Feasibility and outcomes of switching factor VIII therapies: post-hoc analysis of patients transitioning from older plasma-derived and first-generation recombinant factor VIII to newer third-generation recombinant factor VIII replacement therapies within the Takeda factor VIII portfolio.

BACKGROUND

The recent discontinuation of antihemophilic factor Method M, monoclonally purified (AHF-M) and recombinant antihemophilic factor (rAHF) requires evaluation of hemophilia A treatment strategies for some patients. This post-hoc analysis characterized the safety and efficacy of third-generation recombinant factor VIII (FVIII) products (antihemophilic factor [recombinant], plasma/albumin-free method [rAHF-PFM] and PEGylated rAHF [rAHF-PEG]) after switching from plasma-derived AHF-M or first-generation rAHF.

RESEARCH DESIGN AND

METHODS

Previously treated patients from three trials (rAHF-PFM: two; rAHF-PEG: one) whose last recorded FVIII replacement therapy was either AHF-M or rAHF were included. Bleeding outcomes, consumption, hemostatic efficacy, safety, and immunogenicity were evaluated.

RESULTS

Of 114 participants, 19 were previously treated with AHF-M and 95 with rAHF; 97 participants transitioned to rAHF-PFM and 17 to rAHF-PEG. Participants switching to rAHF-PEG prophylaxis achieved lower bleeding rates compared with previous prophylaxis. Most bleeding events were treated with one to two infusions of rAHF-PFM or rAHF-PEG with good or excellent hemostatic efficacy ratings. No participants developed inhibitors to rAHF-PFM or rAHF-PEG.

CONCLUSIONS

Results from this post-hoc analysis demonstrated improvements in bleeding outcomes in participants switching to rAHF-PEG and were consistent with the original trial results, supporting the feasibility of transitioning from the older- to newer-generation Takeda FVIII replacement therapies.