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  • 1
    In: Annals of Hematology, Springer Science and Business Media LLC, Vol. 89, No. 3 ( 2010-3), p. 309-316
    Type of Medium: Online Resource
    ISSN: 0939-5555 , 1432-0584
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2010
    detail.hit.zdb_id: 1458429-3
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  • 2
    In: Thrombosis and Haemostasis, Georg Thieme Verlag KG, Vol. 121, No. 11 ( 2021-11), p. 1400-1408
    Abstract: Introduction FVIII inhibitor development is the most serious contemporary treatment complication in haemophilia A, particularly in previously untreated patients (PUPs). No inhibitors developed in clinical trials in previously treated patients treated with simoctocog alfa (Nuwiq), a fourth-generation recombinant FVIII produced in a human cell line. Methods The NuProtect study investigated the immunogenicity of simoctocog alfa in PUPs. NuProtect was a prospective, multinational, open-label, non-controlled, phase III study. PUPs with severe haemophilia A (FVIII:C 〈 1%) of any age and ethnicity were treated with simoctocog alfa for 100 exposure days or a maximum of 5 years. Patients were true PUPs without prior exposure to FVIII concentrates or blood components. Inhibitor titres were measured with the Nijmegen-modified Bethesda assay; cut-off for positivity was 0.6 BU mL−1 (≥0.6 to 〈 5 low-titre, ≥5 high titre). Results A total of 108 PUPs with a median age at first treatment of 12.0 months (interquartile range: 8.0–23.5) were treated with simoctocog alfa. F8 mutation type was known for 102 patients (94.4%) of whom 90 (88.2%) had null F8 mutations and 12 (11.8%) had non-null mutations. Of 105 PUPs evaluable for inhibitor development, 28 (26.7%) developed inhibitors; 17 high titre (16.2%) and 11 low titre (10.5%). No PUPs with non-null F8 mutations developed inhibitors. Conclusion In the NuProtect study, the rate of inhibitor development in PUPs with severe haemophilia A treated with simoctocog alfa was lower than the rate reported for hamster-cell-derived recombinant factor VIII products in other recent clinical trials. No inhibitors were reported in PUPs with non-null F8 mutations.
    Type of Medium: Online Resource
    ISSN: 0340-6245 , 2567-689X
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2021
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  • 3
    In: JAMA, American Medical Association (AMA), Vol. 286, No. 15 ( 2001-10-17), p. 1869-
    Type of Medium: Online Resource
    ISSN: 0098-7484
    RVK:
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2001
    detail.hit.zdb_id: 2958-0
    detail.hit.zdb_id: 2018410-4
    SSG: 5,21
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  • 4
    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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  • 5
    In: Health Science Reports, Wiley, Vol. 6, No. 9 ( 2023-09)
    Abstract: What's known Purified human fibrinogen concentrate (HFC) has been used for fibrinogen replacement in acquired bleeding across a number of clinical settings including surgery, trauma and major obstetric hemorrhage. The randomized, controlled, FORMA‐05 study compared efficacy and safety of HFC and cryoprecipitate for hemostasis in surgical bleeding during major abdominal surgery. HFC maintained overall hemostatic efficacy with noninferiority to cryoprecipitate, with coagulation factor levels maintained throughout surgery. What's new This subanalysis of the FORMA‐05 study examined the changes in coagulation parameters during and after surgery in patients receiving HFC versus cryoprecipitate. Seven patients experienced thromboembolic events (TEEs), all of whom were on cryoprecipitate. Of these, two patients had deep vein thromboses (DVT), with higher fibrinogen, FIBTEM A20, and platelet levels, which persisted perioperatively. The five patients who developed pulmonary embolism (PE) had slightly higher preoperative von Willebrand factor (VWF) levels, which increased disproportionately following cryoprecipitate administration and postoperatively. Clinical implications Study results indicated a procoagulant status in patients experiencing DVT, and a disproportionate intra‐ and postoperative increase in VWF for patients experiencing PE. Larger studies in more diverse surgical settings should consider recording coagulation factor levels to gain a better understanding of how coagulation factor levels relate to TEEs.
    Type of Medium: Online Resource
    ISSN: 2398-8835 , 2398-8835
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2927182-4
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  • 6
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2002
    In:  Critical Care Medicine Vol. 30, No. Supplement ( 2002-05), p. S325-S331
    In: Critical Care Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 30, No. Supplement ( 2002-05), p. S325-S331
    Type of Medium: Online Resource
    ISSN: 0090-3493
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2002
    detail.hit.zdb_id: 2034247-0
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  • 7
    In: European Journal of Haematology, Wiley, Vol. 80, No. s70 ( 2008-05), p. 3-35
    Abstract: Patients with von Willebrand disease (VWD) and haemophilia A (HA) lack, to varying degrees, the von Willebrand factor (VWF) and coagulation factor VIII (FVIII) that are critical for normal haemostasis. These conditions in turn make patients prone to uncontrolled bleeding. Historically, patients with severe forms of VWD or HA were crippled before adulthood and their life expectancy was significantly reduced. Over the past decades, specific coagulation factor replacement therapies including Haemate ® P, have been developed to help patients achieve and maintain normal haemostasis. Haemate ® P is a human, plasma‐derived VWF/FVIII medicinal product, which was first licensed in Germany in 1981 for the treatment of HA‐associated bleeding. It has since then come to be accepted as the gold standard for both the treatment and prophylaxis of bleeding in VWD, especially in cases where desmopressin [1‐deamino‐8‐ D ‐arginine vasopressin (DDAVP)] has been ineffective. Haemate ® P was the first effectively virus‐inactivated (pasteurisation: 60°C for 10 h in aqueous solution) FVIII product, whereby the risk of potentially threatening infective complications of plasma‐derived products was reduced. Haemate ® P was also shown to have a VWF multimer profile remarkably close to that of normal plasma. This bibliographic review presents previously unpublished clinical data of Haemate ® P, based upon internal clinical study reports of the proprietor, CSL Behring, in addition to data already presented in other publications. The data demonstrate a predictable and well‐characterised pharmacokinetic profile, and a proven record of short‐ and long‐term safety, while effectively correcting the haemostatic defects in VWD and HA. Recently available data have also shown Haemate ® P to be of haemostatic value in exceptional clinical circumstances including surgical interventions. By virtue of its plasma‐derived combination of VWF and FVIII, in addition to its high VWF:FVIII content ratio (2.4:1), Haemate ® P is also associated with successful immune tolerance induction in those patients developing inhibitor antibodies. Although the theoretical risk of thromboembolic complications does exist while receiving Haemate ® P, as it does with any FVIII replacement therapy, the incidence of such complications has remained notably low. Given the robust data that have accumulated for the use of Haemate ® P, dosing recommendations are also described in this review; the recommendations are tailored to patient‐specific contexts including baseline VWF and FVIII levels in plasma and the type of surgical intervention being undertaken. A wide variety of studies have also provided data on paediatric and geriatric populations, all of which have suggested that Haemate ® P can be safely and effectively used in a wide variety of clinical circumstances.
    Type of Medium: Online Resource
    ISSN: 0902-4441 , 1600-0609
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2008
    detail.hit.zdb_id: 2027114-1
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  • 8
    In: Blood, American Society of Hematology, Vol. 132, No. Supplement 1 ( 2018-11-29), p. 2502-2502
    Abstract: Introduction: Congenital afibrinogenemia is a rare inherited disorder characterized by an absence of plasma fibrinogen. Affected individuals have a highly variable bleeding tendency, which can be severe and include life-threatening bleeding and spontaneous/trauma-related bleeds. Therapeutic substitution with human fibrinogen concentrate (HFC) can correct the hemostatic defect and arrest bleeding. The FORMA-02 study investigated the hemostatic efficacy of a new plasma-derived, double virus-inactivated HFC (Fibryga, Octapharma) for on-demand treatment of bleeding episodes (BEs) and for surgical prophylaxis in patients with afibrinogenemia. Methods: FORMA-02 was a prospective, open-label, uncontrolled, multicenter Phase 3 study. A total of 25 patients with congenital afibrinogenemia (≥12 years) received the new HFC for treatment of a BE and/or for surgical prophylaxis. HFC was individually dosed to achieve a recommended target fibrinogen plasma level dependent on the bleeding type or surgery type (minor or major). The primary endpoint was the efficacy of the new HFC for on-demand treatment of the first BE after signed consent was obtained. Secondary endpoints included hemostatic efficacy of the HFC for the treatment of all BEs during the study period and its efficacy in preventing bleeding during and after surgery. Hemostatic efficacy was assessed by investigators and an Independent Data Monitoring and Endpoint Adjudication Committee (IDMEAC) using objective four-point scales, with treatment success defined as a rating of excellent or good. Thromboelastometry maximum clot firmness (MCF) was also investigated as a surrogate marker of efficacy. Results: A total of 25 patients received the new HFC for treatment of a BE (N=24) and/or surgical prophylaxis (N=9). The mean±SD dose of HFC was 65.51±26.47 mg/kg per BE (89 events) and 40.45±30.78 mg/kg per surgery for surgical prophylaxis (12 events). Hemostatic efficacy for treatment of the first BE (primary endpoint) was rated as excellent or good for all patients by both the investigator and the IDMEAC (Success: 100%; 90% CI 0.89-1.00). When all BEs were evaluated (N=89 BEs in 24 patients), hemostatic efficacy was rated as excellent or good for 96.6% of events by the investigator and 98.9% by the IDMEAC. The first HFC infusion for treatment of the first BE for each patient led to a mean increase in blood fibrinogen concentration of 114.74±25.28 mg/dL 1 hour after administration, while the MCF increased by a mean of 6.48±3.07 mm. Intraoperative hemostatic efficacy for surgical prophylaxis was rated by the surgeon and the IDMEAC as excellent or good for 100% of the 12 surgeries that were performed (success: 100%; 90%CI 0.82-1.00). Postoperative efficacy was also rated as excellent or good in all cases. The first HFC infusion for each surgery led to a mean increase in blood fibrinogen concentration of 104.55±43.64 mg/dL at 1 hour after administration. A total of 15 serious adverse events (SAEs) occurred in 5 patients; only one was deemed to be related to the HFC by the investigator. This was a digital ischemia that resolved without sequelae. No inhibitory anti-fibrinogen antibodies were detected and there were no severe allergic or hypersensitivity reactions related to the HFC. Conclusions: These data indicate that the new HFC was efficacious for on-demand treatment of acute bleeding and for surgical prophylaxis in patients with congenital afibrinogenemia, with hemostatic efficacy rated as 100% in both settings. The HFC showed an acceptable safety profile in this study population. Disclosures Peyvandi: Grifols: Speakers Bureau; Octapharma US: Honoraria; Roche: Speakers Bureau; Shire: Speakers Bureau; Octapharma US: Honoraria; Roche: Speakers Bureau; Shire: Speakers Bureau; Sobi: Speakers Bureau; Shire: Speakers Bureau; Novo Nordisk: Speakers Bureau; Sobi: Speakers Bureau; Novo Nordisk: Speakers Bureau; Octapharma US: Honoraria; Shire: Speakers Bureau; Novo Nordisk: Speakers Bureau; Octapharma US: Honoraria; Octapharma US: Honoraria; Novo Nordisk: Speakers Bureau; Ablynx: Other: Member of Advisory Board, Speakers Bureau; Ablynx: Other: Member of Advisory Board, Speakers Bureau; Ablynx: Other: Member of Advisory Board, Speakers Bureau; Ablynx: Other: Member of Advisory Board, Speakers Bureau; Ablynx: Other: Member of Advisory Board, Speakers Bureau; Kedrion: Consultancy; Kedrion: Consultancy; Kedrion: Consultancy; Kedrion: Consultancy; Kedrion: Consultancy; Grifols: Speakers Bureau; Grifols: Speakers Bureau; Grifols: Speakers Bureau; Novo Nordisk: Speakers Bureau; Grifols: Speakers Bureau; Roche: Speakers Bureau; Roche: Speakers Bureau; Roche: Speakers Bureau; Shire: Speakers Bureau; Sobi: Speakers Bureau; Sobi: Speakers Bureau; Sobi: Speakers Bureau. Schwartz:Octapharma US: Employment. Knaub:Octapharma AG: Employment.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2018
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 9
    Online Resource
    Online Resource
    American Society of Hematology ; 2004
    In:  Blood Vol. 104, No. 11 ( 2004-11-16), p. 1031-1031
    In: Blood, American Society of Hematology, Vol. 104, No. 11 ( 2004-11-16), p. 1031-1031
    Abstract: Hereditary and acquired deficiencies in C1 inhibitor (C1-INH) function can result in potentially life-threatening attacks of hereditary angioedema (HAE). A highly purified and pasteurized C1-INH concentrate has been used effectively as prophylaxis against and treatment for angioedema attacks in patients with hereditary C1-INH deficiencies, but relatively little is known about its pharmacokinetic properties. Objective: To evaluate the pharmacokinetics and in vivo recovery (IVR) of C1-INH concentrate (Berinert®P) in two groups of patients with hereditary angioedema (HAE) receiving this preparation either as individual replacement therapy (IRT, regular, immediate treatment of first HAE symptoms in patients with frequent and severe attacks) or as on-demand treatment. Methods: Forty subjects (15 under IRT, 25 under on-demand treatment) with HAE received intravenous injections of C1-INH (542–1,617 U) in an attack-free interval in a prospective, open, uncontrolled, single-center study. Blood was sampled for determination of C1-INH with a commercially available functional chromogenic assay for up to 72 hours after dosing. Pharmacokinetic parameters were calculated using a single-compartment model and IVR was determined using standard methods. Results: The mean (± SD) time to maximum plasma concentration (Tmax) for C1-INH administered in patients under IRT was 1.3 ± 2.1 hours, the area under the time versus plasma concentration curve (AUC) was 20.5 ± 19.1 hour•U/mL, the elimination half-life (t½) was 33.3 ± 19.8 hours, mean residence time (MRT) was 48.0 ± 28.5 hours, total body clearance (Cl) was 1.1 ± 0.6 mL/kg/hour, and volume of distribution at steady state (Vss) was 39.5 ± 9.9 mL/kg. The respective values for patients treated on demand were 2.9 ± 6.5 hours, 20.0 ± 14.5 hour•U/mL, 43.9 ± 22.4 hours, 63.4 ± 32.3 hours, 1.2 ± 1.0 mL/kg•hour, and 51.4 ± 10.9 mL/kg. The mean IVRs for IRT and on-demand treatment were 108.2 ± 48.3% and 85.8 ± 28.3%, respectively. Children tended to have slightly lower half-life and a slightly higher Vss compared to adults. Conclusions: C1-INH concentrate has a short Tmax and a long, t½ and MRT consistent with the rapid onset of clinical efficacy for this preparation in subjects suffering angioedema attacks and the ability to effectively carry out IRT with injections administered every 2–5 days. This analysis provides to our knowledge the most comprehensive pharmacokinetic evaluation in subjects with HAE.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2004
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 10
    In: Blood, American Society of Hematology, Vol. 128, No. 22 ( 2016-12-02), p. 4968-4968
    Abstract: Introduction and Objective Prospective surveillance studies are a useful tool to monitor drug safety and efficacy in the post-approval period and provide treaters and caregivers with real-life information about von Willebrand disease (VWD) treatment. This ongoing study aims to demonstrate consistency of safety and efficacy data of a VWF/FVIII concentrate with a 1:1 ratio (wilate®) used in routine clinical practice with data obtained in previous clinical studies. Methods This non-interventional post-marketing surveillance study was designed to document the safety, tolerability, and efficacy of a 1:1 VWF/FVIII concentrate in the prophylaxis and treatment of bleeding, as well as in the perioperative bleeding management in VWD patients. Treatment regimens and dosages were at the discretion of the investigators. The primary endpoints were tolerability assessment on a 3-point verbal rating scale and the incidence of investigator reported adverse drug reactions (ADRs). Additionally, the efficacy was assessed using a pre-defined 4-point haemostatic scale for on-demand treatment and surgeries, and the frequency of breakthrough bleeding events (BEs) for prophylaxis. Results Eighty-nine patients qualified as safety population, having received at least one infusion of the VWF/FVIII concentrate. Tolerability was rated 'excellent' for 4261/4450 (96%) assessed infusions. No development of clinically relevant VWF inhibitors or thrombotic events occurred. ADRs were reported in 6 of 89 patients (6.7%). The efficacy population comprised 47 patients undergoing 74 surgeries, 22 patients treated on-demand for 93 BEs, 12 patients on continuous prophylactic treatment, and 4 patients treated for 20 menstrual BEs. Some patients were assessed in more than one treatment group. 100% of rated bleeds in patients on on-demand treatment were assessed as 'excellent/good', receiving a mean total dose per BE of 111.4 (+/-69.78) IU/kg. Of the 44 minor and 31 major surgeries, 73 (99%) were rated as 'excellent/good' efficacy and one (1%) as 'moderate'. Mean dose of VWF/FVIII concentrate used was 78.6 (+/-126.16) IU/kg and 132.4 (+/-102.71) IU/kg for minor and major surgeries, respectively. Patients on continuous prophylaxis received a mean of 111.4 (+/-69.78) IU/kg in a mean of 2.4 (+/-0.86) infusions per week and experienced a median annualized bleeding rate of 2.3 (mean 3.3±5.6; range 0-19.7) for spontaneous bleeds and 2.5 (mean 4.8±6.2; range 0-19.7) for all types of bleeds. Efficacy for menstrual bleeding was rated as excellent or good in 100% of rated episodes (16/20). Conclusion The data confirm the safety, tolerability and efficacy of the 1:1 VWF/FVIII concentrate in the treatment of VWD patients in routine clinical conditions. Disclosures Yaish: Octapharma: Other: Study investigator. Khair:Pfizer: Research Funding; NovoNordisk: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Baxalta, now part of Shire: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Study Investigator, Research Funding; Octapharma: Consultancy, Equity Ownership, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Study Investigator, Patents & Royalties, Research Funding, Speakers Bureau; Sobi/Biogen: Research Funding. von Depka:Octapharma: Other: Study Investigator, Speakers Bureau. Cruz:Octapharma: Other: Study Investigator. Werner:Octapharma: Employment. Knaub:Octapharma: Employment. Rodgers:Octapharma: Other: Study Investigator.
    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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