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Comparative evaluation of the safety and efficacy of recombinant FVIII in severe hemophilia A patients

  • Abolghasemi, Hassan (Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences) ;
  • Panahi, Yunes (Pharmacotherapy Department, Faculty of Pharmacy, Baqiyatallah University of Medical Sciences) ;
  • Ahmadinejad, Minoo. (High Institute of Research, Iranian Blood Transfusion Organization) ;
  • Toogeh, Gholamreza ;
  • Karimi, Mehran (Hematology Research Centre, Shiraz University of Medical Sciences) ;
  • Eghbali, Aziz (Department of Pediatric Hematology-Oncology, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences) ;
  • Mirbehbahani, Nargess Bigom (Golestan University of Medical Sciences) ;
  • Dehdezi, Bighan Keikhaei (Department of Thalassemia & Hemoglobinopathy Research Center, Ahvaz Jundishapur University of Medical Science) ;
  • Badiee, Zahra (Sheikh Hospital, Mashhad University of Medical Sciences) ;
  • Hoorfar, Hamid (Isfahan University of Medical Sciences) ;
  • Eshghi, Peyman (Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences) ;
  • Maghsoudi, Nader (Neuroscience Research Center (NRC), Shahid Beheshti University of Medical Sciences) ;
  • Sahebkar, Amirhossein (Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences) ;
  • Gholami-Fesharaki, Mohammad (Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University)
  • 투고 : 2017.09.12
  • 심사 : 2018.05.17
  • 발행 : 2018.06.30

초록

Objective: This study compared the safety and efficacy of $Safacto^{(R)}$ versus $xyntha^{(R)}$ in patients with severe hemophilia A. Methods: Thirty-three male patients with severe hemophilia A were randomly divided into two groups. Seventeen patients received $Safacto^{(R)}$ and 16 patients received $Xyntha^{(R)}$ for four consecutive times. The dosage of FVIII was 40-50 IU/kg for each injection. Plasma level of FVIII activity was evaluated before every injection, 15 minutes after the injection and one month after the start of the trial. The rate of factor VIII activity, pain and joint motion were also assessed before and after the treatment. Results: Plasma level of FVIII clotting activity in $Safacto^{(R)}$ and $Xyntha^{(R)}$ were $1.96{\pm}0.5IU/dl$ and $1.63{\pm}0.5IU/dl$ and increased to $88.84{\pm}25.2IU/dl$ and $100.09{\pm}17.8IU/dl$, respectively (P<0.001). Pain score and range of motion improvement were $9.3{\pm}0.9$ and $8.7{\pm}0.1$ in $Safacto^{(R)}$ (P=0.17); and $9.4{\pm}0.8$ and $8.8{\pm}0.3$ in $Xyntha^{(R)}$ (P=0.35), respectively. No allergic or other unfavorable reactions was observed with either of the preparations. Conclusion: This study showed that $Safacto^{(R)}$ has a favorable efficacy and safety profile.

키워드

참고문헌

  1. Mannucci PM, Tuddenham EG. The hemophili-as--from royal genes to gene therapy. N Engl J Med. 2001; 344(23): 1773-9. https://doi.org/10.1056/NEJM200106073442307
  2. White GC 2nd, et al. Definitions in hemophilia. Recommendation of the scientific subcommittee on factor VIII and factor IX of the scientific and standardization committee of the International Society on Trombosis and Haemostasis. Tromb Haemost. 2001; 85(3): 560. https://doi.org/10.1055/s-0037-1615621
  3. Cheraghali A. Cost effectiveness of Iran national plasma contract fractionation program. DARU Journal of Pharmaceutical Sciences, 2012; 20(1): 63. https://doi.org/10.1186/2008-2231-20-63
  4. Faranoush M. Patients Perspective in Plasma Products (Focus on Hemophilia). Iranian Journal of Blood and Cancer. 2011; 3(3): 171-5.
  5. Cheraghali AM, Aboofazeli R. Economical impact of plasma fractionation project in Iran on affordability of plasma-derived medicines. Transfusion Medicine. 2009; 19(6): 363-8. https://doi.org/10.1111/j.1365-3148.2009.00961.x
  6. Cheraghali AM, Eshghi P. Cost Assessment of Implementation of Immune Tolerance Induction in Iran. Value in Health Regional Issues. 2012; 1(1): 54-8. https://doi.org/10.1016/j.vhri.2012.03.014
  7. Eshghi P, Abolghasemi H, Malek F, Naderi M, Panahi Y, Habibpanah B, et al. A prospective Crossover Triple-blind Controlled Trial on the Safety and Efficacy of Iranian Recombinant FVIII (Safacto) versus Plasma Derived FVIII A pilot study. Iranian Journal of Blood and Cancer. 2015; 7(4): 171-4.
  8. Kavakli K, Makris M, Zulfkar B, Erhardtsen E, Abrams ZS, Kenet G; NovoSeven trial (F7HAEM-1510) inves- tigators. Home treatment of haemarthroses using a single dose regimen of recombinant activated factor VII in patients with haemophilia and inhibitors. A multi-centre, randomised, double-blind, cross-over trial. Tromb Haemost. 2006; 95(4): 600-5. https://doi.org/10.1160/TH05-07-0510
  9. Verbruggen, B, van Heerde W, Laros-van Gorkom B. Improvements in Factor VIII Inhibitor Detection: From Bethesda to Nijmegen. Seminars in Trombosis and Hemostasis. 2010; 35(8): 752-9.
  10. Toogeh G, Abolghasemi H, Eshghi P, Managhchi M, Shaverdi-Niasari M, Karimi K, et al. Evaluation of Aryoseven Safety (Recombinant Activated Factor VII) in Patients with Bleeding Disorders (An Observational Post-Marketing Surveillance Study). Iran J Pathol. 2016; 11(3): 204-9.
  11. Faranoush M, Abolghasemi H, Mahboudi F, Toogeh G, Karimi M, Eshghi P, et al. A Comparison of Efficacy Between Recombinant Activated Factor VII (Aryoseven) and Novoseven in Patients With Hereditary FVIII Deficiency With Inhibitor. Clin Appl Tromb Hemost. 2016; 22(2): 184-90. https://doi.org/10.1177/1076029614555902
  12. Morfini M, Marchesini E, Paladino E, Santoro C, Zanon E, Iorio A, et al. Pharmacokinetics of plasma-derived vs. recombinant FVIII concentrates: a comparative study. Haemophilia. 2015; 21(2): 204-9. https://doi.org/10.1111/hae.12550
  13. European Medicines Agency. Guideline on the clinical investigation of recombinant and human plasma-derived factor VIII products. 2011 [cited 2017 25 March].
  14. Chalmers EA, Brown SA, Keeling D, Liesner R, Richards M, Stirling D, et al. Early factor VIII exposure and sub-sequent inhibitor development in children with severe haemophilia A. Haemophilia. 2007; 13(2): 149-55. https://doi.org/10.1111/j.1365-2516.2006.01418.x
  15. Gouw SC, van der Bom JG, Auerswald G, Ettinghausen CE, Tedgard U, van den Berg HM. Recombinant versus plasma-derived factor VIII products and the development of inhibitors in previously untreated patients with severe hemophilia A: the CANAL cohort study. Blood. 2007; 109(11): 4693-7. https://doi.org/10.1182/blood-2006-11-056317
  16. F. Peyvandi, P.M. Mannucci, I. Garagiola, A. El‐Beshlawy, M. Elalfy, V. Ramanan, et al. A Randomized Trial of Factor VIII and Neutralizing Antibodies in Hemophilia A. New England Journal of Medicine. 2016; 374(21): 2054-64. https://doi.org/10.1056/NEJMoa1516437
  17. Lee C. The Use of Recombinant Factor VIII Products in Previously Treated Patients with Hemophilia A: Phar-macokinetics, Efficacy, Safety, and Inhibitor Development. Semin Tromb Hemost. 2002; 28(3): 241-6. https://doi.org/10.1055/s-2002-32657
  18. Lusher JM, Lee CA, Kessler CM, Bedrosian CL; Re-Facto Phase 3 Study Group. The safety and efficacy of B-domain deleted recombinant factor VIII concentrate in patients with severe haemophilia A. Haemophilia. 2003; 9(1): 38-49.
  19. Ragni MV, Yabes JG, Fogarty PF, Josephson NC, Kessler CM, Nef AT, et al. Pilot randomized, non-inferiority, cross-over trial of once-weekly vs. three times-weekly recombinant factor VIII prophylaxis in adults with severe haemophilia A. Haemophilia. 2017; 23(1): e43-e6. https://doi.org/10.1111/hae.13131
  20. Saxena K, Lalezari S, Oldenburg J, Tseneklidou-Stoeter D, Beckmann H, Yoon M, et al. Efficacy and safety of BAY 81-8973, a full-length recombinant factor VIII: results from the LEOPOLD I trial. Haemophilia. 2016; 22(5): 706-12. https://doi.org/10.1111/hae.12952
  21. Nolan B, Mahlangu J, Perry D, Young G, Liesner R, Konkle B, et al. Long-term safety and efficacy of recombinant factor VIII Fc fusion protein (rFVIIIFc) in subjects with haemophilia A. Haemophilia. 2016; 22(1): 72-80. https://doi.org/10.1111/hae.12766
  22. Konkle BA, Stasyshyn O, Chowdary P, Bevan DH, Mant T, Shima M, et al. Pegylated, full-length, recombinant factor VIII for prophylactic and on-demand treatment of severe hemophilia A. Blood. 2015;126(9): 1078-85. https://doi.org/10.1182/blood-2015-03-630897
  23. Young G, Mahlangu J, Kulkarni R, Nolan B, Liesner R, Pasi J, et al., Recombinant factor VIII Fc fusion protein for the prevention and treatment of bleeding in children with severe hemophilia A. J Tromb Haemost. 2015; 13(6): 967-77. https://doi.org/10.1111/jth.12911