First report on the safety and efficacy of an extended half-life glycoPEGylated recombinant FVIII for major surgery in severe haemophilia A

K. Hampton, P. Chowdary, S. Dunkley, S. Ehrenforth, L. Jacobsen, A. Neff, E. Santagostino, J. Sathar, H. Takedani, C. M. Takemoto, C. Négrier

Research output: Contribution to journalArticlepeer-review

Abstract

Background: N8-GP (turoctocog alfa pegol) is an extended half-life glycoPEGylated recombinant factor VIII (FVIII) product developed for the prevention and treatment of bleeds in haemophilia A patients. Aim: This is a planned interim analysis of pathfinder™3, an international, open-label, Phase 3 trial evaluating the efficacy and safety (including immunogenicity) of N8-GP administered before, during and after major surgery in severe haemophilia A patients aged ≥12 years. Methods: Sixteen patients who underwent 18 major surgical procedures (including synovectomy, joint replacement and ankle arthrodesis) were included here. Postoperative assessments were conducted daily for days 1-6, and once for days 7-14. Primary endpoint was N8-GP haemostatic efficacy, assessed after completion of surgery using a four-point scale ('excellent', 'good', 'moderate', 'none'). Results: Haemostasis was successful (rated 'excellent' or 'good') on completion of surgery in 17 (94.4%) procedures and rated as 'moderate' (5.6%) for one surgery in a patient with multiple comorbidities who needed an intraoperative N8-GP dose (20.7 IU kg-1). In the postoperative period, three bleeds occurred (one during days 1-6; two during days 7-14); all were successfully treated with N8-GP. Mean N8-GP consumption on day of surgery was 80.0 IU kg-1; patients received a mean of 1.7 doses (median: 2, range: 1-3). No safety concerns were identified. Conclusion: The data showed that N8-GP was effective and well tolerated for the prevention and treatment of bleeds during major surgery; such FVIII products with extended half-lives may modify current treatment schedules, enabling fewer infusions and earlier patient discharge.

Original languageEnglish
Pages (from-to)689-696
JournalHaemophilia
Volume23
Issue number5
DOIs
Publication statusPublished - 2017

Keywords

  • Efficacy
  • Extended half-life
  • Haemophilia A
  • Haemostatic
  • Recombinant FVIII
  • Safety
  • Surgery

ASJC Scopus subject areas

  • Hematology
  • Genetics(clinical)

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