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Evaluation of One-Stage Assays for the Monitoring of Recombinant Human Factor IX Padua Activity After Etranacogene Dezaparvovec Gene Therapy

Astermark, Jan LU ; Miesbach, Wolfgang ; Coppens, Michiel ; Gielen, Sander ; Twisk, Jaap ; Dolmetsch, Ricardo ; Verweij, Stephanie ; Monahan, Paul E. ; Ewenstein, Bruce M. and Nuthalapati, Silpa , et al. (2025) In Haemophilia 31(4). p.799-806
Abstract

Introduction: Accurate and reproducible measures of factor activity are required to guide clinical decision-making following gene therapy for haemophilia B (HB). Highly significant discrepancies have been observed in measurements of various factor IX (FIX) concentrates that carry molecular modifications to extend their half-life, arguing for the need for careful analysis of new HB treatment modalities with respect to FIX assay performance. Aim: To further characterise variability in FIX activity measured using different one-stage assays (OSAs) and chromogenic assays (CAs) in patients with HB receiving gene therapy utilising the FIX Padua variant and to assess whether assay differences were due to the FIX-Padua variant. Methods: FIX... (More)

Introduction: Accurate and reproducible measures of factor activity are required to guide clinical decision-making following gene therapy for haemophilia B (HB). Highly significant discrepancies have been observed in measurements of various factor IX (FIX) concentrates that carry molecular modifications to extend their half-life, arguing for the need for careful analysis of new HB treatment modalities with respect to FIX assay performance. Aim: To further characterise variability in FIX activity measured using different one-stage assays (OSAs) and chromogenic assays (CAs) in patients with HB receiving gene therapy utilising the FIX Padua variant and to assess whether assay differences were due to the FIX-Padua variant. Methods: FIX activity was assessed centrally (OSA and CA) and locally (OSA only) using plasma samples collected from a phase 2b and phase 3 study of etranacogene dezaparvovec and in an in vitro study of wild-type (wt) recombinant human FIX (rhFIX) and rhFIX-Padua. Results: Lower CA than OSA FIX activity for plasma samples from the phase 3 trial was observed (CA:OSA ratio: 0.408 [±0.049]–0.547 [±0.062]). Local OSA:central OSA FIX activity ratios were 0.789 (±0.314)–1.021 (±0.159). Local OSA:central OSA FIX activity ratios across methods and/or reagents were 0.81 (±0.02)–1.28 (±0.04) for rhFIX-wt-spiked samples and 0.67 (±0.02)–1.13 (±0.09) for rhFIX-Padua-spiked samples. Conclusion: FIX activity differences between central and local OSAs were modest; similar differences were observed in vitro with rhFIX-wt versus rhFIX-Padua. Commonly available OSAs can be used to monitor patients post-etranacogene dezaparvovec administration; we recommend using the same assay platform throughout the post-treatment period.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
chromogenic assay, factor IX, gene therapy, haemophilia B, one-stage assay
in
Haemophilia
volume
31
issue
4
pages
8 pages
publisher
John Wiley & Sons Inc.
external identifiers
  • scopus:105008548479
  • pmid:40534246
ISSN
1351-8216
DOI
10.1111/hae.70053
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Author(s). Haemophilia published by John Wiley & Sons Ltd.
id
184db144-7014-45a5-81bb-b2ca83420860
date added to LUP
2026-01-27 13:21:47
date last changed
2026-01-28 03:00:06
@article{184db144-7014-45a5-81bb-b2ca83420860,
  abstract     = {{<p>Introduction: Accurate and reproducible measures of factor activity are required to guide clinical decision-making following gene therapy for haemophilia B (HB). Highly significant discrepancies have been observed in measurements of various factor IX (FIX) concentrates that carry molecular modifications to extend their half-life, arguing for the need for careful analysis of new HB treatment modalities with respect to FIX assay performance. Aim: To further characterise variability in FIX activity measured using different one-stage assays (OSAs) and chromogenic assays (CAs) in patients with HB receiving gene therapy utilising the FIX Padua variant and to assess whether assay differences were due to the FIX-Padua variant. Methods: FIX activity was assessed centrally (OSA and CA) and locally (OSA only) using plasma samples collected from a phase 2b and phase 3 study of etranacogene dezaparvovec and in an in vitro study of wild-type (wt) recombinant human FIX (rhFIX) and rhFIX-Padua. Results: Lower CA than OSA FIX activity for plasma samples from the phase 3 trial was observed (CA:OSA ratio: 0.408 [±0.049]–0.547 [±0.062]). Local OSA:central OSA FIX activity ratios were 0.789 (±0.314)–1.021 (±0.159). Local OSA:central OSA FIX activity ratios across methods and/or reagents were 0.81 (±0.02)–1.28 (±0.04) for rhFIX-wt-spiked samples and 0.67 (±0.02)–1.13 (±0.09) for rhFIX-Padua-spiked samples. Conclusion: FIX activity differences between central and local OSAs were modest; similar differences were observed in vitro with rhFIX-wt versus rhFIX-Padua. Commonly available OSAs can be used to monitor patients post-etranacogene dezaparvovec administration; we recommend using the same assay platform throughout the post-treatment period.</p>}},
  author       = {{Astermark, Jan and Miesbach, Wolfgang and Coppens, Michiel and Gielen, Sander and Twisk, Jaap and Dolmetsch, Ricardo and Verweij, Stephanie and Monahan, Paul E. and Ewenstein, Bruce M. and Nuthalapati, Silpa and Galante, Nick and Young, Guy}},
  issn         = {{1351-8216}},
  keywords     = {{chromogenic assay; factor IX; gene therapy; haemophilia B; one-stage assay}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{799--806}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Haemophilia}},
  title        = {{Evaluation of One-Stage Assays for the Monitoring of Recombinant Human Factor IX Padua Activity After Etranacogene Dezaparvovec Gene Therapy}},
  url          = {{http://dx.doi.org/10.1111/hae.70053}},
  doi          = {{10.1111/hae.70053}},
  volume       = {{31}},
  year         = {{2025}},
}