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Improved cost-effectiveness by pharmacokinetic dosing of factor VIII in prophylactic treatment of haemophilia A

Carlsson, M; Berntorp, E. LU ; Björkman, S; Lethagen, S. LU and Ljung, R. LU (1997) In Haemophilia 3(2). p.96-101
Abstract

The aim of the study was to investigate the feasibility of optimizing prophylactic dosing of factor VIII by the use of individual pharmacokinetic data. Twenty-one patients were enrolled in a randomized cross-over study on standard dosage regimens vs. dosing according to pharmacokinetic principles. The study period was 2 x 6 months. Using single-dose pharmacokinetic data for each patient, plasma factor VIII procoagulant activity (FVIII:C) curves following various doses and intervals were computer-simulated. From these calculations, a suitable dosage was chosen. FVIII:C was also repeatedly measured during study periods. Trough levels of FVIII:C, numbers of spontaneous joint bleedings and amounts of factor concentrate used during the two... (More)

The aim of the study was to investigate the feasibility of optimizing prophylactic dosing of factor VIII by the use of individual pharmacokinetic data. Twenty-one patients were enrolled in a randomized cross-over study on standard dosage regimens vs. dosing according to pharmacokinetic principles. The study period was 2 x 6 months. Using single-dose pharmacokinetic data for each patient, plasma factor VIII procoagulant activity (FVIII:C) curves following various doses and intervals were computer-simulated. From these calculations, a suitable dosage was chosen. FVIII:C was also repeatedly measured during study periods. Trough levels of FVIII:C, numbers of spontaneous joint bleedings and amounts of factor concentrate used during the two study periods were compared for each patient. There was a close correlation between predicted and measured values of FVIII:C. As the half-lives of FVIII:C in the patients varied from 7.8 to 18.3 h, it was obviously beneficial to base the dosage on individual pharmacokinetic data. Fourteen patients completed both study periods. Mean trough level of exogenous FVIII:C was raised from 0.89 (SD 0.73) U dL
-1 during standard dosage to 2.2 (1.5) U dL
-1 during pharmacokinetic dosage. Concomitantly, mean 6-month consumption of factor VIII was decreased from 124,000 (SD 30,000) units to 84,000 (31,000) units. Numbers of reported bleedings were generally similar during both periods. The study demonstrates the usefulness of individual pharmacokinetics as a tool for cost-effective utilization of factor VIII in the prophylactic treatment of haemophilia A.

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author
organization
publishing date
type
Contribution to journal
publication status
published
keywords
Cost-effectiveness, Dosage, Factor VIII, Haemophilia A, Pharmacokinetics, Prophylaxis
in
Haemophilia
volume
3
issue
2
pages
96 - 101
publisher
Federation of European Neuroscience Societies and Blackwell Publishing Ltd
external identifiers
  • Scopus:0030940593
ISSN
1351-8216
language
English
LU publication?
yes
id
9aabd459-0462-4340-87c2-f437dbb4a2cb
alternative location
http://resolver.ebscohost.com/openurl?sid=Entrez:PubMed&id=pmid:27214717
date added to LUP
2016-11-25 14:51:44
date last changed
2016-11-28 12:26:02
@misc{9aabd459-0462-4340-87c2-f437dbb4a2cb,
  abstract     = {<p>The aim of the study was to investigate the feasibility of optimizing prophylactic dosing of factor VIII by the use of individual pharmacokinetic data. Twenty-one patients were enrolled in a randomized cross-over study on standard dosage regimens vs. dosing according to pharmacokinetic principles. The study period was 2 x 6 months. Using single-dose pharmacokinetic data for each patient, plasma factor VIII procoagulant activity (FVIII:C) curves following various doses and intervals were computer-simulated. From these calculations, a suitable dosage was chosen. FVIII:C was also repeatedly measured during study periods. Trough levels of FVIII:C, numbers of spontaneous joint bleedings and amounts of factor concentrate used during the two study periods were compared for each patient. There was a close correlation between predicted and measured values of FVIII:C. As the half-lives of FVIII:C in the patients varied from 7.8 to 18.3 h, it was obviously beneficial to base the dosage on individual pharmacokinetic data. Fourteen patients completed both study periods. Mean trough level of exogenous FVIII:C was raised from 0.89 (SD 0.73) U dL<br>
                        <sup>-1</sup> during standard dosage to 2.2 (1.5) U dL<br>
                        <sup>-1</sup> during pharmacokinetic dosage. Concomitantly, mean 6-month consumption of factor VIII was decreased from 124,000 (SD 30,000) units to 84,000 (31,000) units. Numbers of reported bleedings were generally similar during both periods. The study demonstrates the usefulness of individual pharmacokinetics as a tool for cost-effective utilization of factor VIII in the prophylactic treatment of haemophilia A.</p>},
  author       = {Carlsson, M and Berntorp, E. and Björkman, S and Lethagen, S. and Ljung, R.},
  issn         = {1351-8216},
  keyword      = {Cost-effectiveness,Dosage,Factor VIII,Haemophilia A,Pharmacokinetics,Prophylaxis},
  language     = {eng},
  number       = {2},
  pages        = {96--101},
  publisher    = {ARRAY(0xd1afd58)},
  series       = {Haemophilia},
  title        = {Improved cost-effectiveness by pharmacokinetic dosing of factor VIII in prophylactic treatment of haemophilia A},
  volume       = {3},
  year         = {1997},
}