Gene therapy for people with Haemophilia B: a proposed care delivery model in Italy.

factor IX-Padua gene therapy haemophilia B hub and spoke model laboratory surveillance liver health multidisciplinary team

Journal

Journal of thrombosis and haemostasis : JTH
ISSN: 1538-7836
Titre abrégé: J Thromb Haemost
Pays: England
ID NLM: 101170508

Informations de publication

Date de publication:
20 Aug 2024
Historique:
received: 16 04 2024
revised: 28 06 2024
accepted: 09 07 2024
medline: 23 8 2024
pubmed: 23 8 2024
entrez: 22 8 2024
Statut: aheadofprint

Résumé

Gene therapy is designed to provide people with haemophilia B with a steady and elevated factor IX activity, thereby strengthening protection and relieving the burden of replacement therapy frequent infusions. The European Medicines Agency has approved a gene therapy for the severe and moderately severe forms of haemophilia B that uses the factor IX Padua variant (etranacogene dezaparvovec). The aim is to provide a document dedicated to haemophilia B gene therapy and give a comprehensive overview of the topic. An Italian group of experts in haemophilia has carried out a narrative review of the literature and has discussed during a virtual meeting several key aspects of the delivery of this treatment in Italy. The discussion covered the organisational model, the role of the multidisciplinary team, the laboratory surveillance and the patient journey, from the follow-up to the identification of safety issues and outcome measures. This article highlights the need to follow the Hub and Spoke organisational model and sheds light on the role of each professional figure within the multidisciplinary teams to favour patient engagement, management, and retention. Moreover, this article stresses the need to perform laboratory tests for patient screening and follow-up and proposes a checklist to help patient identification. Finally, the needs of Italian haemophilia centres have been considered to ensure an efficient implementation of the care delivery model. It is crucial to ensure that centres are appropriately organized, equipped and trained to adequately select patients, deliver the gene therapy and perform follow-up.

Sections du résumé

BACKGROUND BACKGROUND
Gene therapy is designed to provide people with haemophilia B with a steady and elevated factor IX activity, thereby strengthening protection and relieving the burden of replacement therapy frequent infusions. The European Medicines Agency has approved a gene therapy for the severe and moderately severe forms of haemophilia B that uses the factor IX Padua variant (etranacogene dezaparvovec). The aim is to provide a document dedicated to haemophilia B gene therapy and give a comprehensive overview of the topic.
METHODS METHODS
An Italian group of experts in haemophilia has carried out a narrative review of the literature and has discussed during a virtual meeting several key aspects of the delivery of this treatment in Italy. The discussion covered the organisational model, the role of the multidisciplinary team, the laboratory surveillance and the patient journey, from the follow-up to the identification of safety issues and outcome measures.
RESULTS RESULTS
This article highlights the need to follow the Hub and Spoke organisational model and sheds light on the role of each professional figure within the multidisciplinary teams to favour patient engagement, management, and retention. Moreover, this article stresses the need to perform laboratory tests for patient screening and follow-up and proposes a checklist to help patient identification. Finally, the needs of Italian haemophilia centres have been considered to ensure an efficient implementation of the care delivery model.
CONCLUSION CONCLUSIONS
It is crucial to ensure that centres are appropriately organized, equipped and trained to adequately select patients, deliver the gene therapy and perform follow-up.

Identifiants

pubmed: 39173877
pii: S1538-7836(24)00484-7
doi: 10.1016/j.jtha.2024.07.029
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Auteurs

Giancarlo Castaman (G)

Center for Bleeding Disorders and Coagulation, Department of Oncology. Careggi University Hospital, Florence, Italy.

Giovanni Di Minno (G)

Department of Clinical Medicine, Federico II University, School of Medicine, Scientific Executive, Governance Headquarters, Campania Network for Inherited Bleeding Disorders, Napoli, Italy.

Paolo Simioni (P)

Hemorrhagic and Thrombotic Diseases Unit, Department of Medicine (DIMED), Padova University Hospital, Padova, Italy.

Angelo Claudio Molinari (AC)

Regional Reference Centre for Haemorrhagic Diseases, IRCSS Istituto Giannini Gaslini, Genoa, Italy.

Sergio Siragusa (S)

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo and Policlinico Paolo Giaccone, Unit of Hematology, Palermo, Italy.

Erminia Baldacci (E)

Haematology, "Umberto I" Policlinico, Department of Translational and Precision Medicine, Sapienza University of Rome, 00118 Rome, Italy.

Vincenzo La Mura (V)

IRCCS Ca' Granda Ospedale Maggiore Policlinico Foundation, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milano, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.

Angelo Lupi (A)

Federation of Haemophilia Associations (FedEmo), Milan, Italy.

Enrico Ferri Grazzi (EF)

Federation of Haemophilia Associations (FedEmo), Milan, Italy.

Flora Peyvandi (F)

IRCCS Ca' Granda Ospedale Maggiore Policlinico Foundation, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milano, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy. Electronic address: flora.peyvandi@unimi.it.

Classifications MeSH