Evidence map›Paper›PMID 39712873›Full record

ArticleTherapeutic advances in hematology2024

Outcomes and management of invasive procedures in participants with hemophilia A post gene therapy: a post hoc analysis of the GENEr8-1 phase III trial.

Doris V Quon, Jiaan-Der Wang, Michael Wang, Dominic Pepperell, Young-Shil Park, Gili Kenet, Johnny Mahlangu, Teh-Liane Khoo, Tara M Robinson, Konstantia-Maria Chavele and 1 more

Abstract read
In one paragraph

Article in Therapeutic advances in hematology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
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

11 authors.

Doris V QuonOrthopaedic Hemophilia Treatment Center, 403 West Adams Blvd., Los Angeles, CA 90007, USA.ORCID https://orcid.org/0000-0002-9148-3268
Jiaan-Der WangCenter for Rare Disease and Hemophilia, Taichung Veterans General Hospital, Taichung, Taiwan.
Michael WangHemophilia and Thrombosis Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Dominic PepperellDepartment of Haematology, Fiona Stanley Hospital, Murdoch, WA, Australia.
Young-Shil ParkKyung Hee University Hospital at Gangdong, Seoul, South Korea.
Gili KenetThe National Hemophilia Center and Amalia Biron Research Institute of Thrombosis and Hemostasis, Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv, Israel.
Johnny MahlanguHemophilia Comprehensive Care Center, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand and NHLS, Johannesburg, South Africa.
Teh-Liane KhooHaematology Department, Haemophilia Treatment Center, The Royal Prince Alfred Hospital, Sydney, NSW, Australia.
Tara M RobinsonBioMarin Pharmaceutical Inc., Novato, CA, USA.
Konstantia-Maria ChaveleBioMarin Pharmaceutical Inc., Novato, CA, USA.
Steven W PipeDepartments of Pediatrics and Pathology, University of Michigan, Ann Arbor, MI, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Hemophilia A is caused by coagulation factor VIII (FVIII) deficiency and increases bleeding risk during invasive procedures. Objectives: To investigate FVIII concentrate use and bleeding outcomes for invasive procedures after valoctocogene roxaparvovec gene transfer. Design: This manuscript presents post hoc analysis of the phase III GENEr8-1 trial. Methods: A post hoc analysis was performed for GENEr8-1, a global, single-arm, open-label, phase III trial that enrolled 134 adults with severe hemophilia A. FVIII activity and bleeding were evaluated after 2 years of follow-up. Invasive procedures were reviewed and categorized as major or minor. FVIII activity was measured with a chromogenic assay. Bleeding was self-reported by participants. Principal investigators completed questionnaires about perioperative management. Results: In total, 111 invasive procedures were performed in 65 participants during GENEr8-1 as of the data cut. Procedures performed with FVIII treatment included 33 minor and 11 major procedures. The remaining 67 invasive procedures were minor and performed without FVIII treatment. When considering these 67 minor procedures, 43/46 investigators completing the questionnaires reported that the gene-therapy-derived FVIII activity was sufficient for the type of procedure. Minor procedures performed without FVIII treatment were associated with participants' higher mean endogenous FVIII activity (50.5 IU/dL) compared with major procedures (14.2 IU/dL) or minor procedures (16.4 IU/dL) performed with concomitant FVIII. Fourteen participants experienced 18 procedure-related bleeds (13 co-occurring with FVIII use). Participants who received FVIII treatment for procedure-related bleeds had numerically lower mean endogenous FVIII activity than those who did not receive FVIII treatment. Conclusion: Invasive procedures were safely performed in participants following treatment with valoctocogene roxaparvovec. The questionnaire responses from investigators generally suggest they used endogenous FVIII activity derived from valoctocogene roxaparvovec to inform clinical decisions in a manner comparable to exogenously administered FVIII, and more commonly prescribed supplementary FVIII concentrate in the peri-procedural period for participants with lower FVIII activity levels.

Indexed as

bleeding riskgene therapyhemophilia Ainvasive proceduresvaloctocogene roxaparvovec

Identifiers

PMID39712873
PMCPMC11660064

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