Susoctocog-alfa (Obizur®) in the treatment of nine elderly patients with acquired haemophilia A: an Italian multicentre real world experience

Blood Transfus. 2020 Jul;18(4):312-321. doi: 10.2450/2020.00006-20. Epub 2020 Jun 4.

Abstract

Background: In 2016, a new recombinant B-domain deleted porcine FVIII (rpFVIII) was licensed in Italy for the treatment of acquired haemophilia A (AHA), but only a few cases of patients receiving this have been reported in the literature. Here we report the largest registry of the use of rpFVIII for the treatment of AHA. The objective of this retrospective study was to describe the efficacy and the safety of susoctocog-alfa for AHA.

Material and methods: We studied a population of nine patients, recruited in five Italian haemophilia centres presenting AHA, and treated with Obizur® as first- or second-line therapy.

Results: rpFVIII was used as a first-line therapy in one-third of the patients. The median delay between clinical onset and diagnosis was 16 days. Initial bolus of infused susoctocog-alfa was 100 IU/kg, lower than the recommended dose. The treatment was maintained for a median of four days. Only one patient with serious co-morbidities and recurrent infections was treated for 32 days. All patients reached a complete resolution of AHA, and no recurrences were reported. Two patients developed a low-titre inhibitor against rpFVIII, neither experienced any complications.

Discussion: In our real world experience, susoctocog-alfa was proven to be an effective and safe therapeutic option for patients with AHA, also at a lower than recommended dosage. In our report, the appearance of low-titre inhibitors against rpFVIII, was not found to be clinically significant.

Publication types

  • Case Reports
  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Factor VIII / administration & dosage*
  • Factor VIII / genetics
  • Female
  • Hemophilia A / blood
  • Hemophilia A / drug therapy*
  • Humans
  • Italy
  • Male
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / genetics
  • Registries*

Substances

  • Recombinant Proteins
  • Factor VIII

Supplementary concepts

  • Factor 8 deficiency, acquired