Advancing Global Data Collection for Women with Bleeding Disorders: Early Insights from the PROBE WBD Module

Brennan F, Clearfield E, Kucher A, Colle Y, Brito del Pino Mouro A, Wilton P, Skouw-Rasmussen N, Ziemele BM, Rotellini D, Delaney M, Curtis RG, O’Mahony B, Page D, Iorio A, Germini F, Skinner MW. Advancing global data collection for women with bleeding disorders: early insights from the PROBE WBD module. Haemophilia. 2026;32:4-224. Abstract PP-399. doi:10.1111/hae.70232.

Introduction

Since 2014, the PROBE (Patient Reported Outcomes, Burdens, and Experiences) Study has generated global patient-reported data to compare health outcomes and quality of life (QoL) across people with haemophilia and control populations. However, PROBE was originally designed primarily for men, leaving a substantial knowledge gap for women with bleeding disorders (WBD), including women and girls with haemophilia A or B, carriers, and those who have or had the potential to menstruate. Limited comparative Quality of Life (QoL) data, together with a longstanding pattern of underdiagnosis and misdiagnosis, highlight the need for a dedicated data-collection framework. This project aims to expand PROBE to better capture the lived experiences and health outcomes of WBD.

 Methods 

Building on earlier PROBE analyses, a structured enhancement process began in 2024. A targeted literature review and conceptual framework exercise identified domains insufficiently captured in the current PROBE instrument, including menstrual bleeding patterns, gynaecological complications, access to care, emergency room utilisation, reproductive decision-making, and impacts on social and leisure activities. Eleven new WBD-specific questions were developed and integrated following consultation with a global expert working group representing the World Federation of Hemophilia (WFH), European Haemophilia Consortium (EHC), Coalition of the Americas (CoA), National Bleeding Disorders Foundation (NBDF), and Canadian Hemophilia Society (CHS). Of the 64 pilot participants, 33% completed the WBD module. The module launched as an online exploratory pilot on International Women’s Day 2025.

 Results

Preliminary data reveals significant unmet needs among WBD. Participants reported a mean age of diagnosis of 20.45 years, with some reporting up to nine emergency department visits in the previous 12 months. The reported average menstrual period length was 10.6 days. Respondents also described moderate to significant impacts of their bleeding diagnosis and symptoms on decisions regarding childbearing and participation in social or leisure activities. Early findings from carriers, individuals with factor and platelet disorders, and those with extremely rare bleeding disorders underscore the diversity and severity of challenges experienced.

 Conclusion 

Early insights from the WBD module reinforce the necessity of integrating a dedicated WBD component into the core PROBE study. Enhanced, inclusive data collection will support more accurate understanding and inform targeted advocacy, research, management, and treatment strategies for this underserved population.

Poster: HERE

Patient-Reported Outcomes in Hemophilia in Kosovo: Results from the PROBE Questionnaire

Svirca I, Kukaj E, Svirca L, Rotellini D, Harvey-Simi K, et al. Patient-reported outcomes in hemophilia in Kosovo: results from the PROBE questionnaire. Haemophilia. 2026;32:4-224. Abstract PP-317. doi:10.1111/hae.70232.

Introduction

National-level patient-reported outcomes (PROs) for people with hemophilia (PWH) in Kosovo are limited. The PROBE (Patient-Reported Outcomes, Burdens and Experiences) questionnaire captures treatment patterns, pain, function, and health status.

The aim is to characterize the Kosovo cohort with PROBE and compare key outcomes between severe and moderate/mild hemophilia contextualized against a local control group with no bleeding disorder (PwNBD).

 Methods 

We conducted a cross-sectional analysis of participants in Kosovo who completed PROBE during the National Bleeding Disorders Foundation and Kosovo Hemophilia Foundation (KHF) World Federation of Hemophilia (WFH) twinning program. A formal framework of cooperation between KHF, WFH, and the Ministry of Health of Kosovo was executed. Data were collected between April 2023 and May 2024. Outcomes included treatment regimen, acute and chronic pain, missed work or school, EQ-5D index, and PROBE total score. Participants were grouped as Severe, Moderate/Mild, or PwNBD, and results were summarized descriptively.

 Results

Thirty-three participants were included in the initial pilot data collection: Severe (n=6), Moderate/Mild (n=13), and No BD/Carriers (n=12). Acute pain was reported by 66.7% of Severe versus 46.2% of Moderate/Mild participants; chronic pain by 50.0% versus 53.9%. Mean days missed from work or school in the previous six months were higher in the PWH group than in PwNBD. The EQ-5D index (mean) was 0.558 in Severe, 0.859 in Moderate/Mild, and 0.950 in PwNBD. PROBE total scores (mean) were 0.794, 0.843, and 0.906, respectively, indicating worse reported outcomes in hemophilia groups versus controls. Additional patient characteristics are described in Table 1.

 Conclusion 

Using the PROBE instrument to measure quality of life, individuals with severe hemophilia in Kosovo reported lower health status (EQ-5D) and higher burden (PROBE score) with greater functional impact (missed work/school) than those with moderate/mild disease, and both groups fared worse than the PwNBD control group. Only one-third of Severe participants were on regular prophylaxis, with half relying on intermittent regimens and some reporting no treatment availability. Findings highlight persistent unmet needs in access to regular prophylaxis, pain management, and joint health. Ongoing data collection will support longitudinal evaluation to guide national health policy for PWH.

 

Table. Patient Characteristics

SevereModerate / MildPwNBD
n (%) / Mean (SD)95% CIn (%) / Mean (SD)95% CIn (%) / Mean (SD)95% CI
n61312
Age average29.5 (8.90)22.377 – 36.62329.46 (8.47)24.856 – 34.06736.25 (11.17)29.932 – 42.568
Years of Education average12.17 (3.76)9.158 – 15.17512.62 (3.20)10.876 – 14.35514.92 (4.33)12.467 – 17.366
Hemophilia A4 (66.67 %)7 (53.85%)n/a
Treatment Regiment
Regular Prophylaxis2 (33.33%)2 (15.39%)n/a
Interm. PROXY3 (50%)3 (23.08%)n/a
On Demand03 (23.08%)n/a
No treatment available1 (16.67%)0n/a
Married3 (50%)9 (69.23%)10 (83.33%)
Children4 (66.67 %)5 (38.46%)8 (66.67%)
Used a mobility device in last 12 months2 (33.33%)00
Pain med Frequency
Never (0% of the time)2 (33.33%)1 (7.69%)6 (50%)
Rarely (1–5% of the time)03 (23.08%)3 (25%)
Occasionally (6–25% of the time)2 (33.33%)6 (46.15%)1 (8.33%)
Sometimes (26%–50% of the time)1 (16.67%)3 (23.08%)2 (16.67%)
Frequently (51%–75% of the time)1 (16.67%)00
Very Frequently (76%–99% of the time)000
All the time (100%)000
Acute pain4 (66.67 %)6 (46.15%)6 (50%)
Mean number of activities where Acute Pain Occurs1.33 (1.37)0.234 – 2.4331.38 (1.73)0.518 – 2.2520.08 (0.28)-0.138 – 0.304
Mean number of activities where Acute Pain interferes2.67 (2.43)0.725 – 4.6081.69 (2.58)1.179 – 3.9880.17 (0.55)-0.146 – 0.479
Chronic pain3 (50%)7 (53.85%)4 (33.33%)
Mean number of activities where Chronic Pain Occurs1.17  (1.34)0.0915 – 2.2421.38 (1.60)0.518 – 2.2520.50 (0.87)0.0100 – 0.990
Mean number of activities where Chronic Pain Interferes1.50 (1.80)0.0575 – 2.9421.85 (2.48)0.500 – 3.1920.82 (1.34)0.0731 – 1.594
Chronic pain in a target joint4 (66.67 %)6 (46.15%)n/a
ADL affected4 (66.67 %)7 (53.85%)2 (16.67%)
Mean number of ADL’s effected2.17 (2.19)0.413 – 3.9211.77 (2.29)0.523 – 3.0150.25 (0.60)-0.087 – 0.587
Employment and Education
Unemployed/ long-term disability/ not a student2 (33.33%)1 (7.69%)0
Unemployed due to health2/2 (100%)1/1 (100%)0/2 (0%)
Working full time / working part time2 (33.33%)11 (84.62%)7 (58.33%)
Work part-time due to health02/5 (40%)3/3 (100%)
Retired000
Retirement due to health000
Stay at home parent1 (16.67%)02 (16.67%)
Student (full time or part-time)3 (50%)3 (23.08%)4 (33.33%)
Education/Career decision due to health3 (50%)3 (23.08%)0
Average of missed days of school or/and work25.67 (42.81)-8.587 – 59.92010.85 (10.41)5.190 – 16.5037.42 (10.75)1.334 – 13.499
Joint Surgery  or Other Procedure2 (33.33%)3 (23.08%)1 (8.33%)
Mean of Joint Surgery  or Other Procedure1.17 (2.19)-0.587 – 2.9210.31 (0.61)-0.022 – 0.6370.08 (0.28)-0.073 – 0.240
EQ5D0.558 (0.296)0.322 – 0.7950.859 (0.169)0.767 – 0.9500.95 (0.07)0.913 – 0.988
PROBE score0.794 (0.105)0.710 – 0.8770.843 (0.108)0.784 – 0.9010.906 (0.07)0.864 – 0.948
Annual Bleed Rate
01 (16.67%)4 (30.77%)n/a
100n/a
2-301 (7.69%)n/a
4-704 (30.77%)n/a
8-103 (50%)1 (7.69%)n/a
11-151 (16.67%)0n/a
16-301 (16.67%)1 (7.69%)n/a
More than 3002 (15.39%)n/a
Bleeding in last 2 weeks5 (83.33%)6 (46.15%)n/a
Target Joints/Problem Joints5 (83.33%)11 (84.62%)n/a
Mean number of Target Joints/Problem Joints4.00 (3.16)1.470 – 6.5302.54 (2.68)1.083 – 3.994n/a
Joint with a reduced Range of motion5 (83.33%)8 (61.54%)n/a
Mean number of joints with a reduced Range of Motion3.00 (2.24)1.211 – 4.7891.77 (1.89)0.743 – 2.795n/a
Life threatening bleed in the last 12 months4 (66.67 %)2 (15.39%)n/a
Mean number of Life threatening bleed in the last 12 months1.00 (1.00)0.200 – 1.8000.31 (0.72)-0.085 – 0.700n/a

 

 

Poster: HERE

Development of a refined data dashboard for PROBE: Enhancing data interpretation and advocacy support for national patient organizations

Kucher A, Clearfield E, Curtis RG, Delaney M, Germini F, Iorio A, O’Mahony B, Page D, Rotellini D, Skinner MW. Development of a refined data dashboard for PROBE: enhancing data interpretation and advocacy support for national patient organizations. Haemophilia. 2026;32:4-224. Abstract FP-038 (514). doi:10.1111/hae.70232.

Introduction

The PROBE (Patient-Reported Outcomes, Burdens and Experiences) study has collected standardized quality-of-life (QoL) data from people with hemophilia (PWH) and without a bleeding disorder since 2014, supported by a dashboard available since 2016. The dashboard allows the visualization of aggregated data. As more patient organizations participate in semi-annual data collection, there is an increasing need for more flexible, intuitive, and visually rich tools to interpret PROBE data and to support local reporting, advocacy, and scientific communications.

Aim is to develop and implement a new interactive dashboard using Microsoft Power BI that (1) improves visualization and interpretation of PROBE QoL data, (2) facilitates preparation of abstracts, reports, and presentations on progress and gaps within national hemophilia communities, and (3) provides a foundation for future PROBE modules for women with bleeding disorders, von Willibrand disease, and other rare bleeding and platelet disorders.

 Methods 

We redesigned the existing PROBE dashboard using Power BI, drawing on feedback from NMOs, clinicians, and patient partners. The dashboard, updated monthly, connects to the central PROBE database. Key PROBE metrics, including EQ-5D-5L, are organized into themed pages: Demographics; Mobility and Activities of Daily Living (ADL); Pain (Chronic and Acute); Employment and Education; Surgery and Co-morbid Conditions; Severity and Inhibitor Status; Treatment; Joints; and PROBE and EQ-5D-5L utility scores. Sections allow users to filter and stratify data (e.g., by age, severity, inhibitor status, country, or collection period) and to export figures and summary tables.

 Results

The PROBE dashboard provides interactive charts and tables that allow users to quickly identify patterns in QoL, including mobility limitations, pain burden, employment and education status, treatment patterns, and joint outcomes. Deep-dive views within each theme support more detailed discussions (e.g., comparing outcomes by severity or inhibitor status) and help patient organizations generate data-driven messages for advocacy and clinical quality improvement. The ability to export standardized visuals and summary statistics simplifies the preparation of national or multi-country reports describing QoL trends and progress, that could be used for research and advocacy.

 Conclusion 

The PROBE dashboard offers patient organizations an enhanced, user-friendly way to interpret QoL data. By improving access to clear, interpretable PROBE and EQ-5D-5L indicators, the dashboard supports global efforts to monitor outcomes, inform policy, and strengthen patient-centered care worldwide.

Presentation: HERE

Adapting the Patient Reported Outcomes Burdens and Experiences (PROBE) Study to Measure Quality of Life in People with von Willebrand Disease (VWD)

Clearfield E, Brennan F, Kucher A, Skouw-Rasmussen N, Ziemele B, Rotellini D, Delaney M, Curtis RG, O’Mahony B, Page D, Iorio A, Germini F, Skinner MW. Adapting the Patient Reported Outcomes Burdens and Experiences (PROBE) Study to Measure Quality of Life in People With von Willebrand Disease (VWD).Poster presented at: WFH 2026 World Congress; 2026 Apr 19–22; Kuala Lumpur, Malaysia. Poster PP-322.

Introduction

The coreVWD Initiative identified a core outcome set for clinical trials for von Willebrand disease (VWD); quality of life (QoL) was included as a core outcome. There is currently no disease-specific patient reported outcome measure (PROM) to assess QoL for people with VWD (PwVWD). A mapping exercise of the coreVWD results to the Patient Reported Outcomes Burdens and Experiences (PROBE) study identified coverage of some core outcomes, but gaps remained on key outcomes agreed to by the multi-stakeholder panel. PROBE is an established QoL survey currently available only for people with hemophilia, carriers, and healthy controls. Our objective is to adapt PROBE for use by PwVWD by creating a VWD-specific section and updating current items to reflect the experience of living with and managing VWD.

 Methods 

This is a protocol for a qualitative study. PROM development consists of semi-structured interviews with PwVWD, which will be recorded and transcribed. Thematic analysis will be performed to develop a conceptual framework for QoL for PwVWD. The framework will be mapped to the current PROBE instrument to identify which concepts are already included and what needs to be added in a VWD module. New/updated items will be tested in cognitive debriefing interviews, with a focus on relevance and respondent understanding to move to a content validated adapted instrument. This work is planned as a two-year project with the updated instrument available at the end of Year 1. In Year 2, the adapted questionnaire will undergo online programming, translation, and further psychometric testing such as test-retest and face validity studies.

 Results

Ethical approval has been obtained. Recruitment for interviews has begun. A thematic overview of new concepts and items requiring adaptation will be presented.

 

 Conclusion 

As more clinical trials for new products and expanding indications are initiated, the adapted PROBE instrument will be an important tool to measure QoL in PwVWD and use in registries such as the World Bleeding Disorders Registry (WBDR). Data from the robust, established PROBE database can serve to benchmark on key QoL indicators, such as pain and interference in activities of daily living, and compare to PROBE scores from people with hemophilia.

Poster: HERE

Development of Women, Girls, and People Who Have or Had the Potential to Menstruate (WGPPM) questionnaire for PROBE study

Kucher A, Skinner M. W., Clearfield E., Brennan F., Rotellini D., Colle Y., Wilton P. A. Development of Women, Girls, and People Who Have or Had the Potential to Menstruate (WGPPM) questionnaire for PROBE study. (2025), Book of Abstracts. Haemophilia, 31: 21-109. https://doi.org/10.1111/hae.70032

Objective

The Patient Reported Outcomes, Burdens, and Experiences (PROBE) survey was first developed in 2012. PROBE currently collects data from people with hemophilia A or B, including carriers, and people without a bleeding disorder (NoBD) who serve as a control group. To date, there has been limited global comparative patient reported data on health outcomes and quality of life (HRQoL) about WGPPM.

Methods

A targeted PubMed literature review was conducted to identify concepts impacting WGPPM quality-of-life. The study team also provided additional examples of past surveys for review. Novel topics and items were mapped to a conceptual framework. The resulting framework was compared to the PROBE questionnaire and subsequently PROBE was updated to include missing concepts. It is anticipated that this exploratory questionnaire will lead to an expanded PROBE to more comprehensively include WGPPM. The questionnaire was developed in consultation with the World Federation of Hemophilia, Coalition of the Americas, European Haemophilia Consortium and National Bleeding Disorders Foundation who constituted the project working group. The new WGPPM questionnaire will be initiated as an on-line survey.

Results

The group identified von Willebrand Disease (VWD), platelet disorders, rare factor deficiencies, and other rare bleeding disorders for inclusion. New concepts include access to healthcare (including specialties); visits to emergency room; bleeding episodes unique to WGPPM (e.g., menstrual bleeding; gynecological problems), decision-making around having children, and impact on social and leisure life.

Conclusions

To advance management and treatment for this underserved population it is crucial to collect and report comprehensive data on WGPPM health outcomes and quality of life.  The WGPPM PROBE exploratory pilot was launched in early 2025. Through this pilot we anticipate more accurate and comprehensive data will be available to support future advocacy, research, management and treatment.  Insights from the pilot will be applied to future PROBE updates.

Poster: HERE

Gene Therapy in Hemophilia A: the Impact of Valoctocogene Roxaparvovec on Patient Outcomes – Initial Results from Patient Reported Outcomes, Burdens and Experiences (PROBE) from the GENEr8-1 Trial

Skinner M, Chen E, Ibrahim Q, Kucher A, Germini F, Karimi M, Clearfield E , O’Mahony B , Jain M. Gene Therapy in Hemophilia A: the Impact of Valoctocogene Roxaparvovec on Patient Outcomes – Initial Results from Patient Reported Outcomes, Burdens and Experiences (PROBE) from the GENEr8-1 Trial. (Abstract). NHF (2023).

Objective

The Patient Reported Outcomes, Burdens and Experiences (PROBE) questionnaire is included in the phase 3, open-label, single-arm study (GENEr8-1) as a tertiary endpoint. The aim is to assess the effect of a single intravenous administration of valoctocogene roxaparvovec on patient-reported health and life experiences using PROBE.

Methods

134 adult men with FVIII ≤1 IU/dL without history of FVIII inhibitors and AAV5 antibodies previously receiving FVIII prophylaxis were enrolled in the GENEr8-1 trial for hemophilia A. Results from baseline, week 52 and week 104 were summarized. The PROBE questionnaire comprises four sections: demographics, general health problems, hemophilia-specific problems, and health-related quality of life (HRQoL) with the 5-level EQ-5D tool. While further validation to understand the performance of PROBE in this context of use is ongoing, this study summarized the initial PROBE summary score results (based on section 2) utilizing existing scoring algorithms. Change from baseline summary score was assessed with paired t-tests.

Summary

PROBE score was available for 124/134 (93%) at baseline, 129/132 (98%) at week 52, and 129/130 (99%) at week 104. Mean PROBE scores (SDs) were 0.82 (0.13), 0.87 (0.12) and 0.86 (0.13) at the baseline, week 52 and week 104 respectively. Average changes in score of  0.05 [95% CI: (0.03, 0.07), p <0.001] and 0.05 (0.02, 0.07), p<0.001) were observed at weeks 52 and 104. Item-level analyses suggested fewer participants reported pain, limitations in activities of daily living, and target joints at weeks 52 and 104 vs. baseline. Two years after treatment, the percentage of participants working full-time increased by >10% (Table 1). Overall, these results were consistent with EQ-5D results (Table 2).

Conclusions

Valoctocogene roxaparvovec led to measurable changes in HRQoL 2 years after a single administration. Further research is necessary to interpret clinically meaningful change in PROBE scores.

Disclosures

Er Chen: Bio Marin Pharmaceutical Inc.; Federico Germini: Bayer Bio Marin Pharmaceutical Inc., Novo Nordisk, Pfizer, Roche, Takeda; Mohit Jain: Bio Marin Pharmaceutical Inc.; Milad Karimi: Bio Marin Pharmaceutical Inc.;

Brian O’Mahony BioMarin Pharmaceutical Inc.CSL Behring; Mark Skinner: Bayer, Bio Marin Pharmaceutical Inc., Blue Cross Blue Shield, ICERMASACNHFNORD, Novo Nordisk, Pfizer, Roche/Genentech, Spark, Takeda, WFH, USA

Poster: HERE

 

Initial results of the impact of valoctocogene roxaparvovec on pain occurrence and interference: Insights from PROBE

Skinner M, Chen E, Kucher A, Germini F, Karimi M, Clearfield E , O’Mahony B , Jain M. Initial results of the impact of valoctocogene roxaparvovec on pain occurrence and interference: Insights from PROBE. (Abstract). NHF (2023).

Introduction

People with severe haemophilia A (PwSHA) commonly present with intramuscular bleeding and hemarthrosis, leading to acute and chronic pain with an overall reduction in health-related quality of life. Here, we report the occurrence of pain in PwSHA before and 2 years after administration of valoctocogene roxaparvovec, and its interference on daily life.

Methods

The Patient Reported Outcomes, Burdens and Experiences (PROBE) questionnaire was included in the phase 3, open-label, single-arm study (GENEr8-1) as a tertiary endpoint to assess the effect of a single 6 × 1013 vg/kg dose of valoctocogene roxaparvovec on patient-reported health and life experiences. While further validation to understand the performance of PROBE in this context of use is ongoing, this study summarized pain-related outcomes collected within the PROBE questionnaire. This analysis evaluated PROBE completions at baseline and 104 weeks post gene therapy, including any occurrence of acute and chronic pain (recall: 12 months) and during eight activities (walking, stair climbing, nighttime, resting, weight bearing, playing, after falling/trauma, other). Participants also reported pain interference in 11 aspects of life (general activity, mood, walking ability, normal work, attending school, relations with others, sleep, enjoyment of life, playing/participating in sports/exercising, lifting, other). Descriptive statistics including 95% confidence intervals (CI) were presented at baseline and Week 104.

Results

Data were available for 124 participants at baseline and 129 at 104 weeks. Median age was 34 (range 21−73 years). Reporting of acute and chronic pain was reduced post gene therapy (acute pain: 60.5% to 41.9%, chronic pain: 65.3% to 57.0%). At 104 weeks, the aggregate instances of self-reported acute pain occurrence decreased from 151 (15.2%) to 113 (10.9%) across the 8 activities (including ‘Other’) [Table 1]. Chronic pain reduced from 238 (24.0%) to 216 (20.9%) [Table 2]. At 104 weeks, the aggregate instances of self-reported acute pain interference decreased from 294 (21.4%) to 204 (14.4%) across the 11 activities (including ‘Other’) [Table 3]. Chronic pain interference was reduced from 332 (24.3%) to 262 (18.5%) [Table 3 and 4].

Conclusions

Initial analysis of PROBE data demonstrates that gene therapy may be associated with a decrease in self-reported acute and chronic pain occurrence and interference with daily life in the study cohort.  Pain is one of the core outcomes of importance to people with haemophilia. The impact of gene therapy on pain, particularly chronic pain as demonstrated from PROBE, a haemophilia-specific tool, has important implications on treatment decision-making and continued disease management.

Disclosures

Er Chen: Bio Marin Pharmaceutical Inc.; Federico Germini: Bayer Bio Marin Pharmaceutical Inc., Novo Nordisk, Pfizer, Roche, Takeda; Mohit Jain: Bio Marin Pharmaceutical Inc.; Milad Karimi: Bio Marin Pharmaceutical Inc.;

Brian O’Mahony BioMarin Pharmaceutical Inc.CSL Behring; Mark Skinner: Bayer, Bio Marin Pharmaceutical Inc., Blue Cross Blue Shield, ICERMASACNHFNORD, Novo Nordisk, Pfizer, Roche/Genentech, Spark, Takeda, WFH, USA

Poster: HERE

 

Self-reflections, lessons learned and suggestions for data quality assurance from a retrospective data analysis from the Canadian Bleeding Disorders Registry

Iorio A, Keepanasseril A, Ibrahim Q, Iserman E, Blaser H. Self-reflections, lessons learned and suggestions for data quality assurance from a retrospective data analysis from the Canadian Bleeding Disorders Registry. (2024), POSTER ABSTRACT (PP-026). (2024), Issue Information. Haemophilia, 30: 1-2. https://doi.org/10.1111/hae.15016

Introduction

Real-world evidence (RWE) is used to complement primary evidence from clinical trials on safety and efficacy and to generate clinical effectiveness data. Theoretically, RWE is not subject to ‘on trial effect’, and it shows the true impact of intervention in unselected populations. Barriers to generating RWE are mostly stemming from the incomplete availability of relevant data points in the real-world setting. Aim: Analyse strengths and limitations of the ‘Real-World Effectiveness of PEGylated, recombinant Antihaemophilic Factor (Rurioctocog alfa pegol) Prophylaxis in Patients with Haemophilia A in Canada: A Retrospective, Intra-Patient Comparison with a Before-AfterDesign’.

Methods

A retrospective study, before-after design, comparing PK, clinical and PR outcomes for patient switched from SHL-FVIII or EHL-FVIII products to Rurioctocog alfa pegol. Outcomes: individual PK parameters (half-life, time spent above factor levels of0.01, 0.03 and 0.05 IU/mL), factor utilisation, bleed rates, QoL (PROBE)and joint function (HJHS). Pre-specified subgroups: previous treatment with SHL-FVIII versus EHL-FVIII, history of inhibitors versus no inhibitors, and age ≤12 versus >12 years. Strengths and limitations of the approach, including the amount/quality of data available for the analysis of the different outcomes, were analysed.

Results

Ninety-eight severe haemophilia A inhibitor-free patients qualified for the analysis. Thirty-seven patients had available PK data. There were four patients with history of inhibitors, six <12 years and eight patients formerly treated with SHL; four had HJHS and four had PROBE data. Clinical, PK and utilisation results have been presented elsewhere.

Conclusions

PROBE data shows a good cross-section of people with Haemophilia A, B and carriers. Brazil has free Selection bias is anticipated to be lower in retrospective design versus post-marketing surveillance (PMS) studies, which also threaten national registries data integrity. Included (n = 37) and excluded (n = 61) patients were similar in terms of age distributions, BMI, and number of surgery or traumatic bleedings, confirming that the retrospective analysis did not identify a selected population. Lim-ited availability of HJHS and PROBE data suggests that routine clinical practice does not yet include standardised recording of patient centred/reported outcomes, hampering the measurement of health care interventions’ value. There is a significant opportunity to improve the breadth/quality of data generation in the future to demonstrate the true impact of factor replacement in routine clinical practice.

Disclosures

Alfonso Iorio: Bayer, CSL, Pfizer, Roche, Sanofi/Sobi, Takeda; Heiko Blaser: Takeda.

View Poster: PP_26_WFH2024

PROBE: Brazil data

Pietrobelli T, Skinner M. PROBE: Brazil data. (2024), POSTER ABSTRACT (PP-165). (2024), Issue Information. Haemophilia, 30: 1-2. https://doi.org/10.1111/hae.15016

Introduction

The Brazilian Haemophilia Federation (FBH) carried out a campaign to increase responses to the PROBE (Patient Reported Outcomes, Burdens, and Experiences) questionnaire, which collaborates with the World Haemophilia Federation and was integrated into myWBDR and GTR. To have robust data on the quality of life, treatment and daily life of people with Haemophilia A and B. The data collected is intended to be used in FBH advocacy actions, to improve Public Policies in Brazil.

Methods

PROBE has real-life data from patients, which is why FBH has been a partner in the study since 2018 and has a specific response link that allows you to know the state where the person lives and the distance from their home to the HTC. The information collected by PROBE allows FBH to hold meetings with government authorities and propose improvements for the treatment of people with haemophilia in all 27 federative units in Brazil.

Results

PROBE has 679 contributions to the questionnaire in Brazil. With 321 people with Haemophilia A, 49 with Haemophilia B, 35 carriers and 274 people without coagulopathy, this last group is considered a comparative group for quality of life. Considering 405 people with Haemophilia A, B and carriers, 168 have Severe Haemophilia and 45 Moderate. Around 65% undergo treatment at home and 28% go tothe HTC for treatment. 75% perform 2–3 infusions per week and only 2.25% infuse daily. 41.75% do not have chronic pain and 58.25% admit to living with chronic pain, of which 85% have chronic pain in the target joints.

Conclusions

PROBE data shows a good cross-section of people with Haemophilia A, B and carriers. Brazil has free treatment through the Public Health System, which is an example for the world and, even so, there are windows of improvement that should be taken advantage of. With this data, FBH will work to improve Public Policies with government authorities to improve access to treatment and quality of life.

Disclosures

Mark Skinner: Band Therapeutics, Bayer, BioMarin, CSL Behring, Novo Nordisk, Pfizer, Roche/Genentech, Sanofi, Takeda, Vega Therapeutics.

View Poster: PP_165_WFH2024

Global Efforts in Uniting all stakeholders in ensuring safety of hemophilia gene therapy patients: the World Federation of Hemophilia Gene Therapy Registry

Naccache M, Konkle B, Peyvandi F, Miesbach W, O’Mahony B, Pile S, Youttananukorn T, Coffin D, Pierce G. Global Efforts in Uniting all stakeholders in ensuring safety of hemophilia gene therapy patients: the World Federation of Hemophilia Gene Therapy Registry. (2024), POSTER ABSTRACT (MP-021). (2024), Issue Information. Haemophilia, 30: 1-2. https://doi.org/10.1111/hae.15016

Introduction

The World Federation of Haemophilia (WFH) launched the Gene Therapy Registry (GTR) aimed at gathering comprehensive data on all people with haemophilia (PWH) who receive gene therapy worldwide.

Methods

The GTR was designed to standardise and centralise global data collection for the gathering and dissemination of gene therapy data. The GTR is a prospective, observational, and longitudinal registry. Data entry occurs once, either directly from haemophilia treatment centre (HTC) into the GTR or through data transfer from National Registries. The GTR Scientific Advisory Board oversees all data entered into the GTR and its dissemination. Specificde-identified data will be shared with various stakeholders: participating patients will have access to view their own data; HTCs and National Registries will receive aggregated global safety data; industry part-ners will receive product-specific data, and regulatory agencies and health technology assessment organisations can request specific data to inform their decisions.

Results

The WFH is engaged with a broad network of collabora-tors, and the GTR National Registries & HTC Consortium has been established to foster dialogue, obtain feedback from our collaborators, and establish mutually beneficial collaboration. This group includes representatives from Brazil, Ireland, Saudi Arabia and Sweden, and registries from Australia, Canada, France, Germany, Japan, the Netherlands, Spain, the United Kingdom and the United States. The European Medicines Agency (EMA) issued a pivotal letter of support to the WFHGTR. The CHMP endorses the GTR as the worldwide registry for consolidating all international data on PWH who receive gene therapy and encourages collaboration of all HTCs and National Registries, stating that the WFH GTR is of particular value for post approval safety and efficacy studies of gene therapies and recommending its use as a planned data source for mandated Phase IV studies.

Conclusions

The GTR facilitates the accumulation of data in one registry and supports the efficient dissemination of valuable information to all stakeholders, advancing our understanding of gene therapy’s safety, efficacy, and long-term effects. In the current landscape of numerous registries in haemophilia around the world, the success of the GTR depends on collaborative relationships with all stakeholders, including patients, HTCs, National Registries, industry partners and regulatory bodies.

Disclosures

Barbara Konkle: Be Biotherapy, Biomarin, Novo Nordisk, Pfizer, Sanofi; Flora Peyvandi: BioMarin Pharmaceutical Inc., CSL Behring, F. Hoffmann-La Roche Ltd., Grifols, Sanofi, Sobi, Takeda; Wolfgang Miesbach: Bayer, BioMarin, Biotest, Chugai, CSL Behring, Free-line, LFB, Novo Nordisk, Octapharma, Pfizer, Regeneron, Roche, Sanofi, Sigilon, Sobi, Takeda/shire; Brian O’Mahony: Biomarin, CSL Behring, Freeline, Irish Haemophilia Society, Pfizer, Roche; Mike Makris: Grifols, Novo Nordisk, Sanofi, Takeda; Steven Pipe: Apcintex, ASC Therapeutics, Bayer, BioMarin, CSL Behring, HEMA Biologics, Freeline, LFB, Novo Nordisk, Pfizer, Regeneron/Intellia, Genentech/Roche, GeneVentiv and Equilibra Bioscience, Sanofi, Takeda, Spark Therapeutics, uniQure, Siemens; Mark Skinner: Band Therapeutics, Bayer, BioMarin, CSL Behring, Novo Nordisk, Pfizer, Roche/Genentech, Sanofi, Takeda, Vega Therapeutics; Glenn F. Pierce: ASC Therapeutics, Be Bio, BioMarin, Decibel Therapeutics, Frontera, Intellia, Metagenomi, Novo Nordisk, Pfizer, Regeneron, Spark Therapeutics, Third Rock Ventures.

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