Evidence map›Paper›PMID 33664606›Full record

ArticleJournal of blood medicine2021

Efficacy of rFVIIIFc versus Emicizumab for the Treatment of Patients with Hemophilia A without Inhibitors: Matching-Adjusted Indirect Comparison of A-LONG and HAVEN Trials.

Robert Klamroth, Piotr Wojciechowski, Samuel Aballéa, Françoise Diamand, Zalmai Hakimi, Jameel Nazir, Lydia Abad-Franch, Stefan Lethagen, Elena Santagostino, Michael D Tarantino

Open access · goldAbstract read
In one paragraph

Article in Journal of blood medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Observational
  5. Review
  6. Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 3 countries.

Robert KlamrothDepartment of Internal Medicine, Hemophilia Treatment Centre, Vivantes Klinikum im Friedrichshain, Berlin, Germany.ORCID 0000-0003-4194-8183
Piotr WojciechowskiCreativ-Ceutical, Krakow, Poland.
Samuel AballéaCreativ-Ceutical, Rotterdam, the Netherlands.
Françoise DiamandCreativ-Ceutical, Paris, France.
Zalmai HakimiHealth Economics and Outcomes Research (Global), Sobi, Stockholm, Sweden.
Jameel NazirHealth Economics and Outcomes Research (Global), Sobi, Stockholm, Sweden.
Lydia Abad-FranchGlobal Medical Affairs Hematology, Sobi, Stockholm, Sweden.
Stefan LethagenMedical and Clinical Sciences, Sobi, Stockholm, Sweden.
Elena SantagostinoMedical Affairs Hematology, Sobi, Stockholm, Sweden.
Michael D TarantinoThe Bleeding and Clotting Disorders Institute, University of Illinois College of Medicine-Peoria, Peoria, IL, USA.
Creativ-Ceutical (France) · FRIllinois College · USKlinikum im Friedrichshain · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePrimary prophylaxis, using factor VIII replacement, is the recognized standard of care for severe hemophilia A. Recombinant factor VIII-Fc fusion protein (rFVIIIFc) and emicizumab, a humanized, bispecific antibody, are approved for routine prophylaxis of bleeding episodes in severe hemophilia A. These products have different mechanisms of action, methods of administration and treatment schedules. In the absence of head-to-head trials, indirect treatment comparisons can provide informative evidence on the relative efficacy of the two treatments. The aim of the study was to compare the approved dosing regimens for each product, rFVIIIFc individualized prophylaxis and emicizumab administered once every week (Q1W), every 2 weeks (Q2W) or every 4 weeks (Q4W), based on clinical trial evidence. PATIENTS AND

methodsThe comparison was conducted using matching-adjusted indirect comparison since clinical evidence did not form a connected network. Individual patient data for rFVIIIFc (A-LONG) were compared with data for emicizumab (HAVEN trial program) for mean annualized bleeding rate (ABR) and proportion of patients with zero bleeds. Safety data reported across the analyzed treatment arms were tabularized but not formally compared.

resultsAfter matching, no significant differences were observed between mean ABR for rFVIIIFc and emicizumab administered Q1W, Q2W or Q4W. The proportion of patients with zero bleeds was significantly higher with rFVIIIFc compared with emicizumab administered Q4W (51.2% versus 29.3%, respectively; odds ratio 2.53; 95% confidence interval 1.09-5.89); no significant differences noted when rFVIIIFc was compared with emicizumab administered Q1W or Q2W. The mean number of adverse events expressed per participant was 1.9 for individualized prophylaxis with rFVIIIFc and 3.7-4.0, 4.1 and 3.6 for emicizumab administered Q1W, Q2W or Q4W, respectively.

conclusionThis indirect treatment comparison suggests that rFVIIIFc individualized prophylaxis is more efficacious than emicizumab Q4W, and at least as effective as more frequent emicizumab regimens, for the management of hemophilia A.

Indexed as

annualized bleeding rateantibodiesbispecificcomparative effectiveness researchefmoroctocog alfafactor VIII deficiencytreatment outcome

Identifiers

PMID33664606
PMCPMC7921628
OpenAlexW3132338031

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.