Altuvoct: Innovative Medicinal Products Benefit from Innovative Approaches to Regulatory Assessment

Efanesoctocog alfa (Altuvoct; BIVV001) is a fusion protein comprising domains of (i) factor VIII, (ii) the von Willebrand factor, and (iii) IgG1 coupled to two polypeptide linkers. The half-life of efanesoctocog alfa in plasma is about 40 h. The polypeptide linkers are released by thrombin activatio...

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Main Authors: Essam Kerwash, Maria Malamatari, John D. Johnston
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Life
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Online Access:https://www.mdpi.com/2075-1729/15/6/848
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author Essam Kerwash
Maria Malamatari
John D. Johnston
author_facet Essam Kerwash
Maria Malamatari
John D. Johnston
author_sort Essam Kerwash
collection DOAJ
description Efanesoctocog alfa (Altuvoct; BIVV001) is a fusion protein comprising domains of (i) factor VIII, (ii) the von Willebrand factor, and (iii) IgG1 coupled to two polypeptide linkers. The half-life of efanesoctocog alfa in plasma is about 40 h. The polypeptide linkers are released by thrombin activation, resulting in an active form of efanesoctocog alfa that results in the formation of a fibrin clot. Data from two single-arm ongoing studies were submitted: the XTEND-1 study enrolled 159 subjects aged 12–72 years, and the XTEND-kids study enrolled 74 subjects aged <12 years; all subjects had severe haemophilia A. Single-arm studies are not amenable to conventional statistical analysis of ‘effect of cause’, and so a supplementary analysis was conducted on the basis of ‘cause of effect’, making use of the scheme described by Toulmin coupled to an analysis of causal inference. Overall, the claim that Altuvoct is indicated to treat people aged ≥2 years with severe (and moderate) haemophilia A was considered to be supported by the results of the submitted studies and associated modelling exercises; the benefit–risk evaluation of Altuvoct was found to be positive in the target population.
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spelling doaj-art-ddc0b509d66c44b89f281baa874a01db2025-08-20T03:16:19ZengMDPI AGLife2075-17292025-05-0115684810.3390/life15060848Altuvoct: Innovative Medicinal Products Benefit from Innovative Approaches to Regulatory AssessmentEssam Kerwash0Maria Malamatari1John D. Johnston2Medicines and Healthcare Products Regulatory Agency (MHRA), 10 South Colonnade, Canary Wharf, London E14 4PU, UKMedicines and Healthcare Products Regulatory Agency (MHRA), 10 South Colonnade, Canary Wharf, London E14 4PU, UKMedicines and Healthcare Products Regulatory Agency (MHRA), 10 South Colonnade, Canary Wharf, London E14 4PU, UKEfanesoctocog alfa (Altuvoct; BIVV001) is a fusion protein comprising domains of (i) factor VIII, (ii) the von Willebrand factor, and (iii) IgG1 coupled to two polypeptide linkers. The half-life of efanesoctocog alfa in plasma is about 40 h. The polypeptide linkers are released by thrombin activation, resulting in an active form of efanesoctocog alfa that results in the formation of a fibrin clot. Data from two single-arm ongoing studies were submitted: the XTEND-1 study enrolled 159 subjects aged 12–72 years, and the XTEND-kids study enrolled 74 subjects aged <12 years; all subjects had severe haemophilia A. Single-arm studies are not amenable to conventional statistical analysis of ‘effect of cause’, and so a supplementary analysis was conducted on the basis of ‘cause of effect’, making use of the scheme described by Toulmin coupled to an analysis of causal inference. Overall, the claim that Altuvoct is indicated to treat people aged ≥2 years with severe (and moderate) haemophilia A was considered to be supported by the results of the submitted studies and associated modelling exercises; the benefit–risk evaluation of Altuvoct was found to be positive in the target population.https://www.mdpi.com/2075-1729/15/6/848haemophilia Ableeding episodesefanesoctocog alfaAltuvoctthe Toulmin schemecause-of-effect analysis
spellingShingle Essam Kerwash
Maria Malamatari
John D. Johnston
Altuvoct: Innovative Medicinal Products Benefit from Innovative Approaches to Regulatory Assessment
Life
haemophilia A
bleeding episodes
efanesoctocog alfa
Altuvoct
the Toulmin scheme
cause-of-effect analysis
title Altuvoct: Innovative Medicinal Products Benefit from Innovative Approaches to Regulatory Assessment
title_full Altuvoct: Innovative Medicinal Products Benefit from Innovative Approaches to Regulatory Assessment
title_fullStr Altuvoct: Innovative Medicinal Products Benefit from Innovative Approaches to Regulatory Assessment
title_full_unstemmed Altuvoct: Innovative Medicinal Products Benefit from Innovative Approaches to Regulatory Assessment
title_short Altuvoct: Innovative Medicinal Products Benefit from Innovative Approaches to Regulatory Assessment
title_sort altuvoct innovative medicinal products benefit from innovative approaches to regulatory assessment
topic haemophilia A
bleeding episodes
efanesoctocog alfa
Altuvoct
the Toulmin scheme
cause-of-effect analysis
url https://www.mdpi.com/2075-1729/15/6/848
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AT mariamalamatari altuvoctinnovativemedicinalproductsbenefitfrominnovativeapproachestoregulatoryassessment
AT johndjohnston altuvoctinnovativemedicinalproductsbenefitfrominnovativeapproachestoregulatoryassessment