Pharmacokinetic evaluation of concizumab for the treatment of hemophilia.

Abstract

Introduction: Replacement therapy is the global standard of care in hemophilia. However, several unmet needs have favored the development of non-factor therapies. Concizumab, an anti-tissue factor pathway inhibitor (anti-TFPI) administered daily, restores thrombin generation in all hemophilia subtypes.

Areas covered: The pharmacokinetic profile of concizumab from several clinical trials demonstrates target-mediated drug disposition (TMDD) and a consistent exposure-response profile when given daily. Concizumab has an acceptable safe profile and efficacy in hemophilia A or B with and without inhibitors.

Expert opinion: Despite the availability of diverse therapies for hemophilia management, unmet needs remain, including limited prophylaxis for hemophilia B inhibitor patients. Concizumab was developed to address this gap. Its target-mediated drug deposition results in a nonlinear pharmacokinetic profile and a need for a daily injection schedule, which ensures a stable, consistent, and sustained pharmacokinetic profile. While the daily injection may seem demanding, it does not compromise the optimal benefits of concizumab prophylaxis. Moreover, the acceptable safe profile and efficacy of concizumab in bleed prevention in hemophilia A or B with and without inhibitors provide reassurance that it may be a therapeutic option in managing all hemophilia patients.