Abstract Number: PB0621
Meeting: ISTH 2021 Congress
Background: Since the availability of Bayesian population-based pharmacokinetic (PK) platforms, estimation of individual PK became widespread. Individual PK assessment considers patient variables (e.g. age, weight, blood group, von Willebrand factor [vWF]), but the gender influence, at the best of our knowledge, is unknown. PK information on women is still missing, especially in pregnant women with hemophilia.
Aims: To describe the PK profile of a female with severe HA during pregnancy.
Methods: We performed PK assessments outside and during the pregnancy, using both myPKFiT (Takeda Pharmaceuticals, Japan) and WAPPS-Hemo (McMaster University, Ontario, Canada) platforms. We also reviewed the clinical data present in patient’s electronic records. Whenever possible, FVIII levels were measured by one stage assays (OSA) [Siemens Healthineers, Marburg, Germany] and chromogenic assays (CSA) [HemosIL Electrachrome, Werfen, USA]. Balanced estimates of terminal half-lives (t1/2) were compared among those two assays. Analysis was performed using t-Student test.
Results: The patient was on prophylaxis with Advate®, twice weekly previously (20 IU/kg) and during pregnancy (25 IU/kg) until gestational age of 31 weeks, when she intensified prophylaxis to 3 times/week (21.5 IU/kg).
The t½ were 17h and 10.5h before pregnancy, and 24.3h and 18.3h at 31 weeks of gestation, using OSA and CSA, respectively. We observed an increase in FVIII levels and mainly a marked vWF rise during pregnancy (1.80 to 3.27 IU/mL). Patient reached half-lives (t½) at 36 weeks of gestation of 20h (WAPPS-Hemo) and 17h (myPKFiT) by OSA.
Conclusions: Outside pregnancy, the higher t½ in the patient compared to the reference mean t½ of Advate® (12.4±2.0 h, Malhangu, 2014), raises the question of whether it is due to individual PK differences or it is dependent of the female gender. The increased t½ during pregnancy confirms what was expected and accompanies the rising of vWF during pregnancy.
To cite this abstract in AMA style:Costa L, Ferreira A, Coutinho M, Pereira M, Cruz E, Morais S. Influence of Pregnancy on the Pharmacokinetic Profile of a Severe Hemophilia A Female [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/influence-of-pregnancy-on-the-pharmacokinetic-profile-of-a-severe-hemophilia-a-female/. Accessed September 24, 2021.
« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/influence-of-pregnancy-on-the-pharmacokinetic-profile-of-a-severe-hemophilia-a-female/