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Individualizing Infusion Interval of Factor VIII Products
Haemophilia; ePub 2017 May 24; Tegenge, et al
It is possible to individualize infusion interval of factor VIII (FVIII) products, restricting dose, trough, and peak concentration within an acceptable range, according to a recent study.
Investigators obtained patient demographic data and pharmacokinetic parameters for FVIII products. Through various simulations they found that:
- ~4% of patients were dosed at an infusion interval of every 24 hours and maintained a target 1 IU/dL FVIII level within the dose range of 10-50 IU/kg.
- This interval was 48 hours in 38% of patients; 72 hours in 37%; and 96 hours in 20%.
- Maintaining an alternative trough value of 3 or 5 IU/dL required more frequent infusion.
- The predicted median probability of bleeding risk/year was ~36% for pharmacokinetic-based dosing maintaining 1 IU/dL.
- Median bleeding risk was ~38% for standard dosing of 20 IU/kg.
- The risk of such for dosing of 30 and 50 IU/kg was ~33% and ~27%, respectively.
- Pharmacokinetic-based dosing led to a dose sparing benefit compared to standard doses.
Citation:
Tegenge M, Yang H, Forshee R. Predicting dose sparing benefit and bleeding risk of pharmacokinetic-based personalized prophylactic dosing of factor VIII products. [Published online ahead of print May 24, 2017]. Haemophilia. doi:10.1111/hae.13270.