SK, Kavakli K, Norton M, Peyvandi F, Shapiro A, Román MÁ, Auerswald G, Vega NB, Celkan T, Huang JN, Beau Mitchell W, Oner AF, Pavord S, Timur C. Efficacy, safety and pharmacokinetics of a new high‐purity factor X concentrate in subjects with hereditary factor X deficiency. Haemophilia 2016; 22:419-25. [DOI: 10.1111/hae.12893] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2015] [Indexed: 02/05/2023]
Affiliation(s)
- S. K. Austin
- St. George's Haemophilia Centre St. George's University Hospitals NHS Foundation Trust London UK
| | - K. Kavakli
- Department of Pediatric Hematology Children's Hospital Ege University Faculty of Medicine Izmir Turkey
| | | | - F. Peyvandi
- Angelo Bianchi Bonomi Hemophilia & Thrombosis Center Milan Italy
- Department of Pathophysiology and Transplantation Università degli Studi di Milano Milan Italy
| | - A. Shapiro
- Indiana Hemophilia & Thrombosis Center Indianapolis IN USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
de Moerloose P, Arnberg D, O'Mahony B, Colvin B. Improving haemophilia patient care through sharing best practice. Eur J Haematol 2015; 95 Suppl 79:1-8. [DOI: 10.1111/ejh.12630] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2015] [Indexed: 02/05/2023]
Affiliation(s)
- Philippe de Moerloose
- Division of Angiology and Haemostasis; University Hospitals and Faculty of Medicine of Geneva; Geneva Switzerland
| | | | | | - Brian Colvin
- Haemophilia Europe; Pfizer Global Innovative Pharma Business; Rome Italy
| |
Collapse
|
29
|
Nemes L, Blatny J, Klukowska A, Spasova M, Trakymiene SS, Serban M. Haemophilia care in Central and Eastern Europe: challenges and ways forward from clinicians' perspective. Haemophilia 2015; 21:e419-21. [PMID: 26058450 DOI: 10.1111/hae.12706] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2015] [Indexed: 01/31/2023]
Affiliation(s)
- L Nemes
- National Haemophilia Center and Haemostasis Department, State Health Center, Budapest, Hungary
| | - J Blatny
- Department of Paediatric Haematology, Children's University Hospital, Brno, Czech Republic
| | - A Klukowska
- Department of Pediatrics, Hematology and Oncology, Medical University, Warsaw, Poland
| | - M Spasova
- Department of Pediatrics, University Multiprofile Hospital for Active Treatment "Sveti Georgi", Plovdiv, Bulgaria
| | - S Saulyte Trakymiene
- Children's Hospital, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania
| | - M Serban
- Louis Turcanu, Timisoara, Romania
| |
Collapse
|
30
|
Ljung R, Gretenkort Andersson N. The current status of prophylactic replacement therapy in children and adults with haemophilia. Br J Haematol 2015; 169:777-86. [DOI: 10.1111/bjh.13365] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Rolf Ljung
- Department of Clinical Sciences Lund-Paediatrics; Lund University; Lund Sweden
- Department of Paediatrics and Malmö Centre for Thrombosis and Haemostasis; Skåne University Hospital; Malmö Sweden
| | - Nadine Gretenkort Andersson
- Department of Paediatrics and Malmö Centre for Thrombosis and Haemostasis; Skåne University Hospital; Malmö Sweden
| |
Collapse
|