The Laboratory Monitoring of Altuvoct (Efanesoctocog Alfa): Recommendations From the Laboratory Working Party of the United Kingdom Haemophilia Centres Doctor's Organisation
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Summary
This summary is machine-generated.Accurate monitoring of Altuvoct requires specific assays. Choose validated one-stage APTT reagents for post-infusion measurements, and chromogenic assays with bovine substrates when FVIII mimetics are present.
Area Of Science
- Hematology
- Clinical Chemistry
Background
- Altuvoct requires specific laboratory assays for accurate monitoring.
- Standard assays may not be suitable, necessitating tailored approaches.
Purpose Of The Study
- To provide recommendations for the accurate measurement of Altuvoct.
- To guide the selection of appropriate assays for monitoring Altuvoct, especially in the presence of FVIII mimetic therapies.
- To outline methods for assessing FVIII inhibitors in patients treated with Altuvoct.
Main Methods
- Evaluation of various one-stage Activated Partial Thromboplastin Time (APTT) reagents for post-infusion Altuvoct measurement.
- Assessment of chromogenic FVIII assays with different substrates (bovine/human FX and FIXa) in the presence of FVIII mimetics.
- Review of methods for FVIII inhibitor assessment using Bethesda or Nijmegen-modified Bethesda assays.
Main Results
- Specific APTT reagents (Actin FSL, Synthafax, CK Prest) are suitable for post-infusion Altuvoct measurement after local validation.
- Certain APTT reagents (Synthasil, Thrombocheck SLA, Actin, Actin FS, Cephen, Cephascreen) are unsuitable due to under- or overestimation.
- Chromogenic FVIII assays using bovine FX and FIXa substrates are recommended in the presence of FVIII mimetics, with a caveat for overestimation.
- Chromogenic assays with human FX or mixed substrates require local validation.
Conclusions
- Assay selection for Altuvoct monitoring depends on the presence or absence of FVIII mimetic therapies.
- Clear identification of Altuvoct use and sampling time is crucial for accurate FVIII level requests.
- Validated chromogenic assays with bovine substrates are essential for monitoring Altuvoct in the presence of FVIII mimetics.