Emicizumab (3) – Hemlibra®

Moderate haemophilia A, without factor VIII inhibitors, with severe bleeding phenotype

Characteristics

Start date 01.03.2023 – Marketing authorisation: 23.01.2023
Resolution 17.08.2023
INN Emicizumab
Brand name Hemlibra®
Pharm. company Roche Pharma AG
G-BA Procedure ID D-912
ATC code B02BX06 Other systemic hemostatics (B02BX)
ICD-10 codes (AIS) D66Hereditary factor VIII deficiency
Alpha-ID codes (AIS) I27819Hemophilia A
Therapeutic area Hematopoietic diseases Hemophilia (Hemophilia A /Hemophilia B)
Reason for procedure New therapeutic indication

Therapeutic indication of the resolution

Emicizumab (Hemlibra) is used as routine prophylaxis of bleeding events in patients with hemophilia A (hereditary factor VIII deficiency) without factor VIII inhibitors with moderate disease (FVIII ≥ 1% and ≤ 5%) with severe bleeding phenotype in all age groups.

Subpopulation Indication Comparator
Patients with moderate-severe hemophilia A (hereditary factor VIII deficiency, FVIII ≥ 1% and ≤ 5%) and a severe bleeding phenotype without factor VIII inhibitors who are eligible for routine prophylaxis Plasmatic or recombinant blood coagulation factor VIII preparations, used as routine prophylaxis

Studies and Results

No. of studies
(best subpopulation)
0 (Data not accepted)
Study design
(best subpopulation)
Data not accepted (Dossier: Single-arm + no comparison)

  • Clinical trials
    • The HAVEN 6 trial is a single-arm trial that included patients of all age groups with mild (residual Factor VIII activity > 5 % and < 40 %) or moderate (residual Factor VIII activity ≥ 1% and ≤ 5%) hereditary haemophilia A without Factor VIII inhibitors, for whom the investigator deemed prophylaxis to be indicated.

Patients with moderate haemophilia A (hereditary factor VIII deficiency, FVIII ≥ 1% and ≤ 5%) and a severe bleeding phenotype without factor VIII inhibitors, who are eligible for routine prophylaxis

  • For patients with moderate haemophilia A (hereditary factor VIII deficiency, FVIII ≥ 1% and ≤ 5%) and a severe bleeding phenotype without factor VIIIinhibitors, who are eligible for routine prophylaxis, the additional benefit of emicizumab as routine prophylaxis compared with the appropriate comparator therapy is not proven.
  • Overall, therefore, additional benefit for emicizumab as routine prophylaxis against bleeding episodes in patients with moderate haemophilia A without factor VIII inhibitors and a severe bleeding phenotype is not proven, compared with the appropriate comparator therapy.
  • morbidity
    • The primary endpoint of the study was treated bleeds, operationalised as the annualised bleeding rate.
  • Overall assessment
    • In the overall review, additional benefit is not proven for emicizumab in the routine prophylaxis of bleeding episodes in patients with moderate haemophilia A without factor VIII inhibitors and a severe bleeding phenotype, compared with the appropriate comparator therapy.

Courtesy translation only, please refer to the German original.

Associated procedures

Emicizumab (3) Hemlibra® Roche Pharma AG Hematopoietic diseases Moderate haemophilia A, without factor VIII inhibitors, with severe bleeding phenotype 220–240 100% additional benefit not proven
Emicizumab (2) Hemlibra® Roche Pharma AG Hematopoietic diseases Hemophilia A, without factor VIII inhibitors 2,000 100% additional benefit not proven
Emicizumab (1) Hemlibra® Roche Pharma AG Hematopoietic diseases Hemophilia A 100 50% Hint for non-quantifiable additional benefit


<< List of all resolutions