Currently approved extended half-life factor concentrates in the US
| Name . | Mechanism of half-life extension . | Half-life (hours)a . | Surgical recommendations (where available in package inset) . | Reference . |
|---|---|---|---|---|
| Hemophilia A | ||||
| Efraloctocog alfa (rFVIII-Fc; Eloctate) | Fc fusion | 19.7 | 35 | |
| Octocog alfa pegol (BAX855; Adynovate) | Pegylation | 14.7 | 36 | |
| Turoctocog alfa pegol (N8-GP; Esperoct) | Glycopegylation | 21.7 | For minor/major surgery: in adolescents/adults: preoperative dose of 50 IU/kg body weight; in children (<12 years), preoperative dose of 65 IU/kg body weight. Frequency of administration is determined by the treating physician. | 37 |
| Damoctocog alfa pegol (BAY94-9027; Jivi) | Pegylation | 17.4 | 38 | |
| Hemophilia B | ||||
| rFIX-Fc; Alprolix | Fc fusion | 97 | Minor surgery: a single infusion to reach FIX level of 50-80 IU/dL may be sufficient. Repeat as needed after 24-48 hours until bleeding stops and healing is achieved. Major surgery: initial infusion to reach FIX level of 60-100 IU/dL. Consider a repeat dose after 6-10 hours and then every 24 hours for the first 3 days and then every 48 hours until bleeding stops and healing is achieved. | 39 |
| rFIX-FP; Idelvion | Albumin fusion | 104 | 40 | |
| Nonacog beta pegol (N9-GP; Rebinyn) | Pegylation | 83.0 after single dose, 114.9 at steady state | Minor surgery: preop dose of 40 IU/kg Major surgery: preop dose of 80 IU/kg, then, as clinically needed for the perioperative management of bleeding, repeated doses of 40 IU/kg (in 1-3 day intervals) within the first week after major surgery may be administered. Frequency may be extended to once weekly after the first week until bleeding stops and healing is achieved | 41 |
| Name . | Mechanism of half-life extension . | Half-life (hours)a . | Surgical recommendations (where available in package inset) . | Reference . |
|---|---|---|---|---|
| Hemophilia A | ||||
| Efraloctocog alfa (rFVIII-Fc; Eloctate) | Fc fusion | 19.7 | 35 | |
| Octocog alfa pegol (BAX855; Adynovate) | Pegylation | 14.7 | 36 | |
| Turoctocog alfa pegol (N8-GP; Esperoct) | Glycopegylation | 21.7 | For minor/major surgery: in adolescents/adults: preoperative dose of 50 IU/kg body weight; in children (<12 years), preoperative dose of 65 IU/kg body weight. Frequency of administration is determined by the treating physician. | 37 |
| Damoctocog alfa pegol (BAY94-9027; Jivi) | Pegylation | 17.4 | 38 | |
| Hemophilia B | ||||
| rFIX-Fc; Alprolix | Fc fusion | 97 | Minor surgery: a single infusion to reach FIX level of 50-80 IU/dL may be sufficient. Repeat as needed after 24-48 hours until bleeding stops and healing is achieved. Major surgery: initial infusion to reach FIX level of 60-100 IU/dL. Consider a repeat dose after 6-10 hours and then every 24 hours for the first 3 days and then every 48 hours until bleeding stops and healing is achieved. | 39 |
| rFIX-FP; Idelvion | Albumin fusion | 104 | 40 | |
| Nonacog beta pegol (N9-GP; Rebinyn) | Pegylation | 83.0 after single dose, 114.9 at steady state | Minor surgery: preop dose of 40 IU/kg Major surgery: preop dose of 80 IU/kg, then, as clinically needed for the perioperative management of bleeding, repeated doses of 40 IU/kg (in 1-3 day intervals) within the first week after major surgery may be administered. Frequency may be extended to once weekly after the first week until bleeding stops and healing is achieved | 41 |
Based on one-stage clotting assay in adults, half-life tends to be shorter in children.
The half-lives of the different CFC products should not be directly compared. Each patient experiences different pharmacokinetics, and the patient populations were not the same in the individual studies of different CFC products. To date, there has never been a comparison study of pharmacokinetics of different CFC products.
Data reproduced with permission of Ling, Nathwani, and Tuddenham.34