Original article

Blood Transfusion - 4 2020 (July-August)

Susoctocog-alfa (Obizur®) in the treatment of nine elderly patients with acquired haemophilia A: an Italian multicentre real world experience

Authors

Key words: acquired haemophilia A, recombinant porcine FVIII, recombinant FVII activated, activated prothrombin complex concentrate
Publication Date: 2020-06-04

Abstract

Background - In 2016, a new recombinant B-domain deleted porcine FVIII (rpFVIII) was licensed in Italy for the treatment of acquired haemophilia A (AHA). But only a few cases of patients receiving this have been reported in the literature. Here we report the largest registry of the use of rpFVIII for the treatment of AHA. The objective of this retrospective study was to describe the efficacy and the safety of susoctocog-alfa for AHA.
Materials and methods - We studied a population of nine patients, recruited in five Italian haemophilia centres presenting AHA, and treated with Obizur® as first- or second-line therapy.
Results - rpFVIII was used as a first-line therapy in one-third of the patients. The median delay between clinical onset and diagnosis was 16 days. Initial bolus of infused susoctocog-alfa was 100 IU/kg, lower than the recommended dose. The treatment was maintained for a median of four days. Only one patient with serious co-morbidities and recurrent infections was treated for 32 days. All patients reached a complete resolution of AHA, and no recurrences were reported. Two patients developed a low-titre inhibitor against rpFVIII, neither experienced any complications.
Discussion - In our real world experience, susoctocog-alfa was proven to be an effective and safe therapeutic option for patients with AHA, also at a lower than recommended dosage. In our report, the appearance of low-titre inhibitors

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Authors

Ezio Zanon - Haemophilia Center, University Hospital, Padua

Samantha Pasca - Haemophilia Center, University Hospital, Padua

Alessandra Borchiellini - Haemostasis and Thrombosis Unit, “Molinette” Hospital, Turin

Corrado Lodigiani - Thrombosis Center, “Humanitas” Clinical Institute, Rozzano

Angelo C. Molinari - ”Gianna Gaslini” Children Hospital, Genoa

Chiara Ambaglio - Haemophilia Center, IRCSS “S. Matteo”, Pavia

Federica Valeri - Haemostasis and Thrombosis Unit, “Molinette” Hospital, Turin

Paola S. Preti - Haemophilia Center, IRCSS “S. Matteo”, Pavia

Paolo Moscatelli - Emergency Department, “San Martino” University Hospital, Genoa

Paolo Simioni - General Medicine Department, University Hospital, Padua, Italy

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