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Damoctocog alfa pegol shows safety and maintained bleed protection in children with severe haemophilia A

Damoctocog alfa pegol shows safety and maintained bleed protection in children with severe haemophil…
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Key Takeaway
Consider preliminary safety data for damoctocog alfa pegol in children; confirm in controlled trials.

This was a phase 3, multicentre, open-label, single-arm study evaluating damoctocog alfa pegol in 35 previously treated children aged 7 to <12 years with severe haemophilia A over 6.0 months. The primary outcome was the incidence of adverse events of special interest (AESI) leading to discontinuation during the first 4 exposure days; no AEs resulted in study drug discontinuation (0/35). The probability of <5% of patients experiencing an AESI was 92.2%. Secondary outcomes indicated bleed protection with prophylaxis was maintained.

Regarding safety, 21/35 children (60%) reported ≥1 adverse event, all of which were mild or moderate. Study drug-related AEs occurred in 3/35 children (8.6%). No AEs led to discontinuation, and 32/35 children completed the 6-month study. One loss of efficacy event (2.9%), considered an AESI, led to a temporary treatment interruption.

Key limitations include the open-label, single-arm study design, which lacks a comparator group. This design means the reported associations should not be interpreted as evidence of causation, and generalizability beyond the studied population and duration is uncertain. The findings provide preliminary evidence of safety and maintained efficacy for this specific patient group, but controlled studies are needed to establish comparative effectiveness and long-term safety.

Study Details

Study typePhase3
EvidenceLevel 2
Follow-up6.0 mo
PublishedApr 2026
View Original Abstract ↓
BACKGROUND: In the earlier PROTECT VIII Kids study (NCT01775618), damoctocog alfa pegol was efficacious for prevention and treatment of bleeds in children aged < 12 years with severe haemophilia A. OBJECTIVE: Assess the safety of damoctocog alfa pegol, including hypersensitivity and loss of efficacy (LoE) due to an immune response to polyethylene glycol, in children aged 7 to < 12 years with severe haemophilia A. METHODS: Alfa-PROTECT is a phase 3, multicentre, open-label, single-arm study (NCT05147662). Primary endpoint was the incidence of adverse events of special interest (AESI) leading to discontinuation during the first 4 exposure days. RESULTS: Overall, 35 children enrolled; 32 completed the 6-month study, 21 (60%) reported ≥ 1 AE. Median (range) treatment duration was 182 (172-198) days. All AEs were mild/moderate; 3/35 children (8.6%) had study drug-related AEs. One (2.9%) LoE event was considered an AESI, and led to temporary treatment interruption. No AEs resulted in study drug discontinuation. The probability of < 5% of patients experiencing an AESI was 92.2%. Bleed protection was maintained with damoctocog alfa pegol prophylaxis. CONCLUSIONS: These data confirm the safety profile of damoctocog alfa pegol in children aged 7 to < 12 years with severe haemophilia A. Secondary endpoints indicate treatment was efficacious. TRIAL REGISTRATION: The Alfa-PROTECT trial is registered at ClinicalTrial.gov (NCT05147662).
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