Prospective evaluation of treatment regimens, efficacy and safety of a recombinant factor VIII concentrate in haemophilia A: the German EffeKt study

Haemophilia. 2016 Sep;22(5):684-91. doi: 10.1111/hae.12941. Epub 2016 Mar 31.

Abstract

Introduction: Collecting clinical data under routine conditions remains important to monitor continuously efficacy and tolerability of an established product.

Aim: This prospective observational study aimed at evaluating efficacy and tolerability of full-length sucrose-formulated recombinant FVIII (rFVIII-FS; KOGENATE(®) Bayer/KOGENATE(®) FS) in routine use and analysing concomitant diseases and medication.

Methods: Haemophilia A patients treated with rFVIII-FS were followed up for 24 or 36 months. Efficacy, tolerability, concomitant medication and diseases were assessed at yearly intervals.

Results: Two hundred and twenty-one documented patients were mainly pretreated, predominantly with prophylaxis (74%). On study, 54 (31%) patients in the efficacy set (n = 174) documented regular prophylaxis, 91 patients (52.3%) failed to document their prescribed prophylactic infusions, 25 (14.4%) received on-demand treatment and four patients (2%) inhibitor adapted therapy. Patients on regular prophylaxis reported 8.4% of infusions for bleeding treatment and on-demand patients reported 55.3%. Young patients experienced mainly trauma-related bleedings and older patients reported spontaneous bleedings. Joint status was good overall. Median annual spontaneous joint bleeding rate in all groups was zero. A total of 79.0% of all bleedings were successfully treated with one or two infusions. Degenerative arthropathy and arterial hypertension were the most prominent concomitant diseases. Eighty-seven patients (40.5%) took at least one concomitant drug on study, mostly drugs for pain treatment related to haemophilic arthropathy. Two patients presented with positive inhibitor titres on study, one of them was a previously untreated patient and the other had a positive inhibitor history.

Conclusion: This study corroborates the tolerability and efficacy profile of rFVIII-FS.

Keywords: clinical study; factor VIII; haemophilia A; prophylaxis.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Factor VIII / therapeutic use*
  • Follow-Up Studies
  • Hemophilia A / drug therapy*
  • Hemophilia A / pathology
  • Hemorrhage
  • Humans
  • Infant
  • Joints / physiopathology
  • Male
  • Middle Aged
  • Prospective Studies
  • Severity of Illness Index
  • Treatment Outcome
  • Young Adult

Substances

  • F8 protein, human
  • Factor VIII