Efanesoctocog Alfa versus Standard and Extended Half-Life Factor VIII Prophylaxis in Adolescent and Adult Patients with Haemophilia A without Inhibitors.

IF 3.4 3区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL Advances in Therapy Pub Date : 2024-11-22 DOI:10.1007/s12325-024-03032-3
Robert Klamroth, Nana Kragh, Alix Arnaud, Patricia Guyot, Amanda Wilson, Piotr Wojciechowski, Marlena Wdowiak, Wojciech Margas, Linda Bystrická, Alberto Tosetto
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Abstract

Introduction: In the Phase 3 XTEND-1 trial, (NCT04161495) efanesoctocog alfa prophylaxis provided superior bleed protection versus pre-study factor VIII (FVIII) replacement therapy in patients with severe haemophilia A. The aim of this study was to indirectly compare bleed outcomes between efanesoctocog alfa and standard/extended half-life (SHL and EHL) FVIII replacement therapies in adolescent and adult patients with severe haemophilia A without inhibitors.

Methods: A systematic literature review was conducted to identify Phase 3 trials of EHL and SHL FVIII replacement therapies for comparison with efanesoctocog alfa data from XTEND-1. Matching-adjusted indirect comparisons were used to compare annualised bleeding rates (ABRs) for any, treated, joint, and spontaneous bleeds between efanesoctocog alfa and comparators. The estimates from respective comparisons were pooled using random-effect meta-analyses to evaluate the overall difference between efanesoctocog alfa and comparator therapies.

Results: Four EHL therapies (rurioctocog alfa pegol, efmoroctocog alfa, turoctocog alfa pegol, damoctocog alfa pegol) and two octocog alfa SHL therapies were included. In meta-analyses, efanesoctocog alfa was associated with significantly lower ABRs for any [mean difference (95% CI) - 2.24 ( - 3.24; - 1.25)], spontaneous [ - 1.52 ( - 2.33; - 0.72)], and joint bleeds [ - 1.60 ( - 2.32; - 0.88)] versus EHL therapies, and with significantly lower ABRs for any [ - 3.61 ( - 4.43; - 2.79)], treated [ - 1.55 ( - 1.89; - 1.20)], spontaneous [ - 2.52 ( - 3.31; - 1.72)], and joint bleeds [ - 3.42 ( - 4.77; - 2.08)] versus SHL therapies.

Conclusion: Efanesoctocog alfa was associated with significantly lower ABRs (any, spontaneous and joint) compared with EHL or SHL prophylaxis therapies. Patients had, on average, 2.2 and 3.6 fewer bleeds per year versus EHL and SHL therapies, respectively.

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Efanesoctocog Alfa 与标准和延长半衰期因子 VIII 对无抑制剂的青少年和成年 A 型血友病患者的预防治疗对比。
简介在XTEND-1三期试验(NCT04161495)中,efanesoctocog alfa预防性治疗与研究前的因子VIII(FVIII)替代疗法相比,可为重症血友病A患者提供更优越的出血保护。本研究旨在间接比较efanesoctocog alfa与标准/延长半衰期(SHL和EHL)FVIII替代疗法在无抑制剂的青少年和成年重症血友病A患者中的出血结果:我们进行了系统性文献回顾,以确定EHL和SHL FVIII替代疗法的3期试验,并与XTEND-1中的efanesoctocog alfa数据进行比较。采用匹配调整间接比较法来比较 efanesoctocog alfa 和比较者之间的任何出血、治疗出血、关节出血和自发性出血的年化出血率 (ABR)。采用随机效应荟萃分析法对各比较的估计值进行汇总,以评估依法尼辛可克α与对比疗法之间的总体差异:纳入了四种EHL疗法(urioctocog alfa pegol、efmoroctocog alfa、turoctocog alfa pegol、damoctocog alfa pegol)和两种octocog alfa SHL疗法。在荟萃分析中,efanesoctocog alfa与EHL疗法相比,任何[平均差异(95% CI)- 2.24 ( - 3.24; - 1.25)]、自发性[- 1.52 ( - 2.33; - 0.72)]和关节出血[- 1.60 ( - 2.32; - 0.88)]的ABR显著较低。88)] 与 EHL 疗法相比,任何[- 3.61 ( - 4.43; - 2.79)]、治疗[- 1.55 ( - 1.89; - 1.20)]、自发[- 2.52 ( - 3.31; - 1.72)]和关节出血[- 3.42 ( - 4.77; - 2.08)]的 ABRs 明显低于 SHL 疗法:结论:与 EHL 或 SHL 预防疗法相比,Efanesoctocog alfa 可显著降低 ABR(任何出血、自发性出血和关节出血)。与EHL和SHL疗法相比,患者每年平均出血量分别减少2.2次和3.6次。
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来源期刊
Advances in Therapy
Advances in Therapy 医学-药学
CiteScore
7.20
自引率
2.60%
发文量
353
审稿时长
6-12 weeks
期刊介绍: Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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