Prolonged activity of a recombinant factor VIII-Fc fusion protein in hemophilia A mice and dogs

Blood. 2012 Mar 29;119(13):3024-30. doi: 10.1182/blood-2011-08-367813. Epub 2012 Jan 13.

Abstract

Despite proven benefits, prophylactic treatment for hemophilia A is hampered by the short half-life of factor VIII. A recombinant factor VIII-Fc fusion protein (rFVIIIFc) was constructed to determine the potential for reduced frequency of dosing. rFVIIIFc has an ∼ 2-fold longer half-life than rFVIII in hemophilia A (HemA) mice and dogs. The extension of rFVIIIFc half-life requires interaction of Fc with the neonatal Fc receptor (FcRn). In FcRn knockout mice, the extension of rFVIIIFc half-life is abrogated, and is restored in human FcRn transgenic mice. The Fc fusion has no impact on FVIII-specific activity. rFVIIIFc has comparable acute efficacy as rFVIII in treating tail clip injury in HemA mice, and fully corrects whole blood clotting time (WBCT) in HemA dogs immediately after dosing. Furthermore, consistent with prolonged half-life, rFVIIIFc shows 2-fold longer prophylactic efficacy in protecting HemA mice from tail vein transection bleeding induced 24-48 hours after dosing. In HemA dogs, rFVIIIFc also sustains partial correction of WBCT 1.5- to 2-fold longer than rFVIII. rFVIIIFc was well tolerated in both species. Thus, the rescue of FVIII by Fc fusion to provide prolonged protection presents a novel pathway for FVIII catabolism, and warrants further investigation.

Publication types

  • Evaluation Study

MeSH terms

  • Animals
  • Coagulants / pharmacokinetics
  • Coagulants / therapeutic use
  • Disease Models, Animal
  • Dog Diseases / drug therapy
  • Dog Diseases / metabolism
  • Dogs
  • Factor VIII / chemistry
  • Factor VIII / genetics
  • Factor VIII / pharmacokinetics*
  • Factor VIII / therapeutic use
  • HEK293 Cells
  • Half-Life
  • Hemophilia A / drug therapy
  • Hemophilia A / metabolism*
  • Hemophilia A / pathology
  • Histocompatibility Antigens Class I / chemistry
  • Histocompatibility Antigens Class I / metabolism
  • Histocompatibility Antigens Class I / pharmacology*
  • Histocompatibility Antigens Class I / therapeutic use
  • Humans
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Mice, Transgenic
  • Receptors, Fc / chemistry
  • Receptors, Fc / metabolism
  • Receptors, Fc / therapeutic use
  • Recombinant Fusion Proteins / pharmacokinetics*
  • Recombinant Fusion Proteins / therapeutic use
  • Whole Blood Coagulation Time

Substances

  • Coagulants
  • Histocompatibility Antigens Class I
  • Receptors, Fc
  • Recombinant Fusion Proteins
  • Factor VIII
  • Fc receptor, neonatal