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      Preclinical safety and efficacy of a new recombinant FIX drug product for treatment of hemophilia B

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          Abstract

          Baxter has developed a new recombinant factor IX (rFIX) drug product (BAX326) for treating patients with hemophilia B, or congenital FIX deficiency. An extensive preclinical program evaluated the pharmacokinetics, efficacy, and safety of BAX326 in different species. The efficacy of BAX326 was tested in three mouse models of primary pharmacodynamics: tail-tip bleeding, carotid occlusion, and thrombelastography. The pharmacokinetics was evaluated after a single intravenous bolus injection in mice, rats, and macaques. Toxicity was assessed in rats and macaques, safety pharmacology in rabbits and macaques, and immunogenicity in mice. BAX326 was shown to be efficacious in all three primary pharmacodynamic studies ( P ≤ 0.0076). Hemostatic efficacy was dose related and similar for the three lots tested. Pharmacokinetic results showed that rFIX activity and rFIX antigen concentrations declined in a bi-phasic manner, similar to a previously licensed rFIX product. BAX326 was well tolerated in rabbits and macaques at all dose levels; no thrombogenic events and no adverse clinical, respiratory, or cardiovascular effects occurred. BAX326 was also shown to have a similar immunogenicity profile to the comparator rFIX product in mice. These results demonstrate that BAX326 has a favorable preclinical safety and efficacy profile, predictive of a comparable effect to that of the previously licensed rFIX in humans.

          Electronic supplementary material

          The online version of this article (doi:10.1007/s12185-013-1448-z) contains supplementary material, which is available to authorized users.

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          Most cited references20

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          Reformulated BeneFix: efficacy and safety in previously treated patients with moderately severe to severe haemophilia B.

          BeneFix, the only recombinant factor IX (FIX), has been reformulated. The reformulation involves a change in diluent and allows for more concentrated infusions of recombinant FIX. A double-blind, randomized, pharmacokinetic (PK) crossover study demonstrated that reformulated BeneFix was bioequivalent to original BeneFix and follow-up PK evaluation after 6 months of treatment demonstrated the PK stability of reformulated BeneFix after multiple exposures. Favourable efficacy and safety profiles, consistent with those already well-established for original BeneFix, were observed: 81.1% of haemorrhages resolved with only a single infusion; 85.3% of initial treatment response ratings were Excellent or Good; more than half of the subjects using reformulated BeneFix for routine prophylaxis (11 of 17, 64.7%) had no spontaneous haemorrhages during their 6-12 month course of prophylactic treatment, with an overall spontaneous bleeding rate of 0.72 year(-1); and for the single surgical procedure (knee washing), treatment was rated Useful. In addition, there was no FIX inhibitor development, allergic-type manifestations, or thrombogenic complications with more than 1100 infusions (nearly 5.2 million IUs) administered in this trial. All efficacy and safety outcomes from this study were achieved with more concentrated recombinant protein infusions than that possible with original BeneFix, and utilization of the 2000 IU per vial dosage strength, newly introduced with the reformulated product, was high (>62%). The reformulation of BeneFix allows smaller delivery volumes and an increased choice of dosage strengths without altering the PK properties (including incremental recovery and half-life) or the established efficacy and safety profile of recombinant FIX.
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            Haemophilia B: database of point mutations and short additions and deletions--eighth edition.

            The eighth edition of the haemophilia B database (http://www.umds.ac. uk/molgen/haemBdatabase.htm ) lists in an easily accessible form all known factor IX mutations due to small changes (base substitutions and short additions and/or deletions of <30 bp) identified in haemophilia B patients. The 1713 patient entries are ordered by the nucleotide number of their mutation. Where known, details are given on: factor IX activity, factor IX antigen in circulation, presence of inhibitor and origin of mutation. References to published mutations are given and the laboratories generating the data are indicated.
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              Biologic assay of a thrombosis-inducing activity in human serum.

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                Author and article information

                Contributors
                +43-1-20100-247 , +43-1-20100-557 , eva_muchitsch@baxter.com
                Journal
                Int J Hematol
                Int. J. Hematol
                International Journal of Hematology
                Springer Japan (Tokyo )
                0925-5710
                1865-3774
                24 September 2013
                2013
                : 98
                : 5
                : 525-532
                Affiliations
                GRID grid.420273.0, ISNI 0000000404806896, Baxter Innovations GmbH, ; Wagramer Straße 17-19, 1221 Vienna, Austria
                Article
                1448
                10.1007/s12185-013-1448-z
                7091414
                24061775
                53ac5740-a8c6-4f8a-9e3f-c743c9272b51
                © The Japanese Society of Hematology 2013

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 23 July 2013
                : 12 September 2013
                : 12 September 2013
                Categories
                Original Article
                Custom metadata
                © The Japanese Society of Hematology 2013

                Hematology
                hemophilia b,rfix,pharmacokinetics,safety,efficacy
                Hematology
                hemophilia b, rfix, pharmacokinetics, safety, efficacy

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