[Pharmacokinetic Study of Coagulation Factor Ⅷ in Adults with Severe Hemophilia A].

Autor: Zhang Y; Department of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), Taiyuan 030006, Shanxi Province, China., Guo ZF; Department of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), Taiyuan 030006, Shanxi Province, China., Wang JJ; Department of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), Taiyuan 030006, Shanxi Province, China., Lu WL; Department of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), Taiyuan 030006, Shanxi Province, China., Hao JY; Department of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), Taiyuan 030006, Shanxi Province, China., Wang X; Department of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), Taiyuan 030006, Shanxi Province, China., Pan ZJ; Department of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), Taiyuan 030006, Shanxi Province, China., Guo YR; Department of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), Taiyuan 030006, Shanxi Province, China., Guo XL; Department of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), Taiyuan 030006, Shanxi Province, China., Sun JJ; Department of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), Taiyuan 030006, Shanxi Province, China., Jiang B; Department of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), Taiyuan 030006, Shanxi Province, China., Li Z; Department of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), Taiyuan 030006, Shanxi Province, China., Guo ZP; Department of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), Taiyuan 030006, Shanxi Province, China.E-mail: guozhiping7830@163.com.
Jazyk: čínština
Zdroj: Zhongguo shi yan xue ye xue za zhi [Zhongguo Shi Yan Xue Ye Xue Za Zhi] 2024 Oct; Vol. 32 (5), pp. 1509-1517.
DOI: 10.19746/j.cnki.issn.1009-2137.2024.05.032
Abstrakt: Objective: To detect the pharmacokinetic (PK) parameters of coagulation factor Ⅷ (FⅧ) in adult patients with severe hemophilia A, identify the potential factors influencing FⅧ PK, and optimize the use of FⅧ in individual prophylaxis regimens.
Methods: PK characteristics of FⅧ were studied in a total of 23 severe hemophilia A adults. The correlation of patients' characteristics including age, von Willebrand factor antigen (vWF:Ag), blood group, weight, body mass index (BMI) and FⅧ genotype, with FⅧ PK were evaluated. Individual prophylaxis regimens were given based on FⅧ PK parameters.
Results: The mean terminal half‑life (t 1/2 ) of FⅧ was 20.6±9.3 h, ranged from 11.47 h to 30.12 h. The age ( r =0.580) and vWF:Ag ( r =0.814) were significantly positively correlated with t 1/2 of FⅧ. The mean area under the plasma concentration curve (AUC) of FⅧ was 913±399 (328-1 878) IU·h/dl, and the AUC of FⅧ was positively correlated with age ( r =0.557) and vWF:Ag ( r =0.784). The mean residence time (MRT) of FⅧ was 24.7±12.4 (13.2-62.2) h, and the MRT of FⅧ was positively correlated with age ( r =0.664) and vWF:Ag ( r =0.868). The mean in vivo recovery (IVR) of FⅧ was 2.59±0.888 (1.5-4.29) IU/dl per IU/kg, the mean clearance (CL) of FⅧ was 3±1.58（0.97-7.18）ml/(kg·h)，and there was no significant correlation of IVR and CL with age and vWF:Ag. According to the individual PK parameters, ultra low-dose, low-dose and moderate-dose FⅧ were applied to 15, 6, 2 adults patients with severe hemophilia A for prophylaxis, respectively.
Conclusion: There are significant individual differences in the FⅧ half-life of adult patients with severe hemophilia A. The older the patient, the higher the vWF:Ag level, and the longer the FⅧ half-life. Individual administration is required based on the FⅧ PK parameters to optimize prophylaxis treatment.
Databáze: MEDLINE
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