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Adverse Reactions in Clinical Trials

  • Zero previously treated patients (PTPs) and previously untreated patients (PUPs) developed antibodies to the host cell proteins
  • Zero events of anaphylaxis or thrombosis were reported

Development of inhibitors to Factor VIII can occur following administration of Factor VIII products.

  • Zero inhibitors observed in clinical trials of PTPs
  • PUPs are at greatest risk. 12 of 24 treated subjects developed an inhibitor to Factor VIII
  • If expected Factor VIII levels are not attained or bleeding is not controlled with appropriate dose, perform a Bethesda inhibitor assay to measure Factor VIII inhibitor concentration

Adverse reactions

The most common adverse reactions reported in clinical trials (>0.5% of subjects) were Factor VIII inhibition in previously untreated patients (PUPs), dizziness, and hypersensitivity.

Adverse reactions reported for AFSTYLA (N=258)*

0.4%

Paresthesia

Rash

Erythema

Pruritus

Pyrexia

Injection-site pain

Chills

Feeling hot

0.8%

Dizziness

1.6%

Hypersensitivity

One patient withdrew due to an adverse reaction (hypersensitivity).

*Adverse reactions reported in adult/adolescent and pediatric studies in previously treated patients

Monitor Factor VIII activity using either the chromogenic or one-stage clotting assay

Chromogenic
assay
One-stage clotting assay

Use chromogenic assay if available to measure Factor VIII activity

  • Most accurately reflects the clinical hemostatic potential of AFSTYLA
  • Should be used if available

One-stage assay results can be used with a simple calculation

The one-stage clotting assay result underestimates the Factor VIII activity level compared to the chromogenic assay result by approximately one-half.

If the one-stage clotting assay is used, multiply the result by a conversion factor of 2 to determine the patient’s Factor VIII activity level.

One-stage assay results x 2 = Activity level

Study design

Data from three AFSTYLA studies: Safety of AFSTYLA was assessed in patients enrolled in the phase I/III, open-label, multicenter, crossover study, the phase III, open-label study, and the ongoing phase III, open-label, multicenter extension study. Adverse reactions were reported for 14 of 258 (5.4%) patients in all studies. In the clinical studies, there have been a total of 28,418 exposure days, with at least 28,492 injections of AFSTYLA administered.

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