Pattern of bleeding in a large prospective cohort of haemophilia A patients

A three-year follow-up of the AHEAD (Advate in HaEmophilia A outcome Database) study

the AHEAD Study Group

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Introduction: Outcome data on treatment of patients with haemophilia A spanning several years of real-world evidence collection are currently very limited. Aim and methods: The global prospective long-term Advate® Haemophilia A Outcome Database (AHEAD) cohort study collects real-world data from patients with severe and moderate haemophilia. We report an interim data read-out after three years of observation. Results: A total of 522 patients were enrolled from 21 countries: 334 completed year 1 follow-up, 238 completed year 2 and 136 completed year 3, with an overall follow-up of 811 patient-years. Median annual bleeding rates (ABR) were 1.7 in the prophylaxis group and 8.9 in the on-demand group at year 1 visit, 1.6 and 13.0, respectively, at year 2 visit and 2.2 and 10.3, respectively, at year 3 visit. Moreover, about 42% of patients on prophylaxis vs 12% of patients on on-demand had zero annual joint bleeding rates (AJBR). Effectiveness of prophylaxis and on-demand treatment was deemed excellent/good in the majority of cases. Octocog alfa (Advate®) was well tolerated. The inhibitors that developed in nine patients all disappeared spontaneously. Three patients had been previously exposed to FVIII for ≤50 exposure days (EDs), 3 for >50 EDs and 3 showed a borderline positive inhibitory activity (≤0.6 BU/mL). Conclusions: These data confirm that the goal of zero bleeds is achievable, although not yet achieved in all patients. Understanding reasons behind the lower response to standard prophylaxis regimens in some patients and personalizing prophylactic treatment may further improve outcome in patients with haemophilia A.

Original languageEnglish
Pages (from-to)85-96
Number of pages12
JournalHaemophilia
Volume24
Issue number1
DOIs
Publication statusPublished - Jan 1 2018

Fingerprint

Hemophilia A
Outcome Assessment (Health Care)
Databases
Hemorrhage
Cohort Studies
Therapeutics
Joints
Observation

Keywords

  • bleeding
  • haemophilia A
  • prophylaxis
  • real-world evidence

ASJC Scopus subject areas

  • Hematology
  • Genetics(clinical)

Cite this

Pattern of bleeding in a large prospective cohort of haemophilia A patients : A three-year follow-up of the AHEAD (Advate in HaEmophilia A outcome Database) study. / the AHEAD Study Group.

In: Haemophilia, Vol. 24, No. 1, 01.01.2018, p. 85-96.

Research output: Contribution to journalArticle

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abstract = "Introduction: Outcome data on treatment of patients with haemophilia A spanning several years of real-world evidence collection are currently very limited. Aim and methods: The global prospective long-term Advate{\circledR} Haemophilia A Outcome Database (AHEAD) cohort study collects real-world data from patients with severe and moderate haemophilia. We report an interim data read-out after three years of observation. Results: A total of 522 patients were enrolled from 21 countries: 334 completed year 1 follow-up, 238 completed year 2 and 136 completed year 3, with an overall follow-up of 811 patient-years. Median annual bleeding rates (ABR) were 1.7 in the prophylaxis group and 8.9 in the on-demand group at year 1 visit, 1.6 and 13.0, respectively, at year 2 visit and 2.2 and 10.3, respectively, at year 3 visit. Moreover, about 42{\%} of patients on prophylaxis vs 12{\%} of patients on on-demand had zero annual joint bleeding rates (AJBR). Effectiveness of prophylaxis and on-demand treatment was deemed excellent/good in the majority of cases. Octocog alfa (Advate{\circledR}) was well tolerated. The inhibitors that developed in nine patients all disappeared spontaneously. Three patients had been previously exposed to FVIII for ≤50 exposure days (EDs), 3 for >50 EDs and 3 showed a borderline positive inhibitory activity (≤0.6 BU/mL). Conclusions: These data confirm that the goal of zero bleeds is achievable, although not yet achieved in all patients. Understanding reasons behind the lower response to standard prophylaxis regimens in some patients and personalizing prophylactic treatment may further improve outcome in patients with haemophilia A.",
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