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Pharmacokinetic Profile of Southeastern Brazilian Hemophilia A Patients on Prophylaxis with Octocog Alfa

A. Borges1, P. Giacometto1, T. Anegawa2, L. Hirle1, M. Amarante2, L. Jardim3, R. Camelo3

1Universidade Estadual de Maringa, Hemocentro Regional de Maringa, Maringa, Brazil, 2Universidade Estadual de Londrina, Hemocentro Regional de Londrina, Londrina, Brazil, 3Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

Abstract Number: PB0901

Meeting: ISTH 2020 Congress

Theme: Hemophilia and Rare Bleeding Disorders » Hemophilia - Clinical

Background: Hemophilia A (HA) is an inherited bleeding disorder characterized by deficiency of procoagulant factor VIII (FVIII). Prophylaxis with FVIII is the most effective treatment in patients with moderate/severe (ms) HA (FVIII:C< 5%), which can prevent spontaneous bleeding episodes. Although standard prophylaxis based on body weight and at least 1% of plasmatic FVIII trough levels is effective, spontaneous bleeding still occurs. The modern individualized therapy then considers patient behaviour and FVIII pharmacokinetic (PK) parameters.

Aims: The aim of this study is to describe the PK profiles of msHA patients who were submitted to PK-individualized therapy with octocog alfa (rFVIII).

Methods: Patients were invited from two Southern Brazilian hemophilia treatment centers, if they were 1 year or older, they weighed at least 12 kg, their inhibitor status was negative for at least 6 months, they had ≥ 50 exposition days and they were bleeding-free for at least 2 weeks. Data were obtained from medical files. PK profile was calculated according to the myPKFiT protocol.

Results: Thirty-three patients on PK-individualized prophylaxis were included. Median age was 12.0 [IQR,8.0-24.0] years. One patient was excluded from the analyses because his FVIII half-life was below the normal value. Patients were divided in two groups: younger than 15 years (n=21) and 15 years or more (n=12). Median FVIII half-life was statistically lower (p=0.001) and median clearance was statistically higher (p=0.016) in the youngest patient group than in the oldest group, although the estimated doses to keep FVIII trough level of at least 1% with each-other-day infusion were similar between the groups (p=0.065).

Conclusions: Our results confirm previous studies which described a shorter FVIII half-life among children, but surprisingly the estimated doses to keep a trough level above 1% were similar between the age groups. The significance of these findings will be further elucidated after inclusion and follow-up of new patients.

To cite this abstract in AMA style:

Borges A, Giacometto P, Anegawa T, Hirle L, Amarante M, Jardim L, Camelo R. Pharmacokinetic Profile of Southeastern Brazilian Hemophilia A Patients on Prophylaxis with Octocog Alfa [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/pharmacokinetic-profile-of-southeastern-brazilian-hemophilia-a-patients-on-prophylaxis-with-octocog-alfa/. Accessed October 2, 2023.

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