Blood Res (2024) 59:27
Published online August 8, 2024
https://doi.org/10.1007/s44313-024-00024-8
© The Korean Society of Hematology
Correspondence to : *Correspondence:
Eun Jin Choi
ejchoi2@cu.ac.kr
Background To investigate the clinical treatment status, such as treatment regimen, bleeding events, and drug dose, in patients with hemophilia B in South Korea.
Methods In this retrospective chart review, data of patients with hemophilia B from eight university hospitals were collected. Demographic and clinical data, treatment data, such as regimen and number of injections, dose of factor IX concentrate, and bleeding data were reviewed. Descriptive analyses were performed with annual data for 2019, 2020, and 2021, as well as the three years consecutively.
Results The medical records of 150 patients with hemophilia B between January 1, 2019, and December 31, 2021, were collected. Among these, 72 (48.0%) were severe, 47 (31.3%) were moderate, and 28 (18.7%) were mild. The results showed approximately two times more patients receiving prophylaxis as those receiving on-demand therapy, with 66.1% of patients receiving prophylaxis in 2019, 64.9% in 2020, and 72.1% in 2021. Annualized bleeding rates were 2.2% (± 3.1) in 2019, 1.8% (± 3.0) in 2020, and 1.8% (± 2.9) in 2021 among patients receiving prophylaxis. For the doses of factor IX concentrate, patients receiving prophylaxis received an average of 41.6 (± 11.9) IU/Kg/Injection in 2019, 45.7 (± 12.9) IU/Kg/Injection in 2020, and 60.1 (± 24.0) IU/Kg/Injection in 2021.
Conclusions Clinically, prophylaxis is more prevalent than reported. Based on insights gained from current clinical evidence, it is expected that the unmet medical needs of patients can be identified, and physicians can evaluate the status of patients and actively manage hemophilia B using more effective treatment strategies.
Keywords: Hemophilia B, Clinical data, Prophylaxis, Treatment regimen
Blood Res 2024; 59():
Published online August 8, 2024 https://doi.org/10.1007/s44313-024-00024-8
Copyright © The Korean Society of Hematology.
Young Shil Park1, Ji Kyoung Park2, Jeong A Park3, Hee Jo Baek4, Jae Hee Lee5, Chur Woo You6, Chuhl Joo Lyu7 and Eun Jin Choi8*
1 Department of Pediatrics, Kyunghee University Hospital at Gandong, Seoul, Republic of Korea
2 Department of Pediatrics, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
3 Department of Pediatrics, Inha University College of Medicine, Incheon, Republic of Korea
4 Department of Pediatrics, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
5 Chungbuk National University Hospital, Cheongju, Republic of Korea
6 Daejeon Eulji Medical Center, Eulji University, Daejeon, Republic of Korea
7 Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea
8 Department of Pediatrics, Daegu Catholic University Medical Center, Daegu, Republic of Korea
Correspondence to:*Correspondence:
Eun Jin Choi
ejchoi2@cu.ac.kr
Background To investigate the clinical treatment status, such as treatment regimen, bleeding events, and drug dose, in patients with hemophilia B in South Korea.
Methods In this retrospective chart review, data of patients with hemophilia B from eight university hospitals were collected. Demographic and clinical data, treatment data, such as regimen and number of injections, dose of factor IX concentrate, and bleeding data were reviewed. Descriptive analyses were performed with annual data for 2019, 2020, and 2021, as well as the three years consecutively.
Results The medical records of 150 patients with hemophilia B between January 1, 2019, and December 31, 2021, were collected. Among these, 72 (48.0%) were severe, 47 (31.3%) were moderate, and 28 (18.7%) were mild. The results showed approximately two times more patients receiving prophylaxis as those receiving on-demand therapy, with 66.1% of patients receiving prophylaxis in 2019, 64.9% in 2020, and 72.1% in 2021. Annualized bleeding rates were 2.2% (± 3.1) in 2019, 1.8% (± 3.0) in 2020, and 1.8% (± 2.9) in 2021 among patients receiving prophylaxis. For the doses of factor IX concentrate, patients receiving prophylaxis received an average of 41.6 (± 11.9) IU/Kg/Injection in 2019, 45.7 (± 12.9) IU/Kg/Injection in 2020, and 60.1 (± 24.0) IU/Kg/Injection in 2021.
Conclusions Clinically, prophylaxis is more prevalent than reported. Based on insights gained from current clinical evidence, it is expected that the unmet medical needs of patients can be identified, and physicians can evaluate the status of patients and actively manage hemophilia B using more effective treatment strategies.
Keywords: Hemophilia B, Clinical data, Prophylaxis, Treatment regimen
Table 1 . Baseline demographic and clinical characteristics of study participants, 2019–2021 (N = 150).
Variables All | patients | |
---|---|---|
n | % | |
Sex | ||
Female | 3 | 2.0 |
Male | 147 | 98.0 |
Age (years)a | ||
Mean (SD) | 28.8 | (19.3) |
Median | 23 | |
Min | 1 | |
Max | 86 | |
Age Group | ||
< 12 years | 33 | 22.0 |
> = 12 to < 20 years | 29 | 19.3 |
> = 20 to < 40 years | 47 | 31.3 |
> = 40 to < 60 years | 29 | 19.3 |
> = 60 years | 12 | 8.0 |
Blood Types (Category) | ||
O | 25 | 17.0 |
Non-O (A, B, and AB) | 72 | 48.0 |
UK | 53 | 35.0 |
Weight (Kg, at the most recent visit) | ||
N | 146 | |
Mean (SD) | 62.3 | (24.8) |
Median | 64.3 | |
Min | 10.0 | |
Max | 120.0 | |
Medical status (allows duplication) | ||
Acquired immunodeficiency syndrome | 0 | |
Chronic bronchitis | 2 | |
Chronic hepatitis B | 2 | |
Chronic hepatitis C / Hepatitis C | 7 | |
Hepatitis C RNA negative (-) | 5 | |
Not reported RNA results | 2 | |
Diabetes mellitus | 0 | |
Hemophilic arthropathy | 3 | |
Hypertension | 0 | |
Osteonecrosis | 9 | |
Experience of life-threatening bleeding (baseline history) | ||
Intracranial Hemorrhage | 4 | 2.7 |
Intra-abdominal Hemorrhage | 4 | 2.7 |
Severity of Hemophilia B (N = 150) | ||
Mild | 28 | 18.7 |
Moderate | 47 | 31.3 |
Severe | 72 | 48.0 |
NR | 3 | 2.0 |
NR not reported, UK Unknown.
a Age was calculated as of 01 September, 2022.
Table 2 . Annualized bleeding rates (ABR) and drug dose among patients receiving prophylaxis.
Mean | (SD) | Median | Min | Max | ||
---|---|---|---|---|---|---|
ABR | ||||||
2019 (n = 38) | Total | 2.2 | 3.1 | 1.0 | 0 | 12.0 |
Mild (n = 1) | 4.0 | - | - | - | - | |
Moderate (n = 10) | 0.9 | 1.0 | 0.5 | 0 | 3.0 | |
Severe (n = 27) | 2.6 | 3.5 | 1.0 | 0 | 12.0 | |
2020 (n = 45) | Total | 1.8 | 3.0 | 1.0 | 0 | 14.0 |
Mild (n = 3) | 1.3 | 1 | 1.0 | 0 | 3.0 | |
Moderate (n = 12) | 0.6 | 0.9 | 0 | 0 | 3.0 | |
Severe (n = 30) | 2.4 | 3.4 | 1.0 | 0 | 14.0 | |
2021 (n = 45) | Total | 1.8 | 2.9 | 1.0 | 0 | 13.0 |
Mild (n = 2) | 3.5 | 3.5 | 3.5 | 0 | 7.0 | |
Moderate (n = 12) | 1.5 | 3.0 | 0.5 | 0 | 11.0 | |
Severe (n = 31) | 1.7 | 2.8 | 1.0 | 0 | 13.0 | |
Dosea (IU/Kg/1 injection) | ||||||
2019 | Total (n = 38) | 41.6 | 11.9 | 41.5 | 22.4 | 85.9 |
2020 | Total (n = 39) | 45.7 | 12.9 | 43.1 | 18.4 | 79.8 |
2021 | Total (n = 37) | 60.1 | 24.0 | 52.1 | 32.2 | 128.9 |
a Only patients who were receiving the standard half-life (SHL) agents in each year was analyzed.
Table 3 . Annualized bleeding rates (ABR) and drug dose among patients receiving on-demand treatment.
Mean | (SD) | Median | Min | Max | ||
---|---|---|---|---|---|---|
ABR | ||||||
2019 (n = 19) | Total | 2.2 | 3.2 | 1.0 | 0 | 14.0 |
Mild (n = 5) | 0.8 | 0.4 | 1.0 | 0 | 1 | |
Moderate (n = 7) | 2.6 | 4.7 | 1.0 | 0 | 14.0 | |
Severe (n = 7) | 2.8 | 2.0 | 2.0 | 0 | 7.0 | |
2020 (n = 26) | Total | 1.9 | 3.0 | 1.0 | 0 | 14.0 |
Mild (n = 10) | 0.9 | 0.7 | 1.0 | 0 | 2.0 | |
Moderate (n = 9) | 2.3 | 4.2 | 1.0 | 0 | 14.0 | |
Severe (n = 7) | 2.9 | 3.0 | 2.0 | 0 | 10.0 | |
2021 (n = 19) | Total | 1.8 | 1.8 | 1.0 | 0 | 8.0 |
Mild (n = 4) | 0.8 | 0.4 | 1.0 | 0 | 1.0 | |
Moderate (n = 7) | 2.3 | 2.5 | 1.0 | 0 | 8.0 | |
Severe (n = 8) | 2.0 | 1.1 | 1.5 | 0 | 4 | |
Dosea (IU/Kg/1 injection) | ||||||
2019 | Total (n = 19) | 41.0 | 16.1 | 37.7 | 15.9 | 77.8 |
2020 | Total (n = 26) | 55.6 | 43.6 | 46.8 | 23.4 | 228.2 |
2021 | Total (n = 19) | 55.3 | 23.5 | 47.7 | 31.0 | 134.2 |
a Only patients who were receiving the standard half-life (SHL) agents in each year was analyzed.
Table 4 . Dose among patients receiving prophylaxis during three consecutive years (n = 24).
Mean | (SD) | Median | Min | Max | |
---|---|---|---|---|---|
ABR | |||||
3-year averagea | 2.0 | (3.1) | 0.7 | 0 | 13 |
2019 | 2.3 | (3.5) | 1.0 | 0 | 12 |
2020 | 2.3 | (3.3) | 1.0 | 0 | 14 |
2021 | 1.5 | (3.0) | 0.0 | 0 | 13 |
Dose (IU/Kg/1 injection) | |||||
2019 | 41.8 | (9.3) | 41.5 | 23.0 | 64.2 |
2020 | 44.5 | (8.5) | 44.8 | 26.0 | 57.7 |
2021 | 62.9 | (28.2) | 51.5 | 32.2 | 128.9 |
a Average of 3-year average ABR per patient.
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