Comprehensive laboratory assessment of lonoctocog alfa versus octocog alfa in severe haemophilia A.

assay discrepancies coagulation biomarkers lonoctocog alfa octocog alfa thrombin generation

Journal

Haemophilia : the official journal of the World Federation of Hemophilia
ISSN: 1365-2516
Titre abrégé: Haemophilia
Pays: England
ID NLM: 9442916

Informations de publication

Date de publication:
20 Aug 2024
Historique:
revised: 02 08 2024
received: 03 06 2024
accepted: 08 08 2024
medline: 21 8 2024
pubmed: 21 8 2024
entrez: 20 8 2024
Statut: aheadofprint

Résumé

Lonoctocog alfa is a single-chain factor VIII (FVIII) molecule with high binding affinity to von-Willebrand-factor. While it is well known that its plasma activity is underestimated by one-stage clotting assays (OSCA), there is a lack of knowledge on the post-infusion performance of lonoctocog alfa in global coagulation assays or its potential impact on the haemostatic balance in vivo. To characterize lonoctocog alfa versus octocog alfa in pre- and post-infusion samples obtained from patients undergoing repeated investigation of incremental recovery (IR). Eighteen patients with severe haemophilia A (lonoctocog alfa: 10, octocog alfa: 8) were included. A panel of factor-specific and global coagulation assays was applied, comprising a FVIII OSCA, two FVIII chromogenic substrate assays (CSA), rotational thrombelastography and thrombin generation (TG). Potential activation of coagulation was assessed by measuring plasma thrombin markers and levels of activated protein C. Comparable IRs were found for lonoctocog alfa and octocog alfa (2.36 [IU/dL]/[IU/kg] vs. 2.55 [IU/dL]/[IU/kg], respectively). Lonoctocog alfa activities were found to be underestimated by the FVIII OSCA while also the two FVIII CSAs showed statistically significant assay discrepancies on lonoctocog alfa. Effects of both FVIII products on rotational thrombelastography were less distinct than those on TG parameters. No elevated pre- or significantly shifting post-infusion plasma levels of coagulation biomarkers were detected. Lonoctocog alfa and octocog alfa showed comparable recovery and safety in vivo as well as similar impacts on TG in vitro. Observed assay discrepancies on lonoctocog alfa demonstrated variability of results also between different FVIII CSAs.

Identifiants

pubmed: 39164802
doi: 10.1111/hae.15089
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : CSL Behring

Informations de copyright

© 2024 The Author(s). Haemophilia published by John Wiley & Sons Ltd.

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Auteurs

Jens Müller (J)

Institute of Experimental Haematology and Transfusion Medicine, University Hospital Bonn, Bonn, Germany.

Thilo Albert (T)

Institute of Experimental Haematology and Transfusion Medicine, University Hospital Bonn, Bonn, Germany.

Claudia Klein (C)

Institute of Experimental Haematology and Transfusion Medicine, University Hospital Bonn, Bonn, Germany.

Silvia Horneff (S)

Institute of Experimental Haematology and Transfusion Medicine, University Hospital Bonn, Bonn, Germany.

Heiko Rühl (H)

Institute of Experimental Haematology and Transfusion Medicine, University Hospital Bonn, Bonn, Germany.

Bernd Pötzsch (B)

Institute of Experimental Haematology and Transfusion Medicine, University Hospital Bonn, Bonn, Germany.

Georg Goldmann (G)

Institute of Experimental Haematology and Transfusion Medicine, University Hospital Bonn, Bonn, Germany.

Natascha Marquardt (N)

Institute of Experimental Haematology and Transfusion Medicine, University Hospital Bonn, Bonn, Germany.

Johannes Oldenburg (J)

Institute of Experimental Haematology and Transfusion Medicine, University Hospital Bonn, Bonn, Germany.

Classifications MeSH