Safety and efficacy of sucrose-formulated full-length recombinant factor VIII: Experience in the standard clinical setting
Roberto Musso1, Elena Santagostino2, Albert Faradji3, Alfonso Iorio4, Jan van der Meer5, Jørgen Ingerslev6, Thierry Lambert7, Monika Maas-Enriquez8, Eduard Gorina9 for the KOGENATE® Bayer European PMS Study Group*
1Azienda Ospedale Vittorio Emanuele, Ospedale Ferrarotto, Catania, Italy; 2A. Bianchi Bonomi Haemophilia and Thrombosis Centre, IRCCS Maggiore Hospital Foundation, Milan, Italy; 3Haemophilia Regional Centre, Hôpital de Hautepierre, Strasbourg, France; 4Division of Internal and Cardiovascular Medicine and Stroke Unit, University of Perugia, Italy; 5Division of Haemostasis, Thrombosis and Rheology, University Medical Centre Groningen (UMCG), Groningen, the Netherlands; 6Centre for Haemophilia and Thrombosis, Department of Clinical Biochemistry, Aarhus University Hospital, Skejby, Denmark; 7APHP Bicêtre University Hospital, Le Kremlin-Bicêtre, France; 8Bayer Health- Care, Leverkusen, Germany; 9Bayer HealthCare, Berkeley, California, USA
Summary
The safety of full-length sucrose-formulated recombinant factor VIII (rFVIII-FS; Kogenate® FS) for up to 24 months of use was evaluated in a postmarketing observational study in Europe. Long-term safety and efficacy data were available for 212 patients with severe haemophilia A, including 13 previously untreated patients (PUPs) and 12 patients with 1–19 exposure days (EDs). Patients accumulated a mean (± SD) of 187 (121) EDs to rFVIII-FS and received a total of 39,627 infusions, mainly for prophylaxis and for the treatment of 4,283 spontaneous or trauma-related bleeds during an average observation time of 710 (136) days. Of these bleeding episodes, 85.4% were successfully treated with one or two infusions of rFVIII-FS. Haemostasis was also evaluated during 46 minor to major surgical procedures, and the response to infusion was “excellent” or “good” in all cases.FVIII inhibitor formation was observed in six patients (two de novo; four persistent or recurrent). The de novo cases represent 8.0% (2 of 25) of patients who reported 0–19 previous EDs at study entry. Four of the five patients who reported possible drug-related adverse effects developed inhibitors.The results of this observational study demonstrate the efficacy and safety of rFVIII-FS during normal clinical use in the treatment of patients with severe haemophilia A. Furthermore, these findings are consistent with those of previous phase III clinical studies with rFVIII-FS, particularly with regard to its efficacy and low incidence of inhibitor formation. Keywords
Haemophilia, prophylaxis, Inhibitors, Recombinant factor VIII, Kogenate
DOI
http://dx.doi.org/10.1160/TH07-06-0409