ALPROLIX® provides extensive clinical trial experience
ALPROLIX has the longest duration of patient exposure of any extended half-life factor IX on the market2,3
- ALPROLIX has been studied in 153 adult, adolescent, and pediatric males with severe hemophilia B
- ALPROLIX was studied in 2 phase 3 pivotal trials, B-LONG and Kids B-LONG, and an extension trial, B-YOND
Median duration of ALPROLIX exposure through the first B-YOND interim data cut:
in adult patients
in children aged <12 years
Click for the Kids B-LONG
phase 3 study
- A multicenter, open-label study from May 2012 to November 2014 of 30 previously treated pediatric males
- All subjects were treated prophylactically before the study; 15 patients were <6 years of age and 15 patients were 6 to 11 years of age
- All 30 enrolled patients were included in the safety analysis
- All patients received a starting dose of 50 to 60 IU/kg once weekly
- Subsequent doses could be adjusted to a maximum of 100 IU/kg; subsequent dose intervals could be adjusted to a maximum of 2 times per week or a minimum of once per week
Click for the B-LONG
phase 3 study
- A nonrandomized, open-label, multicenter study of 123 previously treated adult and adolescent males between January 2010 and July 2012
- The study included 4 treatment arms: fixed-interval (weekly) prophylaxis, fixed-dose (interval-adjusted) prophylaxis, on-demand treatment, and perioperative treatment
- Patients in the fixed-interval prophylaxis arm (n=63) were initially treated with 50 IU/kg every 7 days, with the dose adjusted as needed
- Patients in the fixed-dose group (n=29) received 100 IU/kg every 10 days, with the interval adjusted as needed
- Patients in the on-demand treatment arm (n=27) received 20 to 100 IU/kg, with the dose adjusted based on bleeding severity
- Patients in the perioperative arm (n=12) received treatment with the dose adjusted based on the type of surgical procedure (40-100 IU/kg)
Click for the B-YOND
- The extension trial enrolled 23 pediatric and 93 adult and adolescent patients who previously completed Kids B-LONG or B-LONG
- The treatment arms included fixed-interval (weekly) prophylaxis, fixed-dose (interval-adjusted) prophylaxis, modified prophylaxis, and on-demand (episodic) treatment
- The on-demand treatment arm was open only to patients aged ≥12 years
- Patients in the fixed-interval arm received 20 to 100 IU/kg every 7 days
- Patients in the fixed-dose prophylaxis arm received 100 IU/kg every 8 to 16 days
- The modified prophylaxis arm allowed investigators to personalize dosing to optimize prophylaxis
Important Safety Information
CONTRAINDICATIONS: ALPROLIX® is contraindicated in patients who have a known history of hypersensitivity reactions, including anaphylaxis, to the product or its excipients.
WARNINGS AND PRECAUTIONS: Allergic-type hypersensitivity reactions, including anaphylaxis, are possible with factor replacement therapies, and have been reported with ALPROLIX. Discontinue use of ALPROLIX if hypersensitivity symptoms occur, and initiate appropriate treatment.
Formation of neutralizing antibodies (inhibitors) to Factor IX has been reported following administration of ALPROLIX, including in previously untreated patients. Patients using ALPROLIX should be monitored for the development of Factor IX inhibitors. Clotting assays (e.g., one-stage) may be used to confirm that adequate Factor IX levels have been achieved and maintained.
The use of Factor IX products has been associated with the development of thromboembolic complications.
Nephrotic syndrome has been reported following attempted immune tolerance induction in hemophilia B patients with Factor IX inhibitors and a history of allergic reactions to Factor IX. The safety and efficacy of using ALPROLIX for immune tolerance induction have not been established.
ADVERSE REACTIONS: Common adverse reactions (incidence ≥1%) observed in clinical trials were headache, oral paresthesia, and obstructive uropathy.
- On-demand treatment and control of bleeding episodes
- Perioperative management of bleeding
- Routine prophylaxis to reduce the frequency of bleeding episodes
Please see Full Prescribing Information.
References: 1. Fischer K, Kulkarni R, Nolan B, et al. Recombinant factor IX Fc fusion protein in children with haemophilia B (Kids B-LONG): results from a multicentre, non-randomised phase 3 study. Lancet Haematol. 2017;4:e75-e82. 2. ALPROLIX® [package insert]. Waltham, MA: Bioverativ®, a Sanofi Company; 2018. 3. Pasi KJ, Fischer K, Ragni M, et al. Long-term safety and efficacy of extended-interval prophylaxis with recombinant factor IX Fc fusion protein (rFIXFc) in subjects with haemophilia B. Thromb Haemost. 2017;117:508-518. 4. Powell JS, Pasi KJ, Ragni MV, et al. Phase 3 study of recombinant factor IX Fc fusion protein in hemophilia B. N Engl J Med. 2013;369(24):2313-2323. 5. Data on file, Bioverativ®, a Sanofi Company. 6. Blanchette VS, Key NS, Ljung LR, Manco-Johnson MJ, van den Berg HM, Srivastava A. Definitions in hemophilia: communication from the SSC of the ISTH. J Thromb Haemost. 2014;12:1935-1939. 7. Iorio A, Fischer K, Blanchette V, et al. Tailoring treatment of haemophilia B: accounting for the distribution and clearance of standard and extended half-life FIX concentrates. Thromb Haemost. 2017;117(6):1023-1030. 8. Diao L, Li S, Ludden T, Gobburu J, Nestorov I, Jiang H. Population pharmacokinetic modelling of recombinant factor IX Fc fusion protein (rFIXFc) in patients with haemophilia B. Clin Pharmacokinet. 2014;53:467-477. 9. Björkman S. Population pharmacokinetics of recombinant factor IX: implications for dose tailoring. Haemophilia. 2013;19:753‐757. 10. IDELVION® [package insert]. Marburg, Germany: CSL Behring GmbH; 2017. 11. AlphaNine® SD [package insert]. Los Angeles, CA: Grifols Biologicals Inc; 2017. 12. BeneFIX® [package insert]. Philadelphia, PA: Wyeth Pharmaceuticals Inc, a subsidiary of Pfizer Inc; 2017. 13. Ixinity® [package insert]. Berwyn, PA: Aptevo BioTherapeutics LLC; 2016. 14. Mononine® [package insert]. Kankakee, IL: CSL Behring LLC; 2016. 15. Profilnine® [package insert]. Los Angeles, CA: Grifols Biologicals Inc; 2013. 16. Rixubis® [package insert]. Westlake Village, CA: Baxalta US Inc; 2016. 17. Rebinyn® [package insert]. Plainsboro, NJ: Novo Nordisk Inc; 2017. 18. Powell JS, Pasi KJ, Ragni MV, et al. Phase 3 study of recombinant factor IX Fc fusion protein in hemophilia B. N Engl J Med. 2013;369(suppl):1-14. https://www.nejm.org/doi/suppl/10.1056/NEJMoa1305074/suppl_file/nejmoa1305074_appendix.pdf. Accessed May 2, 2018. 19. Powell J, Shapiro A, Ragni M, et al. Switching to recombinant factor IX Fc fusion protein prophylaxis results in fewer infusions, decreased factor IX consumption and lower bleeding rates. Br J Haematol. 2015;168:113-123. 20. Kaneko Y, Nimmerjahn F, Ravetch JV. Anti-inflammatory activity of immunoglobulin G resulting from Fc sialylation. Science. 2006;313:670-673. 21. Shapiro A. Development of long-acting recombinant FVIII and FIX Fc fusion proteins for the management of hemophilia. Expert Opin Biol Ther. 2013;13(9):1287-1297. 22. National Hemophilia Foundation. Digital Hemophilia Treatment Center Monitoring Linked to Significant Reduction in Bleeding Rates. https://www.hemophilia.org/Newsroom/Medical-News/Digital-Hemophilia-Treatment-Center-Monitoring-Linked-to-Significant-Reduction-in-Bleeding-Rates. Accessed June 7, 2018.