Abstract Number: PB0796
Meeting: ISTH 2020 Congress
Background: Acquired haemophila A (AHA) is a rare coagulation disorder, more frequent in the elderly people, but often its management is difficult due to the concomitant presence of severe co-morbidities. Susoctocog-alfa could be an interesting option of treatment in these patients.
Aims: To assess the efficacy and safety of rpFVIII in the treatment of an elderly population of patients with AHA and concomitant severe co-morbidieties.
Methods: All data of elderly patients presenting AHA, and treated with susoctocog-alfa were retrospectively collected at five Italian Haemophilia Centres.
Results: Nine patients were retrospectively collected, 88.9% were males, mean age 78.7 years. 44.4% were idiopathic AHAs. Seven patients presented muscular bleeding, among these one patient also had haematuria. At diagnosis the remaining two patients presented respectively intracranial haemorrhage and haematuria with concomitant knee haemartrosis. 7/9 patients presented concomitant severe diseases, among these 71.4% were cardiovascular Susoctocog-alfa as first line therapy was used in 1/3 of cases. Median loading dose in both, first or second-line therapy, was 100.0 IU/kg; median subsequent doses were 50 IU/kg with a median frequency of 12hrs and with a median number of doses of 8. After the loading dose the median FVIII peak was 166%. The rpFVIII-inhibitors were not tested before treatment with susoctocog-alfa, while only two patients developed a low-titre antibodies. Three surgeries were performed under susoctocog-alfa treatment, all without concomitant acute bleeding. rpFVIII was considered effective in all cases and was associated with antifibrinolytics in 22.2% of cases. Low-dose aPCC as short-term prophylaxis to prevent recurrences was started after acute treatment in 55.6% of patients. No adverse events were reported during treatment with this drug or during eight months of follow-up.
Conclusions: Our report showed that susoctocog-alfa may be an effective and safe option for patients with AHA, especially those presenting severe co-morbidities, also if used at a lower dosage than recommended.
To cite this abstract in AMA style:Zanon E, Pasca S, Borchiellini A, Lodigiani C, Molinari AC, Moscatelli P, Ambaglio C, Preti PS, Simioni P. Real World Experience on Use of Susoctocog-alfa (rpFVIII) in the Treatment of a Population of Italian Elderly Patients with Acquired Haemophilia A [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/real-world-experience-on-use-of-susoctocog-alfa-rpfviii-in-the-treatment-of-a-population-of-italian-elderly-patients-with-acquired-haemophilia-a/. Accessed January 28, 2022.
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