Integrated analysis of safety and efficacy of a plasma- and albumin-free recombinant factor VIII (rAHF-PFM) from six clinical studies in patients with hemophilia A

Expert Opin Biol Ther. 2009 Mar;9(3):273-83. doi: 10.1517/14712590902729392.

Abstract

Background: Hemophilia A is an X-linked bleeding disorder that results from insufficient levels of factor VIII (FVIII) coagulant activity.

Objective: To evaluate the efficacy and safety of ADVATE rAHF-PFM (Baxter Healthcare Corporation), a recombinant FVIII concentrate manufactured without human or bovine blood-derived additives, and to assess the effect of compliance with prophylactic use in preventing bleeding episodes (BEs).

Methods: Clinical data were integrated from six prospective studies. Two hundred thirty-four hemophilia A subjects (FVIII levels < or = 2%) (median age 14.7 (range: 0.02 - 72.7) years) were included.

Results: BEs were managed with one or two infusions and nearly all (1953/1956) responded to treatment. Compliance with a prophylactic treatment regimen significantly reduced the incidence of BEs (p = 0.0061) and prevented non-traumatic joint BEs (median annualized BE rate was 0). One previously treated subject developed an inhibitor; no other safety concerns were observed.

Conclusions: These results reinforce the efficacy and safety of rAHF-PFM and suggest that compliance is an essential contributor to the effectiveness of prophylaxis in the treatment of hemophilia A.

Trial registration: ClinicalTrials.gov NCT00157040 NCT00157053 NCT00157105 NCT00157157.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Factor VIII / therapeutic use*
  • Hemophilia A / immunology
  • Hemophilia A / therapy*
  • Hemorrhage / prevention & control
  • Humans
  • Infant
  • Maximum Tolerated Dose
  • Middle Aged
  • Patient Compliance
  • Prospective Studies
  • Safety
  • Serum Albumin / deficiency
  • Treatment Outcome
  • Young Adult

Substances

  • Serum Albumin
  • F8 protein, human
  • Factor VIII

Associated data

  • ClinicalTrials.gov/NCT00157040
  • ClinicalTrials.gov/NCT00157053
  • ClinicalTrials.gov/NCT00157105
  • ClinicalTrials.gov/NCT00157157