Practical aspects of extended half-life products for the treatment of haemophilia

Research output: Contribution to journalReview article

Abstract

Haemophilia A and haemophilia B are congenital X-linked bleeding disorders caused by deficiency of coagulation factor VIII (FVIII) and IX (FIX), respectively. The preferred treatment option for patients with haemophilia is replacement therapy. For patients with severe disease, prophylactic replacement of coagulation factor is the treatment of choice; this has been shown to reduce arthropathy significantly, reduce the frequency of bleeds and improve patients' quality of life. Prophylaxis with standard recombinant factor requires regular intravenous infusion at least two (FIX) to three (FVIII) times a week. Recombinant FVIII and FIX products with an extended half-life are in development, or have been recently licensed. With reported mean half-life extensions of 1.5-1.8 times that of standard products for FVIII and 3-5 times that of standard products for FIX, these products have the potential to address many of the unmet needs of patients currently treated with standard factor concentrates. For example, they may encourage patients to switch from on-demand treatment to prophylaxis and improve the quality of life of patients receiving prophylaxis. Indeed, extended half-life products have the potential to reduce the burden of frequent intravenous injections, reducing the need for central venous lines in children, promote adherence, improve outcomes, potentially allow for more active lifestyles and, depending on the dosing regimen, increase factor trough levels. Members of the Zürich Haemophilia Forum convened for their 19th meeting to discuss the practicalities of incorporating new treatments into the management of people with haemophilia. This review of extended half-life products considers their introduction in haemophilia treatment, including the appropriate dose and schedule of infusions, laboratory monitoring, patient selection, safety considerations, and the economic aspects of care.

Details

Authors
  • Thierry Lambert
  • Gary Benson
  • Gerry Dolan
  • Cedric Hermans
  • Victor Jiménez-Yuste
  • Rolf Ljung
  • Massimo Morfini
  • Silva Zupančić-Šalek
  • Elena Santagostino
Organisations
External organisations
  • Italian Association of Haemophilia Centres
  • Maggiore Hospital Policlinico
  • University Hospital Centre Zagreb
  • University of Osijek
  • University of Zagreb
  • Skåne University Hospital
  • University Hospital La Paz
  • Bicêtre Hospital
  • Belfast City Hospital
  • St Thomas' Hospital
  • Saint-Luc University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Hematology
  • Social and Clinical Pharmacy
Original languageEnglish
Pages (from-to)295-308
Number of pages14
JournalTherapeutic advances in hematology
Volume9
Issue number9
Publication statusPublished - 2018 Sep
Publication categoryResearch
Peer-reviewedYes