39 year old male
Switched to ALTUVIIIO: August 2024
Sean, who has severe hemophilia A, presented for a left total knee arthroplasty (TKA) secondary to joint damage from chronic hemarthroses.
Patient Information
Sean’s Path to High Sustained Factor Replacement Therapy, ALTUVIIIO
Diagnosis
- Sean was diagnosed with hemophilia A (FVIII <1%) at age 4 via a bleeding disorder workup after suffering a swollen knee with bloody arthrocentesis
After diagnosis
- Throughout his life, Sean experienced multiple joint bleeds
- Had limited treatment access, but obtained several boxes of factor (per patient history, factor type is unclear) that he used for on-demand therapy
- Over a span of 5 years, Sean tried multiple therapies:
- 2017-2019: Twice-weekly EHL prophylaxis
- 2019: Gene therapy trial enrollment
- Early 2022: EHL prophylaxis
- Late 2022: Factor-mimetic prophylaxis with on-demand EHL therapy
- His limited access to prophylactic treatment earlier in life ultimately led to arthropathies, severe joint damage, and bilateral TKAs (2023 right TKA, supported by pre- and postoperative EHL therapy)
Before ALTUVIIIO
- Sean presented for left TKA
- Previously treating prophylactically with factor-mimetic therapy and on-demand with EHL therapy
Surgical experience
Acute management
- 3/6/24: Underwent a left TKA
- Infused postoperatively on Day 3 (3/9), Day 5 (3/11), and Day 15 (3/21)
Postoperative clinical course
- 8/19/24: Experienced 2 spontaneous left knee bleeds that were resolved with ALTUVIIIO
After ALTUVIIIO
Switched to ALTUVIIIO: August 2024
- Compared to his first total knee replacement, Sean experienced lower perioperative infusion burden with his first postoperative dose on Day 3
- He completed PT 5 days postoperatively and continued 3 times per week for 8 weeks with no functional limitations
- Five months after surgery, Sean switched from factor-mimetic prophylaxis to once-weekly ALTUVIIIO prophylaxis
- He currently does PT at home and would like to be more active
Do you have patients like Sean?
If so, it may be worth it to consider the following:
How good is good enough?
What considerations would you take into account for perioperative management for a patient like Sean?
Choosing the right treatment
How would you discuss switching to a treatment option like ALTUVIIIO with patients like Sean?
Unlocking high sustained factor levels
Do you think Sean could benefit from perioperative ALTUVIIIO?
BMI=body mass index; BP=blood pressure; EHL=extended half-life; FVIII=Factor VIII; HR=heart rate; PT=physical therapy; SHL=standard half-life; TKA=total knee arthroplasty.
Other ALTUVIIIO patients who made the switch!
Meet Henry
A 14 year old student and avid baseball player with severe hemophilia A, previously treating with factor-mimetic prophylaxis and an on-demand SHL therapy.
Meet Aaron
A 13 year old student and flag-football player with severe hemophilia A previously on SHL prophylaxis therapy.
Indication
Reference: 1. ALTUVIIIO Prescribing Information. Bioverativ Therapeutics Inc. Waltham, MA.
