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Case report
Clinical, pharmacokinetic and economic analysis of the first switch to an extended half-life factor IX (albutrepenonacog alfa, rFIX-FP) in Spain
  1. Manuel Rodríguez López1,
  2. Juan Eduardo Megías Vericat2,3,
  3. Carmen Albo López1 and
  4. Santiago Bonanad4
  1. 1Haemostasis and Thrombosis Unit, Hospital Álvaro Cunqueiro, Vigo, Galicia, Spain
  2. 2Pharmacy Department and Haemostasis and Thrombosis Unit, Hospital Universitari i Politècnic La Fe, Valencia, Spain
  3. 3Pharmacy University, Universitat de Valencia, Valencia, Comunitat Valenciana, Spain
  4. 4Haemostasis and Thrombosis Unit, Hospital Universitari i Politècnic La Fe, Valencia, Spain
  1. Correspondence to Dr Juan Eduardo Megías Vericat; megias_jua{at}


Extended half-life of factor IX (FIX) demonstrated clinical benefit and lower treatment burden than standard half-life FIX products in clinical trials. We analysed the impact in efficacy, pharmacokinetics (PKs) and costs of the switch from nonacog alfa (rFIX) to albutrepenonacog alfa (rFIX-FP) in the first patient with haemophilia B (HB) treated in Spain outside clinical trials. A 7-year-old boy presented with HB with poor venous access and repetition infections using rFIX, which was switched to rFIX-FP. Prophylaxis was adjusted by PKs using WAPPS-Hemo tailoring from 100 IU/kg/week of rFIX to 80 IU/kg/3 weeks of rFIX-FP. Comparing 6 months before, rFIX-FP reduced 68.5% FIX consumption/kg and 58.3% infusion frequency, but total costs/weight showed a slight increase. Ratio of half-life between rFIX and rFIX-FP was 3.4–3.7. This case report revealed that switch to rFIX-FP decreased frequency and FIX consumption, without adverse events and bleeds.

  • haematology (incl blood transfusion)
  • health economics
  • congenital disorders
  • pharmacokinetics

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  • Contributors JEMV, MRL and SB were responsible for collecting all the information from the clinical case and wrote the paper. CAL helped write and proofread the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.