A-SURE: intra-patient comparison of prophylactic effectiveness of a recombinant factor VIII Fc fusion protein versus standard half-life factor VIII in hemophilia A

Background Despite recent advances, factor replacement therapy remains a cornerstone in hemophilia A treatment. Efmoroctocog alfa, a recombinant FVIII Fc fusion protein (rFVIIIFc), has an extended half-life allowing higher FVIII levels and less frequent dosing than standard half-life (SHL) products,...

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Main Authors: Johannes Oldenburg, Charles Hay, Flora Peyvandi, Anna-Elina Lehtinen, Ingrid Pabinger, Eveline Nüesch, Håkan Malmström, Eva Bednar, Stefan Lethagen
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Hematology
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Online Access:https://www.tandfonline.com/doi/10.1080/16078454.2025.2513186
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author Johannes Oldenburg
Charles Hay
Flora Peyvandi
Anna-Elina Lehtinen
Ingrid Pabinger
Eveline Nüesch
Håkan Malmström
Eva Bednar
Stefan Lethagen
author_facet Johannes Oldenburg
Charles Hay
Flora Peyvandi
Anna-Elina Lehtinen
Ingrid Pabinger
Eveline Nüesch
Håkan Malmström
Eva Bednar
Stefan Lethagen
author_sort Johannes Oldenburg
collection DOAJ
description Background Despite recent advances, factor replacement therapy remains a cornerstone in hemophilia A treatment. Efmoroctocog alfa, a recombinant FVIII Fc fusion protein (rFVIIIFc), has an extended half-life allowing higher FVIII levels and less frequent dosing than standard half-life (SHL) products, without increasing factor consumption.Methods A-SURE was a 24-month prospective, non-interventional study assessing real-world effectiveness of rFVIIIFc prophylaxis. This post-hoc, intra-patient analysis included patients with hemophilia A (PwHA) who switched from SHL FVIII to rFVIIIFc prophylaxis. Effectiveness endpoints included annualised bleeding rate (ABR), annualised joint bleeding rate (AjBR), weekly injection frequency and weekly factor consumption.Results Of 131 PwHA eligible for analysis, mean ABR and AjBR decreased from 3.7 and 2.4 to 1.8 and 1.1, respectively, after switching (mean [95% confidence interval (CI)] change of −1.9 [−3.0, −0.8] and −1.2 [−2.0, −0.5]). Mean weekly injection frequency decreased from 3.1 to 2.3 (mean [95% CI] change of −0.8 [−1.0, −0.7]); weekly factor consumption reduced from 89.7 to 84.1 international units (IU)/kg, respectively (mean [95% CI] change of −5.7 [−10.7, −0.6]). These trends were consistent across age groups.Conclusion This intra-patient comparison demonstrates switching from SHL FVIII to rFVIIIFc prophylaxis reduces frequency of bleeds, injection frequency, and factor consumption, complementing previously reported data from A-SURE.Trial registration:ClinicalTrials.gov identifier: NCT02976753.
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spelling doaj-art-d9563e8dfb22472e9c99a4e7ef3af0ba2025-08-20T03:30:14ZengTaylor & Francis GroupHematology1607-84542025-12-0130110.1080/16078454.2025.2513186A-SURE: intra-patient comparison of prophylactic effectiveness of a recombinant factor VIII Fc fusion protein versus standard half-life factor VIII in hemophilia AJohannes Oldenburg0Charles Hay1Flora Peyvandi2Anna-Elina Lehtinen3Ingrid Pabinger4Eveline Nüesch5Håkan Malmström6Eva Bednar7Stefan Lethagen8Institute of Experimental Hematology and Transfusion Medicine, University Hospital Bonn, Medical Faculty, University of Bonn, GermanyUniversity Department of Hematology, Manchester Royal Infirmary, Manchester, UKFondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Haemophilia and Thrombosis Centre, Milan, ItalyCoagulation Disorders Unit, Department of Hematology, Helsinki University Hospital Comprehensive Cancer Centre and University of Helsinki, Helsinki, FinlandClinical Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, AustriaStatistical, Epidemiology and Data Sciences, Sobi, Basel, SwitzerlandStatistical, Epidemiology and Data Sciences, Sobi, Stockholm, SwedenGlobal Medical Affairs and Clinical Development, Sobi, Stockholm, SwedenGlobal Medical Affairs and Clinical Development, Sobi, Stockholm, SwedenBackground Despite recent advances, factor replacement therapy remains a cornerstone in hemophilia A treatment. Efmoroctocog alfa, a recombinant FVIII Fc fusion protein (rFVIIIFc), has an extended half-life allowing higher FVIII levels and less frequent dosing than standard half-life (SHL) products, without increasing factor consumption.Methods A-SURE was a 24-month prospective, non-interventional study assessing real-world effectiveness of rFVIIIFc prophylaxis. This post-hoc, intra-patient analysis included patients with hemophilia A (PwHA) who switched from SHL FVIII to rFVIIIFc prophylaxis. Effectiveness endpoints included annualised bleeding rate (ABR), annualised joint bleeding rate (AjBR), weekly injection frequency and weekly factor consumption.Results Of 131 PwHA eligible for analysis, mean ABR and AjBR decreased from 3.7 and 2.4 to 1.8 and 1.1, respectively, after switching (mean [95% confidence interval (CI)] change of −1.9 [−3.0, −0.8] and −1.2 [−2.0, −0.5]). Mean weekly injection frequency decreased from 3.1 to 2.3 (mean [95% CI] change of −0.8 [−1.0, −0.7]); weekly factor consumption reduced from 89.7 to 84.1 international units (IU)/kg, respectively (mean [95% CI] change of −5.7 [−10.7, −0.6]). These trends were consistent across age groups.Conclusion This intra-patient comparison demonstrates switching from SHL FVIII to rFVIIIFc prophylaxis reduces frequency of bleeds, injection frequency, and factor consumption, complementing previously reported data from A-SURE.Trial registration:ClinicalTrials.gov identifier: NCT02976753.https://www.tandfonline.com/doi/10.1080/16078454.2025.2513186Hemophilia Astandard half-lifeextended half-lifefactor consumptioninjection frequencyreal-world
spellingShingle Johannes Oldenburg
Charles Hay
Flora Peyvandi
Anna-Elina Lehtinen
Ingrid Pabinger
Eveline Nüesch
Håkan Malmström
Eva Bednar
Stefan Lethagen
A-SURE: intra-patient comparison of prophylactic effectiveness of a recombinant factor VIII Fc fusion protein versus standard half-life factor VIII in hemophilia A
Hematology
Hemophilia A
standard half-life
extended half-life
factor consumption
injection frequency
real-world
title A-SURE: intra-patient comparison of prophylactic effectiveness of a recombinant factor VIII Fc fusion protein versus standard half-life factor VIII in hemophilia A
title_full A-SURE: intra-patient comparison of prophylactic effectiveness of a recombinant factor VIII Fc fusion protein versus standard half-life factor VIII in hemophilia A
title_fullStr A-SURE: intra-patient comparison of prophylactic effectiveness of a recombinant factor VIII Fc fusion protein versus standard half-life factor VIII in hemophilia A
title_full_unstemmed A-SURE: intra-patient comparison of prophylactic effectiveness of a recombinant factor VIII Fc fusion protein versus standard half-life factor VIII in hemophilia A
title_short A-SURE: intra-patient comparison of prophylactic effectiveness of a recombinant factor VIII Fc fusion protein versus standard half-life factor VIII in hemophilia A
title_sort a sure intra patient comparison of prophylactic effectiveness of a recombinant factor viii fc fusion protein versus standard half life factor viii in hemophilia a
topic Hemophilia A
standard half-life
extended half-life
factor consumption
injection frequency
real-world
url https://www.tandfonline.com/doi/10.1080/16078454.2025.2513186
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