14 year old Caucasian male
Switched to ALTUVIIIO: July 2023
Henry, who has severe hemophilia A, enjoys playing baseball. He presented with a possible left-elbow bleed after waking up with pain and limited range of motion (inability to extend).
Patient Information
Presented with symptoms of a possible left-elbow bleed:
- History of left-elbow bleeds, mostly relating to injury
- No history of inhibitors
- Henry’s last dose of factor-mimetic therapy was the day prior to presentation. No factor replacement therapy was infused
- No surgeries
- Brother and maternal grandfather have severe hemophilia A
- BP: 122/86
- HR: 71
- Swelling and pain noted in left elbow
- Inhibitor titer negative
Henry’s Path to High Sustained Factor Replacement Therapy, ALTUVIIIO
Diagnosis
- Henry was diagnosed with severe hemophilia A (FVIII <1%) at birth
After diagnosis
- At approximately 14 months old, Henry started SHL infusions 3x a week via a port
- From 11 to 12 years old, he enjoyed playing baseball and switched to prophylaxis with factor-mimetic therapy and an on-demand SHL therapy
- Throughout his childhood, Henry experienced multiple elbow bleeds (not considered a target joint)
- At 14 years old, he experienced 1 left-elbow bleed and 1 left bicep muscle bleed secondary to an injury
- He treated these injuries with an SHL therapy, received 4 weeks of physical therapy, and refrained from baseball for 4 weeks
Before ALTUVIIIO
- After a 4-week hiatus from baseball, Henry participated in a baseball game and woke up the next day with pain and swelling in his left elbow
- Henry presented to the HTC with a possible left-elbow bleed
- Treatment regimen at the time: prophylaxis with factor-mimetic therapy and on-demand SHL therapy
- Planned to treat bleed with on-demand ALTUVIIIO for 4 weeks while continuing factor-mimetic prophylaxis
Considering the switch
Henry, his parents, and his comprehensive care team discussed Henry’s:
- Physical activity
- Lifestyle goal to be on monotherapy
Together, they decided that switching to ALTUVIIIO would meet Henry’s treatment goals.
After ALTUVIIIO
Switched to ALTUVIIIO: July 2023
- Henry’s parents have been retrained on factor infusions
- Since starting ALTUVIIIO prophylaxis, Henry has normal to near-normal Factor VIII levels (>40%) for >3 days of the week1 and has experienced 0 breakthrough bleeds
Do you have patients like Henry?
If so, it may be worth it to consider the following:
How good is good enough?
Would you consider a patient like Henry to be doing okay on their current treatment?
Choosing the right treatment
How would you discuss switching to a treatment option like ALTUVIIIO with patients like Henry?
Unlocking high sustained factor levels
Do you think high sustained factor levels and once-weekly dosing with ALTUVIIIO1 could benefit your patients like Henry?
BMI=body mass index; BP=blood pressure; FVIII=Factor VIII; HR=heart rate; HTC=hemophilia treatment center; SHL=standard half-life.
Other ALTUVIIIO patients who made the switch!
Meet Aaron
A 13 year old student and flag-football player with severe hemophilia A, previously on SHL prophylaxis therapy.
Meet Sean
A 39 year old technical support professional with severe hemophilia A who underwent a total knee arthroplasty.
Indication
Reference: 1. ALTUVIIIO Prescribing Information. Bioverativ Therapeutics Inc. Waltham, MA.
