Real-World Clinical Outcomes and Replacement Factor VIII Consumption in Patients with Haemophilia A in Italy: A Comparison between Prophylaxis Pre and Post Octocog Alfa (BAY 81-8973)

Authors: Cortesi, PA; Di Minno, G; Zanon, E; Giuffrida, G; Santoro, RC; Marino, R; D’Angiolella, LS; Antonazzo, IC; Squassabia, G; Clemente, F; Di Laura, D; Cimino, E; Pasca, S; Nicolosi, D; Mantovani, LG

Affiliations: Research Centre on Public Health (CESP), University of Milano-Bicocca, 20900 Monza, Italy. Value-Based Healthcare Unit, IRCCS Multimedica, 20099 Sesto San Giovanni, Italy. Regional Reference Center for Coagulation Disorders, Federico II University Hospital, 80131 Naples, Italy. Hemophilia Center, University Hospital of Padua, 35128 Padua, Italy. Division of Haematology, A.O.U. Policlinico Vittorio Emanuele, 95123 Catania, Italy.

Publication: Journal of Clinical Medicine; 2022; 11

Abstract: BACKGROUND: new generations of rFVIII products offered the possibility to improve personalized therapeutic approaches, reducing the number of infusions or increasing the protection against bleeding risk. The aim of this study was to assess the effectiveness of prophylaxis with BAY 81-8973 (octocog alfa, Kovaltry(®), Bayer Pharma AG) in the real-world setting and its impact on FVIII consumption compared to previous standard half-life treatments. METHODS: a retrospective observational study was conducted in five Italian Haemophilia Centers. Patients with haemophilia A under prophylactic treatment with BAY 81-8973 for at least one year, and previously on prophylaxis with a different product were included in the study. Annual bleeding rate (ABR) and annual FVIII consumption were compared. RESULTS: forty-four patients were included in the study. After switching to BAY 81-8973, ABR was significantly reduced (1.76 vs. 0.23; p = 0.015), the percentage of patients with zero bleeds increased from 54.6% to 84.1% (p = 0.003), and the overall FVIII consumption decreased by 25,542 (-7.2%, p = 0.046) IU per patient-year. Patients treated every 3 days or 2 times per week increased from 0% to 27.3%. CONCLUSION: our results suggest that prophylaxis with BAY 81-8973 can improve clinical outcomes and reduce FVIII consumption, in the real-world practice, compared with the previous prophylaxis regimen with standard half-life products.