Effectiveness of long-term prophylaxis using pdFVIII/VWF concentrate in patients with inherited von Willebrand disease

Eur J Haematol. 2022 Jul;109(1):109-117. doi: 10.1111/ejh.13778. Epub 2022 Apr 29.

Abstract

Background: Patients with symptomatic von Willebrand disease (VWD) should be offered long-term prophylaxis (LTP) to prevent recurrent bleedings. Our objective was to evaluate the effectiveness and safety of Voncento®, a plasma-derived FVIII/VWF concentrate (ratio 1:2.4), administrated in LTP.

Methods: We included patients from the OPALE study (May 2016 to April 2021), a French multicenter observational study following patients with inherited VWD, who received a Voncento® LTP during the study period.

Results: Among the 130 OPALE-study patients, 23 patients (12 women) received a LTP and were therefore included. The median (range) age was 16 (1-85) years; 16 patients were type 3, 1 was type 2A, 6 were type 2B. Before inclusion, 19 (83%) were under LTP and 4 (17%) received on-demand (OD) treatment. The indications for initiating prophylaxis in the overall population were joint bleeding (43%), ear, nose, and throat (ENT) bleeding including epistaxis or oral bleeding (39%), and recurrent muscle hematoma (22%). The medians (ranges) dose of Voncento® per infusion, frequency, and weekly dose were 45 (33-109) IU/kg, 2 infusions per week, and 96 (44-222) IU/kg/week, respectively. The median (range) annualized bleeding rate (ABR) was 0.8, 0.7 (0-3.5), and 0 (0-2.3) for type 2A, 2B, 3 patients, respectively. There was no difference regarding to the dose, frequency of infusion, or in terms of ABR in 9/19 patients who replaced previous concentrates with Voncento®. During the study period, no adverse event was reported.

Conclusion: These results suggest that Voncento® is effective to prevent recurrent bleedings in patients symptomatic VWD.

Keywords: FVIII/VWF concentrates; Voncento®; bleeding; prophylaxis; von Willebrand disease.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Factor VIII* / administration & dosage
  • Female
  • Hemarthrosis / drug therapy
  • Hemorrhage* / prevention & control
  • Humans
  • Middle Aged
  • Young Adult
  • von Willebrand Diseases* / diagnosis
  • von Willebrand Diseases* / drug therapy
  • von Willebrand Factor* / administration & dosage

Substances

  • von Willebrand Factor
  • Factor VIII

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