GENA-01 was a prospective, randomized, actively controlled, open-label crossover multicenter on-demand trial which involved nine centres in three countries (USA, Germany and Bulgaria). It recruited 22 previously treated patients (PTPs) with severe haemophilia A (mean age 39.6 ± 14.06). Its objectives were pharmacokinetic evaluation, efficacy of on-demand treatment and surgical prophylaxis, incremental recovery of FVIII:C, immunogenicity and safety. GENA-08 was a prospective, single arm, open-label, multinational prophylaxis trial involving 11 centres in four countries

(Austria, Bulgaria, Germany and UK) which recruited 32 PTPs with severe haemophilia A (mean age 37.3 ± 13.6). The primary objective was efficacy of prophylactic treatment, treatment of breakthrough bleeding and surgical prophylaxis. The secondary objectives were incremental recovery of FVIII:C, immunogenicity

and safety. Both studies were similarly designed with regard to the Tanespimycin mouse inclusion/exclusion criteria, study duration and in how the data were captured and analyzed. In addition, the study populations were favourably comparable to each other with regard to age, body mass index, haemophilia joint health score (according to Hilliard et al. [8]), race and historical bleeding sites. In GENA-01, selleck 65.1% of the bleeding episodes were spontaneous. The most common sites of bleeding were the knee (23.3%), elbow (22.8%) and ankle (15.7%). Of the bleeding, 57.4% was moderate to major and 42.2% was minor. There were 986 total bleeding episodes of which 94.4% were successfully treated (excellent or good response with excellent being abrupt pain relief and/or unequivocal improvement in objective signs of bleeding within approximately 8 h after a single infusion, and good being definite pain relief and/or selleck screening library improvement in signs of bleeding within approximately 8–12 h after an infusion requiring ≤2 infusions for complete resolution). A total of 96.7% of all bleeding episodes were managed with one (90.3%) or two (6.4%) infusions. The median dose per infusion was 30 IU kg−1 (range 7–61) and

the median dose per bleeding episode was 30.9 IU kg−1 (range 8–657). The total factor consumption was 156.9 IU kg−1 month−1. In GENA-08, there was good adherence with 93.6% of prophylactic infusions given every 2 days, for a median of 3.4 infusions per week (range 2.01–3.46). The dose per infusion was 33.1 IU kg−1 (median, range 24–39.3). There were 44 breakthrough bleeding events; most (59.1%) were spontaneous and only 28 required treatment. Of the 44 haemorrhages, 28 (63.6%) were minor. There was no major or life-threatening bleeding and 50% of the patients (16/32) did not experience any bleeding episodes during the prophylactic treatment with Human-cl rhFVIII. Before study entry patients treated on demand (n = 11) had a mean monthly bleeding rate of 3.92 episodes. This was reduced to 0.04 with Human-cl rhFVIII.