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Blood, 15 January 2005, Vol. 105, No. 2, pp. 518-525.
Prepublished online as a Blood First Edition Paper on September 21, 2004; DOI 10.1182/blood-2004-06-2283.


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Submitted June 22, 2004
Accepted August 31, 2004

The safety and efficacy of recombinant human blood coagulation factor IX in previously untreated patients with severe or moderately severe hemophilia B

Amy D Shapiro*, Jorge Di Paola, Alice Cohen, John Pasi, Margaret A Heisel, Victor S Blanchette, Thomas C Abshire, W K Hoots, Jeanne M Lusher, Claude Negrier, Chantal Rothschild, and David A Roth

Indiana Hemophilia and Thrombosis Center, Indianapolis, IN, USA
Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Newark Beth Israel Medical Center, Newark, NJ, USA
Royal Free Hampstead NHS Trust, Royal Free Hospital, London, UK
Minneapolis Children's Medical Center, Minneapolis, MN, USA
Department of Pediatrics, University of Toronto, Toronto, Canada
Emory University, AFLAC Cancer Center and Blood Disorders Service, Atlanta, GA, USA
Gulf States Hemophilia Diagnostic HPB and Treatment Center, University of Texas-Houston Medical School, Houston, TX, USA
Division of Hematology, Children's Hospital of Michigan, Detroit, MI, USA
Centre Regional de Traitement de l'Hemophilie, Hopital Edouard Herriot, Lyon, France
Centre de Traitements de l'Hemophilie, Groupe Hopitalier Necker-Enfants Malades, Paris, France
Wyeth Research, Cambridge, MA, USA

* Corresponding author; email: ashapiro{at}ihtc.org.

This international clinical trial evaluated the safety and efficacy of recombinant factor IX (rFIX) in previously untreated patients (PUPs) with severe or moderately severe hemophilia B(FIX activity ≤3 IU/dL). Sixty-three PUPs aged <1 month to 14 years received rFIX (median treatment duration: 37 months; range: 4{Rightarrow}64 months). Mean rFIX recovery (0.68±0.27 IU/dL per IU/kg) remained constant over 5 years and was similar in infants (1 month to <2 years) and children (2 to <12 years). Fifty-four PUPs used rFIX (median dose: 62.7 IU/kg per infusion; range: 8.2-292 IU/kg) to treat 997 hemorrhages. Bleeding was well controlled, with 75% of hemorrhages requiring only one rFIX infusion. Response to rFIX was 'excellent' or 'good' in 94% of cases. Effective hemostasis was achieved in 32 PUPs receiving rFIX for routine prophylaxis, with 91% of prophylaxis responses rated 'excellent'. rFIX administered for 30 surgical procedures in 23 PUPs achieved hemostasis for all rated procedures. Five patients experienced allergic-type manifestations, including 2 (3%) patients who developed FIX inhibitors (both >5 BU/dL). rFIX was well tolerated, with no associated thrombotic events or evidence of viral transmission. These data indicate that rFIX is a safe and effective treatment for PUPs with hemophilia B.


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