News

Executively Speaking click-newsletter

 

We had a very busy summer here at FHA, so I’d like to use this opportunity to reflect on some of the programs and activities that have taken place. Summer started with a Girls Day Out at Painting With a Twist, where the ladies showed off their artistic chops. We hosted the 3rd annual Teen and Young Adult Retreat, an educational luncheon, and a Parents Empowering Parents “PEP” program in Spanish. The highlight of the summer was the 34th Annual Family Education Symposium, where over 350 people enjoyed a wonderful weekend filled with educational tracks, catching up with old friends, and lots of fun!

 

Be sure to read the newsletter in its entirety to find out more about some of these events. We also have more programs planned for fall, so be on the lookout for emails from us so that you can participate!

 

Last, but certainly not least, FHA is working closely with all of our national organizations to stay on top of the state of healthcare in Florida in this time of uncertainty. During the past several months we have sent out “action alerts” asking you to engage with your lawmakers and let them know what you need in healthcare reform. Your voices, and the voices of millions of other grassroots advocates around the country, have made a huge difference in the healthcare debate. We still have more work ahead of us, so please continue to help by taking action when needed!

 

See you soon!
 
Debbi Adamkin

Executive Director

 

 

Mensaje Ejecutivo

 

Tuvimos un verano bastante ocupado aquí en la FHA, por lo que me gustaría aprovechar esta oportunidad para reflexionar sobre algunos de los programas y actividades que se llevaron a cabo. El verano empezó con un día para las chicas pintar (Girls Day Out at Painting With a Twist), en el que las damas demostraron sus aptitudes artísticas. Fuimos los anfitriones del 3.º Retiro anual para adolescentes y jóvenes, un almuerzo educativo, y de un programa en español de Padres capacitando a padres (Parents Empowering Parents, “PEP”). El punto culminante del verano fue el 34.º Simposio anual para la educación de la familia, en el que más de 350 personas disfrutaron de un maravilloso fin de semana repleto de temas educativos, y tuvieron la oportunidad de ponerse al día con viejas amistades y disfrutar un montón.

 

No deje de leer el boletín informativo en su totalidad para saber más sobre algunas de estas actividades. También tenemos planeados más programas para el otoño; así es que esté al pendiente de los correos electrónicos que le enviamos, para que pueda participar.

 

Por último, pero no menos importante, la FHA está colaborando estrechamente con todas nuestras agrupaciones nacionales para dar seguimiento a la situación de la atención médica en Florida durante estos tiempos de incertidumbre. Durante los últimos meses, hemos enviado “llamados a la acción” en los que les pedimos que se pongan en contacto con sus legisladores para dejarles saber lo que necesitan en lo que se refiere a la reforma sanitaria. Sus voces, y las voces de millones de otros defensores comunitarios en todo el país, han hecho una gran diferencia en el debate sobre la atención médica. Todavía tenemos mucho trabajo por delante; así es que, por favor, ¡siga ayudando y tome medidas cuando sea necesario!

 

¡Nos vemos pronto!
 
Debbi Adamkin

Directora Ejecutiva

 

 

Product News

 

Genentech’s Emicizumab Showed Positive Results in Phase III Studies (HAVEN 1 And HAVEN 2) in Hemophilia A With Inhibitors

Emicizumab showed substantial and clinically meaningful reduction in bleeds across two pivotal studies

Data from HAVEN 1 in adults and adolescents and interim data from HAVEN 2 in children to be presented at the 26th International Society on Thrombosis and Haemostasis (ISTH) Meeting

South San Francisco, CA — June 25, 2017 –

Genentech, a member of the Roche Group (SIX: RO, ROG; OTCQX: RHHBY), announced today positive data from the primary analysis of the Phase III HAVEN 1 study in adults and adolescents and interim analysis of the Phase III HAVEN 2 study in children evaluating once-weekly subcutaneous emicizumab prophylaxis (preventative) for the treatment of hemophilia A with inhibitors to factor VIII. Data from both studies will be presented on July 10 at the 26th International Society on Thrombosis and Haemostasis (ISTH) Meeting in Berlin, Germany.

 

The Phase III HAVEN 1 study compared emicizumab prophylaxis with on-demand (no prophylaxis; episodic use only) and prophylactic use of bypassing agents (BPAs) in adults and adolescents with hemophilia A with inhibitors. The primary endpoint was treated bleeds, and results showed a statistically significant and clinically meaningful reduction in bleed rate of 87 percent (RR [risk rate]=0.13, p<0.0001) with emicizumab prophylaxis compared to on-demand treatment with BPAs.

 

After a median observation time of 31 weeks, 62.9 percent of patients receiving emicizumab experienced zero treated bleeds compared to 5.6 percent of those receiving on-demand BPAs. Reduction in bleed rate with emicizumab was consistent across all secondary endpoints, including all bleeds (80 percent; RR=0.20, p<0.0001), treated spontaneous bleeds (92 percent; RR=0.08, p≤0.0001), treated joint bleeds (89 percent; RR=0.11, p=0.0050) and treated target joint bleeds (95 percent; RR=0.05, p=0.0002) compared to on-demand BPAs. Results also showed a statistically significant and clinically meaningful improvement in health-related quality of life (HRQoL) measured at 25 weeks, including Hem-A-QoL physical health domain and total score and EQ-5D-5L visual analog scale and total utility score.

 

In an additional study arm (Arm C, n=49), patients who had previously received prophylaxis with BPAs received emicizumab prophylaxis. A subset of patients in this arm (n=24) had previously participated in a non-interventional study (NIS), allowing for a first-of-its-kind intra-patient analysis. This analysis showed a 79 percent (RR=0.21, p=0.0003) reduction in treated bleeds in people receiving emicizumab compared to their prior prophylaxis with BPAs.

 

Adverse events (AEs) occurring in five percent or more of patients treated with emicizumab were injection site reactions, headache, fatigue, upper respiratory tract infection and arthralgia. As previously reported, serious adverse events of thromboembolic events (TE) and thrombotic microangiopathy (TMA) occurred in two patients and three patients, respectively, while receiving emicizumab prophylaxis. One event occurred after the clinical cut-off date for the primary analysis. The TE and TMA events were associated with repeated high doses of a BPA, activated prothrombin complex concentrate, when used to treat breakthrough bleeds.

 

Interim results from the single-arm HAVEN 2 study in children younger than 12 years of age with hemophilia A with inhibitors who received emicizumab prophylaxis are consistent with the positive results from the HAVEN 1 study. After a median observation time of 12 weeks, the study showed that only one of 19 children receiving emicizumab reported a treated bleed. There were no reported joint or muscle bleeds. An intra-patient comparison (n=8) in patients who were previously enrolled in the NIS showed that all patients experienced a 100 percent reduction in treated bleeds following treatment with emicizumab (previous ABR ranged from 0 to 34.24); this included seven children who had received prior BPA prophylaxis and one who had received prior on-demand BPA. The data also indicate that the same dose of emicizumab is appropriate for children as for adults and adolescents, based on the levels of emicizumab in the blood (pharmacokinetics) of the children compared with the level of emicizumab in the blood of adults and adolescents. The most common AEs with emicizumab in the HAVEN 2 study were mild injection site reactions and common cold symptoms (nasopharyngitis).

 

About HAVEN 1 (NCT02622321)

 

HAVEN 1 is a randomized, multicenter, open-label, Phase III study evaluating the efficacy, safety, and pharmacokinetics of emicizumab prophylaxis compared to on-demand BPA (no prophylaxis; episodic use only) in adults and adolescents with hemophilia A with inhibitors to factor VIII. The study included 109 patients (12 years of age or older) with hemophilia A with inhibitors to factor VIII, who were previously treated with on-demand or prophylactic BPAs. Patients previously treated with on-demand BPAs were randomized in a 2:1 fashion to receive emicizumab prophylaxis (Arm A) or no prophylaxis (Arm B). Patients previously treated with prophylactic BPAs received emicizumab prophylaxis (Arm C). Additional patients previously on BPA (on-demand or prophylaxis) were also enrolled in a separate arm (Arm D). On-demand treatment of breakthrough bleeds with BPAs was allowed per protocol in all arms.

 

The primary endpoint of the study is the number of treated bleeds over time with emicizumab prophylaxis (Arm A) compared with no prophylaxis (Arm B). Secondary endpoints include all bleed rate, joint bleed rate, spontaneous bleed rate, target joint bleed rate, health-related quality of life (HRQoL)/health status, intra-patient comparison to bleed rate on their prior prophylaxis regimen with BPAs (Arm C) or no prophylaxis (Arm A). The study also evaluated safety and pharmacokinetics.

 

A summary of the HAVEN 1 study results to be presented at ISTH is included below.

 

Study Name HAVEN 1 (NCT02622321)
Study description Phase III randomized, multicenter, open-label study evaluating the efficacy, safety, and pharmacokinetics of emicizumab prophylaxis versus no prophylaxis in people with hemophilia A with inhibitors to factor VIII
Patients Patients with hemophilia A with inhibitors aged ≥12 years on episodic or prophylactic treatment with bypassing agent(s)(N=109)
Study group No prophylaxis (prior episodic BPAs)(Arm B; n=18) Emicizumab prophylaxis (prior episodic BPAs)(Arm A; n=35)
Treated bleeds ABR (primary endpoint)
Annualized bleeding rate [ABR]*(95% CI) 23.3(12.33; 43.89) 2.9(1.69; 5.02)
% reduction (RR, p-value) 87% reduction(RR=0.13, p<0.0001)
Median ABR(Interquartile range; IQR) 18.8(12.97; 35.08) 0.0(0.00; 3.73)
% patients with zero bleeds (95% CI) 5.6(0.1; 27.3) 62.9(44.9; 78.5)
Treated bleeds ABR intra-patient comparison(Arm C patients who participated in NIS n=24; secondary endpoint)
Study group Prior prophylaxis with a BPA Emicizumab prophylaxis
ABR*(95% CI) 15.7(11.08; 22.29) 3.3(1.33; 8.08)
% reduction (RR, p-value) 79% reduction(RR=0.21, p=0.0003)
Median ABR (IQR) 12.0 (5.73; 24.22 ) 0.0 (0.00; 2.23)
% patients with zero bleeds 12.5(2.7; 32.4) 70.8(48.9; 87.4)

 

*Negative binomial regression model

 

About HAVEN 2 (NCT02795767)

 

HAVEN 2 is a single-arm, multicenter, open-label, Phase III study evaluating the efficacy, safety, and pharmacokinetics of once-weekly subcutaneous administration of emicizumab. The interim analysis after a median of 12 weeks of treatment included 19 children younger than 12 years of age with hemophilia A with inhibitors to factor VIII, who require treatment with BPAs. The objectives of the study are to evaluate the number of treated bleeds over time with emicizumab prophylaxis, safety, pharmacokinetics, health-related quality of life (HRQoL) and proxy HRQoL with aspects of caregiver burden. The study will enroll a total of 60 children for its final analysis planned after 52 weeks of treatment with emicizumab.

 

About emicizumab (ACE910)

 

Emicizumab is an investigational bispecific monoclonal antibody designed to bring together factors IXa and X, proteins required to activate the natural coagulation cascade and restore the blood clotting process. Emicizumab can be administered by an injection of a ready-to-use solution under the skin (subcutaneously) once weekly. Emicizumab is being evaluated in pivotal Phase III studies in people 12 years of age and older, both with and without inhibitors to factor VIII, and in children under 12 years of age with factor VIII inhibitors. Additional trials are exploring less frequent dosing schedules. The clinical development program is assessing the safety and efficacy of emicizumab and its potential to help overcome current clinical challenges: the short-lasting effects of existing treatments, the development of factor VIII inhibitors and the need for frequent venous access. Emicizumab was created by Chugai Pharmaceutical Co., Ltd. and is being co-developed by Chugai, Roche and Genentech.