High adherence to prophylaxis regimens in haemophilia B patients receiving rIX-FP: Evidence from clinical trials and real-world practice

Haemophilia. 2020 Jul;26(4):637-642. doi: 10.1111/hae.14018. Epub 2020 Jun 15.

Abstract

Introduction: Adherence to prophylaxis regimens is essential for bleed prevention in haemophilia but remains a challenge due to the need for frequent infusions.

Aim: To evaluate patient adherence to prophylaxis regimens with a long-acting recombinant factor IX (rIX-FP; IDELVION® ) in clinical studies and real-world practice.

Methods: In two phase 3 clinical studies, patients with haemophilia B (FIX ≤2%) recorded their dose, dosing frequency and rIX-FP consumption in an e-diary. Adherence to prescribed prophylaxis regimens was assessed in all patients and to prescribed dose in patients ≥12 years only. Additionally, adherence to rIX-FP prophylaxis regimens in real-world practice was captured.

Results: In clinical studies, 94.9% (n = 56/59) of patients ≥12 years and 100% (n = 27) of paediatric patients received ≥80% of the expected number of infusions for their assigned prophylaxis schedule. Overall, mean adherence rate was 95.5% across all prophylaxis regimens in patients ≥12 years and 97.9% with a 7-day regimen in paediatric patients. In patients ≥12 years, 85.7% (n = 54/63) were dose adherent, defined as receiving within 10% of their prescribed dose ≥80% of the time. In real-world practice, adherence was observed in 100% (n = 14 and n = 15, respectively) of patients in two haemophilia treatment centres and 57.1% (n = 4/7) of patients in a third centre; non-adherence (n = 3/7) was linked to insurance-related and parental issues.

Conclusion: In clinical studies, patients with haemophilia B had high adherence rates to rIX-FP prophylaxis regimens with a variety of dosing intervals, enabling them to achieve very low bleeding rates. High adherence may also be achievable in real-world practice.

Keywords: adherence; albutrepenonacog alfa; factor IX; haemophilia B; rIX-FP; treatment.

Publication types

  • Clinical Trial, Phase III

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Factor IX / administration & dosage
  • Factor IX / therapeutic use*
  • Hemophilia B / complications
  • Hemophilia B / drug therapy*
  • Hemorrhage / etiology
  • Hemorrhage / prevention & control*
  • Humans
  • Infusions, Intravenous
  • Middle Aged
  • Practice Patterns, Physicians'
  • Recombinant Fusion Proteins / administration & dosage
  • Recombinant Fusion Proteins / therapeutic use*
  • Serum Albumin / administration & dosage
  • Serum Albumin / therapeutic use*
  • Treatment Adherence and Compliance / psychology
  • Treatment Adherence and Compliance / statistics & numerical data*
  • Young Adult

Substances

  • Recombinant Fusion Proteins
  • Serum Albumin
  • Factor IX
  • albutrepenonacog alfa

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