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DOI: 10.1055/s-0044-1801629
Interim Analysis of Joint Outcomes in Adult and Adolescent Patients with Severe Hemophilia A Receiving Efanesoctocog Alfa During the Phase 3 XTEND-ed Long-Term Extension Study
Authors
Introduction: Hemophilic arthropathy and chronic joint pain from repeated bleeding episodes in hemophilia A may occur despite standard-of-care prophylaxis. In XTEND-1 (NCT04161495), once-weekly efanesoctocog alfa (50 IU/kg) prophylaxis was well tolerated, providing highly effective bleed protection and high-sustained factor VIII activity levels across the weekly dosing interval. The aim is to assess long-term joint health with efanesoctocog alfa prophylaxis in adults/adolescents from XTEND-1 who continued to the extension study, XTEND-ed (NCT04644575).
Method: XTEND-ed is an open-label, multicenter study of previously treated patients with severe hemophilia A. Participants provided informed consent; the study was approved by applicable review boards. Changes from parent study (XTEND-1) baseline to Month 12 in XTEND-ed in Hemophilia Joint Health Scores (HJHS) and target joint resolution for participants aged≥12 years who received once-weekly efanesoctocog alfa (50 IU/kg) prophylaxis are presented descriptively (data cutoff June 8, 2023). Individual joints (left/right elbows, knees, and ankles) were scored according to 8 HJHS domains; gait was also assessed. Total HJHS score encompasses joint and gait score. Target joints were evaluated based on International Society on Thrombosis and Haemostasis criteria.
Results: Arm A of XTEND-ed enrolled 146 participants from XTEND-1 (additional mean [standard deviation, SD] treatment duration 82.5 [14.3] weeks). By Month 12 in XTEND-ed, joint health had improved or been maintained in evaluable participants compared with XTEND-1 baseline, as measured by HJHS total score, total joint score, and subdomain scores ([Fig. 1] [2]). The HJHS domain with the greatest mean (SD) change from baseline to Month 12 was flexion loss -0.6 (2.7). At XTEND-1 baseline, there were 140 target joints among 45 participants; at 1 year, all target joints (n=132) had resolved in participants exposed for≥12 months (n=43).




Conclusion: Interim results from XTEND-ed indicate that once-weekly prophylaxis with efanesoctocog alfa is associated with improvement or maintenance of joint health in adults and adolescents.
Funded by Sanofi and Sobi.
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Artikel online veröffentlicht:
13. Februar 2025
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