Pharmacokinetics of a high-purity plasma-derived factor X concentrate in subjects with moderate or severe hereditary factor X deficiency

• Published in: Haemophilia : the official journal of the World Federation of Hemophilia Vol. 22; no. 3; pp. 426 - 432
• Main Authors: Austin, S. K., Brindley, C., Kavakli, K., Norton, M., Shapiro, A.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.05.2016; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Area Under Curve; Blood Coagulation Tests; Child; clinical trial; Clotting; clotting factor concentrate; Coagulants - pharmacokinetics; Coagulants - therapeutic use; Coagulation factors; Factor X - pharmacokinetics; Factor X - therapeutic use; factor X deficiency; Factor X Deficiency - congenital; Factor X Deficiency - drug therapy; Factor X Deficiency - pathology; Female; Half-Life; Humans; incremental recovery; Male; Middle Aged; Pharmacokinetics; Plasma; Prospective Studies; ROC Curve; Severity of Illness Index; Treatment Outcome; Young Adult; clinical trial; incremental recovery; pharmacokinetics; clotting factor concentrate; factor X deficiency
• ISSN: 1351-8216; 1365-2516; 1365-2516
• DOI: 10.1111/hae.12894

Introduction Hereditary factor X (FX) deficiency affects 1:500 000 to 1:1 000 000 of individuals. There are few published data on the pharmacokinetics (PK) of FX for existing treatments for FX deficiency, and no specific replacement factor concentrate exists. A high‐purity plasma‐derived FX concentrate (pdFX) has been developed for use as replacement therapy in subjects with hereditary FX deficiency. Aim This analysis assessed pdFX PK after a single 25 IU kg−1 bolus dose in subjects with hereditary moderate or severe FX deficiency (plasma FX activity [FX:C] <5 IU dL−1). Methods For a baseline PK assessment, blood samples were taken predose and at intervals up to 144 h (7 days) post dose. After ≥6 months of on‐demand pdFX treatment and treatment of ≥1 bleed with pdFX, subjects underwent repeat PK assessment. Samples were assayed for plasma FX:C (measured using the clotting and chromogenic assays) and FX antigen. Results FX:C peaked at 0.4–0.5 h and subsequently declined over the course of 144 h with a biphasic decay curve. PK parameters observed at the baseline (n = 16) and repeat (n = 15) assessments were equivalent, therefore summary PK values were obtained by combining data from both visits (n = 31). The mean terminal half‐life and incremental recovery of pdFX was 29.4 h and 2.00 IU dL−1 per IU kg−1 respectively. Conclusion This is the most comprehensive PK study to date in subjects with hereditary FX deficiency. These results are consistent with the observed haemostatic efficacy of pdFX and provide the PK data required for the treatment of hereditary FX deficiency using pdFX replacement therapy.