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  • 1
    In: Journal of Thrombosis and Haemostasis, Elsevier BV, Vol. 18, No. 4 ( 2020-04), p. 815-824
    Type of Medium: Online Resource
    ISSN: 1538-7836
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2099291-9
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  • 2
    In: Blood, American Society of Hematology, Vol. 126, No. 23 ( 2015-12-03), p. 4680-4680
    Abstract: Introduction Patients with congenital afibrinogenaemia and hypofibrinogenaemia, experience frequent severe bleeding episodes starting at birth or early childhood. Bleeding may occur after a minor trauma or a small surgical intervention, into the skin, mucosa, muscles, gastrointestinal tract, or the brain. Therapeutic substitution with human fibrinogen concentrate can correct the haemostatic defect and arrest the bleeding in patients with these fibrinogen deficiencies. Octafibrin is a plasma derived, highly purified, lyophilized, fibrinogen concentrate, which has been double virus safeguarded using two dedicated virus inactivation/removal steps. In this study, the (PK) profile of this new concentrate is compared to a commercially available product. Methods This study was a prospective, randomized, open-label, multinational, crossover PK comparison of Octafibrin to an existing marketed product (Haemocomplettan¨ P/RiaSTAPTM) in adult and adolescent afibrinogenemic patients, including comparison of a surrogate efficacy endpoint Maximum Clot Firmness (MCF) measured by ROTEM¨. Patients were randomized to either product and received a single dose of 70mg/kg b.w. and blood samples were collected over 14 days followed by an observational period up to 45 days. Afibrinogenemia was confirmed by baseline fibrinogen activity plasma level of 〈 0.20. All fibrinogen and MCF testing was performed in a central lab using validated methods. Primary objective was to show bioequivalence between both products based on the Normalized Area Under the Curve (AUCnorm). Results Twenty two adult and adolescent patients were included in the final analysis. Mean AUCnorm) for Octafibrin was 1.62, and for the marketed concentrate 1.35 (hákgág/L/mg) and mean clearance 0.67 and 0.82 mL/h/kg, respectively. Both showed a statistically significant differences between the groups (see figure and table below). Other PK parameter were comparable between the products. Comparable haemostatic efficacy of the two products was demonstrated based on their ability to significantly increase MCF from baseline. There were no reports of adverse events (AE) related to the infusion of this novel concentrate. Conclusions In conclusion, this study showed a statistically significantly higher AUCnorm and lower clearance for Octafibrin compared to the comparator. Other PK parameters were in general comparable. Change in MCF compared to baseline as a surrogate efficacy parameter, was similar to that of the licensed comparator used in this study, and there was no related AE or SAE for Octafibrin after single-dose administration. Table. Ratios of Octafibrin Relative to Haemocomplettan¨ P/RiaSTAPTM for AUC and AUCnorm (PK Population, N=22) Fibrinogen activity Parameter ratio Mean 90% CI of mean ratio p-value AUC 1.34 (1.23, 1.41) 〈 0.0001 AUCnorm 1.21 (1.25, 1.44) 0.0002 Figure Mean (± SD) Fibrinogen Levels (g/L) during PK Assessment after Octafibrin and Haemocomplettan¨ P/RiaSTAPTM Administration, Standardized to 70 mg/kg (PK Population, n=22) Figure. Mean (± SD) Fibrinogen Levels (g/L) during PK Assessment after Octafibrin and Haemocomplettan¨ P/RiaSTAPTM Administration, Standardized to 70 mg/kg (PK Population, n=22) Disclosures Ross: Octapharma: Other: Investigator. Rangarajan:Octapharma: Other: Investigator. Karimi:Octapharma: Other: Investigator. Schwartz:Octapharma: Employment. Knaub:Octapharma: Employment. Peyvandi:LFB, Kedrion, Novonordisk, Bayer, Roche, CSL Behring.: Consultancy, Honoraria, Research Funding; Octapharma: Other: Investigator.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2015
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 3
    Online Resource
    Online Resource
    American Society of Hematology ; 2014
    In:  Blood Vol. 124, No. 21 ( 2014-12-06), p. 2817-2817
    In: Blood, American Society of Hematology, Vol. 124, No. 21 ( 2014-12-06), p. 2817-2817
    Abstract: Patients with congenital afibrinogenaemia and hypofibrinogenaemia, experience frequent severe bleeding episodes starting at birth or early childhood. Bleeding may occur after a minor trauma or a small surgical intervention, into the skin, mucosa, muscles, gastrointestinal tract, or the brain. Therapeutic substitution with human fibrinogen concentrate can correct the haemostatic defect and arrest the bleeding in patients with these fibrinogen deficiencies. Octafibrin is plasma derived, highly purified, lyophilized, fibrinogen concentrate, which has been double virus safeguarded using two dedicated virus inactivation/removal steps. In this study, the (PK) profile of this new concentrate is compared to a commercially available product (Haemocomplettan® P/RiaSTAPTM). This ongoing study is a prospective, randomized, open-label, multinational, crossover PK comparison of Octafibrin to an existing marketed product with planned interim data in 9 adult and adolescent patients, including comparison of a surrogate efficacy endpoint Maximum Clot Firmness (MCF) measured by ROTEM®. The study includes a crossover design where both products are given a single dose in a randomized fashion separated by an observation period and washout of any fibrinogen product prior to infusion. Patients are confirmed afibrinogenemic with baseline fibrinogen activity plasma level of 〈 0.20. All fibrinogen and MCF testing was performed in a central lab using validated methods. Nine patients completed the study until the end of May 2014. There have been no reports of adverse events (AE) related to the infusion of this novel concentrate. Comparable PK profiles between the products were seen but in key parameters, Normalized Aria Under the Curve (AUCnorm) (h·mg/mL/(mg/kg) Octafibrin 0.994, Haemocomplettan® P/RiaSTAPTM 0.731 p-value 0.014) and clearance (mL/h/kg Octafibrin 0.522, Haemocomplettan® P/RiaSTAPTM 0.594 p-value 0.033), significant differences were observed between the groups. Comparable haemostatic efficacy of Octafibrin and Haemocomplettan® P/RiaSTAPTM was demonstrated based on their ability to significantly increase MCF. Mean (± SD) Fibrinogen Levels (g/L) during PK Assessment after Octafibrin and Haemocomplettan® P/RiaSTAPTM Administration, Standardized to 70 mg/kg (PK Population, n=9) Figure 1 Figure 1. Ratios of Octafibrin Relative to Haemocomplettan® P/RiaSTAPTM for AUC and AUCnorm (PK Population, N=9) Table 1 Baseline Characteristics of Patients with and without Cardiac Complications in TTP Fibrinogen activity Parameter ratio Mean 90% CI of mean ratio p-value AUC 139.11 79.25, 246.13 0.0173 AUCnorm 139.96 80.26, 245.94 0.0144 In conclusion, this study showed in general a comparable PK profile for Octafibrin and Haemocomplettan® P/RiaSTAPTM in patients with congenital fibrinogen deficiency. Octafibrin showed a significantly higher AUCnorm and lower clearance than the comparator. The haemostatic efficacy of Octafibrin, as measured by change in MCF as a surrogate parameter, was similar to that of the licensed comparator used in this study, and there was no related AE or SAE for Octafibrin after single-dose administration. Disclosures Schwartz: Octapharma: Employment. Knaub:Octapharma: Employment.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2014
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 4
    In: Blood, American Society of Hematology, Vol. 128, No. 22 ( 2016-12-02), p. 1404-1404
    Abstract: Patients with congenital afibrinogenaemia and hypofibrinogenaemia, frequently experience severe bleeding episodes starting already at birth or during early childhood. Bleeding may occur after a minor trauma or a surgical intervention into the skin, mucosa, muscles, gastrointestinal tract, or the brain. Therapeutic substitution with human fibrinogen concentrate (HFC) corrects the haemostatic defect and arrests bleeding in these patients. Octafibrin (Octapharma OPG, Vienna, Austria) is a plasma-derived, highly purified, lyophilized fibrinogen concentrate with two dedicated virus inactivation/removal steps was used in this study. This study was prospective, open-label and multinational, in adult and adolescent a- or hypofibrinogenemic patients, to investigate the safety and efficacy of Octafibrin a new HFC in the treatment of on-demand bleeding (BE) and surgical prophylaxis. A planned interim analysis comprises data of 11 adult and 2 adolescent patients. Efficacy was assessed using a 4 point objective scale completed by the investigator and adjudicated by an independent data monitoring and endpoint adjudication committee (IDMEAC) for each bleeding or surgical episode. Eleven of the 13 patients experienced a total of 23 minor BEs. Sixteen BEs (69.6%) were spontaneous and 7 (30.4%) were traumatic. A majority of BEs (21/23) required one HFC infusion (91.3%) and 2 (8.7%) BEs required two infusions. The median (range) dose of HFCadministered for the treatment of all BEs was 57.5 mg/kg (33.9-71.4 mg/kg) per infusion and 58.8 mg/kg (33.9-101.7 mg/kg) per BE. The success rate (efficacy rating of excellent or good) for all BEs was 100% (90% CI: 0.88, 1.00) as adjudicated by the IDMEAC (all excellent). Maximum clot firmness (MCF) using thromboelastometry (ROTEM®) performed in plasma was also determined for the first infusions administered for the treatment of all 23 BEs in the 11 BE patients. The mean (±SD) change in MCF from baseline (MCF 0) to 1 hour after the first infusion of HFCwas 6.5 mm (±2.0) (95% CI: 5.65, 7.40; p 〈 0.0001). This significant overall increase in MCF from baseline coincided with the 100% haemostatic efficacy for all BEs. Four patients underwent 4 surgeries (3 major 1 minor, two of these patients were treated for both BE and surgery). The post-operative success rate (haemostatic efficacy excellent or good) was 100% (90% CI 0.5, 1.0), as assessed by the investigator and the IDMEAC. There have been no reports of serious adverse events related to the infusion of the HFC. In conclusion this study showed 100% hemostatic efficacy in on-demand treatment with HFC in bleeding patients with congenital fibrinogen deficiency. Also hemostatic efficacy in surgical prophylaxis in 4 patients was rated excellent/good. Maximum clot firmness values showed a statistically significant increase from baseline to 1 hour post-infusion in all patients after HFCadministrations reflecting the successful treatment of bleeding events. There were no related serious adverse events, no thromboembolic events, no allergic or severe hypersensitivity reactions, and no anti-fibrinogen antibodies that developed during the study. Disclosures Schwartz: Octapharma: Employment. Knaub:Octapharma: Employment. Peyvandi:Bayer: Speakers Bureau; Biotest: Other: research funding paid to Luigi Villa Foundation, Research Funding, Speakers Bureau; Ablynx: Membership on an entity's Board of Directors or advisory committees, Other: research funding paid to Luigi Villa Foundation, Research Funding; CSL Behring: Speakers Bureau; Grifols: Speakers Bureau; Alexion: Other: research funding paid to Luigi Villa Foundation, Research Funding; Octapharma: Consultancy; Kedrion Biopharma: Consultancy, Other: research funding paid to Luigi Villa Foundation, Research Funding; LFB: Consultancy; Novo Nordisk: Other: research funding paid to Luigi Villa Foundation, Research Funding, Speakers Bureau; SOBI: Speakers Bureau.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2016
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 5
    In: Transfusion, Wiley, Vol. 58, No. 2 ( 2018-02), p. 413-422
    Abstract: Fibrinogen concentrate is the preferred choice for fibrinogen replacement in congenital fibrinogen deficiency. This study investigated hemostatic efficacy of a new plasma‐derived, double virus‐inactivated (using two dedicated virus inactivation/elimination steps) human fibrinogen concentrate for on‐demand treatment of bleeding episodes (BEs) and surgical prophylaxis. STUDY DESIGN AND METHODS In this planned interim analysis of a prospective, multinational Phase III study (NCT02267226), 13 patients with afibrinogenemia (≥12 years) received fibrinogen concentrate (FIBRYGA, Octapharma AG). Hemostatic efficacy was assessed by investigators and an independent data monitoring and endpoint adjudication committee (IDMEAC) using objective four‐point criteria and by thromboelastometry maximum clot firmness (MCF). RESULTS Fibrinogen concentrate was used on‐demand to treat 23 BEs in 11 patients, with 21 (91.3%) requiring a single infusion only. Treatment success was 95.7% (90% confidence interval [CI], 0.81‐1.00; assessment missing for one BE) by investigators and 100% (90% CI, 0.88‐1.00) by IDMEAC. Mean MCF increased significantly from 0.0 to 6.5 mm (95% CI, 5.65‐7.40; p  〈  0.0001) at 1 hour postinfusion of a median (range) dose of 58.8 (33.9‐101.7) mg/kg per BE. Four patients received fibrinogen concentrate as surgical prophylaxis, with intraoperative and postoperative treatment success rated 100% (90% CI, 0.50‐1.00) by investigators and IDMEAC (median [range] dose per surgery 93.5 [34.1‐225.4] mg/kg). No additional hemostatic interventions were required. No deaths, thromboses, or seroconversions were reported. CONCLUSION These data showed that the new fibrinogen concentrate was efficacious for on‐demand treatment of acute bleeding and surgical prophylaxis in congenital afibrinogenemia patients.
    Type of Medium: Online Resource
    ISSN: 0041-1132 , 1537-2995
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2018415-3
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