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NovoSeven® RT (coagulation Factor VIIa, recombinant)

Alhemo® (concizumab-mtci) injection 60 mg, 150 mg, 300 mg pens

Esperoct® [antihemophilic factor (recombinant), glycopegylated-exei]

Novoeight® (antihemophilic factor, recombinant)

Rebinyn® coagulation factor IX (recombinant), glycoPEGylated

Tretten® (coagulation factor XIII A-subunit [recombinant])

    • Why Esperoct®
    • Pharmacology
    • Mechanism of Action
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Indicated for use in adults and children with hemophilia A for on-demand treatment and control of bleeding episodes, perioperative management of bleeding, and routine prophylaxis to reduce the frequency of bleeding episodes. Esperoct® is not indicated for the treatment of von Willebrand disease.

Talk to us about Esperoct®.

Bleed protection across all ages, pediatric to adult1,2

Esperoct® is an extended half-life (EHL) rFVIII with a proven starting dose and the ability to individualize prophylactic dosing based on bleeding episodes.3

Actor portrayal

Actor portrayal

Routine prophylaxis: 4 days to the next dose

For patients ≥12 years of age

The recommended starting dose of Esperoct® is 50 IU/kg every 4 days.

Routine prophylaxis:

50 IU/kg every 4 days—no dose adjustment needed or related PK testing required1,3

Calendar icon

This regimen may be individually adjusted to less or more frequent dosing based on bleeding episodes.3

In adults and adolescents:

Fewer infusions in adults statistic

a50% fewer if previously dosed every other day; 40% fewer if previously dosed 3x/week.

Esperoct® also may be dosed to achieve a specific target Factor VIII activity level, depending on the severity of hemophilia, for on-demand treatment/control of bleeding episodes, or perioperative management.

To achieve a specific target Factor VIII activity level, use the following formula:
Dosage (IU) = Body Weight (kg) × Desired Factor VIII Increase (IU/dL or % normal) × 0.5

Individualized prophylaxis frequency based on bleeding episodes

Esperoct® 50 IU/kg every 4 days offers effective prophylaxis, but patients with an ABR >1 could benefit from dose and dosing interval individualization.4

Mean ABR reduction4,b,c

-2.72 icon

when switched from Q4D to twice-weekly dosing, in patients with an ABR >1 (n=30)b

See study design

bA subgroup analysis was performed in 71 patients who switched from Esperoct® 50 IU/kg every 4 days (Q4D) in pathfinder2 to 50 IU/kg twice weekly in pathfinder8.4
c
In the subgroup analysis, 30 of the 71 patients had a mean ABR >1 coming from pathfinder2. 90% of these patients demonstrated an improvement in ABR after transitioning to twice-weekly prophylaxis in pathfinder8. Three of these patients demonstrated an increase in ABR after transitioning to the new regimen, with a mean (SD) change in ABR of 2.67 (2.4).4

NHF’s Medical and Scientific Advisory Council logo

MASAC recommends prophylaxis for patients with severe hemophilia A.

MASAC recommends that prophylaxis be considered optimal therapy for individuals with severe hemophilia A (factor VIII <1%).

Prophylactic therapy should be instituted early (prior to the onset of frequent bleeding), with the aim of keeping the trough FVIII level above 1% between doses.5

MASAC=Medical and Scientific Advisory Council, National Hemophilia Foundation

Dosing for treatment of bleeding episodes

For patients ≥12 years of age

Minor/moderate bleeds

40 IU/kg icon

Major bleeds

50 IU/kg icon

dAdditional dose(s) may be administered after 24 hours for moderate bleeding and every 24 hours for major or life-threatening bleeding.3

Dosing for perioperative management

For patients ≥ 12 years of age

For all surgeries

50 IU/kg icon

eFor minor surgeries, additional dose(s) can be administered after 24 hours; for major surgeries, additional doses can be administered every 24 hours for the first week and then approximately every 48 hours until wound healing has occurred.3

Protection across all age groups with individualized prophylaxis frequency based on bleeding episodes.1,2,4

See dosing for children

Dosing for routine prophylaxis

For patients <12 years of age

The recommended starting dose of Esperoct® is 65 IU/kg twice weekly.

Routine prophylaxis:

65 IU/kg twice weekly3,a
PK testing not required when starting therapy

Calendar icon

This regimen may be individually adjusted to less or more frequent dosing based on bleeding episodes3

In children <12 years:

Fewer infusions statistic

Because the clearance of FVIII products may be higher in children <12 years compared to adolescents/adults, higher and more frequent dosing may be required3

aEsperoct® also may be dosed to achieve a specific target Factor VIII activity level, depending on the severity of hemophilia, for on-demand treatment/control of bleeding episodes, or perioperative management. To achieve a specific target Factor VIII activity level, use the following formula: Dosage (IU) = Body Weight (kg) × Desired Factor VIII Increase (IU/dL or % normal) × 0.5
b43% fewer if previously dosed every other day; 33% fewer if previously dosed 3x/week.3

NHF’s Medical and Scientific Advisory Council logo

MASAC recommends prophylaxis for patients with severe hemophilia A.

MASAC recommends that prophylaxis be considered optimal therapy for individuals with severe hemophilia A (factor VIII <1%).

Prophylactic therapy should be instituted early (prior to the onset of frequent bleeding), with the aim of keeping the trough FVIII level above 1% between doses.5

MASAC=Medical and Scientific Advisory Council, National Hemophilia Foundation

Dosing for treatment of bleeding episodes

For patients <12 years of age

The recommended dose of Esperoct® to control bleeding episodes in children is 65 IU/kg.3

Minor/moderate bleeds

65 IU/kg icon

Major bleeds

65 IU/kg icon

cAdditional dose(s) may be administered after 24 hours for moderate bleeding and every 24 hours for major or life-threatening bleeding.3

Dosing for perioperative management

For patients <12 years of age

The recommended dose of Esperoct® for perioperative management in children is 65 IU/kg.3

Pre-operative for all surgeries

65 IU/kg icon

dFor minor surgeries, additional dose(s) can be administered after 24 hours; for major surgeries, additional doses can be administered every 24 hours in the first week and then every 48 hours in the second week until wound healing has occurred.3

Bleed protection across all age groups with individualized prophylaxis frequency based on bleeding episodes.1,2,4

See dosing for adults & adolescents

6 vial sizes for personalized treatment

Esperoct® is supplied in single-dose vials with color-coded caps to differentiate the dose strengths.3

Available vial sizes
Esperoct® multiple vials

Flexible storage for patients on the go3,6‑10,g

You have the flexibility to store Esperoct® up to 104 °F for up to 3 months.3,g

gPrior to reconstitution, Esperoct® can be stored from 36 °F to 46 °F for up to 30 months, at room temperature up to 86 °F for up to 12 months, or up to 104 °F for up to 3 months.3 See Prescribing Information for complete product storage information.

Storage temperature:

Esperoct® storage

Esperoct® requires no refrigeration and can be stored at temperatures up to 104 °F for up to 3 months or up to 86 °F for up to 12 months.3

Storage after reconstitution:

Post-reconstitution storage

Post-reconstitution, Esperoct® can be stored for use within 4 hours at up to 86 °F and up to 24 hours in the refrigerator.3

Please see Prescribing Information for complete product storage information.

Proven safety profile

Count on the clinical trial experience of Esperoct®.

View safety data

Reconstitute in just a few steps

Esperoct® attach, twist, mix

With MixPro®, it’s as quick as attach, twist, and mix.3

See the steps

Study design

Lentz et al4 (2022)
pathfinder8 phase 3 extension trial

Patients: Previously treated males (n=160) with severe hemophilia A (FVIII activity <1%) participating in pathfinder2 (n=102) and pathfinder5 (n=58) trials.

Study design: Multicenter, multinational, open-label, nonrandomized, interventional trial. Patients received Esperoct® prophylaxis dosed every 7 days (Q7D), twice weekly (BIW), or three times weekly (TIW), with dosing interval based on previous regimen and bleeding tendency. All patients on the Q7D regimen were aged ≥12 years, and the dose was 75 IU/kg. Dosing for BIW was 50 IU/kg (patients aged ≥12 years) or 60 IU/kg (patients aged <12 years). TIW dosing was 50 IU/kg (all ages).

Primary endpoint: Number of reported adverse events.

Secondary endpoints: Efficacy endpoints included number of treated bleeds on prophylaxis, pre-dose FVIII activity levels on prophylaxis, and treatment satisfaction. A secondary safety endpoint was the incidence of FVIII inhibitors.

Show More Show Less

Important Safety Information for Esperoct®

Contraindications

  • Do not use in patients who have known hypersensitivity to Esperoct® or its components, including hamster proteins

Warnings and Precautions

  • Hypersensitivity reactions, including anaphylaxis, may occur. Should hypersensitivity reactions occur, discontinue Esperoct® and administer appropriate treatment
  • Development of neutralizing antibodies (inhibitors) has occurred. Perform an assay that measures Factor VIII inhibitor concentration if bleeding is not controlled with the recommended dose of Esperoct® or if the expected plasma Factor VIII activity levels are not attained
  • Temporary decrease in Factor VIII incremental recovery (IR) has been observed after Esperoct® infusion, within the first 5 exposure days, in previously untreated patients (PUPs) <6 years of age. During the decreased IR period, these subjects may have an increased bleeding tendency. If bleeding is not controlled with the recommended dose of Esperoct® and/or the expected Factor VIII activity levels are not attained and Factor VIII inhibitors are not detected, consider adjusting the dose, dosing frequency, or discontinuing Esperoct®

Adverse Reactions

  • The most frequently reported adverse reactions in clinical trials (≥1%) were rash, redness, itching (pruritus), and injection site reactions. Additional frequently reported adverse reactions (≥1%) in PUPs included Factor VIII inhibition and hypersensitivity.

Please click here for Esperoct® Prescribing Information.

Indications and Usage

Esperoct® [antihemophilic factor (recombinant), glycopegylated-exei] is indicated for use in adults and children with hemophilia A for on-demand treatment and control of bleeding episodes, perioperative management of bleeding, and routine prophylaxis to reduce the frequency of bleeding episodes

  • Esperoct® is not indicated for the treatment of von Willebrand disease

Indications and Usage

Esperoct® [antihemophilic factor (recombinant), glycopegylated-exei] is indicated for use in adults and children with hemophilia A for on-demand treatment and control of bleeding episodes, perioperative management of bleeding, and routine prophylaxis to reduce the frequency of bleeding episodes

  • Esperoct® is not indicated for the treatment of von Willebrand disease

Important Safety Information for Esperoct®

Contraindications

  • Do not use in patients who have known hypersensitivity to Esperoct® or its components, including hamster proteins

Warnings and Precautions

  • Hypersensitivity reactions, including anaphylaxis, may occur. Should hypersensitivity reactions occur, discontinue Esperoct® and administer appropriate treatment
  • Development of neutralizing antibodies (inhibitors) has occurred. Perform an assay that measures Factor VIII inhibitor concentration if bleeding is not controlled with the recommended dose of Esperoct® or if the expected plasma Factor VIII activity levels are not attained
  • Temporary decrease in Factor VIII incremental recovery (IR) has been observed after Esperoct® infusion, within the first 5 exposure days, in previously untreated patients (PUPs) <6 years of age. During the decreased IR period, these subjects may have an increased bleeding tendency. If bleeding is not controlled with the recommended dose of Esperoct® and/or the expected Factor VIII activity levels are not attained and Factor VIII inhibitors are not detected, consider adjusting the dose, dosing frequency, or discontinuing Esperoct®

Adverse Reactions

  • The most frequently reported adverse reactions in clinical trials (≥1%) were rash, redness, itching (pruritus), and injection site reactions. Additional frequently reported adverse reactions (≥1%) in PUPs included Factor VIII inhibition and hypersensitivity.

Please click here for Esperoct® Prescribing Information.

Show More Show Less
Show More Show Less

Indications and Usage

Indications and Usage

Esperoct® [antihemophilic factor (recombinant), glycopegylated-exei] is indicated for use in adults and children with hemophilia A for on-demand treatment and control of bleeding episodes, perioperative management of bleeding, and routine prophylaxis to reduce the frequency of bleeding episodes

  • Esperoct® is not indicated for the treatment of von Willebrand disease

Important Safety Information for Esperoct®

Contraindications

  • Do not use in patients who have known hypersensitivity to Esperoct® or its components, including hamster proteins

Important Safety Information for Esperoct®

Contraindications

  • Do not use in patients who have known hypersensitivity to Esperoct® or its components, including hamster proteins

Warnings and Precautions

  • Hypersensitivity reactions, including anaphylaxis, may occur. Should hypersensitivity reactions occur, discontinue Esperoct® and administer appropriate treatment
  • Development of neutralizing antibodies (inhibitors) has occurred. Perform an assay that measures Factor VIII inhibitor concentration if bleeding is not controlled with the recommended dose of Esperoct® or if the expected plasma Factor VIII activity levels are not attained
  • Temporary decrease in Factor VIII incremental recovery (IR) has been observed after Esperoct® infusion, within the first 5 exposure days, in previously untreated patients (PUPs) <6 years of age. During the decreased IR period, these subjects may have an increased bleeding tendency. If bleeding is not controlled with the recommended dose of Esperoct® and/or the expected Factor VIII activity levels are not attained and Factor VIII inhibitors are not detected, consider adjusting the dose, dosing frequency, or discontinuing Esperoct®

Adverse Reactions

  • The most frequently reported adverse reactions in clinical trials (≥1%) were rash, redness, itching (pruritus), and injection site reactions. Additional frequently reported adverse reactions (≥1%) in PUPs included Factor VIII inhibition and hypersensitivity.

Please click here for Esperoct® Prescribing Information.

Important Safety Information for Esperoct®

Contraindications

  • Do not use in patients who have known hypersensitivity to Esperoct® or its components, including hamster proteins

Warnings and Precautions

  • Hypersensitivity reactions, including anaphylaxis, may occur. Should hypersensitivity reactions occur, discontinue Esperoct® and administer appropriate treatment
  • Development of neutralizing antibodies (inhibitors) has occurred. Perform an assay that measures Factor VIII inhibitor concentration if bleeding is not controlled with the recommended dose of Esperoct® or if the expected plasma Factor VIII activity levels are not attained
  • Temporary decrease in Factor VIII incremental recovery (IR) has been observed after Esperoct® infusion, within the first 5 exposure days, in previously untreated patients (PUPs) <6 years of age. During the decreased IR period, these subjects may have an increased bleeding tendency. If bleeding is not controlled with the recommended dose of Esperoct® and/or the expected Factor VIII activity levels are not attained and Factor VIII inhibitors are not detected, consider adjusting the dose, dosing frequency, or discontinuing Esperoct®

Adverse Reactions

  • The most frequently reported adverse reactions in clinical trials (≥1%) were rash, redness, itching (pruritus), and injection site reactions. Additional frequently reported adverse reactions (≥1%) in PUPs included Factor VIII inhibition and hypersensitivity.

Please click here for Esperoct® Prescribing Information.

Indications and Usage

Esperoct® [antihemophilic factor (recombinant), glycopegylated-exei] is indicated for use in adults and children with hemophilia A for on-demand treatment and control of bleeding episodes, perioperative management of bleeding, and routine prophylaxis to reduce the frequency of bleeding episodes

  • Esperoct® is not indicated for the treatment of von Willebrand disease

Indications and Usage

Esperoct® [antihemophilic factor (recombinant), glycopegylated-exei] is indicated for use in adults and children with hemophilia A for on-demand treatment and control of bleeding episodes, perioperative management of bleeding, and routine prophylaxis to reduce the frequency of bleeding episodes

  • Esperoct® is not indicated for the treatment of von Willebrand disease

Important Safety Information for Esperoct®

Contraindications

  • Do not use in patients who have known hypersensitivity to Esperoct® or its components, including hamster proteins

Warnings and Precautions

  • Hypersensitivity reactions, including anaphylaxis, may occur. Should hypersensitivity reactions occur, discontinue Esperoct® and administer appropriate treatment
  • Development of neutralizing antibodies (inhibitors) has occurred. Perform an assay that measures Factor VIII inhibitor concentration if bleeding is not controlled with the recommended dose of Esperoct® or if the expected plasma Factor VIII activity levels are not attained
  • Temporary decrease in Factor VIII incremental recovery (IR) has been observed after Esperoct® infusion, within the first 5 exposure days, in previously untreated patients (PUPs) <6 years of age. During the decreased IR period, these subjects may have an increased bleeding tendency. If bleeding is not controlled with the recommended dose of Esperoct® and/or the expected Factor VIII activity levels are not attained and Factor VIII inhibitors are not detected, consider adjusting the dose, dosing frequency, or discontinuing Esperoct®

Adverse Reactions

  • The most frequently reported adverse reactions in clinical trials (≥1%) were rash, redness, itching (pruritus), and injection site reactions. Additional frequently reported adverse reactions (≥1%) in PUPs included Factor VIII inhibition and hypersensitivity.

Please click here for Esperoct® Prescribing Information.

References:

  1. Giangrande P, Abdul Karim F, Nemes L, et al. Long-term safety and efficacy of N8-GP in previously treated adults and adolescents with hemophilia A: final results from pathfinder2. J Thromb Haemost. 2020;18(suppl 1):5-14.
  2. Šaulytė Trakymiene S, Economou M, Kenet G, Landorph A, Shen C, Kearney S. Long-term safety and efficacy of N8-GP in previously treated pediatric patients with hemophilia A: final results from pathfinder5. J Thromb Haemost. 2020;18(suppl 1):15-25.
  3. Esperoct® [package insert]. Plainsboro, NJ: Novo Nordisk Inc.
  4. Lentz SR, Kavalki K, Klamroth R, et al. Turoctocog alpha pegol (NB-GP) in severe hemophilia A: long-term safety and efficacy in previously treated patients  of all ages in the pathfinder8 study. Res Pract Thromb Haemost. 2022;6(2):e12674.
  5. National Hemophilia Foundation. MASAC recommendations concerning prophylaxis for hemophilia A and B with and without inhibitors, #267. New York, NY: National Hemophilia Foundation; 2022.
  6. Giangrande P, Andreeva T, Chowdary P, et al. Clinical evaluation of glycoPEGylated recombinant FVIII: efficacy and safety in severe haemophilia A. Thromb Haemost. 2017;117(2):252-261.
  7. Adynovate® [package insert]. Lexington, MA: Baxalta US Inc; 2023.                                 
  8. Afstyla® [package insert]. Kankakee, IL: CSL Behring LLC; 2023.                           
  9. Altuviiio® [package insert]. Waltham, MA: Bioverativ Therapeutics Inc; 2023.                   
  10. Eloctate® [package insert]. Waltham, MA: Bioverativ Therapeutics Inc; 2023.                 
  11. Jivi® [package insert]. Whippany, NJ: Bayer HealthCare LLC; 2018.
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