Pharmacokinetics of a novel extended half-life glycoPEGylated factor IX, nonacog beta pegol (N9-GP) in previously treated patients with haemophilia B: results from two phase 3 clinical trials

Haemophilia. 2017 Jul;23(4):547-555. doi: 10.1111/hae.13191. Epub 2017 Feb 24.

Abstract

Introduction: Nonacog beta pegol (N9-GP) is a glycoPEGylated recombinant factor IX (FIX) with an extended half-life developed for routine prophylaxis and the prevention and treatment of bleeding episodes in patients with haemophilia B.

Aim: The aim of this study was to evaluate the pharmacokinetics (PK) of N9-GP.

Methods: Data from 41 previously treated haemophilia B patients, enrolled globally (16 adolescents/adults and 25 children; FIX activity ≤0.02 IU mL-1 ) with no history of FIX inhibitors, were included. N9-GP was administered once-weekly as 10 IU kg-1 or 40 IU kg-1 in adolescents/adults and 40 IU kg-1 in children. Blood was sampled up to 168 h (1 week) post dose. Standard PK was estimated on the basis of plasma FIX activity vs. time (PK profiles) using non-compartmental methods. Furthermore, a population PK analysis and FIX activity predictions were performed.

Results: Incremental recoveries were 0.02 (IU mL-1 )/(IU kg-1 ) in both adolescents/adults and children. The extended half-life resulted in mean trough levels of 0.27 IU mL-1 for adolescents/adults and 0.17 IU mL-1 for children at steady-state after weekly dosing at 40 IU kg-1 . The population PK analysis confirmed a mono-exponential decay in FIX activity and allowed for predictions of FIX activity for adolescents/adults above 0.15 IU mL-1 at all times and 6.4 days week-1 in children.

Conclusion: N9-GP has the potential to shift previously treated haemophilia B patients from a severe/moderate disease state into a mild- or non-haemophilic range for most of the dosing interval, which is expected to reduce the number of bleeding episodes.

Keywords: blood coagulation disorders; extended half-life; haemophilia B; nonacog beta pegol; pharmacokinetics.

Publication types

  • Clinical Trial, Phase III

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Dose-Response Relationship, Drug
  • Factor IX / pharmacokinetics*
  • Factor IX / therapeutic use
  • Hemophilia B / drug therapy*
  • Hemophilia B / metabolism*
  • Humans
  • Male
  • Polyethylene Glycols / pharmacokinetics*
  • Polyethylene Glycols / therapeutic use
  • Recombinant Proteins / pharmacokinetics
  • Recombinant Proteins / therapeutic use
  • Tissue Distribution

Substances

  • Recombinant Proteins
  • nonacog beta pegol
  • Polyethylene Glycols
  • Factor IX