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  • Wiley  (2)
  • Kuter, David J.  (2)
  • 1
    In: American Journal of Hematology, Wiley, Vol. 97, No. 6 ( 2022-06), p. 691-699
    Kurzfassung: Patients with relapsed warm antibody autoimmune hemolytic anemia (wAIHA) have limited treatment options. Fostamatinib is a potent, orally administered spleen tyrosine kinase inhibitor approved in the United States and Europe for the treatment of adults with chronic immune thrombocytopenia (ITP). This phase 2 study evaluated the response to fostamatinib, administered at 150 mg BID orally with or without food in adults with wAIHA and active hemolysis with hemoglobin (Hgb) 〈 10 g/dL who had failed at least one prior treatment. Hemoglobin levels and safety assessments were performed at visits every 2 weeks. The primary endpoint was Hgb 〉 10 g/dL with an increase of ≥2 g/dL from baseline by week 24 without rescue therapy or red blood cell transfusion. Eleven of 24 (46%) patients achieved the primary endpoint. Increases in median Hgb were detected at week 2 and sustained over time. Median lactate dehydrogenase levels and reticulocyte counts generally declined over time with little change in median haptoglobin levels. The most common adverse events (AEs) were diarrhea (42%), fatigue (42%), hypertension (27%), dizziness (27%), and insomnia (23%). AEs were manageable and consistent with the fostamatinib safety database of over 3900 patients across multiple diseases (rheumatoid arthritis, B‐cell lymphoma, COVID‐19, and ITP). No new safety signals were detected. Fostamatinib may be a promising therapeutic option for wAIHA. A randomized, double‐blind, phase 3 study is nearing completion.
    Materialart: Online-Ressource
    ISSN: 0361-8609 , 1096-8652
    URL: Issue
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2022
    ZDB Id: 1492749-4
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
    In: American Journal of Hematology, Wiley, Vol. 98, No. 8 ( 2023-08), p. 1246-1253
    Kurzfassung: Cold agglutinin disease (CAD) is a rare, autoimmune, classical complement pathway (CP)‐mediated hemolytic anemia. Sutimlimab selectively inhibits C1s of the C1 complex, preventing CP activation while leaving the alternative and lectin pathways intact. In Part A (26 weeks) of the open‐label, single‐arm, Phase 3 CARDINAL study in patients with CAD and a recent history of transfusion, sutimlimab demonstrated rapid effects on hemolysis and anemia. Results of the CARDINAL study Part B (2‐year extension) study, described herein, demonstrated that sutimlimab sustains improvements in hemolysis, anemia, and quality of life over a median of 144 weeks of treatment. Mean last‐available on‐treatment values in Part B were improved from baseline for hemoglobin (12.2 g/dL on‐treatment versus 8.6 g/dL at baseline), bilirubin (16.5 μmol/L on‐treatment versus 52.1 μmol/L at baseline), and FACIT‐Fatigue scores (40.5 on‐treatment versus 32.4 at baseline). In the 9‐week follow‐up period after sutimlimab cessation, CP inhibition was reversed, and hemolytic markers and fatigue scores approached pre‐sutimlimab values. Overall, sutimlimab was generally well tolerated in Part B. All 22 patients experienced ≥1 treatment‐emergent adverse event (TEAE); 12 (54.5%) patients experienced ≥1 serious TEAE, including seven (31.8%) with ≥1 serious infection. Three patients discontinued due to a TEAE. No patients developed systemic lupus erythematosus or meningococcal infections. After cessation of sutimlimab, most patients reported adverse events consistent with recurrence of CAD. In conclusion, the CARDINAL 2‐year results provide evidence of sustained sutimlimab effects for CAD management, but that disease activity reoccurs after treatment cessation. NCT03347396. Registered November 20, 2017.
    Materialart: Online-Ressource
    ISSN: 0361-8609 , 1096-8652
    URL: Issue
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2023
    ZDB Id: 1492749-4
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
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