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Kulkarni R, James AH, Norton M, Shapiro A. Efficacy, safety and pharmacokinetics of a new high-purity factor X concentrate in women and girls with hereditary factor X deficiency. J Thromb Haemost 2018; 16:849-857. [PMID: 29460388 DOI: 10.1111/jth.13983] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Indexed: 08/31/2023]
Abstract
Essentials Plasma-derived factor X concentrate (pdFX) is used to treat hereditary factor X deficiency. pdFX pharmacokinetics, safety and efficacy were assessed in factor X-deficient women/girls. Treatment success rate was 98%; only 6 adverse events in 2 subjects were possibly pdFX related. On-demand pdFX 25 IU kg-1 was effective and safe in women/girls with factor X deficiency. SUMMARY Background A high-purity, plasma-derived factor X concentrate (pdFX) has been approved for the treatment of hereditary FX deficiency, an autosomal recessive disorder. Objective To perform post hoc assessments of pdFX pharmacokinetics, safety and efficacy in women and girls with hereditary FX deficiency. Patients/Methods Subjects aged ≥ 12 years with moderate/severe FX deficiency (plasma FX activity of < 5 IU dL-1 ) received on-demand or preventive pdFX (25 IU kg-1 ) for ≤ 2 years. Results Of 16 enrolled subjects, 10 women and girls (aged 14-58 years [median, 25.5 years]) received 267 pdFX infusions. Mean monthly infusions per subject were higher among women and girls (2.48) than among men and boys (1.62). In women and girls, 132 assessable bleeding episodes (61 heavy menstrual bleeds, 47 joint bleeds, 15 muscle bleeds, and nine other bleeds) were treated with pdFX, with a 98% treatment success rate versus 100% in men and boys. Mean pdFX incremental recovery was similar in the two groups (2.05 IU dL-1 versus 1.91 IU dL-1 per IU kg-1 ), as was the mean half-life (29.3 h versus 29.5 h). Of 142 adverse events in women and girls, headache was the most common (12 events in six subjects). Six events (two infusion-site erythema, two fatigue, one back pain, one infusion-site pain) in two subjects were considered to be possibly pdFX-related. Following the trial, pdFX was used to successfully maintain hemostasis in two subjects undergoing obstetric delivery. Conclusions pdFX was well tolerated and effective in women and girls with FX deficiency. Although women and girls had different bleeding symptoms and sites than men and boys, their pdFX pharmacokinetic profile was comparable.
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Carcao M, Shapiro A, Staber JM, Hwang N, Druzgal C, Lieuw K, Belletrutti M, Thornburg CD, Ahuja SP, Morales-Arias J, Dumont J, Miyasato G, Tsao E, Jain N, Pipe SW. Recombinant factor VIII Fc fusion protein for immune tolerance induction in patients with severe haemophilia A with inhibitors-A retrospective analysis. Haemophilia 2018; 24:245-252. [PMID: 29436077 DOI: 10.1111/hae.13413] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Immune tolerance induction (ITI) is the gold standard for eradication of factor VIII inhibitors in severe haemophilia A; however, it usually requires treatment for extended periods with associated high burden on patients and healthcare resources. AIM Review outcomes of ITI with recombinant factor VIII Fc fusion protein (rFVIIIFc) in patients with severe haemophilia A and high-titre inhibitors. METHODS Multicentre retrospective chart review of severe haemophilia A patients treated with rFVIIIFc for ITI. RESULTS Of 19 patients, 7 were first-time ITI and 12 were rescue ITI. Of 7 first-time patients, 6 had at least 1 high-risk feature for ITI failure. Four of 7 first-time patients were tolerized in a median of 7.8 months. The remaining 3 patients continue on rFVIIIFc ITI. Of 12 rescue patients, 7 initially achieved a negative Bethesda titre (≤0.6) in a median of 3.3 months, 1 had a decrease in Bethesda titre and continues on rFVIIIFc ITI and 4 have not demonstrated a decrease in Bethesda titre. Of these 4, 3 continue on rFVIIIFc ITI and 1 switched to bypass therapy alone. Two initially responsive patients transitioned to other factors due to recurrence. Overall, 16 of 19 patients remain on rFVIIIFc (prophylaxis or ITI). For those still undergoing ITI, longer follow-up is needed to determine final outcomes. No adverse events reported. CONCLUSIONS Recombinant factor VIII Fc fusion protein demonstrated rapid time to tolerization in high-risk first-time ITI patients. For rescue ITI, rFVIIIFc showed therapeutic benefit in some patients who previously failed ITI with other products. These findings highlight the need to further evaluate the use of rFVIIIFc for ITI.
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Karimi M, Peyvandi F, Naderi M, Shapiro A. Factor XIII deficiency diagnosis: Challenges and tools. Int J Lab Hematol 2017; 40:3-11. [PMID: 29027765 DOI: 10.1111/ijlh.12756] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 09/06/2017] [Indexed: 01/06/2023]
Abstract
Factor XIII deficiency (FXIIID) is a rare hereditary bleeding disorder arising from heterogeneous mutations, which can lead to life-threatening hemorrhage. The diagnosis of FXIIID is challenging due to normal standard coagulation assays requiring specific FXIII assays for diagnosis, which is especially difficult in developing countries. This report presents an overview of FXIIID diagnosis and laboratory methods and suggests an algorithm to improve diagnostic efficiency and prevent missed or delayed FXIIID diagnosis. Assays measuring FXIII activity: The currently available assays utilized to diagnose FXIIID, including an overview of their complexity, reliability, sensitivity, and specificity, as well as mutational analysis are reviewed. The use of a FXIII inhibitor assay is described. Diagnostic tools in FXIIID: Many laboratories are not equipped with quantitative FXIII activity assays, and if available, limitations in lower activity ranges are important to consider. Clot solubility tests are not standardized, have a low sensitivity, and are therefore not recommended as routine screening test; however, they are the first screening test in almost all coagulation laboratories in developing countries. To minimize the number of patients with undiagnosed FXIIID, test quality should be improved in less well-equipped laboratories. Common country-specific mutations may facilitate diagnosis through targeted genetic analysis in reference laboratories in suspected cases. However, genetic analysis may not be feasible in every country and may miss spontaneous mutations. Centralized FXIII activity measurements should also be considered. An algorithm for diagnosis of FXIIID including different approaches dependent upon laboratory capability is proposed.
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Shapiro A, Trujillo E, Taylor C, Mills J, Johnson S, Spees C. Malnutrition Screening: An Underutilized Screening Tool for Outpatient Oncology Patients. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.06.127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Shapiro A, Holden E, McGovern P, Alderson D, Morelli S. Screening for pre-diabetes in infertile women: how predictive is hemoglobin A1c? Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cooney T, Shapiro A, Tate C. END-OF-LIFE PLANNING AND DECISION-MAKING: THE IMPORTANCE OF FAMILY TIES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Soucie JM, Grosse SD, Siddiqi AEA, Byams V, Thierry J, Zack MM, Shapiro A, Duncan N. The effects of joint disease, inhibitors and other complications on health-related quality of life among males with severe haemophilia A in the United States. Haemophilia 2017; 23:e287-e293. [PMID: 28574229 DOI: 10.1111/hae.13275] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2017] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Health-related quality of life (HRQoL) is reduced among persons with haemophilia. Little is known about how HRQoL varies with complications of haemophilia such as inhibitors and joint disease. Estimates of preference-based HRQoL measures are needed to model the cost-effectiveness of prevention strategies. AIM We examined the characteristics of a national sample of persons with severe haemophilia A for associations with two preference-based measures of HRQoL. METHODS We analysed utility weights converted from EuroQol 5 Dimensions (EQ-5D) and the Short Form 6 Dimensions (SF-6D) scores from 1859 males aged ≥14 years with severe haemophilia A treated at 135 US haemophilia treatment centres in 2005-2011. Bivariate and regression analyses examined age-group-specific associations of HRQoL with inhibitor status, overweight/obesity, number of bleeds, viral infections, indicators of liver and joint disease, and severe bleeding at the time of the first HRQoL measurement. RESULTS Overall mean HRQoL utility weight values were 0.71 using the SF-6D and 0.78 using the EQ-5D. All studied patient characteristics except for overweight/obesity were significantly associated with HRQoL in bivariate analyses. In a multivariate analysis, only joint disease was significantly associated with utility weights from both HRQoL measures and across all age groups. After adjustment for joint disease and other variables, the presence of an inhibitor was not significantly associated with HRQoL scores from either of the standardized assessment tools. CONCLUSION Clinically significant complications of haemophilia, especially joint disease, are strongly associated with HRQoL and should be accounted for in studies of preference-based health utilities for people with haemophilia.
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Sharma R, Dunn A, Aschman D, Cheng D, Wheeler A, Soni A, McGuinn C, Knoll C, Stein DT, Young G, French J, Sanders J, Davis JA, Tarantino M, Lim M, Gruppo R, Sidonio R, Ahuja S, Carpenter S, Pipe S, Shapiro A. Radionuclide synovectomy/synoviorthesis (RS) in persons with bleeding disorders: A review of impact of national guidance on frequency of RS using the ATHNdataset. Haemophilia 2017; 23:e385-e388. [DOI: 10.1111/hae.13273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2017] [Indexed: 11/29/2022]
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Rodriguez LF, Shapiro A. Evaluation of Gamma-Ray Shielding Calculations and Determination of Shielding Parameters with Bremsstrahlung Radiation. NUCL SCI ENG 2017. [DOI: 10.13182/nse72-a22547] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Jain S, Gupta S, Ambrusko SJ, Shapiro A. Successful management of refractory haematuria with recombinant porcine factor VIII replacement for paediatric congenital haemophilia A with high-titre inhibitor. Haemophilia 2017; 23:e358-e361. [PMID: 28474428 DOI: 10.1111/hae.13240] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2017] [Indexed: 11/29/2022]
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Shapiro A, Barad D, Darmon S, Albertini D, Gleicher N, Kushnir V. Effect of race and ethnicity on live birth rates in third-party ART cycles in the U.S. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.1043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kushnir V, Shapiro A, Barad D, Darmon S, Albertini D, Gleicher N. Effect of race and ethnicity on fertility rates and utilization of ART in the USA. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.1044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Shapiro A, Barad D, Darmon S, Albertini D, Gleicher N, Kushnir V. Racial and ethnic disparities in the use of third-party art in the U.S. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Austin SK, Kavakli K, Norton M, Peyvandi F, Shapiro A, Román MÁ, Auerswald G, Vega NB, Celkan T, Huang JN, Beau Mitchell W, Oner AF, Pavord S, Timur C. Efficacy, safety and pharmacokinetics of a new high‐purity factor X concentrate in subjects with hereditary factor X deficiency. Haemophilia 2016; 22:419-25. [DOI: 10.1111/hae.12893] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2015] [Indexed: 02/05/2023]
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Austin SK, Brindley C, Kavakli K, Norton M, Shapiro A, Román MÁ, Auerswald G, Vega NB, Celkan T, Huang JN, Beau Mitchell W, Oner AF, Pavord S, Timur C. Pharmacokinetics of a high‐purity plasma‐derived factor X concentrate in subjects with moderate or severe hereditary factor X deficiency. Haemophilia 2016; 22:426-32. [DOI: 10.1111/hae.12894] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2015] [Indexed: 11/26/2022]
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Petrikovets A, Shapiro A, Shakiba K. Robotic Excision of Migrated Inguinal Hernia Mesh into the Paravesical Space. J Minim Invasive Gynecol 2015; 22:S152-S153. [DOI: 10.1016/j.jmig.2015.08.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Shapiro A. Comments on "Quantifying Adventitious Error in a Covariance Structure as a Random Effect" by Hao Wu and Michael Browne. PSYCHOMETRIKA 2015; 80:611-612. [PMID: 25813466 DOI: 10.1007/s11336-015-9454-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Indexed: 06/04/2023]
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Kruse‐Jarres R, St‐Louis J, Greist A, Shapiro A, Smith H, Chowdary P, Drebes A, Gomperts E, Bourgeois C, Mo M, Novack A, Farin H, Ewenstein B. Efficacy and safety ofOBI‐1, an antihaemophilic factorVIII(recombinant), porcine sequence, in subjects with acquired haemophilia A. Haemophilia 2015; 21:162-170. [DOI: 10.1111/hae.12627] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2015] [Indexed: 11/28/2022]
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Nakar C, Manco-Johnson MJ, Lail A, Donfield S, Maahs J, Chong Y, Blades T, Shapiro A. Prompt immune tolerance induction at inhibitor diagnosis regardless of titre may increase overall success in haemophilia A complicated by inhibitors: experience of two US centres. Haemophilia 2015; 21:365-373. [DOI: 10.1111/hae.12608] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2014] [Indexed: 01/19/2023]
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Shapiro A, Kistler W. Facial feature changes are hard to track in the color wagon-wheel illusion. J Vis 2014. [DOI: 10.1167/14.10.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Lock J, Raat H, Duncan N, Shapiro A, Beijlevelt M, Peters M, Tamminga RYJ, Leebeek FWG, Moll HA, Cnossen MH. Adherence to treatment in a Western European paediatric population with haemophilia: reliability and validity of the VERITAS-Pro scale. Haemophilia 2014; 20:616-23. [DOI: 10.1111/hae.12463] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2014] [Indexed: 11/29/2022]
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Ricordi C, Hering B, Bridges N, Eggerman T, Naji A, Posselt A, Stock P, Kaufman D, Larsen C, Turgeon N, Oberholzer J, Barbaro B, Korsgren O, Markmann J, Alejandro R, Rickels M, Senior P, Luo X, Zhang X, Bellin M, Lei J, Clarke W, Hunsicker L, Goldstein J, Czarniecki C, Priore A, Green N, Shapiro A. Completion of the first FDA phase 3 multicenter trial of Islet transplantation in type 1 diabetes by the NIH CIT consortium. Cytotherapy 2014. [DOI: 10.1016/j.jcyt.2014.01.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Hoots WK, Blanchette V, Shapiro A, Navale L, Spotts G, Rogy S, Ewenstein B. Clinical evaluation of an advanced category recombinant FVIII, anti-hemophilic factor (recombinant) plasma/albumin-free method (rAHF-PFM) in pediatric previously treated patients (PTPs). J Thromb Haemost 2014. [DOI: 10.1111/j.1538-7836.2003.tb05382.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Duncan N, Roberson C, Lail A, Donfield S, Shapiro A. A haemophilia disease management programme targeting cost and utilization of specialty pharmaceuticals. Haemophilia 2014; 20:519-26. [PMID: 24456125 DOI: 10.1111/hae.12370] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2013] [Indexed: 11/26/2022]
Abstract
The high cost of clotting factor concentrate (CFC) used to treat haemophilia and von Willebrand disease (VWD) attracts health plans' attention for cost management strategies such as disease management programmes (DMPs). In 2004, Indiana's high risk insurance health plan, the Indiana Comprehensive Health Insurance Association, in partnership with the Indiana Hemophilia and Thrombosis Center developed and implemented a DMP for beneficiaries with bleeding disorders. This report evaluates the effectiveness of the DMP 5 years post implementation, with specific emphasis on the cost of CFC and other medical expenditures by severity of disease. A pre/post analysis was used. The main evaluation measures were total cost, total outpatient CFC IU dispensed and adjusted total outpatient CFC cost. Summary statistics and mean and median plots were calculated. Overall, 1000 non-parametric bootstrap replicates were created and percentile confidence limits for 95% confidence intervals (CI) are reported. Mean emergency department (ED) visits and mean and median duration of hospitalizations are also reported. The DMP was associated with a significant decrease in mean annualized total cost including decreased CFC utilization and cost in most years in the overall group, and specifically in patients with severe haemophilia. Patients with mild and moderate haemophilia contributed little to overall programme expenditures. This specialty health care provider-administered DMP exemplifies the success of targeted interventions developed and implemented through a health care facility expert in the disease state to curb the cost of specialty pharmaceuticals in conditions when their expenditures represent a significant portion of total annual costs of care.
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